Effects of behavioral therapy or pharmacotherapy on brain glucose metabolism in subjects with obsessive-compulsive disorder as assessed by brain FDG PET.
This prospective study investigated the effect of pharmacotherapy (PT) and cognitive behavioral therapy (CBT) on cerebral glucose metabolism in adults with obsessive-compulsive disorder (OCD). Dynamic positron emission tomography (PET) of the brain with F-18-fluorodeoxyglucose (FDG) was performed before and after treatment in 16 subjects diagnosed for OCD for at least 2 years (PT: n=7). Pre-to-post-treatment change of scaled local metabolic rate of glucose (SLMRGlc) was assessed separately in therapy responders and non-responders. Correlation was tested between SLMRGlc change and change of OCD, depression, or anxiety symptoms. SLMRGlc increased in the right caudate after successful therapy. The increase tended to correlate with the improvement of OCD symptom severity. The finding of increased local caudate activity after successful therapy is in contrast to most previous studies. Possible explanations include effects of therapy on concomitant depression symptoms and/or the large proportion of early-onset OCD in the present sample.
Department of Nuclear Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Ivayla
I
Apostolova
Suzette
S
Block
Ralph
R
Buchert
Bernhard
B
Osen
Miriam
M
Conradi
Susanne
S
Tabrizian
Simon
S
Gensichen
Karin
K
Schröder-Hartwig
Susanne
S
Fricke
Michael
M
Rufer
Angela
A
Weiss
Iver
I
Hand
Malte
M
Clausen
Jost
J
Obrocki
D000328:Adult; D000704:Analysis of Variance; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism; D001931:Brain Mapping; D015928:Cognitive Behavioral Therapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000628:therapy*; D017374:Paroxetine / Q000627:therapeutic use*; D011446:Prospective Studies; D011877:Radionuclide Imaging; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D016896:Treatment Outcome
D019788:Fluorodeoxyglucose F18; D005947:Glucose; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors