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Gray Matter Volumes in Obsessive-Compulsive Disorder Before and After Fluoxetine or Cognitive-Behavior Therapy: A Randomized Clinical Trial

Hoexter, Marcelo Queiroz; De Souza Duran, Fabio Luis; D'Alcante, Carina Chaubet; Dougherty, Darin Dean; Shavitt, Roseli Gedanke; Lopes, Antonio Carlos; Diniz, Juliana Belo; Deckersbach, Thilo; Batistuzzo, Marcelo Camargo; Bressan, Rodrigo Affonseca; Miguel, Euripedes Constantino; Busatto, Geraldo Filho Universidade De São Paulo

NEUROPSYCHOPHARMACOLOGY, LONDON, v. 37, n. 3, supl. 4, Part 1-2, pp. 734-745, FEB, 2012

NATURE PUBLISHING GROUP; LONDON 2013-08-02

Acesso online

  • Título:
    Gray Matter Volumes in Obsessive-Compulsive Disorder Before and After Fluoxetine or Cognitive-Behavior Therapy: A Randomized Clinical Trial
  • Autor: Hoexter, Marcelo Queiroz; De Souza Duran, Fabio Luis; D'Alcante, Carina Chaubet; Dougherty, Darin Dean; Shavitt, Roseli Gedanke; Lopes, Antonio Carlos; Diniz, Juliana Belo; Deckersbach, Thilo; Batistuzzo, Marcelo Camargo; Bressan, Rodrigo Affonseca; Miguel, Euripedes Constantino; Busatto, Geraldo Filho
  • Universidade De São Paulo
  • Assuntos: Ocd; Neuroimaging; Magnetic Resonance Imaging; Serotonin Reuptake Inhibitors; Cognitive-Behavior Therapy; Randomized Clinical Trial; Ventromedial Prefrontal Cortex; Voxel-Based Morphometry; Cerebral-Blood-Flow; Serotonin Reuptake Inhibitors; Glucose Metabolic-Rate; Fear Extinction; Major Depression; Cell-Proliferation; Pediatric-Patients; Human Brain; Neurosciences; Pharmacology & Pharmacy; Psychiatry
  • É parte de: NEUROPSYCHOPHARMACOLOGY, LONDON, v. 37, n. 3, supl. 4, Part 1-2, pp. 734-745, FEB, 2012
  • Descrição: Serotonin reuptake inhibitors and cognitive-behavior therapy (CBT) are considered first-line treatments for obsessive-compulsive disorder (OCD). However, little is known about their modulatory effects on regional brain morphology in OCD patients. We sought to document structural brain abnormalities in treatment-naive OCD patients and to determine the effects of pharmacological and cognitive-behavioral treatments on regional brain volumes. Treatment-naive patients with OCD (n = 38) underwent structural magnetic resonance imaging scan before and after a 12-week randomized clinical trial with either fluoxetine or group CBT. Matched-healthy controls (n = 36) were also scanned at baseline. Voxel-based morphometry was used to compare regional gray matter (GM) volumes of regions of interest (ROIs) placed in the orbitofrontal, anterior cingulate and temporolimbic cortices, striatum, and thalamus. Treatment-naive OCD patients presented smaller GM volume in the left putamen, bilateral medial orbitofrontal, and left anterior cingulate cortices than did controls (p<0.05, corrected for multiple comparisons). After treatment with either fluoxetine or CBT (n = 26), GM volume abnormalities in the left putamen were no longer detectable relative to controls. ROI-based within-group comparisons revealed that GM volume in the left putamen significantly increased (p<0.012) in fluoxetine-treated patients (n = 13), whereas no significant GM volume changes were observed in CBT-treated patients (n = 13). This study supports the involvement of orbitofronto/cingulo-striatal loops in the pathophysiology of OCD and suggests that fluoxetine and CBT may have distinct neurobiological mechanisms of action. Neuropsychopharmacology (2012) 37, 734-745; doi: 10.1038/npp.2011.250; published online 26 October 2011
    Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP, Foundation for the Support of Research in the State of Sao Paulo)
    Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP, Foundation for the Support of Research in the State of Sao Paulo) [2005/55628-8]
    FAPESP [06/61459-7, 06/50273-0, 2008/10257-0, 06/58286-3, 2005/04206-6]
    FAPESP
    Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES, Agency for Support and Evaluation of Graduate Education)
    Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES, Agency for Support and Evaluation of Graduate Education) [4375/08-4]
    Medtronic
    Eli Lilly
    McNeil
    Cyberonics
    NIMH
    NARSAD
    TSA
    OCF
    Tufts University
    MGH Psychiatry Academy
    BrainCells
    Systems Research and Applications Corporation
    Boston University
    Catalan Agency for Health Technology Assessment and Research
    National Association of Social Workers Massachusetts
    Massachusetts Medical Society
    NIDA
    German Research Foundation/Federal Ministry for Education and Research
    Oxford University Press
    NIH
    NIA
    AHRQ
    Janssen Pharmaceuticals
    Forest Research Institute
    Shire Development
    Northstar
    Janssen
    AstraZeneca
    Lundbeck
    Solvay
  • DOI: 10.1038/npp.2011.250
    10.1590/clin.v68i10.77008
  • Títulos relacionados: NEUROPSYCHOPHARMACOLOGY
  • Editor: NATURE PUBLISHING GROUP; LONDON
  • Data de publicação: 2013-08-02
  • Idioma: Inglês

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