Neurological Changes Associated With Behavioral Activation Treatment For Depression (BATD) Using A Functional MRI Reward Responsivity Paradigm

Functional magnetic resonance imaging (fMRI) was used to examine functional brain activity in two demographically matched depressed women following their participation in a Behavioral Activation Treatment for Depression (BATD; Hopko & Lejuez, 2007) or Pragmatic Psychodynamic Psychotherapy (PPP; Summers & Barber, 2010). A reward responsiveness pleasurable music listening scanner paradigm was employed during brain scanning to assess reward responsivity prior to and following treatment. Both women responded positively to treatment, evidenced reductions in depression, and exhibited changes in their blood oxygenation level dependence (BOLD) response as measured by fMRI following treatment. BOLD response changes were not observed in either patient in subcortical regions implicated in reward responsiveness following treatment. However, BOLD response changes were observed for both patients in regions of the dorsolateral and medial orbital prefrontal cortex and subgenual cingulate following treatment, with each treatment affecting these areas. These findings support the notion that when BATD and PPP are implemented effectively they are associated with functional brain changes in areas implicated in the pathophysiology of depression.