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

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author HOEXTER, Marcelo Queiroz FMUSP-HC
DURAN, Fabio Luis de Souza FMUSP-HC
D'ALCANTE, Carina Chaubet FMUSP-HC
DOUGHERTY, Darin Dean
SHAVITT, Roseli Gedanke FMUSP-HC
LOPES, Antonio Carlos FMUSP-HC
DINIZ, Juliana Belo FMUSP-HC
DECKERSBACH, Thilo
BATISTUZZO, Marcelo Camargo FMUSP-HC
BRESSAN, Rodrigo Affonseca
MIGUEL, Euripedes Constantino FMUSP-HC
BUSATTO, Geraldo Filho FMUSP-HC
dc.date.issued 2012
dc.identifier.citation NEUROPSYCHOPHARMACOLOGY, v.37, n.3, p.734-745, 2012
dc.identifier.issn 0893-133X
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/1098
dc.description.abstract 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
dc.description.sponsorship · Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [2005/55628-8]
· Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [06/61459-7, 06/50273-0, 2008/10257-0, 06/58286-3, 2005/04206-6]
· 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
· National Institute of Mental Health (NIH-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
· National Institute on Drug Abuse (NIH-NIDA)
· German Research Foundation/Federal Ministry for Education and Research
· Oxford University Press
· National Institutes of Health (NIH)
· NIH-NIA
· AHRQ
· Janssen Pharmaceuticals
· Forest Research Institute
· Shire Development
· Northstar
· Janssen
· AstraZeneca
· Lundbeck
· Solvay
dc.language.iso eng
dc.publisher NATURE PUBLISHING GROUP
dc.relation.ispartof Neuropsychopharmacology
dc.rights restrictedAccess
dc.subject OCD; neuroimaging; magnetic resonance imaging; cognitive-behavior therapy; randomized clinical trial
dc.subject.other 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
dc.title Gray Matter Volumes in Obsessive-Compulsive Disorder Before and After Fluoxetine or Cognitive-Behavior Therapy: A Randomized Clinical Trial
dc.type article
dc.rights.holder Copyright NATURE PUBLISHING GROUP
dc.description.group LIM/21
dc.identifier.doi 10.1038/npp.2011.250
dc.identifier.pmid 22030709
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author HOEXTER, Marcelo Queiroz:HC:IPQ
hcfmusp.author DURAN, Fabio Luis de Souza:FM:MPS
hcfmusp.author D'ALCANTE, Carina Chaubet:HC:IPQ
hcfmusp.author SHAVITT, Roseli Gedanke:HC:IPQ
hcfmusp.author LOPES, Antonio Carlos:HC:IPQ
hcfmusp.author DINIZ, Juliana Belo:FM:
hcfmusp.author BATISTUZZO, Marcelo Camargo:FM:
hcfmusp.author MIGUEL, Euripedes Constantino:FM:MPS
hcfmusp.author BUSATTO, Geraldo Filho:FM:MPS
hcfmusp.author.external · DOUGHERTY, Darin Dean:Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Psychiat, Boston, MA USA
· DECKERSBACH, Thilo:Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Psychiat, Boston, MA USA
· BRESSAN, Rodrigo Affonseca:Univ Fed Sao Paulo UNIFESP, Dept Psychiat, Interdisciplinary Lab Clin Neurosci LiNC, Sao Paulo, Brazil
hcfmusp.origem.id 2-s2.0-84855896196
hcfmusp.origem.id WOS:000299117900015
hcfmusp.publisher.city LONDON
hcfmusp.publisher.country ENGLAND
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dc.description.index MEDLINE
hcfmusp.citation.scopus 74
hcfmusp.citation.wos 69
hcfmusp.affiliation.country Brasil
hcfmusp.affiliation.country Estados Unidos


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