What the study found
Neural measures taken before treatment were often linked to how much people improved after treatment in internalizing disorders, including depressive and anxiety disorders. The pattern differed by type of emotion regulation: lower baseline activity during explicit regulation, especially cognitive reappraisal, was generally associated with greater symptom improvement, while higher baseline activity during implicit regulation was generally associated with greater symptom improvement.
Why the authors say this matters
The authors conclude that neural predictors of treatment outcome through emotion regulation may help contribute to precision medicine, which means using individual biological and clinical features to better match people with treatments. They also state that these findings underscore the relevance of such neural predictors in internalizing disorders.
What the researchers tested
The paper is a narrative review of functional magnetic resonance imaging (fMRI), a brain-imaging method that measures activity indirectly through blood-flow changes, in studies of emotion regulation and treatment response. It examined explicit regulation, meaning effortful regulation, and implicit regulation, meaning automatic regulation, in the presence of negative stimuli.
What worked and what didn't
For explicit regulation, most studies focused on cognitive reappraisal, and pre-treatment activity in medial and lateral prefrontal cortex frequently predicted treatment response. For implicit regulation, most studies used emotional interference tasks, and predictors often involved prefrontal cortex and anterior cingulate cortex; the direction was usually that more baseline activity predicted greater symptom improvement. Findings involving other regions, including the amygdala, were reported but were less consistent.
What to keep in mind
The abstract reports substantial gaps in the literature. Explicit-regulation studies mainly examined cognitive reappraisal, and most studies involved major depressive disorder, anxiety disorders, and posttraumatic stress disorder, with insufficient representation of other internalizing disorders. The abstract does not describe additional limitations beyond these scope gaps.
Key points
- Baseline brain activity during emotion regulation was often associated with later treatment response in internalizing disorders.
- Lower pre-treatment activity during explicit regulation was generally linked to greater symptom improvement.
- Higher pre-treatment activity during implicit regulation was generally linked to greater symptom improvement.
- Most explicit-regulation studies focused on cognitive reappraisal.
- Most studies involved major depressive disorder, anxiety disorders, and posttraumatic stress disorder.
Disclosure
- Research title:
- Neural activity patterns predicted treatment response in internalizing disorders
- Authors:
- Heide Klumpp, Delaney K. Davey, Scott A. Langenecker
- Institutions:
- Edward Hines, Jr. VA Hospital, University of Illinois Chicago, The Ohio State University
- Publication date:
- 2026-03-07
- OpenAlex record:
- View
Get the weekly research newsletter
Stay current with peer-reviewed research without reading academic papers — one filtered digest, every Friday.