Project 4: FMRI Study

Kircher et al.
Neural Basis of Cognitive Behavioural Therapy Effects on Positive Symptoms in Patients with Psychosis

Objectives
The neurophysiological processes underlying the development and amelioration of symptoms of delusion are being investigated. Using functional magnetic resonance imaging (fMRI) differential effects of Cognitive Behavioral Therapy (CBT) and Supportive Therapy (ST) on cerebral activation is being investigated.
The following questions will be addressed:
1) What are the neural correlates of delusions taped by the dysfunctional processes of attributional bias and jumping to conclusions?
2) Can future therapeutic success be predicted on the basis of specific brain activation patterns already before treatment?
3) Which components of neural circuits can potentially by altered by CBT?
4) Are there distinct brain structures that can be linked to delusions?


Methods and measurement

To answer the questions named above, those persons out of the pool of participants of Project 1 will be investigated that are free of contraindication for fMRI.

80 patients from Project 1 with chronic psychosis and 80 healthy subjects will investigated. Before and after the 9-month therapy - either with CBT or with ST - an fMRI-scan will be performed using an jumping to conclusions and an attributional bias paradigm. Differences in brain activation between patients and healthy subjects will be investigated across time further comparing both forms of therapy. The paradigms focus on characteristicly altered cognitive processes in psychotic patients, i.e. jumping to conclusions ("balls in the bottle task") and the attributional bias during the self- vs. external reference of situations.