MRSI Correlates of CBT in Pediatric OCD

A recent study published in Progress in Neuro-Psychopharmacological & Biological Psychiatry found that Cognitive Behavior Therapy (CBT) is effective in altering metabolic hyperactivity of neurochemicals associated with OCD symptoms in pediatric obsessive-compulsive disorder (OCD) patients. OCD is an anxiety disorder in which individuals experience obsessive, anxiety producing thoughts and seek relief through engaging in repetitive, compulsive behaviors. The current study investigated effects of CBT on neurochemicals in pediatric OCD. A variation of magnetic resonance imaging (MRI) was used to study the effects of CBT on specific neurochemicals in specific areas of the brain that are associated with OCD.

The participants included five, medication-free patients with diagnosed OCD and no prior exposure to CBT. The average age of the participants was 13. Each participant underwent exposure-based CBT once a week for 12 weeks. OCD symptom severity was assessed before and after the 12-week intervention using the Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). MRIs were also conducted on each patient before and after the study to measure neurochemical levels.

Certain neurochemicals associated with OCD significantly contribute to the obsessive thoughts and ritualistic behaviors characteristic of the disorder. Normally, these chemicals work in tandem in a specific neural pathway to moderate the initiation, sustainability and eventual ending of behavioral routines. In individuals with OCD, however, there is increased activity in this pathway, creating an imbalance in activity. When patients adhere to exposure-based CBT techniques, the chemicals have a chance to correct the imbalance, allowing the brain, body and behaviors to synchronize. In this study, four of the five participants had significant post-CBT decreases in the chemicals known to negatively affect the behavioral routine cycle. Though not statistically significant, participants also had a 32.8% decline in symptom severity based on their post-CBT CY-BOCS score. It is evident that CBT, which is based on modifying maladaptive thoughts and behaviors, can actually alter abnormal brain chemistry in OCD patients which helps reduce symptoms of the disorder.

O’Neill, J., Piacentini, J.C., Chang, S., Levitt, G. J., Rozenman, M., Bergman, L.,…McCraken, J.T. (2011). MRSI correlates of cognitive-behavioral therapy in pediatric obsessive- compulsive disorder. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 36 (2012) 161-168.