Resting-state connectivity of the amygdala predicts response to cognitive behavioral therapy in obsessive compulsive disorder
Resting-state connectivity of the amygdala predicts response to cognitive behavioral therapy in obsessive compulsive disorder
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DOI：
10.1016/j.biopsycho.2015.09.004
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发表时间：
2015-10-01
影响因子：
2.6
通讯作者：
Zurowski, Bartosz
中科院分区：
文献类型：
--
作者：
Goettlich, Martin;Kraemer, Ulrike M.;Zurowski, Bartosz
背景资料：强迫症（OCD）是一种以反复出现的侵入性想法（强迫）和仪式化的重复行为或精神行为（强迫）为特征的精神障碍。治疗强迫症的金标准是认知行为疗法（CBT）与暴露和反应预防。这是第一个研究探索的预测价值的休息状态功能连接的CBT.Methods的结果：我们评估了全脑休息状态功能连接在一组17个未用药的强迫症住院患者CBT前相比，19个健康对照使用功能磁共振成像。图论度量度中心性作为改变的体素全脑功能连接的指标。耶鲁-布朗强迫量表（YBOCS）评分的相对变化被用来评估治疗outcome.Results：杏仁核的右基底外侧核群的程度中心性与随后的CBT的反应呈正相关。强迫症患者表现出较低程度的集中性的浅杏仁核（双边）。结论：我们的研究结果表明，两个不同的子区域的杏仁核和他们各自的神经网络受到影响，在强迫症：浅杏仁核和网络相关的评估的冒险者和风险预期和基底外侧杏仁核，这是牵连在恐惧处理。在基底外侧杏仁核中心性较低的患者中，CBT反应减弱反映了这些患者的恐惧回路不足，这可能会影响恐惧消退作为基于恐惧的CBT的核心机制。(C)2015爱思唯尔B. V.保留所有权利。
Background: Obsessive-compulsive disorder ( OCD) is a psychiatric disorder which is characterized by recurrent intrusive thoughts (obsessions) and ritualized, repetitive behaviors or mental acts (compulsions). The gold standard for the treatment of OCD is cognitive behavioral therapy (CBT) with exposure and response prevention. This is the first study exploring the predictive value of resting-state functional connectivity for the outcome of CBT.Methods: We assessed whole-brain resting-state functional connectivity in a group of 17 un-medicated OCD inpatients prior to CBT compared to 19 healthy controls using functional magnetic resonance imaging. The graph theoretical metric degree centrality served as indicator for altered voxel-wise whole-brain functional connectivity. The relative change in the Yale-Brown Obsessive Compulsive Scale (YBOCS) score was used to evaluate treatment outcome.Results: The degree centrality of the right basolateral nuclei group of the amygdala was positively correlated with the response to subsequent CBT. OCD patients showed a lower degree centrality of the superficial amygdala (bilateral).Conclusions: Our results suggest that two different sub-regions of the amygdala and their respective neural networks are affected in OCD: the superficial amygdala and networks related to evaluation of reinforcers and risk anticipation and the basolateral amygdala which is implicated in fear processing. The diminished CBT response in patients showing a lower degree centrality of the basolateral amygdala reflects a deficient fear circuit in these patients which may impact fear extinction as a core mechanism of exposure-based CBT. (C) 2015 Elsevier B.V. All rights reserved.