Obsessive-compulsive disorder and the size of two brain structures

Recent research has explored to what extent the size of two brain structures might help predict the effectiveness of psychological behavior therapy in children with obsessive-compulsive disorder.

The study was carried out by a team made up of, among others, Sara Bertolín, from the Bellvitge University Hospital (HUB) in Hospitalet de Llobregat, Barcelona, ​​and Carles Soriano, professor at the Faculty of Psychology of the University of Barcelona (UB ).

In the child population, obsessive-compulsive disorder generally manifests itself with anxiety in situations that are perceived as annoying or uncontrollable. This leads to the need to, for example, organize things in a certain way, repeat words or behaviors a certain number of times, or repeatedly make sure that an action, such as turning off the light, has been done successfully.

These symptoms interfere with the normal development of family, social and academic activities of these children, and significantly affect their well-being and that of their families.

The treatment of choice for these cases is cognitive-behavioral therapy, a form of psychological intervention that is based on exposing the patient, in a controlled manner, to situations that generate anxiety and letting this anxiety end up being extinguished. In addition, to achieve this normalization of anxiety during exposure to feared situations, cognitive or thought modulation strategies are often used.

Sara Bertolín and Carles Soriano, from the research team. (Photo: UB / IDIBELL)

The size of two brain structures is associated with the response to cognitive-behavioral psychological therapy in children with obsessive-compulsive disorder (OCD), according to the conclusions reached in the aforementioned study, led by teams from the University of Barcelona; the Bellvitge Biomedical Research Institute (IDIBELL); located in Hospitalet de Llobregat and which is part of the CERCA institution of the Generalitat of Catalonia; the University Hospital of Bellvitge; and the Mental Health Network Biomedical Research Center (CIBERSAM) in Spain.

Brain MRI analysis of 168 children and adolescents from centers around the world revealed that those with larger-than-usual size in two structures of the prefrontal cortex had a greater reduction in obsessive-compulsive symptoms after therapy intervention. of the conduct

The results obtained could mean that those patients who have more developed these prefrontal structures —which are related to the response to anxiety— could have a better capacity to take advantage of the emotional regulation strategies provided by behavior therapy.

Carles Soriano, professor at the Faculty of Psychology of the University of Barcelona (UB), principal investigator at IDIBELL and member of CIBERSAM, indicates that “the identification of these structures can mean a great improvement in the clinical management of children with OCD. Although behavioral therapy is more than 60% effective, we still do not know much of the mechanism of action. This prevents us from predicting which patients may benefit.”

In the same study, a large sample of adults was also examined, but no correlation was observed between the size of the aforementioned brain structures and the effectiveness of the therapy. Thus, although behavior therapy is equally effective, the results indicate that the mechanisms of action of this intervention may differ from those of children.

The study is titled “Right Prefrontal Cortical Thickness Is Associated With Response to Cognitive-Behavioral Therapy in Children With Obsessive-Compulsive Disorder.” And it has been published in the Journal of the American Academy of Child and Adolescent Psychiatry. (Source: UB)