FDG-PET predictors of response to behavioral therapy and pharmacotherapy in obsessive compulsive disorder
In subjects with obsessive-compulsive disorder (OCD), lower pre-treatment metabolism in the right orbitofrontal cortex (OFC) and anterior cingulate gyrus (AC) has been associated with a better response to clomipramine. We sought to determine pre-treatment metabolic predictors of response to behavior...
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| Veröffentlicht in: | Psychiatry research 1998-11, Vol.84 (1), p.1-6 |
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| creator | Brody, Arthur L Saxena, Sanjaya Schwartz, Jeffrey M Stoessel, Paula W Maidment, Karron Phelps, Michael E Baxter, Lewis R |
| description | In subjects with obsessive-compulsive disorder (OCD), lower pre-treatment metabolism in the right orbitofrontal cortex (OFC) and anterior cingulate gyrus (AC) has been associated with a better response to clomipramine. We sought to determine pre-treatment metabolic predictors of response to behavioral therapy (BT) vs. pharmacotherapy in subjects with OCD. To do this, [
18F]fluorodeoxyglucose positron emission tomography scans of the brain were obtained in subjects with OCD before treatment with either BT or fluoxetine. A Step-Wise Variable Selection was applied to normalized pre-treatment glucose metabolic rates in the OFC, AC, and caudate by treatment response (change in Yale–Brown Obsessive-Compulsive Scale) in the larger BT group. Left OFC metabolism (normalized to the ipsilateral hemisphere) alone was selected as predicting treatment response in the BT-treated group (
F=6.07, d.f.=1,17,
P=0.025). Correlations between normalized left OFC metabolism and treatment response revealed that higher normalized metabolism in this region was associated with greater improvement in the BT-treated group (τ=0.35,
P=0.04), but worse outcome (τ=−0.57,
P=0.03) in the fluoxetine-treated group. These results suggest that subjects with differing patterns of metabolism preferentially respond to BT vs. medication. |
| doi_str_mv | 10.1016/S0925-4927(98)00041-9 |
| format | Article |
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18F]fluorodeoxyglucose positron emission tomography scans of the brain were obtained in subjects with OCD before treatment with either BT or fluoxetine. A Step-Wise Variable Selection was applied to normalized pre-treatment glucose metabolic rates in the OFC, AC, and caudate by treatment response (change in Yale–Brown Obsessive-Compulsive Scale) in the larger BT group. Left OFC metabolism (normalized to the ipsilateral hemisphere) alone was selected as predicting treatment response in the BT-treated group (
F=6.07, d.f.=1,17,
P=0.025). Correlations between normalized left OFC metabolism and treatment response revealed that higher normalized metabolism in this region was associated with greater improvement in the BT-treated group (τ=0.35,
P=0.04), but worse outcome (τ=−0.57,
P=0.03) in the fluoxetine-treated group. These results suggest that subjects with differing patterns of metabolism preferentially respond to BT vs. medication.</description><identifier>ISSN: 0925-4927</identifier><identifier>ISSN: 0165-1781</identifier><identifier>EISSN: 1872-7506</identifier><identifier>DOI: 10.1016/S0925-4927(98)00041-9</identifier><identifier>PMID: 9870412</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>Adult ; Antidepressive Agents, Tricyclic - therapeutic use ; Behavior Therapy - methods ; Behavior therapy. Cognitive therapy ; Biological and medical sciences ; Brain - diagnostic imaging ; Brain - metabolism ; Clomipramine - therapeutic use ; Female ; Fluorodeoxyglucose ; Fluoxetine ; Humans ; Male ; Medical sciences ; Middle Aged ; Neuropharmacology ; Obsessive-compulsive disorder ; Obsessive-Compulsive Disorder - diagnosis ; Obsessive-Compulsive Disorder - therapy ; Orbitofrontal cortex ; Pharmacology. Drug treatments ; Positron emission tomography ; Psycholeptics: tranquillizer, neuroleptic ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Psychopharmacology ; Tomography, Emission-Computed ; Treatment response ; Treatments</subject><ispartof>Psychiatry research, 1998-11, Vol.84 (1), p.1-6</ispartof><rights>1998 Elsevier Science Ireland Ltd</rights><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-887925dc148e64206f8ef66dea195fe838b64c013719f123f625d936549621a43</citedby><cites>FETCH-LOGICAL-c455t-887925dc148e64206f8ef66dea195fe838b64c013719f123f625d936549621a43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0925492798000419$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1812958$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9870412$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Brody, Arthur