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

Miquel A. Fullana, Xi Zhu, Pino Alonso, Narcís Cardoner, Eva Real, Clara López-Solà, Cinto Segalàs, Marta Subirà, Hanga Galfalvy, José M. Menchón, H. Blair Simpson, Rachel Marsh, Carles Soriano-Mas

Research output: Contribution to journalArticleResearchpeer-review

24 Citations (Scopus)

Abstract

© 2017 Joule Inc. or its licensors. 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.
Original languageEnglish
Pages (from-to)378-385
JournalJournal of Psychiatry and Neuroscience
Volume42
Issue number6
DOIs
Publication statusPublished - 1 Nov 2017

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