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

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Title: Frontostriatal activation in patients with obsessive–compulsive disorder before and after cognitive behavioral therapy.
Authors: Freyer T (AUTHOR), Klöppel S (AUTHOR), Tüscher O (AUTHOR), Kordon A (AUTHOR), Zurowski B (AUTHOR), Kuelz A (AUTHOR), Speck O (AUTHOR), Glauche V (AUTHOR), Voderholzer U (AUTHOR)
Source: Psychological Medicine. Jan2011, Vol. 41 Issue 1, p207-216. 10p.
Abstract: 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. [ABSTRACT FROM AUTHOR]
Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Frontostriatal activation in patients with obsessive–compulsive disorder before and after cognitive behavioral therapy.
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  Data: <searchLink fieldCode="AR" term="%22Freyer+T%22">Freyer T</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Klöppel+S%22">Klöppel S</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tüscher+O%22">Tüscher O</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kordon+A%22">Kordon A</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Zurowski+B%22">Zurowski B</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kuelz+A%22">Kuelz A</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Speck+O%22">Speck O</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Glauche+V%22">Glauche V</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Voderholzer+U%22">Voderholzer U</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Psychological+Medicine%22">Psychological Medicine</searchLink>. Jan2011, Vol. 41 Issue 1, p207-216. 10p.
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: 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. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Psychological Medicine is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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