Resting-State Connectivity and Response to Psychotherapy Treatment in Adolescents and Adults With OCD: A Randomized Clinical Trial

Block, Stefanie Russman; Norman, Luke; Zhang, Xiaoxi; Mannella, Kristin A.; Yang, Huan; Angstadt, Mike; Abelson, James L.; Himle, Joseph A.; Taylor, Stephan F.; Fitzgerald, Kate D.

doi:10.1176/appi.ajp.21111173

Cited by 13 publications

(4 citation statements)

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“…We identified 30 unique studies that met PICO criteria. These studies comprised 35 comparisons and 2,057 children and adolescents with OCD randomized to one of eight conditions: in‐person CBT (20 comparisons; Asbahr et al., 2005; Aspvall et al., 2021; Barrett, Healy‐Farrell, & March, 2004; Bolton et al., 2011; Bolton & Perrin, 2008; de Haan, Hoogduin, Buitelaar, & Keijsers, 1998; Fatori et al., 2018; Freeman et al., 2008, 2014; Himle et al., 2003; Lewin et al., 2014; O'Neill et al., 2017; Piacentini et al., 2011; POTS, 2004; Russman Block et al., 2023; Storch et al., 2013; Williams et al., 2010), SRIs (14 comparisons; DeVeaugh‐Geiss et al., 1992; Geller et al., 2001, 2004; Liebowitz et al., 2002; March et al., 1998; March, Johnston, Jefferson, Kobak, & Greist, 1990; POTS, 2004; Riddle et al., 1992, 2001), in‐person CBT + SRIs (five comparisons; POTS, 2004; Storch et al., 2013) CBT delivered via webcam/telephone (four comparisons; Comer et al., 2017; Hollmann et al., 2022; Storch et al., 2011; Turner et al., 2014), ICBT (two comparisons; Aspvall et al., 2021; Lenhard et al., 2017), pill placebo (nine comparisons; DeVeaugh‐Geiss et al., 1992; Geller et al., 2001, 2004; Liebowitz et al., 2002; March et al., 1990, 1998; POTS, 2004; Riddle et al., 1992, 2001), relaxation training (five comparisons; Freeman et al., 2008, 2014; Himle et al., 2003; Piacentini et al., 2011; Russman Block et al., 2023), and waitlist (eight comparisons; Barrett et al., 2004; Bolton et al., …”

Section: Resultsmentioning

confidence: 99%

Efficacy and acceptability of cognitive‐behavioral therapy and serotonin reuptake inhibitors for pediatric obsessive‐compulsive disorder: a network meta‐analysis

Cervin,

McGuire,

D'Souza

et al. 2024

Child Psychology Psychiatry

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BackgroundCognitive‐behavioral therapy (CBT) and serotonin reuptake inhibitors (SRIs) are recommended treatments for pediatric obsessive‐compulsive disorder (OCD), but their relative efficacy and acceptability have not been comprehensively examined. Further, it remains unclear whether the efficacy of in‐person CBT is conserved when delivered in other formats, such as over telephone/webcam or as Internet‐delivered CBT (ICBT).MethodsPubMed, PsycINFO, trial registries, and previous systematic reviews were searched for randomized controlled trials (RCTs) comparing CBT (in‐person, webcam/telephone‐delivered, or ICBT) or SRIs with control conditions or each other. Network meta‐analyses were conducted to examine efficacy (post‐treatment Children's Yale‐Brown Obsessive Compulsive Scale) and acceptability (treatment discontinuation). Confidence in effect estimates was evaluated with CINeMA (Confidence in Network Meta‐Analysis).ResultsThirty eligible RCTs and 35 contrasts comprising 2,057 youth with OCD were identified. In‐person CBT was significantly more efficacious than ICBT, waitlist, relaxation training, and pill placebo (MD range: 3.95–11.10; CINeMA estimate of confidence: moderate) but did not differ significantly from CBT delivered via webcam/telephone (MD: 0.85 [−2.51, 4.21]; moderate), SRIs (MD: 3.07 [−0.07, 6.20]; low), or the combination of in‐person CBT and SRIs (MD: −1.20 [−5.29, 2.91]; low). SRIs were significantly more efficacious than pill placebo (MD: 4.59 [2.70, 6.48]; low) and waitlist (MD: 8.03 [4.24, 11.82]; moderate). No significant differences for acceptability emerged, but confidence in estimates was low.ConclusionsIn‐person CBT and SRIs produce clear benefits compared to waitlist and pill placebo and should be integral parts of the clinical management of pediatric OCD, with in‐person CBT overall having a stronger evidence base. The combination of in‐person CBT and SRIs may be most efficacious, but few studies hinder firm conclusions. The efficacy of CBT appears conserved when delivered via webcam/telephone, while more trials evaluating ICBT are needed.

