The majority of patients suffering from obsessive-compulsive disorder (OCD) are treated with cognitive-behavioral therapy, but this approach is not always successful. New research may have uncovered a way to use brain scans to determine whether or not this approach will work for an individual patient.
Cognitive-behavioral therapy aims to help patients understand the thoughts and feeling that are the root of their compulsive behaviors, and work towards eliminating them, the University of California, Los Angeles reported. Not all OCD sufferers find success in this treatment, symptoms return after the therapy is completed in about 20 percent of patients. The new brain scan analysis technique could allow clinicians to identify which patients are most likely to relapse.
"The efficiency of brain network connectivity before treatment predicts the worsening of symptoms after treatment," said Jamie Feusner, a UCLA associate professor of psychiatry and director of the Semel Institute's Adult OCD Program.
A team of researchers used functional magnetic resonance imaging (fMRI) to look at the brains of 17 people between the ages of 21 and 40 with OCD. Scans were taken both before and after the patients completed an intensive four-week course of cognitive-behavioral therapy. The patients monitored for recurring symptoms for the following 12 months.
"We found that cognitive-behavioral therapy itself results in more densely connected local brain networks, which likely reflects more efficient brain activity," Feusner said.
The team found patients with more efficient brain connectivity at the beginning of the study actually did worse in the follow-up period, and neither the severity of symptoms before treatment nor the amount of symptom improvement during treatment proved to indicate the likelihood of a relapse.
"Cognitive-behavioral therapy is in many cases very effective, at least in the short term. But it is costly, time-consuming, difficult for patients and, in many areas, not available," Feusner said. "Thus, if someone will end up having their symptoms return, it would be useful to know before they get treatment."
The researchers noted patients who are not found to be good candidates for this type of approach could be treated with medication or through cognitive-behavioral therapy that lasts longer than the four-week period looked at in the study.
The findings were published in a recent edition of the journal Frontiers in Psychology.
