Cargando…

Neurobiological outcomes of cognitive behavioral therapy for obsessive-compulsive disorder: A systematic review

INTRODUCTION: Obsessive-compulsive disorder (OCD) is characterized by recurrent distressing thoughts and repetitive behaviors, or mental rituals performed to reduce anxiety. Recent neurobiological techniques have been particularly convincing in suggesting that cortico-striatal-thalamic-cortico (CSTC...

Descripción completa

Detalles Bibliográficos
Autores principales: Poli, Andrea, Pozza, Andrea, Orrù, Graziella, Conversano, Ciro, Ciacchini, Rebecca, Pugi, Daniele, Angelo, Nicole Loren, Angeletti, Lorenzo Lucherini, Miccoli, Mario, Gemignani, Angelo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9780289/
https://www.ncbi.nlm.nih.gov/pubmed/36569616
http://dx.doi.org/10.3389/fpsyt.2022.1063116
_version_ 1784856804856954880
author Poli, Andrea
Pozza, Andrea
Orrù, Graziella
Conversano, Ciro
Ciacchini, Rebecca
Pugi, Daniele
Angelo, Nicole Loren
Angeletti, Lorenzo Lucherini
Miccoli, Mario
Gemignani, Angelo
author_facet Poli, Andrea
Pozza, Andrea
Orrù, Graziella
Conversano, Ciro
Ciacchini, Rebecca
Pugi, Daniele
Angelo, Nicole Loren
Angeletti, Lorenzo Lucherini
Miccoli, Mario
Gemignani, Angelo
author_sort Poli, Andrea
collection PubMed
description INTRODUCTION: Obsessive-compulsive disorder (OCD) is characterized by recurrent distressing thoughts and repetitive behaviors, or mental rituals performed to reduce anxiety. Recent neurobiological techniques have been particularly convincing in suggesting that cortico-striatal-thalamic-cortico (CSTC) circuits, including orbitofrontal cortex (OFC) and striatum regions (caudate nucleus and putamen), are responsible for mediation of OCD symptoms. However, it is still unclear how these regions are affected by OCD treatments in adult patients. To address this yet open question, we conducted a systematic review of all studies examining neurobiological changes before and after first-line psychological OCD treatment, i.e., cognitive-behavioral therapy (CBT). METHODS: Studies were included if they were conducted in adults with OCD and they assessed the neurobiological effects of CBT before and after treatment. Two databases were searched: PsycINFO and PubMed for the time frame up to May 2022. RESULTS: We obtained 26 pre-post CBT treatment studies performed using different neurobiological techniques, namely functional magnetic resonance imaging (fMRI), Positron emission tomography (PET), regional cerebral blood flow (rCBF), 5-HT concentration, magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), Electroencephalography (EEG). Neurobiological data show the following after CBT intervention: (i) reduced activations in OFC across fMRI, EEG, and rCBF; (ii) decreased activity in striatum regions across fMRI, rCBF, PET, and MRI; (iii) increased activations in cerebellum (CER) across fMRI and MRI; (iv) enhanced neurochemical concentrations in MRS studies in OFC, anterior cingulate cortex (ACC) and striatum regions. Most of these neurobiological changes are also accompanied by an improvement in symptom severity as assessed by a reduction in the Y-BOCS scores. CONCLUSION: Cognitive-behavioral therapy seems to be able to restructure, modify, and transform the neurobiological component of OCD, in addition to the clinical symptoms. Nevertheless, further studies are necessary to frame the OCD spectrum in a dimensional way.
format Online
Article
Text
id pubmed-9780289
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-97802892022-12-24 Neurobiological outcomes of cognitive behavioral therapy for obsessive-compulsive disorder: A systematic review Poli, Andrea Pozza, Andrea Orrù, Graziella Conversano, Ciro Ciacchini, Rebecca Pugi, Daniele Angelo, Nicole Loren Angeletti, Lorenzo Lucherini Miccoli, Mario Gemignani, Angelo Front Psychiatry Psychiatry INTRODUCTION: Obsessive-compulsive disorder (OCD) is characterized by recurrent distressing thoughts and repetitive behaviors, or mental rituals performed to reduce anxiety. Recent neurobiological techniques have been particularly convincing in suggesting that cortico-striatal-thalamic-cortico (CSTC) circuits, including orbitofrontal cortex (OFC) and striatum regions (caudate nucleus and putamen), are responsible for mediation of OCD symptoms. However, it is still unclear