ORBITOFRONTAL THICKNESS AS A MEASURE FOR TREATMENT RESPONSE PREDICTION IN OBSESSIVE-COMPULSIVE DISORDER

Autor(es):Mostrar menos -

Hoexter, Marcelo Q. ^{[1, 2, 3]} ; Diniz, Juliana B. ^[3] ; Lopes, Antonio C. ^[3] ; Batistuzzo, Marcelo C. ^[3] ; Shavitt, Roseli G. ^[3] ; Dougherty, Darin D. ^[1] ; Duran, Fabio L. S. ^[3] ; Bressan, Rodrigo A. ^[2] ; Busatto, Geraldo F. ^[3] ; Miguel, Euripides C. ^[3] ; Sato, Joao R. ^[4]

Afiliação do(s) autor(es)

^[1] Harvard Univ, Sch Med, Dept Psychiat, Massachusetts Gen Hosp, Boston, MA 02115 - USA

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

^[3] Univ Sao Paulo, Sch Med, Dept Psychiat, Inst Psychiat, BR-05403010 Sao Paulo, SP - Brazil

^[4] Fed Univ ABC, Ctr Math Computat & Cognit, Santo Andre - Brazil

• Tipo de documento: Artigo Científico
• Fonte: DEPRESSION AND ANXIETY; v. 32, n. 12, p. 900-908, DEC 2015.
• Citações Web of Science: 6

Resumo

BackgroundEarly prediction of treatment response could reduce exposure to ineffective treatments and optimize the use of medical resources. Neuroimaging techniques have been used to identify biomarkers that are predictive of outcomes. The aims of this study were to investigate orbitofrontal cortex (OFC) thickness as a potential morphometric biomarker to discriminate outcomes in obsessive-compulsive disorder (OCD) and then to reexamine this biomarker in an independent cohort MethodsUsing a logistic regression model based on the mean baseline thickness of subregions of the OFC, we estimated the probability of treatment response in 29 treatment-naive OCD patients who participated in a clinical trial. That algorithm was then tested in an independent cohort of 12 patients with a confirmed diagnosis of refractory OCD ResultsAmong the treatment-naive OCD patients, measures of OFC thickness statistically significantly differentiated responders (n = 13) and nonresponders (n = 16), with an overall classification accuracy of approximate to 80%, a sensitivity of 77% (10/13), and a specificity of 81% (13/16). Of the refractory OCD patients in the second independent cohort, 67% were correctly classified as nonresponders. The most discriminative measures in the initial cohort of treatment-naive patients were the thicknesses of the left and right medial OFC (P = .009 and P = .028, respectively) ConclusionsWe found OFC thickness to be a strong predictor of treatment response in treatment-naive OCD patients. Although there are not yet any brain imaging biomarkers with clinical utility, our results highlight the potential of these measures as tools for predicting treatment outcomes in OCD. (AU)

• Processo FAPESP: 13/00506-1 - Séries temporais, ondaletas e análise de dados funcionais
• Beneficiário: Pedro Alberto Morettin
• Modalidade de apoio: Auxílio à Pesquisa - Temático
• Processo FAPESP: 13/10498-6 - Aprendizado de máquina em neuroimagem: desenvolvimento de métodos e aplicações clínicas em transtornos psiquiátricos
• Beneficiário: João Ricardo Sato
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 13/16864-4 - Capsulotomia ventral por raios gama com lesões únicas bilaterais e estimulação encefálica profunda no TOC: avaliação da eficácia, eventos adversos e alterações no funcionamento cerebral
• Beneficiário: Marcelo Queiroz Hoexter
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado
• Processo FAPESP: 11/21357-9 - Investigação de circuitos neuronais e marcadores biológicos envolvidos no transtorno obsessivo-compulsivo por meio de paradigmas comportamentais de medo e ansiedade
• Beneficiário: Eurípedes Constantino Miguel Filho
• Modalidade de apoio: Auxílio à Pesquisa - Temático