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Section: Resultsmentioning

confidence: 99%

Efficacy and acceptability of cognitive‐behavioral therapy and serotonin reuptake inhibitors for pediatric obsessive‐compulsive disorder: a network meta‐analysis

Cervin,

McGuire,

D'Souza

et al. 2024

Child Psychology Psychiatry

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“…In other psychiatric disorders, mega-analyses using a large amount of rsfMRI data have been conducted (20,21). Many studies have focused on resting-state functional connectivity and reported abnormalities that may lead to the discovery of biomarkers related to psychiatric disorders (21)(22)(23)(24)(25). Up to date, there is only one study focusing rsfMRI in HD, and that study using independent component analysis (ICA) (26).…”

Section: Introductionmentioning

confidence: 99%

Reduced resting-state functional connectivity between insula and inferior frontal gyrus and superior temporal gyrus in hoarding disorder

Kato,

Tomiyama,

Murayama

et al. 2024

Front. Psychiatry

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BackgroundHoarding disorder (HD) is characterized by cognitive control impairments and abnormal brain activity in the insula and anterior cingulate cortex (ACC) during disposal of personal items or certain executive function tasks. However, whether there are any changes in resting-state functional connectivity of the insula and ACC remains unclear.MethodsA total of 55 subjects, including 24 patients with HD and 31 healthy controls (HCs), participated in the study. We acquired resting-state functional magnetic resonance imaging data and examined group differences in functional connectivity from the insula and ACC in whole-brain voxels.ResultsIn patients with HD, functional connectivity was significantly lower between the right insula and right inferior frontal gyrus (IFG) and left superior temporal gyrus (STG) compared to HCs. There was no correlation between these connectivities and HD symptoms.ConclusionsAlthough the clinical implication is uncertain, our results suggest that patients with HD have resting-state functional alterations between the insula and IFG and STG, corresponding with the results of previous fMRI studies. These findings provide new insight into the neurobiological basis of HD.

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“…Given that voluntary tic suppression and CBIT may share some common underpinnings, we wanted to assess whether functional connectivity in this network was associated with CBIT outcome. In treatments across several neurodevelopmental and mental health conditions, functional connectivity in networks that are associated with specific mechanisms relevant for that condition or treatment was found to either predict treatment outcome (Baumel et al, 2022; Cyr et al, 2020; Russman Block et al, 2022) or change after treatment (Baumel et al, 2022; Izadi-Najafabadi, Rinat, & Zwicker, 2022; Venkataraman et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Functional connectivity during tic suppression predicts reductions in vocal tics following behavior therapy in children with Tourette syndrome

et al. 2023

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Background Comprehensive Behavioral Intervention for Tics (CBIT) is recommended as a first-line treatment for Tourette syndrome in children and adults. While there is strong evidence proving its efficacy, the mechanisms of reduction in tic severity during CBIT are still poorly understood. In a recent study, our group identified a functional brain network involved in tic suppression in children with TS. We reasoned that voluntary tic suppression and CBIT may share some mechanisms and thus we wanted to assess whether functional connectivity during tic suppression was associated with CBIT outcome. Methods Thirty-two children with TS, aged 8 to 13 years old, participated in a randomized controlled trial of CBIT v. a treatment-as-usual control condition. EEG was recorded during tic suppression in all participants at baseline and endpoint. We used a source-reconstructed EEG connectivity pipeline to assess functional connectivity during tic suppression. Results Functional connectivity during tic suppression did not change from baseline to endpoint. However, baseline tic suppression-related functional connectivity specifically predicted the decrease in vocal tic severity from baseline to endpoint in the CBIT group. Supplementary analyses revealed that the functional connectivity between the right superior frontal gyrus and the right angular gyrus was mainly driving this effect. Conclusions This study revealed that functional connectivity during tic suppression at baseline predicted reduction in vocal tic severity. These results suggest probable overlap between the mechanisms of voluntary tic suppression and those of behavior therapy for tics.

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Resting-State Connectivity and Response to Psychotherapy Treatment in Adolescents and Adults With OCD: A Randomized Clinical Trial

Cited by 13 publications

References 47 publications

Efficacy and acceptability of cognitive‐behavioral therapy and serotonin reuptake inhibitors for pediatric obsessive‐compulsive disorder: a network meta‐analysis

Efficacy and acceptability of cognitive‐behavioral therapy and serotonin reuptake inhibitors for pediatric obsessive‐compulsive disorder: a network meta‐analysis

Reduced resting-state functional connectivity between insula and inferior frontal gyrus and superior temporal gyrus in hoarding disorder

Functional connectivity during tic suppression predicts reductions in vocal tics following behavior therapy in children with Tourette syndrome

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