Brainteract

The aim of this project is to understand the effects of cognitive behavioural therapy (CBT) on the brain. To achieve this, we will use imaging technology to analyse brain activity in people who have used CBT to treat depression.

CBT is a talking therapy aimed at helping people manage their mental health problems by changing the way they think and behave. It’s effective in treating depression but its underlying effects on the brain have not been studied.

We aim to investigate the effects of CBT on brain circuits important for emotion, working memory and reward processing. We will use functional magnetic resonance imaging (fMRI) to do this. FMRI measures brain activity by looking at the small changes in blood flow that occur when a participant is asked to carry out specific tasks.

We will recruit participants with depression, who are already taking part in the INTERACT trial. INTERACT is a 9-year programme that aims to develop a new way of delivering CBT. It integrates online CBT materials and input from an accredited CBT therapist to treat depression.

During our study, we will ask participants to undergo fMRI whilst performing three cognitive tasks. This will happen six months after they take part in INTERACT. We will compare brain activity in participants who had received CBT to patients receiving standard care.

The three tasks will assess whether CBT leads to changes in:

• Neural processing of happy and sad facial expressions
• Working memory
• Response to positive and negative reward feedback.

We will also assess the correlation in the activity of brain regions when no task is being performed (resting-state connectivity) as well as changes in brain structure. This will allow us to understand which neural mechanisms successful treatment of depression with online CBT relies on as well as helping us to predict longer-term outcomes.