Brain Plasticity and Prediction of Response to Psychotherapy

Abstract

Abstract Psychotherapy improves the mental health of many patients, and such improvement must occur through change (plasticity) in the human brain. Such plasticity can be measured with neuroimaging to reveal the neural mechanisms of psychotherapy. Here we review what is known about neuroanatomical, neurophysiological, and neurochemical plasticity associated with one well-validated form of psychotherapy—cognitive behavioral therapy (CBT)—for the most common mental health difficulty—anxiety disorders (i.e., generalized anxiety disorder, social anxiety disorder, and specific phobia). CBT, like other behavioral and pharmacological treatments, is effective for about half of patients, and presently there is no scientific basis for clinicians or patients to select a particular treatment that is most likely to be effective for an individual patient (precision or personalized medicine). We review evidence about neuroimaging measures (biomarkers), collected prior to CBT interventions, that are associated with or predictive of patient response to treatment. With further advancement, such predictive biomarkers may allow for individualized selections of treatments that lead to higher rates of therapeutic benefits for patients.