Is glutamate associated with fear extinction and cognitive behavior therapy outcome in OCD? A pilot study
Cognitive behavioral therapy (CBT) including exposure and response prevention is a well-established treatment for obsessive–compulsive disorder (OCD) and is based on the principles of fear extinction. Fear extinction is linked to structural and functional variability in the ventromedial prefrontal c...
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| Veröffentlicht in: | European archives of psychiatry and clinical neuroscience 2020-12, Vol.270 (8), p.1003-1014 |
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| creator | Giménez, M. Cano, M. Martínez-Zalacaín, I. Real, E. Alonso, P. Segalàs, C. Munuera, J. Kegeles, L. S. Weinstein, J. J. Xu, X. Menchón, J. M. Cardoner, N. Soriano-Mas, C. Fullana, M. A. |
| description | Cognitive behavioral therapy (CBT) including exposure and response prevention is a well-established treatment for obsessive–compulsive disorder (OCD) and is based on the principles of fear extinction. Fear extinction is linked to structural and functional variability in the ventromedial prefrontal cortex (vmPFC) and has been consistently associated with glutamate neurotransmission. The relationship between vmPFC glutamate and fear extinction and its effects on CBT outcome have not yet been explored in adults with OCD. We assessed glutamate levels in the vmPFC using 3T magnetic resonance spectroscopy, and fear extinction (learning and recall) using skin conductance responses during a 2-day experimental paradigm in OCD patients (
n
= 17) and in healthy controls (HC;
n
= 13). Obsessive–compulsive patients (
n
= 12) then received manualized CBT. Glutamate in the vmPFC was negatively associated with fear extinction recall and positively associated with CBT outcome (with higher glutamate levels predicting a better outcome) in OCD patients. Glutamate levels in the vmPFC in OCD patients were not significantly different from those in HC, and were not associated with OCD severity. Our results suggest that glutamate in the vmPFC is associated with fear extinction recall and CBT outcome in adult OCD patients. |
| doi_str_mv | 10.1007/s00406-019-01056-3 |
| format | Article |
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n
= 17) and in healthy controls (HC;
n
= 13). Obsessive–compulsive patients (
n
= 12) then received manualized CBT. Glutamate in the vmPFC was negatively associated with fear extinction recall and positively associated with CBT outcome (with higher glutamate levels predicting a better outcome) in OCD patients. Glutamate levels in the vmPFC in OCD patients were not significantly different from those in HC, and were not associated with OCD severity. Our results suggest that glutamate in the vmPFC is associated with fear extinction recall and CBT outcome in adult OCD patients.</description><identifier>ISSN: 0940-1334</identifier><identifier>EISSN: 1433-8491</identifier><identifier>DOI: 10.1007/s00406-019-01056-3</identifier><identifier>PMID: 31432262</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Behavior modification ; Behavior therapy ; Cognition & reasoning ; Cognitive ability ; Cognitive behavioral therapy ; Conductance ; Extinction (Learning) ; Extinction behavior ; Fear conditioning ; Magnetic resonance spectroscopy ; Medicine ; Medicine & Public Health ; Neurosciences ; Neurotransmission ; Obsessive compulsive disorder ; Original Paper ; Prefrontal cortex ; Psychiatry ; Response prevention ; Structure-function relationships</subject><ispartof>European archives of psychiatry and clinical neuroscience, 2020-12, Vol.270 (8), p.1003-1014</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019</rights><rights>European Archives of Psychiatry and Clinical Neuroscience is a copyright of Springer, (2019). All Rights Reserved.</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2019.