TY - JOUR
T1 - Effects of Bergen 4-Day Treatment on Resting-State Graph Features in Obsessive-Compulsive Disorder
AU - Thorsen, Anders L
AU - Vriend, Chris
AU - de Wit, Stella J
AU - Ousdal, Olga T
AU - Hagen, Kristen
AU - Hansen, Bjarne
AU - Kvale, Gerd
AU - van den Heuvel, Odile A
N1 - Funding Information: This study was supported by the Helse Vest Health Authority (Grant Nos. 911754 and 911880 [to GK]). ALT was supported by a travel grant from the Faculty of Psychology, University of Bergen , Bergen, Norway, when this work was carried out. Publisher Copyright: © 2020 Society of Biological Psychiatry
PY - 2021/10
Y1 - 2021/10
N2 - Background: Exposure and response prevention is an effective treatment for obsessive-compulsive disorder (OCD), but it is unclear how symptom reduction is related to changes in the brain. We aimed to determine the effects of a 4-day concentrated exposure and response prevention program (Bergen 4-day treatment) on the static and dynamic functional connectome in patients with OCD. Methods: Thirty-four patients with OCD (25 unmedicated) underwent resting-state functional magnetic resonance imaging the day before the Bergen 4-day treatment, and 28 (21 unmedicated) were rescanned after 1 week. Twenty-eight healthy control subjects were also scanned for baseline comparisons and 19 of them were rescanned after 1 week. Static and dynamic graph measures were quantified to determine network topology at the global, subnetwork, and regional levels (including efficiency, clustering, between-subnetwork connectivity, and node flexibility in module allegiance). The Yale-Brown Obsessive Compulsive Scale was used to measure symptom severity. Results: Twenty-four patients (86%) responded to treatment. We found significant group × time effects in frontoparietal-limbic connectivity (η p 2 = 0.19, p =.03) and flexibility of the right subgenual anterior cingulate cortex (η p 2 = 0.18, p =.03), where, in both cases, unmedicated patients showed significant decreases while healthy control subjects showed no significant changes. Healthy control subjects showed increases in global and subnetwork efficiency and clustering coefficient, particularly in the somatomotor subnetwork. Conclusions: Concentrated exposure and response prevention in unmedicated patients with OCD leads to decreased connectivity between the frontoparietal and limbic subnetworks and less flexibility of the connectivity of the subgenual anterior cingulate cortex, suggesting a more independent and stable network topology. This may represent less limbic interference on cognitive control subnetworks after treatment.
AB - Background: Exposure and response prevention is an effective treatment for obsessive-compulsive disorder (OCD), but it is unclear how symptom reduction is related to changes in the brain. We aimed to determine the effects of a 4-day concentrated exposure and response prevention program (Bergen 4-day treatment) on the static and dynamic functional connectome in patients with OCD. Methods: Thirty-four patients with OCD (25 unmedicated) underwent resting-state functional magnetic resonance imaging the day before the Bergen 4-day treatment, and 28 (21 unmedicated) were rescanned after 1 week. Twenty-eight healthy control subjects were also scanned for baseline comparisons and 19 of them were rescanned after 1 week. Static and dynamic graph measures were quantified to determine network topology at the global, subnetwork, and regional levels (including efficiency, clustering, between-subnetwork connectivity, and node flexibility in module allegiance). The Yale-Brown Obsessive Compulsive Scale was used to measure symptom severity. Results: Twenty-four patients (86%) responded to treatment. We found significant group × time effects in frontoparietal-limbic connectivity (η p 2 = 0.19, p =.03) and flexibility of the right subgenual anterior cingulate cortex (η p 2 = 0.18, p =.03), where, in both cases, unmedicated patients showed significant decreases while healthy control subjects showed no significant changes. Healthy control subjects showed increases in global and subnetwork efficiency and clustering coefficient, particularly in the somatomotor subnetwork. Conclusions: Concentrated exposure and response prevention in unmedicated patients with OCD leads to decreased connectivity between the frontoparietal and limbic subnetworks and less flexibility of the connectivity of the subgenual anterior cingulate cortex, suggesting a more independent and stable network topology. This may represent less limbic interference on cognitive control subnetworks after treatment.
KW - B4DT
KW - Exposure and response prevention
KW - Functional connectivity
KW - Graph theory
KW - Limbic
KW - OCD
UR - http://www.scopus.com/inward/record.url?scp=85083093588&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.bpsc.2020.01.007
DO - https://doi.org/10.1016/j.bpsc.2020.01.007
M3 - Article
C2 - 32299791
SN - 2451-9022
VL - 6
SP - 973
EP - 982
JO - Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
JF - Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
IS - 10
ER -