scholarly journals Multivariate resting-state functional connectivity predicts response to cognitive behavioral therapy in obsessive–compulsive disorder

2018 ◽  
Vol 115 (9) ◽  
pp. 2222-2227 ◽  
Author(s):  
Nicco Reggente ◽  
Teena D. Moody ◽  
Francesca Morfini ◽  
Courtney Sheen ◽  
Jesse Rissman ◽  
...  
Keyword(s):  
Functional Connectivity ◽  
Cognitive Behavioral Therapy ◽  
Obsessive Compulsive Disorder ◽  
Resting State ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Resting State Functional Connectivity ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Before And After

Cognitive behavioral therapy (CBT) is an effective treatment for many with obsessive–compulsive disorder (OCD). However, response varies considerably among individuals. Attaining a means to predict an individual’s potential response would permit clinicians to more prudently allocate resources for this often stressful and time-consuming treatment. We collected resting-state functional magnetic resonance imaging from adults with OCD before and after 4 weeks of intensive daily CBT. We leveraged machine learning with cross-validation to assess the power of functional connectivity (FC) patterns to predict individual posttreatment OCD symptom severity. Pretreatment FC patterns within the default mode network and visual network significantly predicted posttreatment OCD severity, explaining up to 67% of the variance. These networks were stronger predictors than pretreatment clinical scores. Results have clinical implications for developing personalized medicine approaches to identifying individual OCD patients who will maximally benefit from intensive CBT.

Orbito-frontal cortex and thalamus volumes in the patients with obsessive-compulsive disorder before and after cognitive behavioral therapy

2016 ◽  
Vol 53 (4) ◽  
pp. 243-255 ◽  
Author(s):  
Murad Atmaca ◽  
Hanefi Yildirim ◽  
Seda Yilmaz ◽  
Neslihan Caglar ◽  
Osman Mermi ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Frontal Cortex ◽  
Obsessive Compulsive Disorder ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Treatment Modalities ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Before And After ◽  
Left And Right

Background The effect of a variety of treatment modalities including psychopharmacological and cognitive behavioral therapy on the brain volumes and neurochemicals have not been investigated enough in the patients with obsessive-compulsive disorder. Therefore, in the present study, we aimed to investigate the effect of cognitive behavioral therapy on the volumes of the orbito-frontal cortex and thalamus regions which seem to be abnormal in the patients with obsessive-compulsive disorder. We hypothesized that there would be change in the volumes of the orbito-frontal cortex and thalamus. Methods Twelve patients with obsessive-compulsive disorder and same number of healthy controls were included into the study. At the beginning of the study, the volumes of the orbito-frontal cortex and thalamus were compared by using magnetic resonance imaging. In addition, volumes of these regions were measured before and after the cognitive behavioral therapy treatment in the patient group. Results The patients with obsessive-compulsive disorder had greater left and right thalamus volumes and smaller left and right orbito-frontal cortex volumes compared to those of healthy control subjects at the beginning of the study. When we compared baseline volumes of the patients with posttreatment ones, we detected that thalamus volumes significantly decreased throughout the period for both sides and that the orbito-frontal cortex volumes significantly increased throughout the period for only left side. Conclusions In summary, we found that cognitive behavioral therapy might volumetrically affect the key brain regions involved in the neuroanatomy of obsessive-compulsive disorder. However, future studies with larger sample are required.

Frontostriatal activation in patients with obsessive–compulsive disorder before and after cognitive behavioral therapy

2010 ◽  
Vol 41 (1) ◽  
pp. 207-216 ◽  
Author(s):  
T. Freyer ◽  
S. Klöppel ◽  
O. Tüscher ◽  
A. Kordon ◽  
B. Zurowski ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Caudate Nucleus ◽  
Obsessive Compulsive Disorder ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Strategy Change ◽  
Before And After ◽  
The Impact

BackgroundCognitive behavioral therapy (CBT) with exposure and response prevention (ERP) is the psychotherapeutic treatment of choice for obsessive–compulsive disorder (OCD). However, little is known about the impact of CBT on frontostriatal dysfunctioning, known to be the neuronal correlate of OCD.MethodA probabilistic reversal learning (RL) task probing adaptive strategy switching capabilities was used in 10 unmedicated patients with OCD and 10 healthy controls during an event-related functional magnetic resonance imaging (fMRI) experiment. Patients were scanned before and after intensive CBT, controls twice at comparable intervals.ResultsStrategy change within the RL task involved activity in a broad frontal network in patients and controls. No significant differences between the groups or in group by time interactions were detected in a whole-brain analysis corrected for multiple comparisons. However, a reanalysis with a more lenient threshold revealed decreased responsiveness of the orbitofrontal cortex and right putamen during strategy change before treatment in patients compared with healthy subjects. A group by time effect was found in the caudate nucleus, demonstrating increased activity for patients over the course of time. Patients with greater clinical improvement, reflected by greater reductions in Yale–Brown Obsessive Compulsive Scale (YBOCS) scores, showed more stable activation in the pallidum.ConclusionsAlthough these findings are preliminary and need to be replicated in larger samples, they indicate a possible influence of psychotherapy on brain activity in core regions that have been shown to be directly involved both in acquisition of behavioral rules and stereotypes and in the pathophysiology of OCD, the caudate nucleus and the pallidum.

scholarly journals Internet-based cognitive behavioral therapy in children and adolescents with obsessive compulsive disorder: a feasibility study

2021 ◽  
Vol 128 (9) ◽  
pp. 1445-1459 ◽  
Author(s):  
Karsten Hollmann ◽  
Katharina Allgaier ◽  
Carolin S. Hohnecker ◽  
Heinrich Lautenbacher ◽  
Verena Bizu ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Children And Adolescents ◽  
Obsessive Compulsive Disorder ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Obsessive Compulsive ◽  
Face To Face ◽  
Compulsive Disorder ◽  
First Choice ◽  
Before And After

AbstractCognitive behavioral therapy (CBT) is the first choice of treatment of obsessive–compulsive disorder (OCD) in children and adolescents. However, there is often a lack of access to appropriate treatment close to the home of the patients. An internet-based CBT via videoconferencing could facilitate access to state-of-the-art treatment even in remote areas. The aim of this study was to investigate feasibility and acceptability of this telemedical approach. A total of nine children received 14 sessions of CBT. The first session took place face-to-face, the remaining 13 sessions via videoconference. OCD symptoms were recorded with a smartphone app and therapy materials were made accessible in a data cloud. We assessed diagnostic data before and after treatment and obtained measures to feasibility, treatment satisfaction and acceptability. Outcomes showed high acceptance and satisfaction on the part of patients with online treatment (89%) and that face-to-face therapy was not preferred over an internet-based approach (67%). The majority of patients and their parents classified the quality of treatment as high. They emphasized the usefulness of exposures with response prevention (E/RP) in triggering situations at home. The app itself was rated as easy to operate and useful. In addition to feasibility, a significant decrease in obsessive–compulsive symptoms was also achieved. Internet-based CBT for pediatric OCD is feasible and well received by the patients and their parents. Furthermore, obsessive–compulsive symptomatology decreased in all patients. The results of this study are encouraging and suggest the significance of further research regarding this technology-supported approach, with a specific focus on efficacy.Trial registration number: Clinical trials AZ53-5400.1-004/44.

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