Beyond dopamine: functional MRI predictors of responsiveness to cognitive behaviour therapy for psychosis

Veena Kumari; Elena Antonova; Dominic Fannon; Emmanuelle R Peters; Dominic H Ffytche; Preethi Premkumar; Vinodkumar Raveendran; Christopher Andrew; Louise C Johns; Philip A McGuire; Steven C.R. Williams; Elizabeth Kuipers

doi:10.3389/neuro.08.004.2010

Beyond dopamine: functional MRI predictors of responsiveness to cognitive behaviour therapy for psychosis

Veena Kumari, Elena Antonova, Dominic Fannon, Emmanuelle R Peters, Dominic H Ffytche, Preethi Premkumar, Vinodkumar Raveendran, Christopher Andrew, Louise C Johns, Philip A McGuire, Steven C.R. Williams, Elizabeth Kuipers

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18 Citations (Scopus)

Abstract

Despite the favourable effects of antipsychotics on positive symptoms of schizophrenia, many patients continue to suffer from distressing symptoms. Additional benefits of cognitive behaviour therapy for psychosis (CBTp) have been reported for approximately 50% of such patients. Given the role of left hemisphere-based language processes in responsiveness to CBT for depression, and language pathway abnormalities in psychosis, this study examined whether pre-therapy brain activity during a verbal monitoring task predicts CBTp responsiveness in schizophrenia. Fifty-two outpatients, stable on antipsychotics with at least one persistent distressing positive symptom and wishing to receive CBTp adjunctive to their treatment-as-usual, and 20 healthy participants underwent fMRI during monitoring of self- and externally-generated (normal and distorted) speech. Subsequently, 26 patients received CBTp for 6-8 months adjunctive to their treatment-as-usual (CBTp + TAU, 20 completers), and 26 continued with their treatment-as-usual (TAU-alone, 18 completers). Symptoms were assessed (blindly) at entry and follow-up. The CBTp + TAU and TAU-alone groups had comparable demographic characteristics, performance and baseline symptoms. Only the CBTp + TAU group showed improved symptoms at follow-up. CBTp responsiveness was associated with (i) greater left inferior frontal gyrus (IFG) activity during accurate monitoring, especially of own voice, (ii) less inferior parietal deactivation with own, relative to others', voice, and (iii) less medial prefrontal deactivation and greater thalamic and precuneus activation during monitoring of distorted, relative to undistorted, voices. CBTp + TAU patients, on average, displayed left IFG and thalamic hypo-activation (thalamus), insight and self-awareness (medial prefrontal and parietal cortices) in CBTp responsiveness in schizophrenia.

Original language	English
Article number	4
Pages (from-to)	N/A
Number of pages	15
Journal	Frontiers in Behavioral Neuroscience
Volume	4
Issue number	N/A
Early online date	12 Feb 2010
DOIs	https://doi.org/10.3389/neuro.08.004.2010
Publication status	Published - 2010

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Kumari, V., Antonova, E., Fannon, D., Peters, E. R., Ffytche, D. H., Premkumar, P., Raveendran, V., Andrew, C., Johns, L. C., McGuire, P. A., Williams, S. C. R., & Kuipers, E. (2010). Beyond dopamine: functional MRI predictors of responsiveness to cognitive behaviour therapy for psychosis. Frontiers in Behavioral Neuroscience, 4(N/A), N/A. Article 4. https://doi.org/10.3389/neuro.08.004.2010

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title = "Beyond dopamine: functional MRI predictors of responsiveness to cognitive behaviour therapy for psychosis",

abstract = "Despite the favourable effects of antipsychotics on positive symptoms of schizophrenia, many patients continue to suffer from distressing symptoms. Additional benefits of cognitive behaviour therapy for psychosis (CBTp) have been reported for approximately 50% of such patients. Given the role of left hemisphere-based language processes in responsiveness to CBT for depression, and language pathway abnormalities in psychosis, this study examined whether pre-therapy brain activity during a verbal monitoring task predicts CBTp responsiveness in schizophrenia. Fifty-two outpatients, stable on antipsychotics with at least one persistent distressing positive symptom and wishing to receive CBTp adjunctive to their treatment-as-usual, and 20 healthy participants underwent fMRI during monitoring of self- and externally-generated (normal and distorted) speech. Subsequently, 26 patients received CBTp for 6-8 months adjunctive to their treatment-as-usual (CBTp + TAU, 20 completers), and 26 continued with their treatment-as-usual (TAU-alone, 18 completers). Symptoms were assessed (blindly) at entry and follow-up. The CBTp + TAU and TAU-alone groups had comparable demographic characteristics, performance and baseline symptoms. Only the CBTp + TAU group showed improved symptoms at follow-up. CBTp responsiveness was associated with (i) greater left inferior frontal gyrus (IFG) activity during accurate monitoring, especially of own voice, (ii) less inferior parietal deactivation with own, relative to others', voice, and (iii) less medial prefrontal deactivation and greater thalamic and precuneus activation during monitoring of distorted, relative to undistorted, voices. CBTp + TAU patients, on average, displayed left IFG and thalamic hypo-activation (thalamus), insight and self-awareness (medial prefrontal and parietal cortices) in CBTp responsiveness in schizophrenia.",

