title: Increased orbital frontal gray matter volume after cognitive behavioural therapy in paediatric obsessive compulsive disorder.
abstract: OBJECTIVE
  Identify differences in regional brain volume between medication-free pediatric OCD patients and controls and examine changes after cognitive behavioural therapy.
  
  
  METHODS
  We assessed 29 medication-free paediatric OCD patients (Age: M = 13.78 years; SD = 2.58; range 8.2-19.0) and 29 controls, matched on age and gender, with T1-weighted MR scans in a repeated measures, pre-post treatment design. Voxel based morphometry (VBM) following diffeomorphic anatomical registration through exponential lie algebra (DARTEL) was used to test voxel-wise for the effects of diagnosis and treatment on regional gray matter (GM) and white matter (WM) volumes.
  
  
  RESULTS
  After cognitive behavioural therapy, orbitofrontal GM and capsula externa WM increased in paediatric OCD relative to controls. In patients, changes in symptom severity (delta CY-BOCS) correlated positively with GM volume in the orbitofrontal cortex after treatment. Furthermore, before treatment, paediatric OCD patients, compared to the controls, showed larger GM volume in left frontal pole and left parietal cortex and larger WM volume in cingulum and corpus callosum.
  
  
  CONCLUSIONS
  Our findings underscore the involvement of the ventral frontal-striatal circuit in paediatric OCD and the plasticity of this circuit in response to the modulatory effects of CBT. The possible relation to brain development is discussed.
authors: Department of Child and Adolescent Psychiatry, University of Amsterdam , AMC, Amsterdam , The Netherlands. c.huyser@debascule.com
authors: Chaim
authors: C
authors: Huyser
authors: Odile A
authors: OA
authors: van den Heuvel
authors: Lidewij H
authors: LH
authors: Wolters
authors: Else
authors: E
authors: de Haan
authors: Frits
authors: F
authors: Boer
authors: Dick J
authors: DJ
authors: Veltman
mesh_terms: D000293:Adolescent; D001921:Brain / Q000473:pathology; D016022:Case-Control Studies; D002648:Child; D015928:Cognitive Behavioral Therapy; D005260:Female; D005625:Frontal Lobe / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D036421:Nerve Fibers, Unmyelinated / Q000473:pathology*; D009434:Neural Pathways / Q000473:pathology*; D009771:Obsessive-Compulsive Disorder / Q000473:pathology / Q000628:therapy*; D009929:Organ Size; D055815:Young Adult