The effects of cognitive behavioral therapy on resting-state functional brain network in drug-naive patients with obsessive-compulsive disorder


Ping Li, Xiangyun Yang, Andrew J. Greenshaw, Sufang Li, Jia Luo, Haiying Han, Jing Liu, Zhaoxi Zhong, Zhihua Guo, Hongfang Xiong, Shumin Yao, Yunhui Chen, Jing Sun, and Zhanjiang Li

Posted on April 16, 2018 in Brain and Behavior volume 8, issue 5;



Introduction

This article is the first study to investigate the effect of CBT on intrinsic functional network hubs and whole-brain connections in patients with OCD at resting-state, who are not receiving pharmacotherapy and do not suffer from comorbidities.


Main part

Twenty OCD patients with no underlying medical conditions were recruited. Patients did not receive pharmacotherapy for 12 weeks before and after CBT treatment. Resting functional magnetic resonance imaging was performed. A graph-theory approach and a functional connectivity method were used to analyze the state of the entire brain functional network and connectivity changes in patients with OCD before and after CBT treatment. Analysis of the state of the functional brain network revealed significant group and temporal interactions in the left dorsolateral prefrontal cortex in patients with OCD before CBT, which was significantly reduced after the course of cognitive-behavioral therapy. Resting-state functional connectivity between the left dorsolateral prefrontal cortex and right orbitofrontal cortex was increased in the OCD patients at baseline, and normalized after CBT treatment. Resting state functional connectivity changes between the left dorsolateral prefrontal cortex and default mode network (DMN) positively correlated with changes in clinical symptoms in OCD patients.


Conclusion

These findings suggest that CBT may modulate changes in intrinsic functional network hubs in the cortico-striato-thalamo-cortical circuit in OCD patients. The cognitive control network and default mode network (DMN) connectivity may be a potential imaging biomarker for evaluating CBT treatment for OCD.