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Using electronically delivered therapy and brain imaging to understand OCD pathology: A pilot feasibility study
BACKGROUND: Obsessive–compulsive disorder (OCD) is a debilitating mental health disorder with current psychotherapeutic treatments, while somewhat effective, yielding low accessibility and scalability. A lack of knowledge regarding the neural pathology of OCD may be hindering the development of inno...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10033802/ https://www.ncbi.nlm.nih.gov/pubmed/36970278 http://dx.doi.org/10.3389/fpsyt.2023.1050530 |
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author | Stephenson, Callum Malakouti, Niloufar Nashed, Joseph Y. Salomons, Tim Cook, Douglas J. Milev, Roumen Alavi, Nazanin |
author_facet | Stephenson, Callum Malakouti, Niloufar Nashed, Joseph Y. Salomons, Tim Cook, Douglas J. Milev, Roumen Alavi, Nazanin |
author_sort | Stephenson, Callum |
collection | PubMed |
description | BACKGROUND: Obsessive–compulsive disorder (OCD) is a debilitating mental health disorder with current psychotherapeutic treatments, while somewhat effective, yielding low accessibility and scalability. A lack of knowledge regarding the neural pathology of OCD may be hindering the development of innovative treatments. Previous research has observed baseline brain activation patterns in OCD patients, elucidating some understanding of the implications. However, by using neuroimaging to observe the effects of treatment on brain activation, a more complete picture of OCD can be drawn. Currently, the gold standard treatment is cognitive behavioral therapy (CBT). However, CBT is often inaccessible, time-consuming, and costly. Fortunately, it can be effectively delivered electronically (e-CBT). OBJECTIVES: This pilot study implemented an e-CBT program for OCD and observed its effects on cortical activation levels during a symptom provocation task. It was hypothesized that abnormal activations could be attenuated following treatment. METHODS: OCD patients completed a 16-week e-CBT program administered through an online platform, mirroring in-person content. Treatment efficacy was evaluated using behavioral questionnaires and neuroimaging. Activation levels were assessed at the resting state and during the symptom provocation task. RESULTS: In this pilot, seven participants completed the program, with significant improvements (p < 0.05) observed between baseline and post-treatment for symptom severity and levels of functioning. No statistically significant (p = 0.07) improvement was observed in the quality of life. Participants had mostly positive qualitative feedback, citing accessibility benefits, comprehensive formatting, and relatable content. No significant changes in cortical activation were observed between baseline and post-treatment. CONCLUSION: This project sheds light on the application of e-CBT as a tool to evaluate the effects of treatment on cortical activation, setting the stage for a larger-scale study. The program showed great promise in feasibility and effectiveness. While there were no significant findings regarding changes in cortical activation, the trends were in agreeance with previous literature, suggesting future work could provide insight into whether e-CBT offers comparable cortical effects to in-person psychotherapy. Applying a greater knowledge of the neural mechanisms of action in OCD can help develop novel treatment plans in the future. |
format | Online Article Text |
id | pubmed-10033802 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-100338022023-03-24 Using electronically delivered therapy and brain imaging to understand OCD pathology: A pilot feasibility study Stephenson, Callum Malakouti, Niloufar Nashed, Joseph Y. Salomons, Tim Cook, Douglas J. Milev, Roumen Alavi, Nazanin Front Psychiatry Psychiatry BACKGROUND: Obsessive–compulsive disorder (OCD) is a debilitating mental health disorder with current psychotherapeutic treatments, while somewhat effective, yielding low accessibility and scalability. A lack of knowledge regarding the neural pathology of OCD may be hindering the development of innovative treatments. Previous research has observed baseline brain activation patterns in OCD patients, elucidating some understanding of the implications. However, by using neuroimaging to observe the effects of treatment on brain activation, a more complete picture of OCD can be drawn. Currently, the gold standard treatment is cognitive behavioral therapy (CBT). However, CBT is often inaccessible, time-consuming, and costly. Fortunately, it can be effectively delivered electronically (e-CBT). OBJECTIVES: This pilot study implemented an e-CBT program for OCD and observed its effects on cortical activation levels during a symptom provocation task. It was hypothesized that abnormal activations could be attenuated following treatment. METHODS: OCD patients completed a 16-week e-CBT program administered through an online platform, mirroring in-person content. Treatment efficacy was evaluated using behavioral questionnaires and neuroimaging. Activation levels were assessed at the resting state and during the symptom provocation task. RESULTS: In this pilot, seven participants completed the program, with significant improvements (p < 0.05) observed between baseline and post-treatment for symptom severity and levels of functioning. No statistically significant (p = 0.07) improvement was observed in the quality of life. Participants had mostly positive qualitative feedback, citing accessibility benefits, comprehensive formatting, and relatable content. No significant changes in cortical activation were observed between baseline and post-treatment. CONCLUSION: This project sheds light on the application of e-CBT as a tool to evaluate the effects of treatment on cortical activation, setting the stage for a larger-scale study. The program showed great promise in feasibility and effectiveness. While there were no significant findings regarding changes in cortical activation, the trends were in agreeance with previous literature, suggesting future work could provide insight into whether e-CBT offers comparable cortical effects to in-person psychotherapy. Applying a greater knowledge of the neural mechanisms of action in OCD can help develop novel treatment plans in the future. Frontiers Media S.A. 2023-03-09 /pmc/articles/PMC10033802/ /pubmed/36970278 http://dx.doi.org/10.3389/fpsyt.2023.1050530 Text en Copyright © 2023 Stephenson, Malakouti, Nashed, Salomons, Cook, Milev and Alavi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Psychiatry Stephenson, Callum Malakouti, Niloufar Nashed, Joseph Y. Salomons, Tim Cook, Douglas J. Milev, Roumen Alavi, Nazanin Using electronically delivered therapy and brain imaging to understand OCD pathology: A pilot feasibility study |
title | Using electronically delivered therapy and brain imaging to understand OCD pathology: A pilot feasibility study |
title_full | Using electronically delivered therapy and brain imaging to understand OCD pathology: A pilot feasibility study |
title_fullStr | Using electronically delivered therapy and brain imaging to understand OCD pathology: A pilot feasibility study |
title_full_unstemmed | Using electronically delivered therapy and brain imaging to understand OCD pathology: A pilot feasibility study |
title_short | Using electronically delivered therapy and brain imaging to understand OCD pathology: A pilot feasibility study |
title_sort | using electronically delivered therapy and brain imaging to understand ocd pathology: a pilot feasibility study |
topic | Psychiatry |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10033802/ https://www.ncbi.nlm.nih.gov/pubmed/36970278 http://dx.doi.org/10.3389/fpsyt.2023.1050530 |
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