Prefrontal-limbic circuit modulation in anxiety disorders: Differential neural effects of psychotherapy versus pharmacotherapy revealed by ALE meta-analysis.
Juan Qiu, Junjie Ren, Jin Chang et al.
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In 30 seconds
This meta-analysis examined the neural effects of psychotherapy versus pharmacotherapy in anxiety disorders (ADs) using task-based fMRI data from 27 studies with 561 patients. Results indicated that psychotherapy primarily reduced activation in prefrontal and striatal regions, while pharmacotherapy showed focal decreases in the right uncus. A large pooled symptom reduction was observed with a Hedges' g of 1.44.
Key findings
- Psychotherapy led to decreased activation in medial, middle, and inferior frontal gyri and caudate nucleus.
- Pharmacotherapy resulted in more focal decreases in the right uncus.
- A large pooled symptom reduction was noted with Hedges' g = 1.44.
- Subgroup analyses revealed heterogeneity across therapies, diagnoses, and tasks.
Why it matters
Understanding the distinct neural pathways engaged by psychotherapy and pharmacotherapy can inform treatment decisions for anxiety disorders, potentially leading to more tailored therapeutic approaches based on individual patient needs.
What to keep in mind
Findings remain exploratory due to the limited and heterogeneous evidence base.