Neurochemical analyses in pediatric obsessive-compulsive disorder in patients treated with cognitive-behavioral therapy

Objective: To investigate neurochemical changes in the caudate nucleus of pediatric obsessive-compulsive disorder (OCD) patients before and after cognitive-behavioral therapy (CBT), and to examine corresponding changes in symptom severity. Method: Single-voxel proton magnetic resonance spectroscopic (¹H-MRS) examination of the left caudate was conducted in 21 treatment-naive children, aged 6 to 16 years, before and after 12 weeks of CBT. Subjects were measured at baseline and posttreatment by the Yale-Brown Obsessive Compulsive Scale for Children, Hamilton Depression Rating Scale, and Hamilton Anxiety Rating Scale. Results: No significant changes in caudate neurochemistry were observed in OCD patients before and after CBT despite unambiguous improvement in OCD symptoms, depression, and anxiety. Conclusions: Findings suggest that reduction in caudate Glx may be specific to SSRI treatment and not due to a more generalized treatment response or spontaneous improvement of symptoms. Differential sets of pathophysiologic and treatment response markers may moderate/mediate the effects of particular treatments on outcome.