Predicting OCD treatment success with brain scans

Chuck Bednar for – @BednarChuck

Researchers from the UCLA Semel Institute for Neuroscience and Human Behavior have found that brain scans could help determine which people suffering from obsessive-compulsive disorder (OCD) could benefit most from cognitive-behavioral therapy.

In research published in the journal Frontiers in Psychiatry, Jamie Feusner, a UCLA associate professor of psychiatry and director of the Semel Institute’s Adult OCD Program, and Joseph O’Neill, an associate professor of child psychiatry and a research scientist at the Semel Institute, explained that details of those scans could predict which patients are at risk of relapsing.

They explained that up to two percent of the US population could at some point suffer from the disorder. OCD is marked by recurrent and intrusive thoughts and/or recurring behaviors that can cause distress to the patient, adversely impact their ability to function in society, and affect their ability to maintain employment.

Cognitive-behavioral therapy, which is designed to help patients understand the thoughts and feelings that influence their behaviors, and ultimately work toward eliminating them, is one of the most common and effective treatments for OCD. However, not all patients can enjoy its long-term benefits, as symptoms return in an estimated one-fifth of them.

Brain connectivity can predict potential for relapse

Feusner, O’Neill, and their colleagues discovered that a specific detail from a patient’s brain scan could help doctors better indentify which individuals are most likely to have a relapse following cognitive-behavioral therapy. The efficiency of brain network connectivity prior to the treatment can predict the worsening of symptoms afterwards.

The researchers used functional magnetic resonance imaging (fMRI) to analyze the brains of 17 OCD patients between the ages of 21 and 50. They took scans both before and immediately after the patients completed an intensive four-week course of cognitive-behavioral therapy. Doctors then monitored the subjects’ clinical symptoms over the course of the next year.

“We found that cognitive-behavioral therapy itself results in more densely connected local brain networks, which likely reflects more efficient brain activity,” Feusner said. They also found that people with more efficient brain connectivity before treatment began did worse in the follow-up period, and that severity of symptoms did not accurately predict post-treatment success.

“Cognitive-behavioral therapy is in many cases very effective, at least in the short term. But it is costly, time-consuming, difficult for patients and, in many areas, not available,” Feusner added. “Thus, if someone will end up having their symptoms return, it would be useful to know before they get treatment,” so that the patients can receive the best possible care available.


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