title: Caudate glucose metabolic rate changes with both drug and behavior therapy for obsessive-compulsive disorder.
abstract: We used positron emission tomography to investigate local cerebral metabolic rates for glucose (LCMRG1c) in patients with obsessive-compulsive disorder before and after treatment with either fluoxetine hydrochloride or behavior therapy. After treatment, LCMRG1c in the head of the right caudate nucleus, divided by that in the ipsilateral hemisphere (Cd/hem), was decreased significantly compared with pretreatment values in responders to both drug and behavior therapy. These decreases in responders were also significantly greater than right Cd/hem changes in nonresponders and normal controls, in both of whom values did not change from baseline. Percentage change in obsessive-compulsive disorder symptom ratings correlated significantly with the percent of right Cd/hem change with drug therapy and there was a trend to significance for this same correlation with behavior therapy. By lumping all responders to either treatment, right orbital cortex/hem was significantly correlated with ipsilateral Cd/hem and thalamus/hem before treatment but not after, and the differences before and after treatment were significant. A similar pattern was noted in the left hemisphere. A brain circuit involving these brain regions may mediate obsessive-compulsive disorder symptoms.
authors.affiliation: Department of Psychiatry, UCLA School of Medicine.
authors.forename: L R
authors.initials: LR
authors.lastname: Baxter
authors.forename: J M
authors.initials: JM
authors.lastname: Schwartz
authors.forename: K S
authors.initials: KS
authors.lastname: Bergman
authors.forename: M P
authors.initials: MP
authors.lastname: Szuba
authors.forename: B H
authors.initials: BH
authors.lastname: Guze
authors.forename: J C
authors.initials: JC
authors.lastname: Mazziotta
authors.forename: A
authors.initials: A
authors.lastname: Alazraki
authors.forename: C E
authors.initials: CE
authors.lastname: Selin
authors.forename: H K
authors.initials: HK
authors.lastname: Ferng
authors.forename: P
authors.initials: P
authors.lastname: Munford
mesh_terms: D000328:Adult; D001521:Behavior Therapy; D002421:Caudate Nucleus / Q000378:metabolism*; D002540:Cerebral Cortex / Q000378:metabolism; D003847:Deoxyglucose / Q000031:analogs & derivatives / Q000378:metabolism; D005260:Female; D019788:Fluorodeoxyglucose F18; D005473:Fluoxetine / Q000627:therapeutic use*; D007839:Functional Laterality; D005947:Glucose / Q000378:metabolism*; D006179:Gyrus Cinguli / Q000378:metabolism; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy / Q000378:metabolism* / Q000628:therapy; D013788:Thalamus / Q000378:metabolism; D014055:Tomography, Emission-Computed
chemical_list: D005473:Fluoxetine; D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose; D005947:Glucose