Right Prefrontal Cortical Thickness Is Associated With Response to Cognitive-Behavioral Therapy in Children With Obsessive-Compulsive Disorder.

Journal: Journal of the American Academy of Child and Adolescent Psychiatry

Volume: 62

Issue: 4

Year of Publication: 2023

Affiliated Institutions:  Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain; CIBERSAM, Barcelona, Spain. Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain; CIBERSAM, Barcelona, Spain; University of Barcelona, Barcelona, Spain. Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain; University of Barcelona, Barcelona, Spain. Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain; University of Barcelona, Barcelona, Spain; CIBERobn, ISCIII, Spain. McLean Hospital, Belmont, Massachusetts; Harvard Medical School, Boston, Massachusetts. CIBERSAM, Barcelona, Spain; University of Barcelona, Barcelona, Spain; Image Diagnostic Center, Hospital Clinic, Barcelona, Spain; Magnetic Resonance Image Core Facility (IDIBAPS), Barcelona, Spain. Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil; Pontificial Catholic University of Sao Paulo, Brazil. Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands. University of California Los Angeles, Los Angeles, California; University of Toronto, Canada; Centre for Addiction and Mental Health, Toronto, Canada; Karolinksa Institutet, Stockholm, Sweden. Columbia University, New York; The New York State Psychiatric Institute, New York. Columbia University Medical College, Columbia University, New York. Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway; Centre for Crisis Psychology, University of Bergen, Bergen, Norway. Research Center for Child Mental Development, Chiba University, Chiba, Japan; United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan. Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil; LiNC - Laboratory of Integrative Neuroscience of Universidade Federal de São Paulo (UNIFESP), Brazil. Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands; Amsterdam UMC, Amsterdam, the Netherlands. Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, California. University of British Columbia, Vancouver, Canada; British Columbia Children's Hospital Research Institute, Vancouver, Canada. Research Center for Child Mental Development, Chiba University, Chiba, Japan. Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway; University of Bergen, Bergen, Norway. CIBERSAM, Barcelona, Spain; University of Barcelona, Barcelona, Spain; IDIBAPS, Barcelona, Spain; Hospital Clínic, Barcelona, Spain. Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal; ICVS/B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal. The New York State Psychiatric Institute, New York; Columbia University Medical College, Columbia University, New York. University of Michigan, Ann Arbor. University of California Los Angeles, Los Angeles, California. UCLA Division of Child and Adolescent Psychiatry, Los Angeles, California; UCLA Brain Research Institute, Los Angeles, California. IDIBAPS, Barcelona, Spain; Hospital Clínic, Barcelona, Spain. University of Illinois at Urbana Champaign, Champaign, Illinois. UCLA Division of Child and Adolescent Psychiatry, Los Angeles, California; UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California. Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil. University of British Columbia, Vancouver, Canada; British Columbia Children's Hospital Research Institute, Vancouver, Canada; British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, Canada. University Hospital of Psychiatry Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland. Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands. Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands. SAMRC Unit on Risk and Resilience in Mental Disorders, Neuroscience Institute, University of Cape Town, Cape Town, South Africa. Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain; CIBERSAM, Barcelona, Spain; University of Barcelona, Barcelona, Spain. Electronic address: csoriano@idibell.cat.

Abstract summary 

Cognitive-behavioral therapy (CBT) is considered a first-line treatment for obsessive-compulsive disorder (OCD) in pediatric and adult populations. Nevertheless, some patients show partial or null response. The identification of predictors of CBT response may improve clinical management of patients with OCD. Here, we aimed to identify structural magnetic resonance imaging (MRI) predictors of CBT response in 2 large series of children and adults with OCD from the worldwide ENIGMA-OCD consortium.Data from 16 datasets from 13 international sites were included in the study. We assessed which variations in baseline cortical thickness, cortical surface area, and subcortical volume predicted response to CBT (percentage of baseline to post-treatment symptom reduction) in 2 samples totaling 168 children and adolescents (age range 5-17.5 years) and 318 adult patients (age range 18-63 years) with OCD. Mixed linear models with random intercept were used to account for potential cross-site differences in imaging values.Significant results were observed exclusively in the pediatric sample. Right prefrontal cortex thickness was positively associated with the percentage of CBT response. In a post hoc analysis, we observed that the specific changes accounting for this relationship were a higher thickness of the frontal pole and the rostral middle frontal gyrus. We observed no significant effects of age, sex, or medication on our findings.Higher cortical thickness in specific right prefrontal cortex regions may be important for CBT response in children with OCD. Our findings suggest that the right prefrontal cortex plays a relevant role in the mechanisms of action of CBT in children.

Authors & Co-authors:  Bertolín Sara S Alonso Pino P Martínez-Zalacaín Ignacio I Menchón Jose M JM Jimenez-Murcia Susana S Baker Justin T JT Bargalló Nuria N Batistuzzo Marcelo Camargo MC Boedhoe Premika S W PSW Brennan Brian P BP Feusner Jamie D JD Fitzgerald Kate D KD Fontaine Martine M Hansen Bjarne B Hirano Yoshiyuki Y Hoexter Marcelo Q MQ Huyser Chaim C Jahanshad Neda N Jaspers-Fayer Fern F Kuno Masaru M Kvale Gerd G Lazaro Luisa L Machado-Sousa Mafalda M Marsh Rachel R Morgado Pedro P Nakagawa Akiko A Norman Luke L Nurmi Erika L EL O'Neill Joseph J Ortiz Ana E AE Perriello Chris C Piacentini John J Picó-Pérez Maria M Shavitt Roseli G RG Shimizu Eiji E Simpson Helen Blair HB Stewart S Evelyn SE Thomopoulos Sophia I SI Thorsen Anders Lillevik AL Walitza Susanne S Wolters Lidewij H LH Thompson Paul M PM van den Heuvel Odile A OA Stein Dan J DJ Soriano-Mas Carles C

Study Outcome 

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Statistics
Citations :  Ruscio A, Stein D, Chiu W, Kessler R. The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry [Internet]. 2010;15(1):53–63. 10.1038/mp.2008.94
Authors :  46
Identifiers
Doi : 10.1016/j.jaac.2022.07.865
SSN : 1527-5418
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
anxiety disorders;cognitive-behavioral therapy;magnetic resonance imaging;neuroimaging;obsessive-compulsive disorder
Study Design
Cross Sectional Study
Study Approach
Mixed Methods
Country of Study
Publication Country
United States