how these regions are affected by OCD treatments in adult patients. To address this yet open question, we conducted a systematic review of all studies examining neurobiological changes before and after first-line psychological OCD treatment, i.e., cognitive-behavioral therapy (CBT). METHODS: Studies were included if they were conducted in adults with OCD and they assessed the neurobiological effects of CBT before and after treatment. Two databases were searched: PsycINFO and PubMed for the time frame up to May 2022. RESULTS: We obtained 26 pre-post CBT treatment studies performed using different neurobiological techniques, namely functional magnetic resonance imaging (fMRI), Positron emission tomography (PET), regional cerebral blood flow (rCBF), 5-HT concentration, magnetic resonance imaging (MRI), magnetic resonance spectroscopy (MRS), Electroencephalography (EEG). Neurobiological data show the following after CBT intervention: (i) reduced activations in OFC across fMRI, EEG, and rCBF; (ii) decreased activity in striatum regions across fMRI, rCBF, PET, and MRI; (iii) increased activations in cerebellum (CER) across fMRI and MRI; (iv) enhanced neurochemical concentrations in MRS studies in OFC, anterior cingulate cortex (ACC) and striatum regions. Most of these neurobiological changes are also accompanied by an improvement in symptom severity as assessed by a reduction in the Y-BOCS scores. CONCLUSION: Cognitive-behavioral therapy seems to be able to restructure, modify, and transform the neurobiological component of OCD, in addition to the clinical symptoms. Nevertheless, further studies are necessary to frame the OCD spectrum in a dimensional way. Frontiers Media S.A. 2022-12-09 /pmc/articles/PMC9780289/ /pubmed/36569616 http://dx.doi.org/10.3389/fpsyt.2022.1063116 Text en Copyright © 2022 Poli, Pozza, Orrù, Conversano, Ciacchini, Pugi, Angelo, Angeletti, Miccoli and Gemignani. 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
Poli, Andrea
Pozza, Andrea
Orrù, Graziella
Conversano, Ciro
Ciacchini, Rebecca
Pugi, Daniele
Angelo, Nicole Loren
Angeletti, Lorenzo Lucherini
Miccoli, Mario
Gemignani, Angelo
Neurobiological outcomes of cognitive behavioral therapy for obsessive-compulsive disorder: A systematic review
title Neurobiological outcomes of cognitive behavioral therapy for obsessive-compulsive disorder: A systematic review
title_full Neurobiological outcomes of cognitive behavioral therapy for obsessive-compulsive disorder: A systematic review
title_fullStr Neurobiological outcomes of cognitive behavioral therapy for obsessive-compulsive disorder: A systematic review
title_full_unstemmed Neurobiological outcomes of cognitive behavioral therapy for obsessive-compulsive disorder: A systematic review
title_short Neurobiological outcomes of cognitive behavioral therapy for obsessive-compulsive disorder: A systematic review
title_sort neurobiological outcomes of cognitive behavioral therapy for obsessive-compulsive disorder: a systematic review
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9780289/
https://www.ncbi.nlm.nih.gov/pubmed/36569616
http://dx.doi.org/10.3389/fpsyt.2022.1063116
work_keys_str_mv AT poliandrea neurobiologicaloutcomesofcognitivebehavioraltherapyforobsessivecompulsivedisorderasystematicreview
AT pozzaandrea neurobiologicaloutcomesofcognitivebehavioraltherapyforobsessivecompulsivedisorderasystematicreview
AT orrugraziella neurobiologicaloutcomesofcognitivebehavioraltherapyforobsessivecompulsivedisorderasystematicreview
AT conversanociro neurobiologicaloutcomesofcognitivebehavioraltherapyforobsessivecompulsivedisorderasystematicreview
AT ciacchinirebecca neurobiologicaloutcomesofcognitivebehavioraltherapyforobsessivecompulsivedisorderasystematicreview
AT pugidaniele neurobiologicaloutcomesofcognitivebehavioraltherapyforobsessivecompulsivedisorderasystematicreview
AT angelonicoleloren neurobiologicaloutcomesofcognitivebehavioraltherapyforobsessivecompulsivedisorderasystematicreview
AT angelettilorenzolucherini neurobiologicaloutcomesofcognitivebehavioraltherapyforobsessivecompulsivedisorderasystematicreview
AT miccolimario neurobiologicaloutcomesofcognitivebehavioraltherapyforobsessivecompulsivedisorderasystematicreview
AT gemignaniangelo neurobiologicaloutcomesofcognitivebehavioraltherapyforobsessivecompulsivedisorderasystematicreview