Potenciais biomarcadores da terapia cognitivo-comportamental para o transtorno de estresse pós-traumático: uma revisão sistemática

Abstract

Background: The establishment of biomarkers related to cognitive-behavior therapy (CBT) is a method to objectively consolidate treatment efficacy, which is critical to advancing the field. Objectives: We systematically reviewed studies that used biological parameters to assess the efficacy of CBT for the treatment of post-traumatic stress disorder (PTSD) and studies that used these parameters as predictors of response to CBT. Methods: Computerized literature searches were conducted in PubMed/Medline, ISI/Thompson Reuters, and Pilot databases using both thesaurus and free-word search terms. Results: 12 articles met the selection criteria; 4 of them were response predictors studies. A relationship was found between CBT efficacy and changes in the measured parameters, with heart rate responses to symptom provocation being the parameter most often studied. The reduction in heart rate was associated with an improvement in PTSD symptoms. The potential biomarkers of response predictions found included 5α-reductase, amygdala activation, activation and volume of the anterior cingulate cortex, and heart rate. Discussion: Despite the scarcity of studies and their methodological shortcomings, initial investigations indicate that biomarkers of CBT in PTSD patients hold promise for more objective treatment outcome monitoring, identification of response predictors, and for developing novel treatment and prevention strategies.

Listening to the heart: A meta-analysis of cognitive behavior therapy impact on the heart rate of patients with anxiety disorders

“…Gonçalves et al (2011) investigated potential CBT biomarkers of efficacy in the treatment of PTSD and found results consistent with this meta-analysis regarding heart rate. In a recent systematic review (Zantvoord et al, 2013), also in patients with PTSD, reduced physiological reactivity was found in line with the decrease in symptoms after treatment with CBT.…”

Cognitive function and posttraumatic stress disorder: A case study.

“…Between the first and second assessment, the treatment and intervention for PTSD was conducted using Cognitive Behavioral Therapy (CBT) twice per week for a period of 12 months. Cognitive Behavioral Therapy has been considered a resource of choice for the treatment of PTSD (Gonçalves et al, 2011).…”

The Effects of Individual Psychotherapy in BDNF Levels of Patients With Mental Disorders: A Systematic Review

“…Beyond pharmacological treatment, it is possible to observe increases in this neurotrophin's levels via electroconvulsive therapy (13) and physical activity (14) concurrent to the remission of psychological symptoms. Previous reviews of psychotherapies showed few potential response biomarkers for this treatment in patients diagnosed with PTSD such as the 5-alfa-reductase, heart rate changes (15), glucocorticoid metabolism, gene methylation, (16) and structural brain changes (17).…”