Right Prefrontal Cortical Thickness Is Associated With Response to Cognitive-Behavioral Therapy in Children With Obsessive-Compulsive Disorder - 28/03/23
Doi : 10.1016/j.jaac.2022.07.865
Sara Bertolín, MD a, b, Pino Alonso, MD, PhD a, b, c, Ignacio Martínez-Zalacaín, MSc a, c, Jose M. Menchón, MD, PhD a, b, c, Susana Jimenez-Murcia, PhD a, c, d, Justin T. Baker, MD, PhD e, f, Nuria Bargalló, MD, PhD b, c, g, h, Marcelo Camargo Batistuzzo, PhD i, j, Premika S.W. Boedhoe, PhD k, Brian P. Brennan, MD e, f, Jamie D. Feusner, MD l, m, n, o, Kate D. Fitzgerald, MD p, q, Martine Fontaine, MA r, Bjarne Hansen, PhD s, t, Yoshiyuki Hirano, PhD u, v, Marcelo Q. Hoexter, MD, PhD i, w, Chaim Huyser, MD, PhD x, y, Neda Jahanshad, PhD z, Fern Jaspers-Fayer, PhD aa, ab, Masaru Kuno, MD, PhD u, Gerd Kvale, PhD s, ac, Luisa Lazaro, MD, PhD b, c, ad, ae, Mafalda Machado-Sousa, MSc af, ag, ah, Rachel Marsh, PhD q, r, Pedro Morgado, MD, PhD af, ag, ah, Akiko Nakagawa, MD, PhD u, Luke Norman, PhD ai, Erika L. Nurmi, MD, PhD l, Joseph O’Neill, PhD aj, ak, Ana E. Ortiz, MD, PhD ad, ae, Chris Perriello, BS al, John Piacentini, PhD aj, am, Maria Picó-Pérez, PhD af, ag, ah, Roseli G. Shavitt, MD, PhD i, Eiji Shimizu, MD, PhD u, v, Helen Blair Simpson, MD, PhD q, r, S. Evelyn Stewart, MD aa, ab, an, Sophia I. Thomopoulos, BA z, Anders Lillevik Thorsen, PhD s, t, Susanne Walitza, MD, MSc ao, ap, Lidewij H. Wolters, PhD x,
ENIGMA-OCD Working Group
Eva Real, MD, PhD, Cinto Segalas, MD, PhD, Astrid Morer, MD, PhD, Silvia Brem, PhD, Sonia Ferreira, MSc, Pedro Silva Moreira, PhD, Kristen Hagen, PhD, Sayo Hamatani, PhD, Jumpei Takahashi, MD, PhD, Tokiko Yoshida, PhD, Maria Alice de Mathis, MD, PhD, Euripedes C. Miguel, MD, PhD, Jose C. Pariente, MSc, Jinsong Tang, MD, PhD
Paul M. Thompson, PhD z, Odile A. van den Heuvel, MD, PhD aq, Dan J. Stein, MD, PhD ar, Carles Soriano-Mas, PhD a, b, c, ⁎
a Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital, Barcelona, Spain
b CIBERSAM, Barcelona, Spain
c University of Barcelona, Barcelona, Spain
d CIBERobn, ISCIII, Spain
e McLean Hospital, Belmont, Massachusetts
f Harvard Medical School, Boston, Massachusetts
g Image Diagnostic Center, Hospital Clinic, Barcelona, Spain
h Magnetic Resonance Image Core Facility (IDIBAPS), Barcelona, Spain
i Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
j Pontificial Catholic University of Sao Paulo, Brazil
k Amsterdam UMC, Location VUmc, Amsterdam, the Netherlands
l University of California Los Angeles, Los Angeles, California
m University of Toronto, Canada
n Centre for Addiction and Mental Health, Toronto, Canada
o Karolinksa Institutet, Stockholm, Sweden
p Columbia University, New York
q The New York State Psychiatric Institute, New York
r Columbia University Medical College, Columbia University, New York
s Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway
t Centre for Crisis Psychology, University of Bergen, Bergen, Norway
u Research Center for Child Mental Development, Chiba University, Chiba, Japan
v United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Suita, Japan
w LiNC - Laboratory of Integrative Neuroscience of Universidade Federal de São Paulo (UNIFESP), Brazil
x Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, the Netherlands
y Amsterdam UMC, Amsterdam, the Netherlands
z Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, California
aa University of British Columbia, Vancouver, Canada
ab British Columbia Children's Hospital Research Institute, Vancouver, Canada
ac University of Bergen, Bergen, Norway
ad IDIBAPS, Barcelona, Spain
ae Hospital Clínic, Barcelona, Spain
af Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
ag ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
ah Clinical Academic Center - Braga, Braga, Portugal
ai University of Michigan, Ann Arbor
aj UCLA Division of Child and Adolescent Psychiatry, Los Angeles, California
ak UCLA Brain Research Institute, Los Angeles, California
al University of Illinois at Urbana Champaign, Champaign, Illinois
am UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, California
an British Columbia Mental Health and Substance Use Services Research Institute, Vancouver, Canada
ao University Hospital of Psychiatry Zurich, University of Zurich, Switzerland
ap Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland
aq Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
ar SAMRC Unit on Risk and Resilience in Mental Disorders, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
∗Correspondence to Carles Soriano-Mas, PhD, Department of Psychiatry, Bellvitge University Hospital-IDIBELL, C/Feixa Llarga s/n, L’Hospitalet de Llobregat, Barcelona 08907, SpainDepartment of PsychiatryBellvitge University Hospital-IDIBELLC/Feixa Llarga s/n, 08907L’Hospitalet de LlobregatBarcelonaSpain
Abstract |
Objective |
Cognitive-behavioral therapy (CBT) is considered a first-line treatment for obsessive-compulsive disorder (OCD) in pediatric and adult populations. Nevertheless, some patients show partial or null response. The identification of predictors of CBT response may improve clinical management of patients with OCD. Here, we aimed to identify structural magnetic resonance imaging (MRI) predictors of CBT response in 2 large series of children and adults with OCD from the worldwide ENIGMA-OCD consortium.
Method |
Data from 16 datasets from 13 international sites were included in the study. We assessed which variations in baseline cortical thickness, cortical surface area, and subcortical volume predicted response to CBT (percentage of baseline to post-treatment symptom reduction) in 2 samples totaling 168 children and adolescents (age range 5-17.5 years) and 318 adult patients (age range 18-63 years) with OCD. Mixed linear models with random intercept were used to account for potential cross-site differences in imaging values.
Results |
Significant results were observed exclusively in the pediatric sample. Right prefrontal cortex thickness was positively associated with the percentage of CBT response. In a post hoc analysis, we observed that the specific changes accounting for this relationship were a higher thickness of the frontal pole and the rostral middle frontal gyrus. We observed no significant effects of age, sex, or medication on our findings.
Conclusion |
Higher cortical thickness in specific right prefrontal cortex regions may be important for CBT response in children with OCD. Our findings suggest that the right prefrontal cortex plays a relevant role in the mechanisms of action of CBT in children.
Le texte complet de cet article est disponible en PDF.Key words : obsessive-compulsive disorder, neuroimaging, magnetic resonance imaging, cognitive-behavioral therapy, anxiety disorders
Plan
| This study was supported by Carlos III Health Institute trough FIS grant (PI18/00856, PI16/00950, PI19/01171, PI19/01184 [Alonso, Soriano-Mas, Menchón]); Bertolín was supported by Río Hortega grant (CM21/00278); Martínez-Zalacaín was supported by a PFIS grant (FI17/00294); co-funded by European Social Fund (ESF) investing in your future. Jimenez-Murcia was supported by Ministerio de Ciencia, Innovación y Universidades (RTI2018-101837-B-100); and research funded by the Delegación del Gobierno para el Plan Nacional sobre Drogas (2017I067, 2019I47, and 2021I031). Baker was supported by JSPS KAKENHI (26461762 and 16K04344). Fitzgerald was supported by National Institute of Mental Health (NIMH; K23 MH082176) and Charles Dana Foundation (UL1TR000433). Hirano was supported by AMED Brain/MINDS Beyond (JP21dm0307002) and JSPS KAKENHI (19K03309). Jahanshad was supported by NIMH (R01MH117601). Jaspers-Fayer was supported by Michael Smith Foundation for Health Research. Kuno was supported by JSPS KAKENHI (18K13315). Lazaro was supported by The Marato TV3 Foundation grants (091710). Machado-Sousa was supported by Portuguese Foundation for Science and Technology (2020.07946.BD). Marsh was supported by NIMH (R01MH104648 and R21MH101441). Morgado was supported by National funds, through the Foundation for Science and Technology (FCT) (UIDB/50026/2020 and UIDP/50026/2020). Nakagawa was supported by JSPS KAKENHI (19K03308). O’Neill was supported by NIMH (R01MH081864 and R01MH085900-01A2). Piacentini was supported by NIMH (R01MH081864). Feusner was supported by NIMH (R01MH085900-01A2). Shavitt was supported by Conselho Nacional de Desenvolvimento Cientifico e Tecnológico (303754/2018-4 and 573974/2008-0); and FAPESP (2008/57896-8). Shimizu was supported by AMED Brain/MINDS Beyond (JP21dm0307002). Thompson was supported by the National Institutes of Health (NIH; U54 EB020403). VIDI grant awarded to van den Heuvel (91717306). Walitza was supported by the Swiss National Science Foundation (320030_130237) and by the Hartmann Müller Foundation (1460). |
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| The ethical committees in clinical research of each participating institution approved the research. |
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| Each center used its own document of consent for collecting the data. |
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| Author Contributions Conceptualization: Bertolín, van den Heuvel, Thompson, Stein, Soriano-Mas Data curation: Bertolín, Alonso, Martínez-Zalacaín, Jimenez-Murcia, Baker, Boedhoe, Brennan, Fitzgerald, Hirano, Hoexter, Huyser, Kvale, Lazaro, Marsh, Morgado, Nurmi, O’Neill, Shavitt, Simpson, Stewart, Walitza, ENIGMA-OCD Working Group, Thompson, van den Heuvel, Stein, Soriano-Mas Formal analysis: Bertolín, Boedhoe, van den Heuvel, Soriano-Mas Funding acquisition: Alonso, Fitzgerald, Hirano, Lázaro, Simpson, Marsh, Menchón, Morgado, O'Neill, Soriano-Mas, Thompson, van den Heuvel, Walitza Investigation: Bertolín, Boedhoe, van den Heuvel, Soriano-Mas Methodology: Bertolín, Boedhoe, Stein, Thompson, van den Heuvel, Soriano-Mas Project administration: Bertolín, Boedhoe, Thomopoulos, Thompson, van den Heuvel, Stein, Soriano-Mas Resources: Martínez-Zalacaín, Menchón, van den Heuvel, Stein, Thompson, Soriano-Mas Software: Bertolín, Boedhoe, Martínez-Zalacaín, Soriano-Mas Supervision: Stein, Thompson, van den Heuvel, Soriano-Mas Validation: Alonso, Martínez-Zalacaín, Menchón, Jimenez-Murcia, Baker, Bargalló, Batistuzzo, Brennan, Feusner, Fitzgerald, Fontaine, Hansen, Hirano, Hoexter, Huyser, Jahanshad, Jaspers-Fayer, Kuno, Kvale, Lazaro, Machado-Sousa, Marsh, Morgado, Nakagawa, Norman, Nurmi, O’Neill, Ortiz, Perriello, Piacentini, Picó-Pérez, Shavitt, Shimizu, Simpson, Stewart, Thomopoulos, Thorsen, Wolters, Walitza, ENIGMA-OCD Working Group, Thompson, van den Heuvel, Stein Visualization: Bertolín, Soriano-Mas Writing – original draft: Bertolín, Soriano-Mas Writing – review and editing: Bertolín, Alonso, Martínez-Zalacaín, Jimenez-Murcia, Baker, Bargalló, Batistuzzo, Boedhoe, Brennan, Feusner, Fitzgerald, Fontaine, Hansen, Hirano, Hoexter, Huyser, Jahanshad, Jaspers-Fayer, Kuno, Kvale, Lazaro, Machado-Sousa, Marsh, Morgado, Nakagawa, Norman, Nurmi, O’Neill, Ortiz, Perriello, Piacentini, Picó-Pérez, Shavitt, Shimizu, Simpson, Stewart, Thomopoulos, Thorsen, Wolters, Walitza, ENIGMA-OCD Working Group, Thompson, van den Heuvel, Stein, Soriano-Mas |
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| ENIGMA-OCD Working Group members: Eva Real, MD, PhD and Cinto Segalas, MD, PhD are with Bellvitge Biomedical Research Institute-IDIBELL. Eva Real, Cinto Segalas and Astrid Morer, MD, PhD are with CIBERSAM, Barcelona, Spain. Cinto Segalas and Astrid Morer, are also with University of Barcelona. Silvia Brem, PhD is with University Hospital of Psychiatry Zurich, University of Zurich, Switzerland; and Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland. Sonia Ferreira, MSc and Pedro Silva Moreira, PhD are with Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; and ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal. Sonia Ferreria is also with Clinical Academic Center - Braga, Braga, Portugal. Pedro Silva Moreira are also with Psychological Neuroscience Lab, CIPsi, University of Minho, Braga, Portugal. Kristen Hagen, PhD is with Bergen Center