Navigation Links
GUMC: fMRI predicts outcome to talk therapy in children with an anxiety disorder
Date:11/14/2010

San Diego - A brain scan with functional MRI (fMRI) is enough to predict which patients with pediatric anxiety disorder will respond to "talk therapy," and so may not need to use psychiatric medication, say neuroscientists from Georgetown University Medical Center.

Their study, being presented at the annual meeting of the Society for Neuroscience in San Diego, showed that children and adolescents, ages 8 to16, who show fear when looking at happy faces on a screen inside an fMRI scanner were those who had least success with an eight-week course of cognitive behavioral therapy.

Conversely, children who showed fear while looking at fearful faces benefitted from the treatment, which is also known as talk therapy, the researchers found.

"Anxiety and fear are intrinsically linked, so how the brain's fear center responds would naturally affect how anxiety disorders manifest," says the study's lead author, Steve Rich, a fourth year medical student.

"Indeed, the impact on their responses to therapy was impressive," he says. "Past studies have shown that many people react to fearful faces with fear themselves, but our most robust finding indicated that some anxiety disorder patients have more anxiety towards happy faces than fearful ones, and those patients were the least likely to respond to cognitive behavioral therapy."

The study enrolled 13 boys and 10 girls in this study, all of whom had been diagnosed with pediatric anxiety disorder.

While inside the fMRI machine, the participants were shown pictures of faces that expressed certain emotions strongly. "The questions we were trying to answer were: What emotions make people afraid when they witness them on others' faces, and does that pattern predict response to talk therapy," Rich says.

An fMRI is a type of scan that records changes in blood flow being used at each location in the brain, thus showing levels of activity. In this study, the researchers zeroed in on the amygdala, a brain structure known to represent the emotion of fear.

They then correlated the differing responses they saw in the amygdala with outcomes from an eight-week course in cognitive behavioral therapy.

The researchers found a significant correlation, indicating that pre-treatment fMRI can be used to select patients who likely do well with talk therapy alone, and those that may require other therapy, such as medication.

Rich says that one explanation for the results is that those patients who have greater anxiety towards happy faces than towards fearful ones have a subtly different disorder, one that is very similar but cannot be treated by cognitive behavioral therapy.

"In this subset of patients, that support may actually elicit even more anxiety, thus alienating them from the therapist," he says. "Further study is required to determine whether this is indeed a unique disease subtype, or whether a modified approach to cognitive behavioral therapy that requires the therapist to stay completely neutral could make therapy more effective for these patients."

Rich and his co-authors do not expect that every pediatric anxiety disorder patient should receive an fMRI diagnosis.

"fMRI is expensive, and this study does not by any means suggest that it should be used as a universal screening tool," he says. "Even so, once the field develops further, our results suggest that neuroimaging studies like fMRI may be able to help us understand why a given patient might not be responding to the first-line treatment. In other words, when routine care is not enough, we can focus on the nuances of the individual."


'/>"/>

Contact: Karen Mallet
km463@georgetown.edu
215-514-9751
Georgetown University Medical Center
Source:Eurekalert

Related medicine news :

1. Metabolic status before pregnancy predicts subsequent gestational diabetes
2. Blood test accurately predicts death from prostate cancer up to 25 years in advance
3. Microsoft Excel-based algorithm predicts cancer prognosis
4. Personalized medicine: Molecular imaging predicts treatment success in many cancers
5. EEG predicts response to medication for schizophrenia
6. Socioeconomic status predicts survival of Canadian cancer patients
7. Baseline PSA predicts risk of death from prostate cancer
8. New metric predicts language recovery following stroke
9. Onrec Predicts Significant Recruiting Activity this Fall
10. Body-image distortion predicts onset of unsafe weight-loss behaviors
11. First-time parents daily sleep duration predicts their relationship satisfaction
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/4/2016)... ... May 04, 2016 , ... All-Star Insurance ... to assist the people of their local community. The agency pledges to select ... leaders. Their hope is to bring awareness to important local causes with fundraising ...
(Date:5/4/2016)... ... May 04, 2016 , ... Dr. Elyson and Dr. ... removal surgery at their office. Wisdom tooth removal, a common dental procedure, is performed ... they often are improperly erupted, resulting in risks of complications. By providing wisdom tooth ...
(Date:5/4/2016)... (PRWEB) , ... May 04, 2016 , ... Francesca Loparco, ... changed her life forever with a same-day LASIK procedure at Christenbury Eye ... eyesight. Dr. Jonathan Christenbury performed her surgery the same day as her in-office consultation ...
(Date:5/4/2016)... ... May 04, 2016 , ... Bayco ... compact tactical (6.7 inch) dual-light flashlights in models NSP-9842XL and NSR-9844XL . ... retail starting at $59.95) uses 2 included CR-123 batteries to produce up to ...
(Date:5/4/2016)... , ... May 04, 2016 , ... Warren L. Smith ... infections, also called UTIs, have plagued people since the beginning of recorded medical ... get bladder infections every year. It's not just a matter of inconvenience; bladder infections ...
Breaking Medicine News(10 mins):
(Date:5/3/2016)... , May 3, 2016  Specialty Silicone Fabricators ... that shows how a cleanroom works. The free ... about science and technology. ... a technology company, SSF enthusiastically supports the Science, ... educators foster the next generation of innovators. We ...
(Date:5/3/2016)... 2016 Norgine B.V. ... einen entscheidenden Meilenstein durch diese Veröffentlichung zur  ... Handeln, um Patientenresultate  bei Verdauungs- und Lebererkrankungen ... im Verständnis der Hepatischen Enzephalopathie bei und ... Hepatische Enzephalopathie in der Öffentlichkeit zu schaffen ...
(Date:5/2/2016)... 2, 2016  While nearly three-quarters of Americans (71%) ... on their health, only about half report taking any ... results of a new survey announced today by Hologic ... of National Osteoporosis Month, Hologic is raising awareness of ... 56 million Americans. Osteoporosis is a disease ...
Breaking Medicine Technology: