Related Experiment Video

Updated: Aug 17, 2025

Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging
09:14

Exploring the Neural Correlates of Cognitive Reappraisal in Obsessive-Compulsive Disorder Using Task-based Functional Magnetic Resonance Imaging

Published on: March 14, 2025

301

Right Prefrontal Cortical Thickness Is Associated With Response to Cognitive-Behavioral Therapy in Children With

Sara Bertolín1, Pino Alonso2, Ignacio Martínez-Zalacaín3

  • 1Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain; CIBERSAM, Barcelona, Spain.

Journal of the American Academy of Child and Adolescent Psychiatry
|December 16, 2022
PubMed

Insights

Cognitive-behavioral therapy (CBT) response in pediatric obsessive-compulsive disorder (OCD) is predicted by right prefrontal cortex thickness. Thicker frontal pole and rostral middle frontal gyrus are associated with better CBT outcomes in children with OCD.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Radiology

Background:

  • Cognitive-behavioral therapy (CBT) is a primary treatment for obsessive-compulsive disorder (OCD).
  • Some patients exhibit limited or no response to CBT.
  • Identifying predictors of CBT response is crucial for optimizing OCD treatment.

Purpose of the Study:

  • To identify structural magnetic resonance imaging (MRI) predictors of CBT response in pediatric and adult OCD patients.
  • To analyze baseline cortical thickness, surface area, and subcortical volumes as potential predictors.
  • To leverage data from the ENIGMA-OCD consortium for robust findings.

Main Methods:

  • Utilized data from 16 datasets across 13 international sites.
  • Assessed 168 children/adolescents and 318 adults with OCD.
  • Employed mixed linear models with random intercepts to analyze baseline neuroimaging data and predict CBT response.
  • CBT response was measured as the percentage of symptom reduction.

Main Results:

  • Predictive imaging markers were found exclusively in the pediatric sample.
  • Increased cortical thickness in the right prefrontal cortex positively correlated with CBT response.
  • Post hoc analysis identified the frontal pole and rostral middle frontal gyrus as key regions.

Conclusions:

  • Higher cortical thickness in specific right prefrontal regions is a significant predictor of CBT response in children with OCD.
  • These findings highlight the role of the right prefrontal cortex in CBT's mechanism of action for pediatric OCD.
  • No significant influence of age, sex, or medication on the observed neuroimaging predictors was detected.
Abstract

Keywords:
anxiety disorderscognitive-behavioral therapymagnetic resonance imagingneuroimagingobsessive-compulsive disorder

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