Does Cognitive Behavioral Therapy Change the Brain? A Systematic Review of Neuroimaging in Anxiety Disorders

This systematic review aims to investigate neurobiological changes related to cognitive-behavioral therapy (CBT) in anxiety disorders detected through neuroimaging techniques and to identify predictors of response to treatment. Cognitive-behavioral therapy modified the neural circuits involved in the regulation of negative emotions and fear extinction in judged treatment responders. The only study on predictors of response to treatment was regarding obsessive-compulsive disorder and showed higher pretreatment regional metabolic activity in the left orbitofrontal cortex associated with a better response to behavioral therapy. Despite methodological limitations, neuroimaging studies revealed that CBT was able to change dysfunctions of the nervous system.Univ Fed Rio de Janeiro, IBCCF, Rio De Janeiro, BrazilUniv Fed Fluminense, BR-24220000 Niteroi, RJ, BrazilUniv Fed Sao Paulo, EPM, Sao Paulo Med Sch, Dept Psychiat & Med Psychol, Sao Paulo, BrazilUniv Fed Rio de Janeiro, Inst Psychiat, IPUB, Rio De Janeiro, BrazilUniv Fed Rio de Janeiro, Inst Psychol, Rio De Janeiro, BrazilUniv Fed Sao Paulo, EPM, Sao Paulo Med Sch, Dept Psychiat & Med Psychol, Sao Paulo, BrazilWeb of Scienc