TY - JOUR
T1 - Pre-CBT resting-state connectivity and white matter integrity in OCD remission
T2 - A multimodal MRI study
AU - Ikemizu, Yuki
AU - Isobe, Yuko
AU - Sudo, Yusuke
AU - Ota, Junko
AU - Chhatkuli, Ritu Bhusal
AU - Sasaki, Tubasa
AU - Kurita, Kohei
AU - Yoshida, Tokiko
AU - Matsumoto, Koji
AU - Kuno, Masaru
AU - Kato, Naoko
AU - Nakagawa, Akiko
AU - Shimizu, Eiji
AU - Hirano, Yoshiyuki
N1 - Publisher Copyright:
© 2025 The Authors
PY - 2025/9
Y1 - 2025/9
N2 - Background: Obsessive-compulsive disorder (OCD) is commonly treated with cognitive-behavioral therapy (CBT), yet many patients fail to achieve remission. Neuroimaging markers, such as pre-treatment functional and structural connectivity, may help elucidate OCD pathology and CBT mechanisms, and predict treatment outcomes. This study investigates the relationship between pre-treatment functional and structural connectivity and remission status in OCD patients following CBT. Methods: Thirty-three OCD patients underwent multimodal MRI, including resting-state fMRI to assess pre-treatment functional connectivity and diffusion tensor imaging (DTI) to evaluate white matter integrity. Functional connectivity multivariate pattern analysis (fc-MVPA) identified patterns linked to treatment outcomes. TRACULA, a probabilistic tractography technique, analyzed white matter tracts, focusing on diffusion metrics such as fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD). Analysis of covariance (ANCOVA) was used to examine group differences. Results: Remission was associated with significantly higher pre-treatment resting-state functional connectivity between the occipital pole and lateral occipital cortex (height threshold: p < 0.001 uncorrected and cluster threshold: p < 0.05 cluster-size FDR corrected for multiple comparisons), suggesting a role in visual processing. Differences in white matter integrity were found in the corpus callosum rostrum, left acoustic radiation, right dorsal cingulum bundle, and right superior longitudinal fasciculus II, though these results were not corrected for multiple comparisons. Conclusion: Enhanced pre-treatment functional connectivity in visual processing regions and specific white matter tracts may serve as biomarkers for remission in OCD following CBT. These findings could improve understanding of CBT's neural effects and guide personalized treatment strategies.
AB - Background: Obsessive-compulsive disorder (OCD) is commonly treated with cognitive-behavioral therapy (CBT), yet many patients fail to achieve remission. Neuroimaging markers, such as pre-treatment functional and structural connectivity, may help elucidate OCD pathology and CBT mechanisms, and predict treatment outcomes. This study investigates the relationship between pre-treatment functional and structural connectivity and remission status in OCD patients following CBT. Methods: Thirty-three OCD patients underwent multimodal MRI, including resting-state fMRI to assess pre-treatment functional connectivity and diffusion tensor imaging (DTI) to evaluate white matter integrity. Functional connectivity multivariate pattern analysis (fc-MVPA) identified patterns linked to treatment outcomes. TRACULA, a probabilistic tractography technique, analyzed white matter tracts, focusing on diffusion metrics such as fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD). Analysis of covariance (ANCOVA) was used to examine group differences. Results: Remission was associated with significantly higher pre-treatment resting-state functional connectivity between the occipital pole and lateral occipital cortex (height threshold: p < 0.001 uncorrected and cluster threshold: p < 0.05 cluster-size FDR corrected for multiple comparisons), suggesting a role in visual processing. Differences in white matter integrity were found in the corpus callosum rostrum, left acoustic radiation, right dorsal cingulum bundle, and right superior longitudinal fasciculus II, though these results were not corrected for multiple comparisons. Conclusion: Enhanced pre-treatment functional connectivity in visual processing regions and specific white matter tracts may serve as biomarkers for remission in OCD following CBT. These findings could improve understanding of CBT's neural effects and guide personalized treatment strategies.
KW - Cognitive-behavioral therapy
KW - Diffusion MRI
KW - Obsessive-compulsive disorder
KW - Prediction
KW - Resting-state fMRI
KW - Tractography
KW - fc-MVPA
UR - https://www.scopus.com/pages/publications/105009877404
U2 - 10.1016/j.ynirp.2025.100275
DO - 10.1016/j.ynirp.2025.100275
M3 - Article
AN - SCOPUS:105009877404
SN - 2666-9560
VL - 5
JO - Neuroimage: Reports
JF - Neuroimage: Reports
IS - 3
M1 - 100275
ER -