Changes in brain activity of somatoform disorder patients during emotional empathy after multimodal psychodynamic psychotherapy

Moritz de Greck, Annette F. Bölter, Lisa Lehmann, Cornelia Ulrich, Eva Stockum, Björn Enzi, Thilo Hoffmann, Claus Tempelmann, Manfred Beutel, Jörg Frommer, Georg Northoff

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Somatoform disorder patients show a variety of emotional disturbances including impaired emotion recognition and increased empathic distress. In a previous paper, our group showed that several brain regions involved in emotional processing, such as the parahippocampal gyrus and other regions, were less activated in pre-treatment somatoform disorder patients (compared to healthy controls) during an empathy task. Since the parahippocampal gyrus is involved in emotional memory, its decreased activation might reflect the repression of emotional memories (which - according to psychoanalytical concepts - plays an important role in somatoform disorder). Psychodynamic psychotherapy aims at increasing the understanding of emotional conflicts as well as uncovering repressed emotions. We were interested, whether brain activity in the parahippocampal gyrus normalized after (inpatient) multimodal psychodynamic psychotherapy. Using fMRI, subjects were scanned while they shared the emotional states of presented facial stimuli expressing anger, disgust, joy and a neutral expression; distorted stimuli with unrecognizable content served as control condition. 15 somatoform disorder patients were scanned twice, pre and post multimodal psychodynamic psychotherapy; in addition, 15 age-matched healthy control subjects were investigated. Effects of psychotherapy on hemodynamic responses were analyzed implementing two approaches: (i) an a priori region of interest approach and (ii) a voxelwise whole brain analysis. Both analyses revealed increased hemodynamic responses in the left and right parahippocampal gyrus (and other regions) after multimodal psychotherapy in the contrast 'empathy with anger'-'control'. Our results are in line with psychoanalytical concepts about somatoform disorder. They suggest the parahippocampal gyrus is crucially involved in the neurobiological mechanisms which underly the emotional deficits of somatoform disorder patients.

Original languageEnglish
JournalFrontiers in Human Neuroscience
Issue numberJUL
DOIs
Publication statusPublished - Jul 11 2013
Externally publishedYes

Fingerprint

Psychodynamic Psychotherapy
Somatoform Disorders
Parahippocampal Gyrus
Brain
Anger
Psychotherapy
Emotions
Hemodynamics
Affective Symptoms
Inpatients
Healthy Volunteers
Magnetic Resonance Imaging

Keywords

  • Emotional empathy
  • FMRI
  • Psychodynamic
  • Psychotherapy
  • Somatoform disorder

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Neurology
  • Biological Psychiatry
  • Behavioral Neuroscience
  • Neuropsychology and Physiological Psychology

Cite this

Changes in brain activity of somatoform disorder patients during emotional empathy after multimodal psychodynamic psychotherapy. / de Greck, Moritz; Bölter, Annette F.; Lehmann, Lisa; Ulrich, Cornelia; Stockum, Eva; Enzi, Björn; Hoffmann, Thilo; Tempelmann, Claus; Beutel, Manfred; Frommer, Jörg; Northoff, Georg.

In: Frontiers in Human Neuroscience, No. JUL, 11.07.2013.

Research output: Contribution to journalArticle

de Greck, Moritz ; Bölter, Annette F. ; Lehmann, Lisa ; Ulrich, Cornelia ; Stockum, Eva ; Enzi, Björn ; Hoffmann, Thilo ; Tempelmann, Claus ; Beutel, Manfred ; Frommer, Jörg ; Northoff, Georg. / Changes in brain activity of somatoform disorder patients during emotional empathy after multimodal psychodynamic psychotherapy. In: Frontiers in Human Neuroscience. 2013 ; No. JUL.
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