title: Functional MRI study of brain activation alterations in patients with obsessive-compulsive disorder after symptom improvement.
abstract: Dysfunction of the frontal-subcortical circuits has been the most common finding in the pathophysiology of obsessive-compulsive disorder (OCD), and recent neuropsychological studies have shown cognitive impairments in OCD. To clarify the pathophysiology of OCD without the confounding effects of medication, we investigated the alterations of brain function in OCD patients and changes after clinical improvement due solely to behavior therapy. The participants were 11 outpatients with OCD and 19 normal controls. The patients received 12 weeks of behavior therapy. We investigated the differences in the behavioral performance and functional magnetic resonance imaging results during the Stroop test in the patients and normal controls, and their changes after treatment in the patients. The patients showed less activation in the anterior cingulate gyrus and cerebellum than control subjects. Following significant improvement in OC symptoms, the cerebellum and parietal lobe showed increased activation, and the orbitofrontal cortex, middle frontal gyrus, and temporal regions showed decreased activation during the Stroop task, and performance of the task itself improved. Our findings suggest that dysfunction of the posterior brain regions, especially the cerebellum, is involved in the pathogenesis of OCD, and that normalization in function can occur with improvement of OC symptoms.
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Maiko
authors.initials: M
authors.lastname: Nabeyama
authors.forename: Akiko
authors.initials: A
authors.lastname: Nakagawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshiura
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nakao
authors.forename: Eriko
authors.initials: E
authors.lastname: Nakatani
authors.forename: Osamu
authors.initials: O
authors.lastname: Togao
authors.forename: Chika
authors.initials: C
authors.lastname: Yoshizato
authors.forename: Kazuko
authors.initials: K
authors.lastname: Yoshioka
authors.forename: Mayumi
authors.initials: M
authors.lastname: Tomita
authors.forename: Shigenobu
authors.initials: S
authors.lastname: Kanba
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods; D001921:Brain / Q000503:physiopathology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy