Effects of behavioral therapy or pharmacotherapy on brain glucose metabolism in subjects with obsessive-compulsive disorder as assessed by brain FDG PET

Psychiatry Res. 2010 Nov 30;184(2):105-16. doi: 10.1016/j.pscychresns.2010.08.012. Epub 2010 Oct 14.

Abstract

This prospective study investigated the effect of pharmacotherapy (PT) and cognitive behavioral therapy (CBT) on cerebral glucose metabolism in adults with obsessive-compulsive disorder (OCD). Dynamic positron emission tomography (PET) of the brain with F-18-fluorodeoxyglucose (FDG) was performed before and after treatment in 16 subjects diagnosed for OCD for at least 2 years (PT: n=7). Pre-to-post-treatment change of scaled local metabolic rate of glucose (SLMRGlc) was assessed separately in therapy responders and non-responders. Correlation was tested between SLMRGlc change and change of OCD, depression, or anxiety symptoms. SLMRGlc increased in the right caudate after successful therapy. The increase tended to correlate with the improvement of OCD symptom severity. The finding of increased local caudate activity after successful therapy is in contrast to most previous studies. Possible explanations include effects of therapy on concomitant depression symptoms and/or the large proportion of early-onset OCD in the present sample.

MeSH terms

  • Adult
  • Analysis of Variance
  • Brain / diagnostic imaging*
  • Brain / metabolism
  • Brain Mapping
  • Cognitive Behavioral Therapy*
  • Female
  • Fluorodeoxyglucose F18
  • Glucose / metabolism*
  • Humans
  • Image Processing, Computer-Assisted
  • Linear Models
  • Male
  • Middle Aged
  • Obsessive-Compulsive Disorder / diagnostic imaging*
  • Obsessive-Compulsive Disorder / metabolism
  • Obsessive-Compulsive Disorder / therapy*
  • Paroxetine / therapeutic use*
  • Prospective Studies
  • Radionuclide Imaging
  • Serotonin Uptake Inhibitors / therapeutic use
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Serotonin Uptake Inhibitors
  • Fluorodeoxyglucose F18
  • Paroxetine
  • Glucose