L</creatorcontrib><creatorcontrib>Saxena, Sanjaya</creatorcontrib><creatorcontrib>Schwartz, Jeffrey M</creatorcontrib><creatorcontrib>Stoessel, Paula W</creatorcontrib><creatorcontrib>Maidment, Karron</creatorcontrib><creatorcontrib>Phelps, Michael E</creatorcontrib><creatorcontrib>Baxter, Lewis R</creatorcontrib><title>FDG-PET predictors of response to behavioral therapy and pharmacotherapy in obsessive compulsive disorder</title><title>Psychiatry research</title><addtitle>Psychiatry Res</addtitle><description>In subjects with obsessive-compulsive disorder (OCD), lower pre-treatment metabolism in the right orbitofrontal cortex (OFC) and anterior cingulate gyrus (AC) has been associated with a better response to clomipramine. We sought to determine pre-treatment metabolic predictors of response to behavioral therapy (BT) vs. pharmacotherapy in subjects with OCD. To do this, [
18F]fluorodeoxyglucose positron emission tomography scans of the brain were obtained in subjects with OCD before treatment with either BT or fluoxetine. A Step-Wise Variable Selection was applied to normalized pre-treatment glucose metabolic rates in the OFC, AC, and caudate by treatment response (change in Yale–Brown Obsessive-Compulsive Scale) in the larger BT group. Left OFC metabolism (normalized to the ipsilateral hemisphere) alone was selected as predicting treatment response in the BT-treated group (
F=6.07, d.f.=1,17,
P=0.025). Correlations between normalized left OFC metabolism and treatment response revealed that higher normalized metabolism in this region was associated with greater improvement in the BT-treated group (τ=0.35,
P=0.04), but worse outcome (τ=−0.57,
P=0.03) in the fluoxetine-treated group. These results suggest that subjects with differing patterns of metabolism preferentially respond to BT vs. medication.</description><subject>Adult</subject><subject>Antidepressive Agents, Tricyclic - therapeutic use</subject><subject>Behavior Therapy - methods</subject><subject>Behavior therapy. Cognitive therapy</subject><subject>Biological and medical sciences</subject><subject>Brain - diagnostic imaging</subject><subject>Brain - metabolism</subject><subject>Clomipramine - therapeutic use</subject><subject>Female</subject><subject>Fluorodeoxyglucose</subject><subject>Fluoxetine</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neuropharmacology</subject><subject>Obsessive-compulsive disorder</subject><subject>Obsessive-Compulsive Disorder - diagnosis</subject><subject>Obsessive-Compulsive Disorder - therapy</subject><subject>Orbitofrontal cortex</subject><subject>Pharmacology. Drug treatments</subject><subject>Positron emission tomography</subject><subject>Psycholeptics: tranquillizer, neuroleptic</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Psychopharmacology</subject><subject>Tomography, Emission-Computed</subject><subject>Treatment response</subject><subject>Treatments</subject><issn>0925-4927</issn><issn>0165-1781</issn><issn>1872-7506</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUtLJDEQgIMoOqv-BCEHkfXQmqS708lpWXztgqCgnkMmXWEi3Z3eVM-A_944M6tHTylSXz34ipATzi444_LyiWlRF5UWzU-tzhljFS_0Dplx1YiiqZncJbNP5ID8QHxlTJRKlvtkX6sm82JGwu31XfF480zHBG1wU0xIo6cJcIwDAp0incPCrkJMtqPTApId36gdWjoubOqti___wkDjHAExrIC62I_Lbh22AWNqIR2RPW87hOPte0hebm-er_4U9w93f69-3xeuquupUKrJS7eOVwpkJZj0CryULViuaw-qVHNZOcbLhmvPRellpnUp60pLwW1VHpKzTd8xxX9LwMn0AR10nR0gLtFIzZngTZPBegO6FBETeDOm0Nv0ZjgzH4rNWrH58Ge0MmvFRue6k-2A5byH9rNq6zTnT7d5i852PtnBBfxqrrjQtcrYrw0GWcYqQDLoAgwunyGBm0wbwzeLvANykZhP</recordid><startdate>19981109</startdate><enddate>19981109</enddate><creator>Brody, Arthur L</creator><creator>Saxena, Sanjaya</creator><creator>Schwartz, Jeffrey M</creator><creator>Stoessel, Paula W</creator><creator>Maidment, Karron</creator><creator>Phelps, Michael E</creator><creator>Baxter, Lewis R</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19981109</creationdate><title>FDG-PET predictors of response to behavioral therapy and pharmacotherapy in obsessive compulsive disorder</title><author>Brody, Arthur L ; Saxena, Sanjaya ; Schwartz, Jeffrey M ; Stoessel, Paula W ; Maidment, Karron ; Phelps, Michael E ; Baxter, Lewis