Does trauma-focused psychotherapy change the brain? A systematic review of neural correlates of therapeutic gains in PTSD
A systematic literature search of studies employing structural or functional MRI measurements before & after treatment of patients with PTSD.
Article Abstract
“Background: Meta-analytic results indicate that posttraumatic stress disorder (PTSD) is associated with hypoactivation of the medial prefrontal cortex (mPFC), hyperactivation of the amygdala, and volume reductions of the hippocampus. Effective psychotherapeutic treatments were hypothesized to normalize these neural patterns via upregulation of prefrontal structures, which in turn downregulate limbic regions.
Objective: To gain a sound understanding of the effects of successful psychotherapy on the brain, neural changes from pre- to post-treatment in PTSD patients will be aggregated.
Method: A systematic literature search identified 24 original studies employing structural or functional MRI measurements both before and after treatment of patients diagnosed with PTSD.
Results: In conjunction, the review returned little evidence of an activation increase in the mPFC/rostral anterior cingulate cortex (rACC) following successful treatment. Five out of 12 studies observed such an increase (especially during emotion processing tasks), albeit in partially non-overlapping brain regions. Conversely, neither the putative related activation decrease in the amygdala nor volumetric changes or altered activation during the resting state could be convincingly established.
Conclusion: Successful psychological treatments might potentially work via upregulation of the mPFC, which thus may be involved in symptom reduction. However, the role of the amygdala in recovery from PTSD remains unclear. There is currently no indication that the various PTSD treatment approaches employed by the reviewed studies differ regarding their action mechanisms, but further research on this topic is needed.”
—Description from publisher
Article Access
Open Access
Manthey, A., Sierk, A., Brakemeier, E. L., Walter, H., & Daniels, J. K. (2021). Does trauma-focused psychotherapy change the brain? A systematic review of neural correlates of therapeutic gains in PTSD. European Journal of Psychotraumatology, 12(1). https://doi.org/10.1080/20008198.2021.1929025
Date
August 6, 2021
Creator(s)
Antje Manthey, Anika Sierk, Eva-Lotta Brakemeier
Contributor(s)
Henrik Walter, Judith K. Daniels
Practice & Methods
Mechanisms of Action, Neurobiology
Extent
22 pages
Publisher
Taylor & Francis
Rights
© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
APA Citation
Manthey, A., Sierk, A., Brakemeier, E. L., Walter, H., & Daniels, J. K. (2021). Does trauma-focused psychotherapy change the brain? A systematic review of neural correlates of therapeutic gains in PTSD. European Journal of Psychotraumatology, 12(1). https://doi.org/10.1080/20008198.2021.1929025
Audience
EMDR Therapists, Other Mental Health Professionals
Language
English
Content Type
Article, Meta-analyses/Systematic Reviews, Peer-Reviewed
Access Type
External Resource, Open Access
