Changes after behavior therapy among responsive and nonresponsive patients with obsessive-compulsive disorder.
Neuroimaging studies have suggested that behavior therapy (BT) might change abnormal activity in the frontal-subcortical circuits of the brain in patients with obsessive-compulsive disorder (OCD). However, the results of these studies have been rather inconsistent. The aim of the present study was to use statistical parametric mapping (SPM) analysis to explore the effects of successful BT on regional cerebral blood flow (rCBF) in patients with OCD. Forty-five OCD patients who were treatment-resistant to a single serotonin reuptake inhibitor (SRI) trial were examined. Single photon emission computed tomography (SPECT) using 99mTc-ECD was performed before and after the completion of 12 weeks of BT. Although no significant differences in pre-treatment rCBF were observed between responders and nonresponders to BT, the post-treatment rCBF values in the left medial prefrontal cortex (Brodmann area 10) and bilateral middle frontal gyri (Brodmann area 10) were significantly lower in the responders than in the nonresponders. Furthermore, the baseline rCBF in the bilateral orbitofrontal cortex (OFC) was significantly correlated with the change in the Y-BOCS score among the responders. Our results support the hypothesis that while the OFC may be associated with the BT response, BT may result in changes in rCBF in the medial and middle frontal cortex.
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Japan.
Tomoaki
T
Yamanishi
Shutaro
S
Nakaaki
Ichiro M
IM
Omori
Nobuhiko
N
Hashimoto
Yoshihiro
Y
Shinagawa
Jin
J
Hongo
Masaru
M
Horikoshi
Junko
J
Tohyama
Tatsuo
T
Akechi
Tsutomu
T
Soma
Tetsuya
T
Iidaka
Toshi A
TA
Furukawa
D000328:Adult; D001521:Behavior Therapy; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging*; D003545:Cysteine / Q000031:analogs & derivatives; D005260:Female; D005625:Frontal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D015609:Organotechnetium Compounds; D017397:Prefrontal Cortex / Q000098:blood supply / Q000000981:diagnostic imaging; D011569:Psychiatric Status Rating Scales; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
D015609:Organotechnetium Compounds; C059659:technetium Tc 99m bicisate; D003545:Cysteine