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c403t-6786a476f0b99f69810a299ee775b5039218245346aa9074c51d88e8d039c2bf3</citedby><cites>FETCH-LOGICAL-c403t-6786a476f0b99f69810a299ee775b5039218245346aa9074c51d88e8d039c2bf3</cites><orcidid>0000-0003-0675-9483 ; 0000-0002-5779-9111 ; 0000-0001-9633-0888 ; 0000-0003-4523-1649 ; 0000-0003-4574-6597 ; 0000-0002-0959-0356 ; 0000-0001-5154-1796 ; 0000-0002-8083-1167 ; 0000-0002-3877-6483 ; 0000-0003-2757-0145 ; 0000-0002-6231-6524 ; 0000-0003-3863-5223 ; 0000-0002-4036-0284</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00406-019-01056-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00406-019-01056-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31432262$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Giménez, M.</creatorcontrib><creatorcontrib>Cano, M.</creatorcontrib><creatorcontrib>Martínez-Zalacaín, I.</creatorcontrib><creatorcontrib>Real, E.</creatorcontrib><creatorcontrib>Alonso, P.</creatorcontrib><creatorcontrib>Segalàs, C.</creatorcontrib><creatorcontrib>Munuera, J.</creatorcontrib><creatorcontrib>Kegeles, L. S.</creatorcontrib><creatorcontrib>Weinstein, J. J.</creatorcontrib><creatorcontrib>Xu, X.</creatorcontrib><creatorcontrib>Menchón, J. M.</creatorcontrib><creatorcontrib>Cardoner, N.</creatorcontrib><creatorcontrib>Soriano-Mas, C.</creatorcontrib><creatorcontrib>Fullana, M. A.</creatorcontrib><title>Is glutamate associated with fear extinction and cognitive behavior therapy outcome in OCD? A pilot study</title><title>European archives of psychiatry and clinical neuroscience</title><addtitle>Eur Arch Psychiatry Clin Neurosci</addtitle><addtitle>Eur Arch Psychiatry Clin Neurosci</addtitle><description>Cognitive behavioral therapy (CBT) including exposure and response prevention is a well-established treatment for obsessive–compulsive disorder (OCD) and is based on the principles of fear extinction. Fear extinction is linked to structural and functional variability in the ventromedial prefrontal cortex (vmPFC) and has been consistently associated with glutamate neurotransmission. The relationship between vmPFC glutamate and fear extinction and its effects on CBT outcome have not yet been explored in adults with OCD. We assessed glutamate levels in the vmPFC using 3T magnetic resonance spectroscopy, and fear extinction (learning and recall) using skin conductance responses during a 2-day experimental paradigm in OCD patients (
n
= 17) and in healthy controls (HC;
n
= 13). Obsessive–compulsive patients (
n
= 12) then received manualized CBT. Glutamate in the vmPFC was negatively associated with fear extinction recall and positively associated with CBT outcome (with higher glutamate levels predicting a better outcome) in OCD patients. Glutamate levels in the vmPFC in OCD patients were not significantly different from those in HC, and were not associated with OCD severity. Our results suggest that glutamate in the vmPFC is associated with fear extinction recall and CBT outcome in adult OCD patients.</description><subject>Behavior modification</subject><subject>Behavior therapy</subject><subject>Cognition & reasoning</subject><subject>Cognitive ability</subject><subject>Cognitive behavioral therapy</subject><subject>Conductance</subject><subject>Extinction (Learning)</subject><subject>Extinction behavior</subject><subject>Fear conditioning</subject><subject>Magnetic resonance spectroscopy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurosciences</subject><subject>Neurotransmission</subject><subject>Obsessive compulsive disorder</subject><subject>Original Paper</subject><subject>Prefrontal cortex</subject><subject>Psychiatry</subject><subject>Response prevention</subject><subject>Structure-function relationships</subject><issn>0940-1334</issn><issn>1433-8491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kU1r3DAQhkVoabZp_0AOQdBLL25HH9bHKYRNPwKBXNqzkGV5V8G2NpKcZP991W6aQg85iBHMM-8MPAidEvhEAOTnDMBBNEB0fdCKhh2hFeGMNYpr8gqtQHNoCGP8GL3N-RYASEvhDTpmlaJU0BUKVxlvxqXYyRaPbc7Rhfrr8UMoWzx4m7B_LGF2JcQZ27nHLm7mUMK9x53f2vsQEy5bn-xuj-NSXJw8DjO-WV-e4wu8C2MsOJel379Drwc7Zv_-qZ6gn1-__Fh_b65vvl2tL64bx4GVRkglLJdigE7rQWhFwFKtvZey7VpgmhJFecu4sFaD5K4lvVJe9bXlaDewE_TxkLtL8W7xuZgpZOfH0c4-LtlQxmqq4kRV9MN_6G1c0lyvM5RLIlpCqHiRolIIzQTIStED5VLMOfnB7FKYbNobAua3LnPQZaou80eXYXXo7Cl66SbfP4_89VMBdgBybc0bn_7tfiH2F7E2nX4</recordid><startdate>20201201</startdate><enddate>20201201</enddate><creator>Giménez, M.