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Title: The impacts of cognitive-behavioral therapy on the treatment of phobic disorders measured by functional neuroimaging techniques: a systematic review
Authors: Almeida, Amanda Cristina Galvão Oliveira de [UNIFESP]
Araujo Filho, Gerardo Maria de [UNIFESP]
Berberian, Arthur de Almeida [UNIFESP]
Trezsniak, Clarissa
Nery-Fernandes, Fabiana
Araujo Neto, Cesar Augusto
Jackowski, Andrea Parolin [UNIFESP]
Miranda-Scippa, Ângela Marisa de Aquino [UNIFESP]
Oliveira, Irismar Reis de
Universidade Federal da Bahia School of Medicine Department of Neurosciences and Mental Health
Universidade Federal de São Paulo (UNIFESP)
Faculdade de Medicina de São José do Rio Preto Department of Psychiatry and Medical Psychology
Universidade de São Paulo (USP)
King's College London Institute of Psychiatry Department of Psychosis Studies
UFBA Medical School Department of Imaging Diagnosis
Keywords: Phobia
cognitive therapy
functional magnetic resonance imaging
positron-emission tomography
Issue Date: 1-Sep-2013
Publisher: Associação Brasileira de Psiquiatria - ABP
Citation: Revista Brasileira de Psiquiatria. Associação Brasileira de Psiquiatria - ABP, v. 35, n. 3, p. 279-283, 2013.
Abstract: Objective: Functional neuroimaging techniques represent fundamental tools in the context of translational research integrating neurobiology, psychopathology, neuropsychology, and therapeutics. In addition, cognitive-behavioral therapy (CBT) has proven its efficacy in the treatment of anxiety disorders and may be useful in phobias. The literature has shown that feelings and behaviors are mediated by specific brain circuits, and changes in patterns of interaction should be associated with cerebral alterations. Based on these concepts, a systematic review was conducted aiming to evaluate the impact of CBT on phobic disorders measured by functional neuroimaging techniques. Methods: A systematic review of the literature was conducted including studies published between January 1980 and April 2012. Studies written in English, Spanish or Portuguese evaluating changes in the pattern of functional neuroimaging before and after CBT in patients with phobic disorders were included. Results: The initial search strategy retrieved 45 studies. Six of these studies met all inclusion criteria. Significant deactivations in the amygdala, insula, thalamus and hippocampus, as well as activation of the medial orbitofrontal cortex, were observed after CBT in phobic patients when compared with controls. Conclusion: In spite of their technical limitations, neuroimaging techniques provide neurobiological support for the efficacy of CBT in the treatment of phobic disorders. Further studies are needed to confirm this conclusion.
ISSN: 1516-4446
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