for Brain Plasticity, Haukeland University Hospital, Bergen, Norway; and Hospital of Molde, Molde, Norway. Sayo Hamatani, PhD, Jumpei Takahashi, MD, PhD and Tokiko Yoshida, PhD are with Research Center for Child Mental Development, Chiba University, Chiba, Japan. Maria Alice de Mathis, MD, PhD and Euripedes C. Miguel, MD, PhD are with Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil. Astrid Morer, MD, PhD is with Hospital Clínic, Barcelona, Spain; and IDIBAPS, Barcelona, Spain. Jose C Pariente, MSc is with Magnetic Resonance Image Core Facility (IDIBAPS). Jinsong Tang, MD, PhD is with Zhejiang University School of Medicine, Hangzhou, China. |
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| Disclosure: Dr. Feusner has served as a consultant to NOCD, Inc. Dr. Morgado has received CME-related honoraria or consulting fees from Angelini, AstraZeneca, Bial, Biogen, DGS-Portugal, FCT, FLAD, Janssen-Cilag, Gulbenkian Foundation, Lundbeck, Springer Healthcare, Tecnimede, Viatris and 2CA-Braga. Dr. O’Neill has been an unpaid Scientific Advisory Board member for Myriad Genetics and has received funding for clinical trial from Emalex Pharmaceuticals. Dr. Simpson has received royalties from UpToDate, Inc. and Cambridge University Press and a stipend from the American Medical Association for serving as Associate Editor of JAMA-Psychiatry. Dr. Stewart has received grant/research support from the Canadian Institutes for Health Research, the Social Sciences and Humanities Research Council (Canada), the BC Ministry of Health COVID-19 Research Priorities Fund, the BC Centre for Disease Control, the University of British Columbia Faculty of Medicine (Strategic Investment Fund), British Columbia Children’s Hospital, and the BC Mental Health and Substance Use Services Research Institute. She has served on advisory boards/DSMB / speakers bureaus / travel expenses from the International OCD Foundation (IOCDF). She has served on advisory boards/DSMB of Anxiety Canada, the Youth Development Instrument Provincial Practice and Policy Group, and the British Columbia Ministry of Mental Health and Addictions. She has served as consultant / honoraria from the Misophonia Research Foundation and the Milken Institute. She has reported editorship/editorial board of Canadian Journal of Psychiatry and Annals of Clinical Psychiatry. She has reported authorship of assessment tools: Abramovitch A, Abramowitz JS, McKay D, Cham H, Anderson KS, Farrell L, Geller DA, Hanna GL, Mathieu S, McGuire JF, Rosenberg DR, Stewart SE, Storch EA, Wilhelm S. A Revision of the Obsessive-Compulsive Inventory – Child Version: The OCI-CV-R. Journal of Anxiety Disorders (accepted manuscript, January 2022). Dr. Walitza has received royalties from Thieme Hogrefe, Kohlhammer, Springer, Beltz, and Elsevier. Her work was supported by the Swiss National Science Foundation (SNF), diff. EU FP7s, Bfarm Germany, ZInEP, Olga Gertrud Thalmann, Vontobel, Unicentia, Erika Schwarz Fonds. Outside professional activities and interests are declared under the link of the University of Zurich web/. Dr. Wolters reports personal fees from Bohn Stafleu van Loghum, Houten, the Netherlands (publisher). Dr. Thompson has received partial research support from Biogen, Inc., for research unrelated to this manuscript. Dr. Van den Heuvel has received consultation honorarium from Lundbeck. Drs. Bertolín, Alonso, Menchón, Jimenez-Murcia, Baker, Bargalló, Batistuzzo, Boedhoe, Brennan, Fitzgerald, Hansen, Hirano, Hoexter, Huyser, Jahanshad, Jaspers-Fayer, Kuno, Kvale, Lazaro, Marsh, Nakagawa, Norman, Nurmi, Ortiz, Piacentini, Picó-Pérez, Shavitt, Shimizu, Thorsen, Stein, and Soriano-Mas, Mr. Martínez-Zalacaín, Mss. Fontaine and Machado-Sousa, Mr. Perriello, and Ms. Thomopoulos have reported no biomedical financial interests or potential conflicts of interest. |
© 2022
American Academy of Child and Adolescent Psychiatry. Tous droits réservés.
Vol 62 - N° 4
P. 403-414 - avril 2023 Retour au numéro
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