Atmaca Murad, Yildirim Hanefi, Yilmaz Seda, Caglar Neslihan, Mermi Osman, Korkmaz Sevda, Akaslan Unsal, Gurok M Gurkan, Kekilli Yasemin, Turkcapar Hakan
1 School of Medicine, Department of Psychiatry, Firat University, Elazig, Turkey.
2 School of Medicine, Department of Radiology, Firat University, Elazig, Turkey.
Int J Psychiatry Med. 2018 Jul;53(4):243-255. doi: 10.1177/0091217415621038. Epub 2016 Jan 5.
Background The effect of a variety of treatment modalities including psychopharmacological and cognitive behavioral therapy on the brain volumes and neurochemicals have not been investigated enough in the patients with obsessive-compulsive disorder. Therefore, in the present study, we aimed to investigate the effect of cognitive behavioral therapy on the volumes of the orbito-frontal cortex and thalamus regions which seem to be abnormal in the patients with obsessive-compulsive disorder. We hypothesized that there would be change in the volumes of the orbito-frontal cortex and thalamus. Methods Twelve patients with obsessive-compulsive disorder and same number of healthy controls were included into the study. At the beginning of the study, the volumes of the orbito-frontal cortex and thalamus were compared by using magnetic resonance imaging. In addition, volumes of these regions were measured before and after the cognitive behavioral therapy treatment in the patient group. Results The patients with obsessive-compulsive disorder had greater left and right thalamus volumes and smaller left and right orbito-frontal cortex volumes compared to those of healthy control subjects at the beginning of the study. When we compared baseline volumes of the patients with posttreatment ones, we detected that thalamus volumes significantly decreased throughout the period for both sides and that the orbito-frontal cortex volumes significantly increased throughout the period for only left side. Conclusions In summary, we found that cognitive behavioral therapy might volumetrically affect the key brain regions involved in the neuroanatomy of obsessive-compulsive disorder. However, future studies with larger sample are required.
包括心理药理学和认知行为疗法在内的多种治疗方式对强迫症患者脑容量和神经化学物质的影响尚未得到充分研究。因此,在本研究中,我们旨在探讨认知行为疗法对强迫症患者中似乎异常的眶额皮质和丘脑区域体积的影响。我们假设眶额皮质和丘脑的体积会发生变化。
12名强迫症患者和相同数量的健康对照者被纳入研究。在研究开始时,使用磁共振成像比较眶额皮质和丘脑的体积。此外,在患者组中,在认知行为疗法治疗前后测量这些区域的体积。
在研究开始时,与健康对照者相比,强迫症患者的左右丘脑体积更大,左右眶额皮质体积更小。当我们将患者的基线体积与治疗后的体积进行比较时,我们发现双侧丘脑体积在整个时期均显著减小,而仅左侧眶额皮质体积在整个时期显著增加。
总之,我们发现认知行为疗法可能在体积上影响强迫症神经解剖学中涉及的关键脑区。然而,需要未来进行更大样本量的研究。