27.4 FUNCTIONAL CONNECTIVITY OF THE DORSOLATERAL PREFRONTAL CORTEX IS MODULATED BY PSYCHOTHERAPY FOR YOUTH WITH MOOD DYSREGULATION AT HIGH-RISK FOR BIPOLAR DISORDER

Objectives

Previously, our group reported that improvements in depressive symptoms following psychotherapy are associated with enhanced activation in the dorsolateral prefrontal cortex (DLPFC). For the current study, we aimed to extend our understanding of the brain networks linked to the DLPFC and the longitudinal changes in connectivity that take place following psychotherapy for youth with mood dysregulation.

Methods

fMRI data were collected from 37 youth before and after approximately 4 months of either family-focused therapy or a shorter modified version. During the scan, patients viewed affective facial expressions, including fear, happy, and calm. Functional connectivity analyses were conducted with the generalized psychophysiological interaction toolbox, using previously identified DLPFC site as a seed. Longitudinal changes in connectivity from baseline (BL) to end of treatment (EOT) were examined

Results

From BL to EOT, functional connectivity increased between the DLPFC and the inferior parietal cortex, fusiform, and cerebellum. At the EOT scan, lower severity of depressive symptoms was correlated with less connectivity between the DLPFC and the medial frontal cortex. No regions decreased in connectivity with the DLPFC after therapy.

Conclusions

These results extend our previous findings by suggesting that brain networks linked to the DLPFC site may work together to facilitate symptom improvement. After family treatment, the DLPFC is participating more in visual attention networks needed for the task at hand. Furthermore, lower depressive symptoms after therapy are associated with allocating fewer resources to self-focused thoughts subserved by the medial frontal cortex.

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