Gray Matter Volumes in Obsessive-Compulsive Disorder Before and After Fluoxetine or Cognitive-Behavior Therapy: A Randomized Clinical Trial

Author(s):Show less -

Hoexter, Marcelo Queiroz ^{[1, 2, 3, 4]} ; de Souza Duran, Fabio Luis ^{[1, 3]} ; D'Alcante, Carina Chaubet ^{[1, 3]} ; Dougherty, Darin Dean ^[4] ; Shavitt, Roseli Gedanke ^{[1, 3]} ; Lopes, Antonio Carlos ^{[1, 3]} ; Diniz, Juliana Belo ^{[1, 3]} ; Deckersbach, Thilo ^[4] ; Batistuzzo, Marcelo Camargo ^{[1, 3]} ; Bressan, Rodrigo Affonseca ^[2] ; Miguel, Euripedes Constantino ^{[1, 3]} ; Busatto, Geraldo Filho ^{[1, 3]}

Affiliation

^[1] Univ Sao Paulo, Sch Med, Inst Psychiat, Sao Paulo - Brazil

^[2] Univ Fed Sao Paulo UNIFESP, Dept Psychiat, Interdisciplinary Lab Clin Neurosci LiNC, Sao Paulo - Brazil

^[3] Univ Sao Paulo, Sch Med, Dept Psychiat, Sao Paulo - Brazil

^[4] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Psychiat, Boston, MA - USA

• Document type: Journal article
• Source: NEUROPSYCHOPHARMACOLOGY; v. 37, n. 3, p. 734-745, 2011.
• Web of Science Citations: 67

Abstract

Serotonin reuptake inhibitors and cognitive-behavior therapy (CBT) are considered first-line treatments for obsessive-compulsive disorder (OCD). However, little is known about their modulatory effects on regional brain morphology in OCD patients. We sought to document structural brain abnormalities in treatment-naive OCD patients and to determine the effects of pharmacological and cognitive-behavioral treatments on regional brain volumes. Treatment-naive patients with OCD (n = 38) underwent structural magnetic resonance imaging scan before and after a 12-week randomized clinical trial with either fluoxetine or group CBT. Matched-healthy controls (n = 36) were also scanned at baseline. Voxel-based morphometry was used to compare regional gray matter (GM) volumes of regions of interest (ROIs) placed in the orbitofrontal, anterior cingulate and temporolimbic cortices, striatum, and thalamus. Treatment-naive OCD patients presented smaller GM volume in the left putamen, bilateral medial orbitofrontal, and left anterior cingulate cortices than did controls (p<0.05, corrected for multiple comparisons). After treatment with either fluoxetine or CBT (n = 26), GM volume abnormalities in the left putamen were no longer detectable relative to controls. ROI-based within-group comparisons revealed that GM volume in the left putamen significantly increased (p<0.012) in fluoxetine-treated patients (n = 13), whereas no significant GM volume changes were observed in CBT-treated patients (n = 13). This study supports the involvement of orbitofronto/cingulo-striatal loops in the pathophysiology of OCD and suggests that fluoxetine and CBT may have distinct neurobiological mechanisms of action. Neuropsychopharmacology (2012) 37, 734-745; doi: 10.1038/npp.2011.250; published online 26 October 2011 (AU)

• FAPESP's process: 05/55628-8 - Phenotypic, genetic, immunological and neurobiological characterization of the obsessive compulsive disorder and its implications for treatment
• Grantee: Eurípedes Constantino Miguel Filho
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 08/10257-0 - Ventral striatal/ventral capsular Gamma capsulotomy for obsessive-compulsive disorder: a randomized controlled trial
• Grantee: Antonio Carlos Lopes
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• FAPESP's process: 06/50273-0 - Pharmacological augmentation strategies in treatment of resistant obsessive-compulsive disorder: a double-blind placebo-controlled trial
• Grantee: Juliana Belo Diniz
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)