Impact of problem solving therapy on brain networks associated with depressive symptoms in poststroke older adults

Problem-solving therapy (PST) shows promise as an evidence-based approach to treat depression of stroke survivors. The purpose of this study was to determine the impact of PST on brain networks associated with depressive symptoms in older stroke survivors. This study employed the use of a functional magnetic resonance imaging (fMRI) task, in which participants matched either emotion faces or neutral shape, which has been previously used in the study of depression. [1,2] This pilot study was designed as a two-arm randomized trial (intervention vs. attention-control group), where the treatment group received six weekly PST sessions each sessions (1-1.5 hrs each), and the attention-control group received six weekly stroke education sessions (1 hr each). Both groups underwent fMRI procedures before and after assigned interventions. Results of the Hariri task indicated that bilateral amygdala activity decreased among those receiving stroke education but increased in those receiving PST at post-treatment. Increased amygdala activation correlated with a drop in depression scores. This may explain mechanism of action of PST on amygdala by rejuvenating a blunted system of emotional reactivity.