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Altered fronto-amygdalar functional connectivity predicts response to cognitive behavioral therapy in pediatric obsessive-compulsive disorder.

Publication ,  Journal Article
Cyr, M; Pagliaccio, D; Yanes-Lukin, P; Goldberg, P; Fontaine, M; Rynn, MA; Marsh, R
Published in: Depress Anxiety
August 2021

BACKGROUND: Based on findings from adults with obsessive-compulsive disorder (OCD), this study examined alterations in resting-state functional connectivity (rs-fc) between the basolateral amygdala (BLA) and the ventromedial prefrontal cortex (vmPFC) in children and adolescents with OCD. We also assessed whether such BLA-vmPFC connectivity changed with or predicted response to exposure and response prevention (E/RP), the first-line treatment for pediatric OCD, given the involvement of these regions in fear processing, regulation, and extinction learning-a probable mechanism of action of E/RP. METHODS: Resting state functional magnetic resonance imaging scans were acquired from 25 unmedicated, treatment-naïve pediatric patients with OCD (12.8 ± 2.9 years) and 23 age- and sex-matched healthy controls (HCs; 11.0 ± 3.3 years). Patients completed a 12-16-week E/RP intervention for OCD. Participants were rescanned after the 12-16-week period. ANCOVAs tested group differences in baseline rs-fc. Cross-lagged panel models examined relationships between BLA-vmPFC rs-fc and OCD symptoms pre- and posttreatment. All tests were adjusted for participants' age, sex, and head motion. RESULTS: Right BLA-vmPFC rs-fc was significantly reduced (more negative) in patients with OCD relative to HCs at baseline, and increased following treatment. In patients, more positive (less negative) right BLA-vmPFC rs-fc pretreatment predicted greater OCD symptoms reduction posttreatment. Changes in BLA-vmPFC rs-fc was unassociated with change in OCD symptoms pre- to posttreatment. CONCLUSIONS: These results provide further evidence of the BLA-vmPFC pathway as a potential target for novel treatments or prevention strategies aimed at facilitating adaptive learning and fear extinction in children with OCD or subclinical OCD symptoms.

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Published In

Depress Anxiety

DOI

EISSN

1520-6394

Publication Date

August 2021

Volume

38

Issue

8

Start / End Page

836 / 845

Location

United States

Related Subject Headings

  • Rest
  • Psychiatry
  • Obsessive-Compulsive Disorder
  • Neural Pathways
  • Magnetic Resonance Imaging
  • Humans
  • Fear
  • Extinction, Psychological
  • Cognitive Behavioral Therapy
  • Child
 

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Cyr, M., Pagliaccio, D., Yanes-Lukin, P., Goldberg, P., Fontaine, M., Rynn, M. A., & Marsh, R. (2021). Altered fronto-amygdalar functional connectivity predicts response to cognitive behavioral therapy in pediatric obsessive-compulsive disorder. Depress Anxiety, 38(8), 836–845. https://doi.org/10.1002/da.23187
Cyr, Marilyn, David Pagliaccio, Paula Yanes-Lukin, Pablo Goldberg, Martine Fontaine, Moira A. Rynn, and Rachel Marsh. “Altered fronto-amygdalar functional connectivity predicts response to cognitive behavioral therapy in pediatric obsessive-compulsive disorder.Depress Anxiety 38, no. 8 (August 2021): 836–45. https://doi.org/10.1002/da.23187.
Cyr M, Pagliaccio D, Yanes-Lukin P, Goldberg P, Fontaine M, Rynn MA, et al. Altered fronto-amygdalar functional connectivity predicts response to cognitive behavioral therapy in pediatric obsessive-compulsive disorder. Depress Anxiety. 2021 Aug;38(8):836–45.
Cyr, Marilyn, et al. “Altered fronto-amygdalar functional connectivity predicts response to cognitive behavioral therapy in pediatric obsessive-compulsive disorder.Depress Anxiety, vol. 38, no. 8, Aug. 2021, pp. 836–45. Pubmed, doi:10.1002/da.23187.
Cyr M, Pagliaccio D, Yanes-Lukin P, Goldberg P, Fontaine M, Rynn MA, Marsh R. Altered fronto-amygdalar functional connectivity predicts response to cognitive behavioral therapy in pediatric obsessive-compulsive disorder. Depress Anxiety. 2021 Aug;38(8):836–845.
Journal cover image

Published In

Depress Anxiety

DOI

EISSN

1520-6394

Publication Date

August 2021

Volume

38

Issue

8

Start / End Page

836 / 845

Location

United States

Related Subject Headings

  • Rest
  • Psychiatry
  • Obsessive-Compulsive Disorder
  • Neural Pathways
  • Magnetic Resonance Imaging
  • Humans
  • Fear
  • Extinction, Psychological
  • Cognitive Behavioral Therapy
  • Child