</creator><creator>Cano, M.</creator><creator>Martínez-Zalacaín, I.</creator><creator>Real, E.</creator><creator>Alonso, P.</creator><creator>Segalàs, C.</creator><creator>Munuera, J.</creator><creator>Kegeles, L. 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A.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>European archives of psychiatry and clinical neuroscience</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Giménez, M.</au><au>Cano, M.</au><au>Martínez-Zalacaín, I.</au><au>Real, E.</au><au>Alonso, P.</au><au>Segalàs, C.</au><au>Munuera, J.</au><au>Kegeles, L. S.</au><au>Weinstein, J. J.</au><au>Xu, X.</au><au>Menchón, J. M.</au><au>Cardoner, N.</au><au>Soriano-Mas, C.</au><au>Fullana, M. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is glutamate associated with fear extinction and cognitive behavior therapy outcome in OCD? A pilot study</atitle><jtitle>European archives of psychiatry and clinical neuroscience</jtitle><stitle>Eur Arch Psychiatry Clin Neurosci</stitle><addtitle>Eur Arch Psychiatry Clin Neurosci</addtitle><date>2020-12-01</date><risdate>2020</risdate><volume>270</volume><issue>8</issue><spage>1003</spage><epage>1014</epage><pages>1003-1014</pages><issn>0940-1334</issn><eissn>1433-8491</eissn><abstract>Cognitive behavioral therapy (CBT) including exposure and response prevention is a well-established treatment for obsessive–compulsive disorder (OCD) and is based on the principles of fear extinction. Fear extinction is linked to structural and functional variability in the ventromedial prefrontal cortex (vmPFC) and has been consistently associated with glutamate neurotransmission. The relationship between vmPFC glutamate and fear extinction and its effects on CBT outcome have not yet been explored in adults with OCD. We assessed glutamate levels in the vmPFC using 3T magnetic resonance spectroscopy, and fear extinction (learning and recall) using skin conductance responses during a 2-day experimental paradigm in OCD patients (
n
= 17) and in healthy controls (HC;
n
= 13). Obsessive–compulsive patients (
n
= 12) then received manualized CBT. Glutamate in the vmPFC was negatively associated with fear extinction recall and positively associated with CBT outcome (with higher glutamate levels predicting a better outcome) in OCD patients. Glutamate levels in the vmPFC in OCD patients were not significantly different from those in HC, and were not associated with OCD severity. Our results suggest that glutamate in the vmPFC is associated with fear extinction recall and CBT outcome in adult OCD patients.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>31432262</pmid><doi>10.1007/s00406-019-01056-3</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0003-0675-9483</orcidid><orcidid>https://orcid.org/0000-0002-5779-9111</orcidid><orcidid>https://orcid.org/0000-0001-9633-0888</orcidid><orcidid>https://orcid.org/0000-0003-4523-1649</orcidid><orcidid>https://orcid.org/0000-0003-4574-6597</orcidid><orcidid>https://orcid.org/0000-0002-0959-0356</orcidid><orcidid>https://orcid.org/0000-0001-5154-1796</orcidid><orcidid>https://orcid.org/0000-0002-8083-1167</orcidid><orcidid>https://orcid.org/0000-0002-3877-6483</orcidid><orcidid>https://orcid.org/0000-0003-2757-0145</orcidid><orcidid>https://orcid.org/0000-0002-6231-6524</orcidid><orcidid>https://orcid.org/0000-0003-3863-5223</orcidid><orcidid>https://orcid.org/0000-0002-4036-0284</orcidid></addata></record> |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Behavior modification Behavior therapy Cognition & reasoning Cognitive ability Cognitive behavioral therapy Conductance Extinction (Learning) Extinction behavior Fear conditioning Magnetic resonance spectroscopy Medicine Medicine & Public Health Neurosciences Neurotransmission Obsessive compulsive disorder Original Paper Prefrontal cortex Psychiatry Response prevention Structure-function relationships |
| title | Is glutamate associated with fear extinction and cognitive behavior therapy outcome in OCD? A pilot study |
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