Increase in prefrontal cortical volume following cognitive behavioural therapy in patients with chronic fatigue syndrome
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SourceBrain, 131, 8, (2008), pp. 2172-2180
Article / Letter to editor
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SW OZ DCC CO
General Internal Medicine
Donders Centre for Cognitive Neuroimaging
SW OZ NICI CO
F.C. Donders Centre for Cognitive Neuroimaging
SubjectAction, intention, and motor control; 110 000 Neurocognition of Language; 110 007 PLUS: A neurocomputational model for the Processing of Linguistic Utterances based on the Unification-Space architecture; 110 009 The human brain and Chinese prosody; 110 012 Social cognition of verbal communication; 110 013 Binding and the MUC-model; 111 000 Intention & Action; 111 002 Neural dynamics of movement representations; EBP 1: Determinants of Health and Disease; EBP 3: Effective Primary Care and Public Health; UMCN 4.1: Microbial pathogenesis and host defense; 110 014 Public activities
Chronic fatigue syndrome (CFS) is a disabling disorder, characterized by persistent or relapsing fatigue. Recent studies have detected a decrease in cortical grey matter volume in patients with CFS, but it is unclear whether this cerebral atrophy constitutes a cause or a consequence of the disease. Cognitive behavioural therapy (CBT) is an effective behavioural intervention for CFS, which combines a rehabilitative approach of a graded increase in physical activity with a psychological approach that addresses thoughts and beliefs about CFS which may impair recovery. Here, we test the hypothesis that cerebral atrophy may be a reversible state that can ameliorate with successful CBT. We have quantified cerebral structural changes in 22 CFS patients that underwent CBT and 22 healthy control participants. At baseline, CFS patients had significantly lower grey matter volume than healthy control participants. CBT intervention led to a significant improvement in health status, physical activity and cognitive performance. Crucially, CFS patients showed a significant increase in grey matter volume, localized in the lateral prefrontal cortex. This change in cerebral volume was related to improvements in cognitive speed in the CFS patients. Our findings indicate that the cerebral atrophy associated with CFS is partially reversed after effective CBT. This result provides an example of macroscopic cortical plasticity in the adult human brain, demonstrating a surprisingly dynamic relation between behavioural state and cerebral anatomy. Furthermore, our results reveal a possible neurobiological substrate of psychotherapeutic treatment.
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