R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-887925dc148e64206f8ef66dea195fe838b64c013719f123f625d936549621a43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Adult</topic><topic>Antidepressive Agents, Tricyclic - therapeutic use</topic><topic>Behavior Therapy - methods</topic><topic>Behavior therapy. Cognitive therapy</topic><topic>Biological and medical sciences</topic><topic>Brain - diagnostic imaging</topic><topic>Brain - metabolism</topic><topic>Clomipramine - therapeutic use</topic><topic>Female</topic><topic>Fluorodeoxyglucose</topic><topic>Fluoxetine</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neuropharmacology</topic><topic>Obsessive-compulsive disorder</topic><topic>Obsessive-Compulsive Disorder - diagnosis</topic><topic>Obsessive-Compulsive Disorder - therapy</topic><topic>Orbitofrontal cortex</topic><topic>Pharmacology. Drug treatments</topic><topic>Positron emission tomography</topic><topic>Psycholeptics: tranquillizer, neuroleptic</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Psychopharmacology</topic><topic>Tomography, Emission-Computed</topic><topic>Treatment response</topic><topic>Treatments</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Brody, Arthur L</creatorcontrib><creatorcontrib>Saxena, Sanjaya</creatorcontrib><creatorcontrib>Schwartz, Jeffrey M</creatorcontrib><creatorcontrib>Stoessel, Paula W</creatorcontrib><creatorcontrib>Maidment, Karron</creatorcontrib><creatorcontrib>Phelps, Michael E</creatorcontrib><creatorcontrib>Baxter, Lewis R</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Psychiatry research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Brody, Arthur L</au><au>Saxena, Sanjaya</au><au>Schwartz, Jeffrey M</au><au>Stoessel, Paula W</au><au>Maidment, Karron</au><au>Phelps, Michael E</au><au>Baxter, Lewis R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>FDG-PET predictors of response to behavioral therapy and pharmacotherapy in obsessive compulsive disorder</atitle><jtitle>Psychiatry research</jtitle><addtitle>Psychiatry Res</addtitle><date>1998-11-09</date><risdate>1998</risdate><volume>84</volume><issue>1</issue><spage>1</spage><epage>6</epage><pages>1-6</pages><issn>0925-4927</issn><issn>0165-1781</issn><eissn>1872-7506</eissn><abstract>In subjects with obsessive-compulsive disorder (OCD), lower pre-treatment metabolism in the right orbitofrontal cortex (OFC) and anterior cingulate gyrus (AC) has been associated with a better response to clomipramine. We sought to determine pre-treatment metabolic predictors of response to behavioral therapy (BT) vs. pharmacotherapy in subjects with OCD. To do this, [
18F]fluorodeoxyglucose positron emission tomography scans of the brain were obtained in subjects with OCD before treatment with either BT or fluoxetine. A Step-Wise Variable Selection was applied to normalized pre-treatment glucose metabolic rates in the OFC, AC, and caudate by treatment response (change in Yale–Brown Obsessive-Compulsive Scale) in the larger BT group. Left OFC metabolism (normalized to the ipsilateral hemisphere) alone was selected as predicting treatment response in the BT-treated group (
F=6.07, d.f.=1,17,
P=0.025). Correlations between normalized left OFC metabolism and treatment response revealed that higher normalized metabolism in this region was associated with greater improvement in the BT-treated group (τ=0.35,
P=0.04), but worse outcome (τ=−0.57,
P=0.03) in the fluoxetine-treated group. These results suggest that subjects with differing patterns of metabolism preferentially respond to BT vs. medication.</abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>9870412</pmid><doi>10.1016/S0925-4927(98)00041-9</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adult Antidepressive Agents, Tricyclic - therapeutic use Behavior Therapy - methods Behavior therapy. Cognitive therapy Biological and medical sciences Brain - diagnostic imaging Brain - metabolism Clomipramine - therapeutic use Female Fluorodeoxyglucose Fluoxetine Humans Male Medical sciences Middle Aged Neuropharmacology Obsessive-compulsive disorder Obsessive-Compulsive Disorder - diagnosis Obsessive-Compulsive Disorder - therapy Orbitofrontal cortex Pharmacology. Drug treatments Positron emission tomography Psycholeptics: tranquillizer, neuroleptic Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychopharmacology Tomography, Emission-Computed Treatment response Treatments |
| title | FDG-PET predictors of response to behavioral therapy and pharmacotherapy in obsessive compulsive disorder |
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