CBT reduces CBF: cognitive-behavioral therapy reduces cerebral blood flow in fear‐relevant brain regions in spider phobia

Soravia, Leila M.; Orosz, Ariane; Schwab, Simon; Nakataki, Masahito; Wiest, Roland; Federspiel, Andrea (2016). CBT reduces CBF: cognitive-behavioral therapy reduces cerebral blood flow in fear‐relevant brain regions in spider phobia. Brain and Behavior, 6(9), e00510. Wiley 10.1002/brb3.510

Soravia et a., 2016, Brain and Behav.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (369kB) | Preview

Background Imaging studies have provided evidence that cognitive-behavioral therapy (CBT) is able to change brain activation in phobic patients in response to threatening stimuli. The changes occurred in both emotion-generating and modulatory regions. In this study, we use a data-driven approach to explore resting state cerebral blood flow (CBF) measured by arterial spin labeling (ASL), before and after CBT. Methods Eight female patients with spider phobia were scanned before and 1 month after an exposure-based group therapy for spider phobia. Each MRI session consisted of an ASL resting state measurement acquired before and after a symptom provocation task involving the showing of spider pictures in the scanner. The first ASL acquisition measured anticipatory anxiety and the second measured postprocessing of phobia-relevant stimuli. Results Cognitive-behavioral therapy significantly reduced spider phobic symptoms in all patients. Symptom reduction during anticipatory anxiety was accompanied by reduced bilateral CBF in the parahippocampal gyrus, ventral anterior thalamus, Brodmann area 8, and the anterior cingulate cortex. During postprocessing of phobia-relevant stimuli, patients showed reduced CBF in the bilateral insula, components of the motor cortex, and areas associated with language functions. Conclusions Longitudinal CBF dynamics following CBT were in concordance with results from several studies using BOLD fMRI to investigate the effects of psychotherapy on brain activity. CBF can be quantified by ASL, with the principal advantage of sensitivity to slow variations in neural activity and task independence. Therefore, ASL may be a suitable method for monitoring and evaluating the efficacy of psychotherapy or pharmacotherapy approaches.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Translational Research Center
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Soravia, Leila; Orosz, Ariane; Schwab, Simon; Nakataki, Masahito; Wiest, Roland and Federspiel, Andrea


600 Technology > 610 Medicine & health






[4] Swiss National Science Foundation




Leila Soravia

Date Deposited:

13 Sep 2016 10:13

Last Modified:

10 Sep 2017 20:17

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Anticipatory anxiety; arterial spin labeling; cerebral blood flow; cognitive‐behavioral therapy; fear processing; phobia





Actions (login required)

Edit item Edit item
Provide Feedback