CLINICAL TRIAL article
Front. Psychiatry
Sec. Psychological Therapy and Psychosomatics
Effects of computer-assisted Cognitive Behavioral Therapy on Anxiety in Patients undergoing Functional Endoscopic Sinus Surgery: An Exploratory fNIRS Study of Prefrontal Hemodynamic Functions
Provisionally accepted
- 1First Hospital of Shanxi Medical University, Taiyuan, China
- 2Department of Neurobiology, School of Basic Medicine, Shanxi Medical University, Taiyuan, China
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Introduction: We investigated prefrontal cortex (PFC) activation in patients undergoing functional endoscopic sinus surgery (FESS) surgery who presented with anxiety and evaluated the effect of a computerized cognitive behavioral therapy (cCBT) intervention using functional near-infrared spectroscopy (fNIRS). Methods: Sixty patients scheduled for FESS were randomly assigned to either the active control (AC) group (n = 30) that received health education or cCBT group (n = 30) that received cCBT. Prefrontal hemodynamic responses were assessed using fNIRS during performance of the Verbal Fluency Task (VFT). Levels of anxiety, depression, and insomnia were measured at multiple perioperative time points. Results: The cCBT group exhibited a significantly greater number of activated channels than the AC group (37 vs. 27, p = 0.004) and higher changes in oxygenated hemoglobin (Δoxy-Hb) in specific channels (Channels 15, 23, 26, and 35; p < 0.05). Oxygenated hemoglobin (oxy-Hb) levels in Channel 41 were negatively correlated with state anxiety scores (p = 0.008), whereas those in Channel 42 were positively correlated with insomnia severity (p = 0.038) at baseline. Changes in activation of Channel 34 and Channel 3 were correlated with the alleviation of anxiety and insomnia symptoms, respectively. Discussion: Anxiety in patients undergoing FESS was associated with reduced PFC activation during the VFT. The cCBT intervention improved clinical symptoms and enhanced PFC hemodynamic function. CCBT serves as an effective non-pharmacological intervention for mitigating anxiety and insomnia in this patient population.
Keywords: Computer-based intervention, cognitive behavioral therapy, computerizedcognitive behavioral therapy, Functional endoscopic sinus surgery, Anxiety, insomnia, functional near-infrared spectroscopy
Received: 15 Sep 2025; Accepted: 28 Nov 2025.
Copyright: © 2025 Yang, Zhang, HU and Tong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Chen HU
Yuping Tong
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