4.5 Article

Basolateral amygdala-ventromedial prefrontal cortex connectivity predicts cognitive behavioural therapy outcome in adults with obsessive-compulsive disorder

Journal

JOURNAL OF PSYCHIATRY & NEUROSCIENCE
Volume 42, Issue 6, Pages 378-385

Publisher

CMA-CANADIAN MEDICAL ASSOC
DOI: 10.1503/jpn.160215

Keywords

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Funding

  1. Instituto de Salud Carlos III (ISCIII) [PI12/01306, PI13/01958, PI14/00413, PI16/00889]
  2. FEDER funds/European Regional Development Fund (ERDF) - a way to build Europe - and AGAUR [2014 SGR 1672]
  3. ISCIII [CM15/00189, JR14/00038, CPII16/00048]
  4. Ministerio de Educacion, - Cultura y Deporte de Espana [FPU12/01636]

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Background: Cognitive behavioural therapy (CBT), including exposure and ritual prevention, is a first-line treatment for obsessive-compulsive disorder (OCD), but few reliable predictors of CBT outcome have been identified. Based on research in animal models, we hypothesized that individual differences in basolateral amygdala-ventromedial prefrontal cortex (BLA-vmPFC) communication would predict CBT outcome in patients with OCD. Methods: We investigated whether BLA-vmPFC resting-state functional connectivity (rs-fc) predicts CBT outcome in patients with OCD. We assessed BLA-vmPFC rs-fc in patients with OCD on a stable dose of a selective serotonin reuptake inhibitor who then received CBT and in healthy control participants. Results: We included 73 patients with OCD and 84 healthy controls in our study. Decreased BLA-vmPFC rs-fc predicted a better CBT outcome in patients with OCD and was also detected in those with OCD compared with healthy participants. Additional analyses revealed that decreased BLA-vmPFC rs-fc uniquely characterized the patients with OCD who responded to CBT. Limitations: We used a sample of convenience, and all patients were receiving pharmacological treatment for OCD. Conclusion: In this large sample of patients with OCD, BLA-vmPFC functional connectivity predicted CBT outcome. These results suggest that future research should investigate the potential of BLA-vmPFC pathways to inform treatment selection for CBT across patients with OCD and anxiety disorders.

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