Brain activation of patients with obsessive-compulsive disorder during neuropsychological and symptom provocation tasks before and after symptom improvement: A functional magnetic resonance imaging study

Tomohiro Nakao, Akiko Nakagawa, Takashi Yoshiura, Eriko Nakatani, Maiko Nabeyama, Chika Yoshizato, Akiko Kudoh, Kyoko Tada, Kazuko Yoshioka, Midori Kawamoto, Osamu Togao, Shigenobu Kanba

Research output: Contribution to journalArticlepeer-review

226 Citations (Scopus)

Abstract

Background: Functional neuroimaging studies have implicated hyperactivity of the frontal cortex in obsessive-compulsive disorder (OCD); however, relationships between abnormal brain activity, clinical improvement, and neuropsychological function have not been clarified in OCD. To clarify the pathophysiology of this disorder, regional changes in brain function were examined during administration of cognitive and symptom provocation tasks in patients with OCD before and after treatment. Methods: Ten outpatients with OCD participated in the study. Functional magnetic resonance imaging (fMRI) was performed before and after treatment. Stroop and symptom provocation tasks were administered during fMRI. Each patient was randomly allocated to receive either pharmacotherapy with fluvoxamine 200 mg/day (n = 4) or behavior therapy (n = 6) for 12 weeks. Results: After 12-week treatment, mean (± SD) total score on the Yale-Brown Obsessive-Compulsive Scale decreased from 29.00 ± 3.59 to 14.60 ± 9.22, representing symptomatic improvement from moderate to mild. After symptom improvement, symptom provocation-related activation in the orbitofrontal, dorsolateral-prefrontal, and anterior cingulate cortices decreased. Conversely, Stroop task-related activation in the parietal cortex and cerebellum increased. Conclusions: After improvement of OCD with either fluvoxamine or behavioral therapy, hyperactivation of the frontal lobe related to a symptom-provocative state decreases, and posterior brain activity related to action-monitoring function increases.

Original languageEnglish
Pages (from-to)901-910
Number of pages10
JournalBiological Psychiatry
Volume57
Issue number8
DOIs
Publication statusPublished - Apr 15 2005

All Science Journal Classification (ASJC) codes

  • Biological Psychiatry

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