CBT and the Neural Circuits of Anxiety
Research type
Research Study
Full title
The impact of CBT on threat-potentiated neural circuitry
IRAS ID
255501
Contact name
Oliver J Robinson
Contact email
Sponsor organisation
University College London
Clinicaltrials.gov Identifier
Z6364106/2019/02/25, UCL Data Protection
Duration of Study in the UK
4 years, 0 months, 1 days
Research summary
The impact of CBT on threat-potentiated neural circuitry
Pathological feelings of anxiety constitute the most common psychiatric diagnosis in the developed world, yet current psychological treatments are largely clinically ineffective. CBT (cognitive behavioural therapy) is a structured form of psychological therapy, and can be successful for some individuals, but its neurobiological mechanism of action remains unknown.
This study will aim to test whether specific neural circuitry changes, proposed on the basis of our neurocognitive model of anxiety, are a mechanism of action for CBT interventions. To this end, anxious patients recruited from NHS services will be tested before and after i) CBT or ii) a waiting list period for CBT, on behavioural and neuroimaging measures to determine the impact of CBT on emotional processing and the neural coupling between prefrontal cortex and amygdala. This study aims to elucidate the neurobiological mechanisms of CBT’s therapeutic effect and potentially allow for more targeted/specific approaches to anxiety disorders. The ultimate aim is to improve the efficacy of CBT, and more generally, psychological interventions for anxiety disorders.
The impact of a course of CBT on cortical-subcortical circuitry will be tested via a case-control study in individuals entering IAPT services for anxiety disorders. Each testing session will involve a 2.5 hour functional magnetic resonance imaging (fMRI) session, comprising a cognitive task battery completed under both threat of shock and matched baseline. This will be completed at the Birkbeck-UCL Centre for NeuroImaging. Upon referral into the study from IAPT clinical treatment teams, patients will be randomly assigned to one of two groups. In the CBT group (N=87), we will test patients before and after a course of treatment. In the control group (N=87), we will test patients who are currently seeking (but not undergoing) treatment before and after a wait of equivalent time.
The research will be funded by the Medical Research Council.
REC name
London - Queen Square Research Ethics Committee
REC reference
19/LO/1149
Date of REC Opinion
24 Sep 2019
REC opinion
Further Information Favourable Opinion