Right Prefrontal Cortical Thickness is Associated With Response to Cognitive-Behavioral Therapy in Children With Obsessive-Compulsive Disorder.
Right Prefrontal Cortical Thickness is Associated With Response to Cognitive-Behavioral Therapy in Children With Obsessive-Compulsive Disorder.
复制标题
DOI：
10.1016/j.jaac.2022.07.865
复制
发表时间：
2022-12
影响因子：
13.3
通讯作者：
S. Bertolín;P. Alonso;I. Martínez-Zalacaín;J. Menchón;S. Jiménez-Murcia;J. Baker;N. Bargalló;M. Batistuzzo;P. Boedhoe;B. P. Brennan;Jamie D. Feusner;K. Fitzgerald;Martine Fontaine;B. Hansen;Y. Hirano;M. Hoexter;C. Huyser;N. Jahanshad;Fern Jaspers-Fayer;Masaru Kuno;G. Kvale;L. Lázaro;M. Machado-Sousa;R. Marsh;P. Morgado;A. Nakagawa;L. Norman;E. Nurmi;J. O’Neill;A. E. Ortiz;Chris Perriello;J. Piacentini;M. Picó-Pérez;R. Shavitt;E. Shimizu;H. Simpson;S. E. Stewart;S. Thomopoulos;A. Thorsen;L. Wolters;S. Walitza;P. Thompson;O. A. van den Heuvel;D. Stein;C. Soriano-Mas;E. Real;C. Segalàs;A. Morer;S. Brem;S. Ferreira;P. Moreira;Kristen Hagen;Sayo Hamatani;Jumpei Takahashi;Tokiko Yoshida;Maria Alice de Mathis;E. Miguel;J. Pariente;Jinsong Tang
中科院分区：
文献类型：
--
作者：
S. Bertolín;P. Alonso;I. Martínez-Zalacaín;J. Menchón;S. Jiménez-Murcia;J. Baker;N. Bargalló;M. Batistuzzo;P. Boedhoe;B. P. Brennan;Jamie D. Feusner;K. Fitzgerald;Martine Fontaine;B. Hansen;Y. Hirano;M. Hoexter;C. Huyser;N. Jahanshad;Fern Jaspers-Fayer;Masaru Kuno;G. Kvale;L. Lázaro;M. Machado-Sousa;R. Marsh;P. Morgado;A. Nakagawa;L. Norman;E. Nurmi;J. O’Neill;A. E. Ortiz;Chris Perriello;J. Piacentini;M. Picó-Pérez;R. Shavitt;E. Shimizu;H. Simpson;S. E. Stewart;S. Thomopoulos;A. Thorsen;L. Wolters;S. Walitza;P. Thompson;O. A. van den Heuvel;D. Stein;C. Soriano-Mas;E. Real;C. Segalàs;A. Morer;S. Brem;S. Ferreira;P. Moreira;Kristen Hagen;Sayo Hamatani;Jumpei Takahashi;Tokiko Yoshida;Maria Alice de Mathis;E. Miguel;J. Pariente;Jinsong Tang
目的认知行为疗法(CBT)被认为是儿童和成人强迫症(OCD)的一线治疗方法。然而，一些患者表现出部分或无效反应。确定CBT反应的预测因素可能会改善强迫症患者的临床管理。在这里，我们的目标是确定结构磁共振成像(MRI)预测CBT反应的2大系列儿童和成人强迫症来自世界各地的谜-强迫症联盟。方法数据集来自13个国际地点的16个数据集。我们在2个样本中评估了基线皮质厚度、皮质表面积和皮质下体积的变化对CBT(基线与治疗后症状缓解的百分比)的预测作用，共168名儿童和青少年(年龄范围为5-17.5岁)和318名成人患者(年龄范围为18-63岁)。随机截距的混合线性模型被用来解释潜在的跨部位显像值差异。结果仅在儿科样本中观察到显著的结果。右侧前额叶皮质厚度与CBT反应百分率呈正相关。在一项事后分析中，我们观察到导致这种关系的具体变化是额叶极部和吻部额中回的厚度增加。我们没有观察到年龄、性别或药物对我们的发现的显著影响。结论在特定的右侧前额叶皮质区域，较高的皮质厚度可能是强迫症儿童CBT反应的重要因素。我们的发现表明，右侧前额叶皮质在儿童CBT的作用机制中起着相关的作用。
ObjectiveCognitive-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.MethodData 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.ResultsSignificant 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.ConclusionHigher 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.