Effects of short‐term cognitive‐coping therapy on resting‐state brain function in obsessive‐compulsive disorder

Abstract

Background Obsessive‐compulsive disorder (OCD) tends to be treatment refractory. Recently, cognitive‐coping therapy (CCT) for OCD is reported to be an efficacious psychotherapy. However, the underlying neurophysiological mechanism remains unknown. Here, the effects of CCT on OCD and the resting‐state brain function were investigated. Methods Fifty‐nine OCD patients underwent CCT, pharmacotherapy plus CCT (pCCT), or pharmacotherapy. Before and after a 4‐week treatment, Yale‐Brown obsessive‐compulsive scale (Y‐BOCS) was evaluated and resting‐state functional magnetic resonance imaging (rs‐fMRI) was scanned. Results Compared with the baseline, significant reduction of Y‐BOCS scores was found after four‐week treatment (p < .001) in groups of CCT and pCCT, not in pharmacotherapy. Post‐treatment Y‐BOCS scores of CCT group and pCCT group were not different, but significantly lower than that of pharmacotherapy group (p < .001). Compared with pretreatment, two clusters of brain regions with significant change in amplitude of low‐frequency fluctuation (ALFF) were obtained in those who treated with CCT and pCCT, but not in those who received pharmacotherapy. The ALFF in cluster 1 (insula, putamen, and postcentral gyrus in left cerebrum) was decreased, while the ALFF in cluster 2 (occipital medial gyrus, occipital inferior gyrus, and lingual gyrus in right hemisphere) was increased after treatment (corrected p < .05). The changes of ALFF were correlated with the reduction of Y‐BOCS score and were greater in remission than in nonremission. The reduction of the fear of negative events was correlated to the changes of ALFF of clusters and the reduction of Y‐BOCS score. Conclusions The effectiveness of CCT for OCD was related to the alteration of resting‐state brain function—the brain plasticity. Trial Registration ChiCTR‐IPC‐15005969.

Abnormal resting-state functional connectivity of the insula in medication-free patients with obsessive-compulsive disorder

“…In previous rs-fMRI studies, researchers observed a lower centrality degree of the lingual gyrus [56,57], and the ALFF values were found to be increased in the insular cortex but decreased in the lingual gyrus of OCD patients, which was associated with symptom severity [41,58]. These abnormal local activity patterns could be normalized by coping through cognitive therapy [59]. Interestingly, we further observed that there was a trend of correlation between the reduced intrinsic connectivity of the right insula and lingual gyrus and the enhanced severity of depressive symptoms rather than OCD-related symptoms in the OCD group.…”

“…In previous rs-fMRI studies, researchers observed a lower centrality degree of the lingual gyrus [ 56 , 57 ], and the ALFF values were found to be increased in the insular cortex but decreased in the lingual gyrus of OCD patients, which was associated with symptom severity [ 41 , 58 ]. These abnormal local activity patterns could be normalized by coping through cognitive therapy [ 59 ].…”

Right-deviating prismatic adaptation reduces obsessions in a community sample

“…An increment of the resting motor threshold of the right hemisphere after repetitive transcranial magnetic stimulation (rTMS) treatment was associated with a reduction of OC symptoms ( Mantovani et al, 2006 ). Ma et al (2021) scanned OC disorder patients with resting-state functional magnetic resonance (rs-fMRI) before and after cognitive-coping therapy. The increase of resting state activity (i.e., spontaneous neural activity) in the right hemisphere after cognitive-coping therapy was associated with the reduction of OC symptoms severity.…”

Autobiographical Cerebral Network Activation in Older Adults Before and After Reminiscence Therapy: A Preliminary Report

“…To date, most studies of RT in older adults have not been conducted in healthy older adults, but rather focused on those with anxiety disorders, obsessive-compulsive disorder (Ma et al, 2021; Schiepek et al, 2013), post-traumatic stress disorder (Beauregard, 2014; Karlsson, 2011), or major depression (Won Jeon & Kim, 2015; Wu et al, 2020; Dichter et al, 2010). From this prior work, we would hypothesize that RT will be associated with improved well-being, as well as decreased depression and anxiety scores.…”