Journal Article

Increase in prefrontal cortical volume following cognitive behavioural therapy in patients with chronic fatigue syndrome

Floris P. de Lange, Anda Koers, Joke S. Kalkman, Gijs Bleijenberg, Peter Hagoort, Jos W. M. van der Meer and Ivan Toni

in Brain

Published on behalf of The Guarantors of Brain

Volume 131, issue 8, pages 2172-2180
Published in print August 2008 | ISSN: 0006-8950
Published online June 2008 | e-ISSN: 1460-2156 | DOI: http://dx.doi.org/10.1093/brain/awn140
Increase in prefrontal cortical volume following cognitive behavioural therapy in patients with chronic fatigue syndrome

Show Summary Details

Preview

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.

Keywords: neural plasticity; prefrontal cortex; grey matter increase; cognitive behavioural therapy

Journal Article.  5766 words.  Illustrated.

Subjects: Neurology ; Neuroscience

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.