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Abstract：
The neural mechanisms associated with anhedonia treatment response are poorly understood. Additionally, no study has investigated changes in resting-state functional connectivity (rsFC) accompanying psychosocial treatment for anhedonia.
We evaluated a novel psychotherapy, Behavioral Activation Therapy for Anhedonia (BATA, n = 38) relative to Mindfulness-Based Cognitive Therapy (MBCT, n = 35) in a medication-free, transdiagnostic, anhedonic sample in a parallel randomized controlled trial. Participants completed up to 15 sessions of therapy and up to four 7T MRI scans before, during, and after treatment (n = 185 scans). Growth curve models estimated change over time in anhedonia and in rsFC using average region-of-interest (ROI)-to-ROI connectivity within the default mode network (DMN), frontoparietal network (FPN), salience network, and reward network. Changes in rsFC from pre- to post-treatment were further evaluated using whole-network seed-to-voxel and ROI-to-ROI edgewise analyses.
Growth curve models showed significant reductions in anhedonia symptoms and in average rsFC within the DMN and FPN over time, across BATA and MBCT. There were no differences in anhedonia reductions between treatments. Within-person, changes in average rsFC were unrelated to changes in anhedonia. Between-person, higher than average FPN rsFC was related to less anhedonia across timepoints. Seed-to-voxel and edgewise rsFC analyses corroborated reductions within the DMN and between the DMN and FPN over time, across the sample.
Reductions in rsFC within the DMN, FPN, and between these networks co-occurred with anhedonia improvement across two psychosocial treatments for anhedonia. Future anhedonia clinical trials with a waitlist control group should disambiguate treatment versus time-related effects on rsFC.
We evaluated a novel psychotherapy, Behavioral Activation Therapy for Anhedonia (BATA, n = 38) relative to Mindfulness-Based Cognitive Therapy (MBCT, n = 35) in a medication-free, transdiagnostic, anhedonic sample in a parallel randomized controlled trial. Participants completed up to 15 sessions of therapy and up to four 7T MRI scans before, during, and after treatment (n = 185 scans). Growth curve models estimated change over time in anhedonia and in rsFC using average region-of-interest (ROI)-to-ROI connectivity within the default mode network (DMN), frontoparietal network (FPN), salience network, and reward network. Changes in rsFC from pre- to post-treatment were further evaluated using whole-network seed-to-voxel and ROI-to-ROI edgewise analyses.
Growth curve models showed significant reductions in anhedonia symptoms and in average rsFC within the DMN and FPN over time, across BATA and MBCT. There were no differences in anhedonia reductions between treatments. Within-person, changes in average rsFC were unrelated to changes in anhedonia. Between-person, higher than average FPN rsFC was related to less anhedonia across timepoints. Seed-to-voxel and edgewise rsFC analyses corroborated reductions within the DMN and between the DMN and FPN over time, across the sample.
Reductions in rsFC within the DMN, FPN, and between these networks co-occurred with anhedonia improvement across two psychosocial treatments for anhedonia. Future anhedonia clinical trials with a waitlist control group should disambiguate treatment versus time-related effects on rsFC.
摘要：
与快感缺乏治疗反应相关的神经机制知之甚少。此外,尚无研究调查伴随着快感缺失的心理社会治疗的静息状态功能连接(rsFC)的变化.
我们评估了一种新的心理治疗,快感缺失的行为激活疗法(BATA，n=38)相对于基于正念的认知疗法(MBCT，n=35）在无药物治疗中，诊断,一项平行随机对照试验中的无意义样本。参与者在之前完成了多达15个疗程的治疗和多达四次7TMRI扫描，during,和治疗后（n=185扫描）。生长曲线模型使用默认模式网络(DMN)内的平均感兴趣区域(ROI)到ROI连通性估计快感缺失和rsFC随时间的变化，额顶叶网络（FPN），显著性网络，奖励网络使用全网络种子到体素和ROI到ROI边缘分析进一步评估rsFC从治疗前到治疗后的变化。
生长曲线模型显示，随着时间的推移，DMN和FPN内的快感缺失症状和平均rsFC显著减少，跨越BATA和MBCT。治疗之间的快感减少没有差异。人内,平均rsFC的变化与快感缺失的变化无关。人与人之间，高于平均FPNrsFC与不同时间点的快感缺乏相关.随着时间的推移，种子到体素和边缘rsFC分析证实了DMN内以及DMN和FPN之间的减少，穿过样本。
DMN内rsFC的减少，FPN,在这些网络之间，在两种针对快感缺乏症的社会心理治疗中，快感缺乏症的改善同时发生。未来使用等待名单对照组进行的快感缺乏症临床试验应消除对rsFC的治疗与时间相关影响的歧义。
我们评估了一种新的心理治疗,快感缺失的行为激活疗法(BATA，n=38)相对于基于正念的认知疗法(MBCT，n=35）在无药物治疗中，诊断,一项平行随机对照试验中的无意义样本。参与者在之前完成了多达15个疗程的治疗和多达四次7TMRI扫描，during,和治疗后（n=185扫描）。生长曲线模型使用默认模式网络(DMN)内的平均感兴趣区域(ROI)到ROI连通性估计快感缺失和rsFC随时间的变化，额顶叶网络（FPN），显著性网络，奖励网络使用全网络种子到体素和ROI到ROI边缘分析进一步评估rsFC从治疗前到治疗后的变化。
生长曲线模型显示，随着时间的推移，DMN和FPN内的快感缺失症状和平均rsFC显著减少，跨越BATA和MBCT。治疗之间的快感减少没有差异。人内,平均rsFC的变化与快感缺失的变化无关。人与人之间，高于平均FPNrsFC与不同时间点的快感缺乏相关.随着时间的推移，种子到体素和边缘rsFC分析证实了DMN内以及DMN和FPN之间的减少，穿过样本。
DMN内rsFC的减少，FPN,在这些网络之间，在两种针对快感缺乏症的社会心理治疗中，快感缺乏症的改善同时发生。未来使用等待名单对照组进行的快感缺乏症临床试验应消除对rsFC的治疗与时间相关影响的歧义。
