Background. Aberrant activity of the subcallosal cingulate (SCC) is a common theme across pharmacologic treatment efficacy prediction studies. The functioning of the SCC in psychotherapeutic interventions is relatively understudied, as are functional differences among SCC subdivisions. We conducted functional connectivity analyses (rsFC) on resting-state functional magnetic resonance imaging (fMRI) data, collected before and after a course of cognitive behavioral therapy (CBT) in patients with major depressive disorder (MDD), using seeds from three SCC subdivisions. Methods. Resting-state data were collected from unmedicated patients with current MDD (Hamilton Depression Rating Scale-17 > 16) before and after 14-sessions of CBT monotherapy. Treatment outcome was assessed using the Beck Depression Inventory (BDI). Rostral anterior cingulate (rACC), anterior subcallosal cingulate (aSCC), and Brodmann’s area 25 (BA25) masks were used as seeds in connectivity analyses that assessed baseline rsFC and symptom severity, changes in connectivity related to symptom improvement after CBT, and prediction of treatment outcomes using whole-brain baseline connectivity. Results. Pretreatment BDI negatively correlated with pretreatment rACC ~ dorsolateral prefrontal cortex and aSCC ~ lateral prefrontal cortex rsFC. In a region-of-interest longitudinal analysis, rsFC between these regions increased post-treatment (p < 0.05FDR). In whole-brain analyses, BA25 ~ paracentral lobule and rACC ~ paracentral lobule connectivities decreased post-treatment. Whole-brain baseline rsFC with SCC did not predict clinical improvement. Conclusions. rsFC features of rACC and aSCC, but not BA25, correlated inversely with baseline depression severity, and increased following CBT. Subdivisions of SCC involved in top-down emotion regulation may be more involved in cognitive interventions, while BA25 may be more informative for interventions targeting bottom-up processing. Results emphasize the importance of subdividing the SCC in connectivity analyses.

中文翻译：

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抑郁相关的前扣带回前额叶静息状态连接在认知行为治疗后正常化

背景。胼胝体扣带回 (SCC) 的异常活性是药物治疗疗效预测研究的共同主题。SCC 在心理治疗干预中的功能研究相对较少，SCC 细分之间的功能差异也是如此。我们使用来自三个 SCC 细分的种子，对重度抑郁症 (MDD) 患者在接受认知行为治疗 (CBT) 之前和之后收集的静息状态功能磁共振成像 (fMRI) 数据进行了功能连接分析 (rsFC) . 方法。静息状态数据收集自 14 次 CBT 单药治疗前后未接受药物治疗的当前 MDD（汉密尔顿抑郁量表-17 > 16）患者。使用贝克抑郁量表（BDI）评估治疗结果。Rostral 前扣带回 (rACC)、胼胝体前扣带回 (aSCC) 和 Brodmann 25 区 (BA25) 面具被用作连接分析的种子，用于评估基线 rsFC 和症状严重程度、与 CBT 后症状改善相关的连接变化以及预测使用全脑基线连接的治疗结果。结果。预处理 BDI 与预处理 rACC ~ 背外侧前额叶皮层和 aSCC ~ 外侧前额叶皮层 rsFC 呈负相关。在感兴趣区域纵向分析中，这些区域之间的 rsFC 在治疗后增加（p < 0.05FDR）。在全脑分析中，BA25 ~ 中央旁小叶和 rACC ~ 中央旁小叶结缔组织在治疗后减少。SCC 的全脑基线 rsFC 不能预测临床改善。结论。rACC 和 aSCC 的 rsFC 特征，但不是 BA25，与基线抑郁严重程度成反比，并在 CBT 后增加。涉及自上而下情绪调节的 SCC 细分可能更多地涉及认知干预，而 BA25 可能更多地用于针对自下而上处理的干预。结果强调了在连通性分析中细分 SCC 的重要性。