author = "Veena Kumari and Elena Antonova and Dominic Fannon and Peters, {Emmanuelle R} and Ffytche, {Dominic H} and Preethi Premkumar and Vinodkumar Raveendran and Christopher Andrew and Johns, {Louise C} and McGuire, {Philip A} and Williams, {Steven C.R.} and Elizabeth Kuipers",

year = "2010",

doi = "10.3389/neuro.08.004.2010",

language = "English",

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Kumari, V , Antonova, E, Fannon, D, Peters, ER , Ffytche, DH , Premkumar, P, Raveendran, V, Andrew, C, Johns, LC , McGuire, PA , Williams, SCR & Kuipers, E 2010, 'Beyond dopamine: functional MRI predictors of responsiveness to cognitive behaviour therapy for psychosis', Frontiers in Behavioral Neuroscience, vol. 4, no. N/A, 4, pp. N/A. https://doi.org/10.3389/neuro.08.004.2010

TY - JOUR

T1 - Beyond dopamine

T2 - functional MRI predictors of responsiveness to cognitive behaviour therapy for psychosis

AU - Kumari, Veena

AU - Antonova, Elena

AU - Fannon, Dominic

AU - Peters, Emmanuelle R

AU - Ffytche, Dominic H

AU - Premkumar, Preethi

AU - Raveendran, Vinodkumar

AU - Andrew, Christopher

AU - Johns, Louise C

AU - McGuire, Philip A

AU - Williams, Steven C.R.

AU - Kuipers, Elizabeth

PY - 2010

Y1 - 2010

N2 - Despite the favourable effects of antipsychotics on positive symptoms of schizophrenia, many patients continue to suffer from distressing symptoms. Additional benefits of cognitive behaviour therapy for psychosis (CBTp) have been reported for approximately 50% of such patients. Given the role of left hemisphere-based language processes in responsiveness to CBT for depression, and language pathway abnormalities in psychosis, this study examined whether pre-therapy brain activity during a verbal monitoring task predicts CBTp responsiveness in schizophrenia. Fifty-two outpatients, stable on antipsychotics with at least one persistent distressing positive symptom and wishing to receive CBTp adjunctive to their treatment-as-usual, and 20 healthy participants underwent fMRI during monitoring of self- and externally-generated (normal and distorted) speech. Subsequently, 26 patients received CBTp for 6-8 months adjunctive to their treatment-as-usual (CBTp + TAU, 20 completers), and 26 continued with their treatment-as-usual (TAU-alone, 18 completers). Symptoms were assessed (blindly) at entry and follow-up. The CBTp + TAU and TAU-alone groups had comparable demographic characteristics, performance and baseline symptoms. Only the CBTp + TAU group showed improved symptoms at follow-up. CBTp responsiveness was associated with (i) greater left inferior frontal gyrus (IFG) activity during accurate monitoring, especially of own voice, (ii) less inferior parietal deactivation with own, relative to others', voice, and (iii) less medial prefrontal deactivation and greater thalamic and precuneus activation during monitoring of distorted, relative to undistorted, voices. CBTp + TAU patients, on average, displayed left IFG and thalamic hypo-activation (thalamus), insight and self-awareness (medial prefrontal and parietal cortices) in CBTp responsiveness in schizophrenia.

AB - Despite the favourable effects of antipsychotics on positive symptoms of schizophrenia, many patients continue to suffer from distressing symptoms. Additional benefits of cognitive behaviour therapy for psychosis (CBTp) have been reported for approximately 50% of such patients. Given the role of left hemisphere-based language processes in responsiveness to CBT for depression, and language pathway abnormalities in psychosis, this study examined whether pre-therapy brain activity during a verbal monitoring task predicts CBTp responsiveness in schizophrenia. Fifty-two outpatients, stable on antipsychotics with at least one persistent distressing positive symptom and wishing to receive CBTp adjunctive to their treatment-as-usual, and 20 healthy participants underwent fMRI during monitoring of self- and externally-generated (normal and distorted) speech. Subsequently, 26 patients received CBTp for 6-8 months adjunctive to their treatment-as-usual (CBTp + TAU, 20 completers), and 26 continued with their treatment-as-usual (TAU-alone, 18 completers). Symptoms were assessed (blindly) at entry and follow-up. The CBTp + TAU and TAU-alone groups had comparable demographic characteristics, performance and baseline symptoms. Only the CBTp + TAU group showed improved symptoms at follow-up. CBTp responsiveness was associated with (i) greater left inferior frontal gyrus (IFG) activity during accurate monitoring, especially of own voice, (ii) less inferior parietal deactivation with own, relative to others', voice, and (iii) less medial prefrontal deactivation and greater thalamic and precuneus activation during monitoring of distorted, relative to undistorted, voices. CBTp + TAU patients, on average, displayed left IFG and thalamic hypo-activation (thalamus), insight and self-awareness (medial prefrontal and parietal cortices) in CBTp responsiveness in schizophrenia.

U2 - 10.3389/neuro.08.004.2010

DO - 10.3389/neuro.08.004.2010

M3 - Article

C2 - 20179788

VL - 4

SP - N/A

JO - Frontiers in Behavioral Neuroscience

JF - Frontiers in Behavioral Neuroscience

IS - N/A

M1 - 4

ER -

Beyond dopamine: functional MRI predictors of responsiveness to cognitive behaviour therapy for psychosis

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