Changes in cerebral blood flow following successful psychotherapy combined with cortisol treatment in spider phobia
Ariane Orosz 1 , Leila Soravia 1 , Kay Jann 2 , Roland Wiest 3 , Thomas Dierks 1 , and Andrea Federspiel 1
Department of Psychiatric Neurophysiology,
University Hospital of Psychiatry, Bern, Bern,
of Neurology, UCLA, Ahmanson-Lovelace Brain Mapping
Center, Los Angeles, California, United States,
of Diagnostic and Interventional Neuroradiology,
University Hospital/Inselspital, Bern, Bern, Switzerland
Neuroimaging insights into the neuronal mechanisms
underlying effective treatment of spider phobia may
provide important information for treatment of anxiety
disorders. In this study we measured 15 patients with
spider phobia before and after cognitive behavior
therapy using arterial spin labeling. As the
stress-hormone cortisol is supposed to reduce phobic
fear in anxiety disorder, the patients were assigned to
receive either cortisol or placebo in addition to
psychotherapy in a double-blind study design. We could
show that successful psychotherapy is associated with a
significant decrease in CBF in the prefrontal cortex.
Cortisol further decreases CBF in this region.
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