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The aim of our study was the correlation of regional brain activity with intensity of psychopathology and the correlation of treatment effect of CBT in patients suffering from panic disorder.
Five patients suffering from panic disorder and five healthy controls were studied in fMRI during the exposition of threat-related words compared with neutral words and emotional faces compared with fixation points. Inpatients were treated with CBT (Cognitive Behavioral Therapy) and existing pharmacotherapy for 6 weeks. Patients were studied in fMRI scanner before and after the treatment. Psychopathology was assessed using Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI), The Clinical Global Impression rating scales (CGI), Panic Disorder Severity Scale (PDSS), Dissociative Experiences Scale (DES). Data were analyzed using software for functional magnetic analysis (AFNI) and compared with psychopathology rating scales.
Hyperactivity of cerebellum in patient treated with CBT compared with healthy controls was observed after activation by anxiety words and faces. The scores of psychopathology rating scales decreased in patient treated with CBT and correlates with decrease of hyperactivity in cerebellum.
Changes of brain activity in fMRI after the CBT treatment were observed in patient suffering from panic disorder. Threat-related words and emotional faces showed cerebellum hyperactivity in patients compared with healthy controls. Decrease of cerebellum hyperactivity was observed after treatment with CBT, compared with healthy controls. Predictor of therapeutic response in fMRI was not find. Cerebellum play an important role in panic disorder.
Schemas are self-defeating life patterns of perception, emotion, and physical sensation. Borderline personality disorder patients are characterized by a negative self-image and pronounced vulnerability to negative stimuli activating schemas, which leads to strong negative emotions and conflict in social situations.
We hypothesized that emotional faces and words stimuli will activate amygdala and limbic structures. The activation will be higher in patients compared to healthy controls subject
The aim of our study is to find the differences of schemas orientate words and emotional faces processing in borderline personality disorder compared to healthy controls. To identify neuronal correlates of negative self-image in BPD patients.
Fifteen patients suffering from BPD and healthy controls (HC) were studied in fMRI during the exposition of negative schemas related words compared with positive schemas related words and emotional faces (anxious, angry, neutral) compared with fixation points. Psychopathology was assessed using Clinical Global Impression rating scale (CGI), Beck Anxiety Inventory (BAI) and Borderline personality severity index (BPDSI).
Schema-oriented words showed right amygdala activation and strong precuneus and dorsal cingulum activation in BPD group compared with HC. Emotional faces Activations differ in both groups, BPD patient activated more anterolateral brain regions, HC activated more posteromedial areas.
Schema-oriented words are very hurtful for BPD patients and our fMRI findings confirmed this clinical experience. Processing of emotional faces in patients with borderline personality disorder involve multiple brain regions.
Some patients have a chronic and/or recurrent form of the disorder. Reasons of treatment resistance have been described, but the neurobiological basis of disorder gravity is unclear.
Examine if the hyperactivity of right and left amygdala, left posterior cingulate cortex or left dorsolateral prefrontal cortex predict the treatment effect of Cognitive Behavioral Therapy (CBT).
The aim of our study is to test the hypothesis of treatment predictability in panic disorder patients in fMRI.
24 patients meeting the ICD-10 criteria for panic disorder with or without agoraphobia. Patients were studied in fMRI during the exposition of threat-related words compared with neutral words and emotional faces compared with fixation points. Patients were studied in fMRI scanner before and after CBT treatment. Psychopathology was assessed using Clinical Global Impression rating scale (CGI) and Beck Anxiety Inventory (BAI). Patients were divided into responders and non-responders groups by the 25% reduction in BAI scale.
Significant reduction of activity was observed in responders on the right amygdala, while the left amygdala decreased activity is lower, and could be the effect of habituation. Incresed activation of left Broca’s area 46, and 45 was negative treatment effect predictor.
Negative treatment effect predictor is hyperactivity in left dorsolateral prefrontal cortex BA 46 and 45. Positive predictors are higher reactivity of right amygdala for anxious faces, activation of right angular gyrus, right insula, right temporal pole.
Supported by the project IGA MZ CR NT 11047-4/2010
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