Differential prefrontal gray matter correlates of treatment response to fluoxetine or cognitive-behavioral therapy in obsessive-compulsive disorder

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dc.contributor.author Hoexter, Marcelo Q. [UNIFESP]
dc.contributor.author Dougherty, Darin D.
dc.contributor.author Shavitt, Roseli G.
dc.contributor.author D'Alcante, Carina C.
dc.contributor.author Duran, Fabio L. S.
dc.contributor.author Lopes, Antonio C.
dc.contributor.author Diniz, Juliana B.
dc.contributor.author Batistuzzo, Marcelo C.
dc.contributor.author Evans, Karleyton C.
dc.contributor.author Bressan, Rodrigo A. [UNIFESP]
dc.contributor.author Busatto, Geraldo F.
dc.contributor.author Miguel, Euripedes C.
dc.date.accessioned 2016-01-24T14:31:56Z
dc.date.available 2016-01-24T14:31:56Z
dc.date.issued 2013-07-01
dc.identifier http://dx.doi.org/10.1016/j.euroneuro.2012.06.014
dc.identifier.citation European Neuropsychopharmacology. Amsterdam: Elsevier B.V., v. 23, n. 7, p. 569-580, 2013.
dc.identifier.issn 0924-977X
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/36484
dc.description.abstract Nearly one-third of patients with obsessive-compulsive disorder (OCD) fail to respond to adequate therapeutic approaches such as serotonin reuptake inhibitors and/or cognitive-behavioral therapy (CBT). This study investigated structural magnetic resonance imaging (MRI) correlates as potential pre-treatment brain markers to predict treatment response in treatment-naive OCD patients randomized between trials of fluoxetine or CBI Treatment-naive OCD patients underwent structural MRI scans before randomization to a 12-week clinical trial of either fluoxetine or group-based CBT. Voxel-based morphometry was used to identify correlations between pretreatment regional gray matter volume and changes in symptom severity on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Brain regional correlations of treatment response differed between treatment groups. Notably, symptom improvement in the fluoxetine treatment group (n=14) was significantly correlated with smaller pretreatment gray matter volume within the right middle lateral orbitofrontal cortex (OFC), whereas symptom improvement in the CBT treatment group (n=15) was significantly correlated with larger pretreatment gray matter volume within the right medial prefrontal cortex (mPFC). No significant a priori regional correlations of treatment response were identified as common between the two treatment groups when considering the entire sample (n=29). These findings suggest that pretreatment gray matter volumes of distinct brain regions within the lateral OFC and mPFC were differentially correlated to treatment response to fluoxetine versus CBT in OCD patients. This study further implicates the mPFC in the fear/anxiety extinction process and stresses the importance of lateral portions of the OFC in mediating fluoxetine's effectiveness in OCD. Clinical registration information: http://clinicaltrials.gov-NCT00680602. (C) 2012 Elsevier B.V. and ECNP. All rights reserved. en
dc.description.sponsorship Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.description.sponsorship Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
dc.format.extent 569-580
dc.language.iso eng
dc.publisher Elsevier B.V.
dc.relation.ispartof European Neuropsychopharmacology
dc.rights Acesso restrito
dc.subject OCD en
dc.subject Neuroimaging en
dc.subject Gray matter en
dc.subject Serotonergic reuptake inhibitor en
dc.subject Cognitive-behavioral therapy en
dc.title Differential prefrontal gray matter correlates of treatment response to fluoxetine or cognitive-behavioral therapy in obsessive-compulsive disorder en
dc.type Artigo
dc.rights.license http://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy
dc.contributor.institution Universidade de São Paulo (USP)
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.contributor.institution Harvard Univ
dc.description.affiliation Univ São Paulo, Sch Med, Dept & Inst Psychiat, BR-05403010 São Paulo, Brazil
dc.description.affiliation Fed Univ São Paulo UNIFESP, Dept Psychiat, Interdisciplinary Lab Clin Neurosci LiNC, São Paulo, Brazil
dc.description.affiliation Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Psychiat, Boston, MA USA
dc.description.affiliationUnifesp Fed Univ São Paulo UNIFESP, Dept Psychiat, Interdisciplinary Lab Clin Neurosci LiNC, São Paulo, Brazil
dc.description.sponsorshipID FAPESP: 2005/55628-8
dc.description.sponsorshipID FAPESP: 06/61459-7
dc.description.sponsorshipID FAPESP: 06/50273-0
dc.description.sponsorshipID FAPESP: 2008/10257-0
dc.description.sponsorshipID FAPESP: 06/58286-3
dc.description.sponsorshipID FAPESP: 2005/04206-6
dc.description.sponsorshipID CAPES: 4375/08-4
dc.identifier.doi 10.1016/j.euroneuro.2012.06.014
dc.description.source Web of Science
dc.identifier.wos WOS:000321083700002



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