Changes of brain activation pre- post short-term psychodynamic inpatient psychotherapy: An fMRI study of panic disorder patients

Cognitive–behavioural interventions have been shown to change brain functioning. We used an emotional linguistic go/nogo functional magnetic resonance imaging (fMRI) design to determine changes of brain activation patterns of panic disorder (PD) patients following short-term psychodynamic inpatient treatment. Nine PD patients underwent fMRI before and after treatment; 18 healthy controls were scanned twice at the same interval (4 weeks). In the go/nogo design, responses to panic-specific negative words were compared with linguistically matched positive and neutral words. According to hypotheses, patients rated affective words more strongly than controls and selectively recalled negative vs. positive/neutral words. Before treatment, high limbic (hippocampus and amygdala) activation was accompanied by low prefrontal activation to negative words. Inhibition-related activation patterns indicated difficulties of behavioural regulation in emotional context. At treatment termination, panic-related symptoms had improved significantly, and fronto-limbic activation patterns were normalized. Our results indicate that short-term psychodynamic treatment leads to changes in fronto-limbic circuitry not dissimilar to previous findings on cognitive–behavioural treatments.