Psychopharmacological first-line treatments of anxietydisorders include antidepressant treatment with selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs).67 Positive effects of antidepressant medication can be demonstrated using neuroimaging techniques, too. Citalopram, for example, attenuated amygdala response to aversive faces68 and
reduced activity in prefrontal regions, the striatum, the insula, and paralimbic regions during listening to worry sentences in GAD.69 Thus, SSRI treatment in anxiety disorders seems to alter abnormal Inhibitors,research,lifescience,medical neural processes that were found to be key characteristics of fear and anxiety. The anticonvulsant drug pregabalin has an Inhibitors,research,lifescience,medical anxiolytic potential, too, and is approved for the use in GAD. In a recent study in healthy individuals, pregabalin attenuated amygdalar and insular activity during anticipation of and during Ubiquitin ligase inhibitor emotional processing.70 The neuropeptide oxytocin has stress-reducing and attachment enhancing effects and facilitates
social encounters.71,72 Thus, it might also have positive effects on emotion regulation in patients suffering from abnormally elevated fear of social situations. In patients with social anxiety disorder, Inhibitors,research,lifescience,medical oxytocin attenuated the heightened amygdala activation in response to fearful faces.73 Hence, it appears to modulate the exaggerated amygdala activity during confrontation with social stimuli in pathological social anxiety. These lines of research suggest that neuroimaging Inhibitors,research,lifescience,medical techniques could potentially identify common neural pathways of anxiety treatment, and therefore help us to understand how new pharmacological treatment
options for anxiety disorders might work. Furthermore, there is evidence that pretreatment patterns of functional neuronal activity might predict whether a patient responds to a particular intervention or not.74 Structural Inhibitors,research,lifescience,medical neuroanatomical characteristics were shown to predict response to psychotherapy as well. Bryant et al75 demonstrated in PTSD patients that a smaller volume of the rostral anterior cingulate cortex predicted nonresponse to CBT. The Hesperadin cell line authors assume that exposure-based CBT is, similarly to the extinction of conditioned fear, a process that requires anterior cingulate cortical structures.11 Thus, larger volumes of the anterior cingulate cortex would lead to better control over fear responses during exposure therapy and enhanced extinction, and consequently result in better responding to CBT75 Therefore, pretreatment characteristics in structural and functional neuroanatomy might become important predictors for the kind of treatment that suits best for a particular patient. In summary, in the future, neuroimaging techniques might enable therapists and researchers to continuously monitor treatment success.
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