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CBT and PTSD in the news ...
Talk therapy - CBT - may reverse biological changes in PTSD
patients
A new paper published in Biological
Psychiatry suggests that cognitive behavioral therapy
for posttraumatic stress disorder (PTSD) not
only reduces symptoms but also affects the underlying
biology of this disorder.
Before and after the 12 weeks, the researchers measured the
volumes of certain brain regions using magnetic resonance
imaging. They also collected blood samples to measure
changes in expression of a specific gene, FKBP5, which has
been implicated in the risk for developing PTSD and plays a
role in regulating stress hormones.
Before therapy, compared with the control group, patients
had lower FKBP5 gene expression and smaller hippocampal and
medial orbitofrontal cortex volumes, important brain regions
involved in learning, memory, and emotion regulation.
At the follow-up appointment 12 weeks later, the PTSD
patients showed higher expression of FKBP5 and increased
hippocampal volume. More importantly, these changes were
directly associated with clinical improvement among the
patients. The increased FKBP5 expression, and to a lesser
degree the increased hippocampal volume, actually predicted
improvement in their PTSD symptoms.
"The results show that structural changes in the brain, such
as the shrinkage of the hippocampus, are reversible in
trauma victims. Talk therapy may help normalize these
alterations and improve symptoms," explained Kéri.
"Furthermore, the regeneration of hippocampus correlated
with the expression of a gene that balances the activity of
the stress hormone cortisol at the level of cells."
"This study helps to link the alleviation of PTSD symptoms
to improvement in stress-related alterations in the body and
brain," said Dr. John Krystal, Editor of Biological
Psychiatry. John H.
Krystal, M.D., is Chairman of the Department of Psychiatry
at the Yale University School of Medicine, Chief of
Psychiatry at Yale-New Haven Hospital, and a research
psychiatrist at the VA Connecticut Healthcare System.
Why are these results important? The findings suggest that
talk therapy may modulate fundamental biological factors:
changes in gene expression, brain structure, and
psychological improvement may be closely interrelated.
These conclusions highlight even further the importance of
early invention in PTSD development and treatment.
"Association Among Clinical
Response, Hippocampal Volume, and FKBP5 Gene Expression in
Individuals with Posttraumatic Stress Disorder Receiving
Cognitive Behavioral Therapy" by Einat Levy-Gigi, Csilla
Szabó, Oguz Kelemen, and Szabolcs Kéri (doi:
10.1016/j.biopsych.2013.05.017). Biological Psychiatry.
122013
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