Treatment-Specific Associations Between Brain Activation and Symptom Reduction in OCD Following CBT: A Randomized fMRI Trial

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

doi:10.1176/appi.ajp.2020.19080886

Cited by 28 publications

(12 citation statements)

References 33 publications

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“…Recent studies using fMRI have built upon this research, filling important gaps in the literature by employing predictive frameworks. For example, in a randomized treatment trial, researchers found that baseline activation in the right temporal lobes and rostral anterior cingulate cortex during cognitive control, and in ventromedial prefrontal, orbitofrontal, lateral prefrontal cortex, and amygdala during reward processing, were associated with better CBT response ( 18 ).…”

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confidence: 99%

“…As such, EEG is sensitive to neural synchronization and periodicity at time-scales commensurate with real-world perceptual and cognitive processing. These oscillatory signals can be quantified in different frequency bands, typically labeled by increasing frequency: delta (0.5-3 Hz), theta (4-7 Hz), alpha (8-12 Hz), beta (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29), and gamma (30-100 Hz). EEG's temporal resolution is excellent, measured in milliseconds-compared to seconds in fMRI studies (20,21).…”

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confidence: 99%

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Electroencephalographic Correlates and Predictors of Treatment Outcome in OCD: A Brief Narrative Review

et al. 2021

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Electroencephalography (EEG) measures the brain's electrical activity with high temporal resolution. In comparison to neuroimaging modalities such as MRI or PET, EEG is relatively cheap, non-invasive, portable, and simple to administer, making it an attractive tool for clinical deployment. Despite this, studies utilizing EEG to investigate obsessive-compulsive disorder (OCD) are relatively sparse. This contrasts with a robust literature using other brain imaging methodologies. The present review examines studies that have used EEG to examine predictors and correlates of response in OCD and draws tentative conclusions that may guide much needed future work. Key findings include a limited literature base; few studies have attempted to predict clinical change from EEG signals, and they are confounded by the effects of both pharmacotherapy and psychotherapy. The most robust literature, consisting of several studies, has examined event-related potentials, including the P300, which several studies have reported to be abnormal at baseline in OCD and to normalize with treatment; but even here the literature is quite heterogeneous, and more work is needed. With more robust research, we suggest that the relatively low cost and convenience of EEG, especially in comparison to fMRI and PET, make it well-suited to the development of feasible personalized treatment algorithms.

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Electroencephalographic Correlates and Predictors of Treatment Outcome in OCD: A Brief Narrative Review

et al. 2021

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“…A recent investigation using whole-brain network-based statistics in unmedicated individuals with OCD found network alterations involving the anterior insula significantly predicted response to exposure therapy ( 171 ). Norman et al ( 172 ) found a trend association between greater baseline anterior insula BOLD activity during cognitive control and better ExRP treatment response. Separately, Nakao et al found that individuals with OCD who showed improvement following either 12 weeks of fluvoxamine or exposure therapy showed increased BOLD activity in the bilateral insula during a Stroop task and reduced activity in the left posterior insula during symptom provocation compared to baseline neural activity ( 173 ).…”

Section: Interoception and Ocd Treatmentmentioning

confidence: 99%

Interoception and Obsessive-Compulsive Disorder: A Review of Current Evidence and Future Directions

et al. 2021

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Disrupted interoceptive processes are present in a range of psychiatric conditions, and there is a small but growing body of research on the role of interoception in obsessive-compulsive disorder (OCD). In this review, we outline dimensions of interoception and review current literature on the processing of internal bodily sensations within OCD. Investigations in OCD utilizing objective measures of interoception are limited and results mixed, however, the subjective experience of internal bodily sensations appears to be atypical and relate to specific patterns of symptom dimensions. Further, neuroimaging investigations suggest that interoception is related to core features of OCD, particularly sensory phenomena and disgust. Interoception is discussed in the context of treatment by presenting an overview of existing interventions and suggesting how modifications aimed at better targeting interoceptive processes could serve to optimize outcomes. Interoception represents a promising direction for multi-method research in OCD, which we expect, will prove useful for improving current interventions and identifying new treatment targets.

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“…16 Restingstate functional connectivity between the basolateral amygdala and the ventromedial prefrontal cortex also predicted treatment outcomes for CBT in OCD. 18,19 However, in these studies, patients with OCD were receiving pharmacological treatment before they underwent CBT, so findings may have been confounded by the influence of medication. Moreover, these studies did not assess changes in brain activity or the functional connectivity of the amygdala after CBT, making it impossible to identify associations between changes in the circuit centred at the amygdala and treatment outcomes for CBT.…”

Section: Introductionmentioning

confidence: 99%

Resting-state functional connectivity of the amygdala subregions in unmedicated patients with obsessive–compulsive disorder before and after cognitive behavioural therapy

Gao

Yang

Chen

et al. 2021

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Treatment-Specific Associations Between Brain Activation and Symptom Reduction in OCD Following CBT: A Randomized fMRI Trial

Cited by 28 publications

References 33 publications

Electroencephalographic Correlates and Predictors of Treatment Outcome in OCD: A Brief Narrative Review

Electroencephalographic Correlates and Predictors of Treatment Outcome in OCD: A Brief Narrative Review

Interoception and Obsessive-Compulsive Disorder: A Review of Current Evidence and Future Directions

Resting-state functional connectivity of the amygdala subregions in unmedicated patients with obsessive–compulsive disorder before and after cognitive behavioural therapy

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