Epigenetic and Neural Circuitry Landscape of Psychotherapeutic Interventions

Table 4

Description of psychotherapy and neuroimaging studies: predictors of therapeutic response.

Modality of psychotherapy	Diagnosis	Study (including design if not previously outlined)	Predictors of response
CBT	GAD	Ball et al. (2014); 48 patients (25 GAD, 23 PD), all unmedicated; fMRI; 10 weekly sessions of CBT	Greater activation in hippocampus during maintenance of emotional response to negative images; Greater activation in anterior insula, superior temporal gyrus, supramarginal gyrus, and superior frontal gyrus during cognitive reappraisal
		McClure et al. (2007)	Pretreatment amygdala hyperactivity
CBT	SAD	Doehrmann et al. (2013)	Greater pretreatment activation to angry versus neutral faces in portions of the occipitotemporal cortices
		Klumpp et al. (2013)	Increased pretreatment activity to threat in the superior and middle temporal gyri and in the IFG. Hyperactivation to fearful faces in dmPFC, OFC, and dACC
		Klumpp et al. (2014); [147]; fMRI; 21 patients (unmedicated except for 2 on bupropion); 12 weekly 60-minute sessions	Increased pretreatment activity (in the presence of emotional faces) in the dACC and dmPFC; Decreased pretreatment amygdala and mOFC activity during emotion processing
		Klumpp et al. (2014); [148]; fMRI; 21 patients (unmedicated except for 2 on bupropion); 12 weeks of CBT	Greater pretreatment bilateral amygdala-pgACC connectivity
		Mansson et al. (2015); fMRI/support vector machines (SVM); 26 patients (8 medicated); 13 weeks of Internet-delivered CBT	Pretreatment dACC activation and lower dACC-amygdala coupling during self-referential criticism task (92% balanced accuracy) predicted sustained response one year later
CBT	PD/AG	Lueken et al. (2013)	Greater pretreatment coupling between ACC and amygdala
		Reinecke et al. (2014); fMRI; 14 unmedicated patients with PD; 4 sessions of CBT	Increased pretreatment activation in bilateral insulae and left dlPFC during threat processing; Increased right hippocampus gray matter
		Straube et al. (2014); [149]	Nonresponse associated with heightened amygdala reactivity before and after treatment (informed by 5-HT1A rs6295 polymorphism G/G genotype)
CBT	MDD	Costafreda et al. (2009); 16 unmedicated patients; fMRI; 16 sessions of CBT	Response to treatment (gauged by response to sad faces) predicted by activity in the ACC, superior and middle frontal cortices, paracentral cortex, superior parietal cortex, precuneus, and cerebellum
		Crowther et al. (2015); 20 unmedicated patients; Resting-state functional connectivity MRI; Average of 12 sessions of BATD	Pretreatment connectivity of the insula with the right medial temporal gyrus and between the left intraparietal sulcus and OFC
		Fu et al. (2008)	Pretreatment activity in the dACC comparable to healthy controls predicted response
		Konarski et al. (2009); 7 unmedicated patients; PET; 16 sessions of CBT; Comparison group was on venlafaxine	Nonresponse associated with pretreatment hypermetabolism the interface of the pgACC and sgACC
		Mackin et al. (2013); 22 patients (not receiving antidepressants); MRI; 12 weeks of CBT	Nonresponse associated with thinner bilateral PCC and parahippocampal cortex, left paracentral, cuneus, and insular cortices, and right mOFC and lateral occipital cortex
		McGrath et al. (2014); 82 total patients (unmedicated prior to starting trial); PET; 12–24 weeks of CBT and/or antidepressant (escitalopram) treatment	Nonresponse associated with pretreatment hyperactivity in the subcallosal cingulate and in the superior temporal sulcus
		Ritchey et al. (2011)	Increased pretreatment vmPFC and dlPFC activity predicted response. Parameter analyzed was response to pictures of different affective valence
		Siegle et al. (2006); 14 unmedicated patients; fMRI; 16 sessions of CBT (12 weeks)	Response to treatment was predicted by low sgACC reactivity and high amygdala reactivity to negative words
		Straub et al. (2015)	Pretreatment sgACC hyperactivity to positive (versus negative) stimuli predicted response
		Thompson et al. (2015); 60 patients (59 years and older; 44 completed study; 83% on at least one medication, though type not specified); fMRI; 12 weeks of CBT	Decrease in activation in left inferior frontal triangle and right superior frontal gyrus; Increase in activation of right middle frontal gyrus and left superior frontal gyrus
		Walsh et al. (2016); 33 unmedicated patients; fMRI; Up to 15 BATD sessions (average of 11.67 weekly sessions)	During anticipation phase, response was associated with: greater caudate-dACC and caudate-rACC connectivity; greater right putamen-right OFC connectivity; decreased connectivity between right mPFC and dACC; and decreased connectivity between left putamen and the subcallosal cortex
		Yoshimura et al. (2014)	Pretreatment decreased activity in vACC during self-referential information processing
CBT	PTSD	Bryant et al. (2008)	Pretreatment hyperactivity in amygdala, vACC, and dACC was associated with nonresponse
		Falconer et al. (2013); 13 patients; (6 on stable doses of SSRIs); fMRI; 8 weeks of CBT	Treatment response was predicted by higher pretreatment activation of frontostriatal networks (vlPFC, OFC, mPFC, and dorsal striatum) during inhibitory control tasks (this study employed Go/No-Go task)
Psychodynamic psychotherapy	MDD	Buchheim et al. (2012)	Increased pretreatment activity in the sgACC may predict response
		Roffman et al. (2014)	Pretreatment right precuneus metabolism (significantly higher in treatment completers; correlated also with psychological mindedness)
Guided imagery	MDD	Huang et al. (2014)	Increased pretreatment regional homogeneity within the dACC
EMDR	PTSD	Nardo et al. (2010); 20 patients (15 completed EMDR); unclear if patients were medicated or not (it was not an exclusion criterion); MRI; Five 90-minute sessions	Decreased gray matter density in limbic and paralimbic cortices

Balanced accuracy is a mean of sensitivity and specificity.