The thalamus has been implicated in the pathophysiology of obsessive-compulsive disorder. Using a multislice spectroscopic imaging sequence, we reported reductions in right and left medial thalamic N-acetylaspartate/cytosolic choline + creatine/phosphocreatine and N-acetylaspartate/cytosolic choline levels in 11 pediatric patients with obsessive-compulsive disorder, 8 to 15 years, versus 11 case-matched healthy controls. These changes may reflect a change in N-acetylaspartate, cytosolic choline, or creatine concentrations. Therefore, using a validated phantom replacement methodology, we obtained absolute measures (mmol/L) of N-acetylaspartate, a putative marker of neuronal viability, cytosolic choline, and creatine in these subjects. A significant increase in cytosolic choline was observed in right and left medial but not lateral thalami in patients with obsessive-compulsive disorder versus controls. N-acetylaspartate and creatine did not differ significantly between case-control pairs in the medial or lateral thalamus. These findings provide new evidence of cytosolic choline abnormalities in the thalamus in pediatric obsessive-compulsive disorder.
Anxiety disorders frequently co-occur in youth with autism spectrum disorders (ASD). In addition to developing efficacious treatments for anxiety in children with ASD, it is important to examine the transportability of these treatments to real-world settings. Study aims were to: a) train clinicians to deliver Facing Your Fears: Group Therapy for Managing Anxiety in Children with High-Functioning ASD (FYF) to fidelity; and b) examine feasibility of the program for novel settings. A secondary aim was to examine preliminary youth treatment outcome. Results indicated that clinicians obtained excellent fidelity following a workshop and ongoing consultation. Acceptability ratings indicated that FYF was viewed favorably, and critiques were incorporated into program revisions. Meaningful reductions in anxiety were reported post-treatment for 54% of children. Results support the initial effectiveness and transportability of FYF in new clinical settings.
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