Decreased left amygdala functional connectivity by cognitive-coping therapy in obsessive-compulsive disorder

Area of Science:

• Neuroscience
• Psychiatry
• Medical Imaging

Background:

• Obsessive-compulsive disorder (OCD) requires more effective treatments.
• Cognitive-coping therapy (CCT) shows promise, but its neurophysiological mechanisms are unclear.
• Understanding these mechanisms is crucial for developing targeted OCD therapies.

Purpose of the Study:

• To investigate the neurophysiological mechanisms of CCT and pharmacotherapy plus CCT (pCCT) in OCD patients.
• To examine changes in amygdala functional connectivity (FC) following treatment.
• To identify potential neuroimaging markers for treatment response and OCD subtypes.

Main Methods:

• Seventy-nine OCD patients underwent resting-state functional magnetic resonance imaging (rs-fMRI) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) assessments.
• Scans and assessments were conducted before and after four weeks of CCT, pCCT, or pharmacotherapy.
• Amygdala seed-based FC analysis was performed to compare treatment groups.

Main Results:

• Both CCT and pCCT significantly reduced Y-BOCS scores.
• pCCT decreased left amygdala (LA) FC with the anterior cingulate gyrus and parietal lobe.
• CCT decreased LA-FC with the occipital and parietal regions.
• Reduced LA-FC correlated positively with Y-BOCS score reduction.

Conclusions:

• Both CCT and pCCT effectively reduce OCD symptoms by altering LA-FC.
• Decreased LA-FC with the anterior cingulate cortex or parietal cortex may indicate pCCT response or distinguish OCD subtypes.
• Reduced LA-FC in the parietal region might be a shared mechanism for both pCCT and CCT.