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1113 – Dynamics Of Cognitive And Behavioural Therapy-related Fmri Changes In Obsessive Compulsive Disorder Using a Personalised Symptom Provocation Task

Published online by Cambridge University Press:  15 April 2020

M. Morgiève ,
K. N’Diaye ,
W.I.A. Haynes ,
B. Granger ,
A.-H. Clair ,
A. Pelissolo  and
L. Mallet
M. Morgiève
Affiliation:
CNRS UMR 7225, Inserm UMRS 975, Université Pierre et Marie Curie (UPMC) - Institut du Cerveau et de la Moelle épinière
K. N’Diaye
Affiliation:
CNRS UMR 7225, Inserm UMRS 975, Université Pierre et Marie Curie (UPMC) - Institut du Cerveau et de la Moelle épinière
W.I.A. Haynes
Affiliation:
CNRS UMR 7225, Inserm UMRS 975, Université Pierre et Marie Curie (UPMC) - Institut du Cerveau et de la Moelle épinière
B. Granger
Affiliation:
Département de Santé Publique, de Biostatistiques et d’Information Médicale (bioSPIM), CHU Pitié-Salpêtrière
A.-H. Clair
Affiliation:
CNRS UMR 7225, Inserm UMRS 975, Université Pierre et Marie Curie (UPMC) - Institut du Cerveau et de la Moelle épinière
A. Pelissolo
Affiliation:
CHU Pitié- Salpêtrière, Department of Psychiatry (AP), CHU Pitié-Salpêtrière
L. Mallet
Affiliation:
Clinical Investigation Centre (LM), CHU Pitié-Salpêtrière, Paris, France

Abstract

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Background

Cognitive and Behavioural Therapy (CBT) is a successful treatment of obsessive-compulsive disorder (OCD). It is known to induce changes in cerebral metabolism, but the dynamics of these changes and their relation to clinical evolution remain largely unknown, precluding the identification of individualized response biomarkers.

Methods

We performed systematic clinical and fMRI evaluation of 35 OCD patients immediately before a three-month course of CBT, halfway through and at its end, as well as 6 months after in order to study the dynamics of treatment response. To sensitize fMRI probing, we used an original exposition task using neutral, generic and personalised obsession-inducing images.

Results

CBT produced a significant improvement in OCD, already predicted by response at midtherapy (r2=0.67, p< .001). Initially, patients were more sensitive to personalised than generic or neutral images and had stronger related activations in the anterior cingulate, orbitofrontal and parietal cortices. In the high responder group (ΔYBOCS>45%), behavioural sensitivity to generic stimuli was reduced, even more so for personalised ones. Clinical improvement was markedly concomitant to a decrease of activity in the anterior cingulate and left but not right orbitofrontal cortices.

Conclusions

Using an innovative and highly sensitive exposition paradigm in fMRI, we show that clinical and metabolic phenotypes have parallel evolutions during CBT. Our results, which suggest that the initial CBT sessions are crucial, prompt us to investigate the anatomo-functional modifications underlying the earlier stages of the therapy.

Type
Abstract
Information
European Psychiatry , Volume 28 , Issue S1: Abstracts of the 21th European Congress of Psychiatry , 2013 , 28-E505
Copyright
Copyright © European Psychiatric Association 2013
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