Treatment effect of behavior therapy and pharmacotherapy on obsessive-compulsive disorder exploring by functional neuroimaging techniques

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  • Nakao Tomohiro
    Department of Neuropsychiatry, Graduate School of Medical Sciences Kyushu University

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  • OCDの行動療法と薬物療法─機能的脳画像による効果の検証
  • OCDの行動療法と薬物療法 : 機能的脳画像による効果の検証
  • OCD ノ コウドウ リョウホウ ト ヤクブツ リョウホウ : キノウテキ ノウ ガゾウ ニ ヨル コウカ ノ ケンショウ

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Abstract

There is now ample evidence that selective serotonin reuptake inhibitors (SSRIs) and behavior therapy are highly effective methods for treatment of obsessive- compulsive disorder (OCD). It is, however, still unclear how these interventions improve the symptoms. A large number of recent neuroimaging studies using PET, SPECT and fMRI have found that abnormally high activities occur throughout the frontal cortex and subcortical structures in OCD and these hyperactivities were decreased after successful treatment using either SSRIs or behavioral therapy. In future, we should identify how each treatment repair the functional brain abnormalities in OCD. The evidence from recent neuroimaging studies also suggest that the orbitofronto- striatal model may not be sufficient to explain the brain basis of OCD and broader regions including dorsolateral prefrontal and posterior regions might involve pathophysiology of OCD. Furthermore, we should consider that OCD is heterogeneous and might have some different neural systems related to clinical factors. Neurobiological studies should be performed for development of treatment strategy with comprehension of OCD pathophysiology.

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