This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Jeffrey M. Schwartz, MD; Paula W. Stoessel, PhD; Lewis R. Baxter, Jr, MD; Karron M. Martin, RN; Michael E. Phelps, PhD

Arch Gen Psychiatry. 1996;53(2):109-113.

Abstract
Background
We sought to determine in a new patient sample whether symptomatic improvement in obsessivecompulsive disorder treated with behavior modification is accompanied by significant changes in glucose metabolic rates in the caudate nucleus, measured with positron emission tomography, as seen in a previous study. Second, by combining samples from this and the previous study, we also examined whether there were pathologic correlational relationships among brain activity in the orbital cortex, caudate nucleus, and thalamus that obtained before behavioral treatment of obsessivecompulsive disorder, but that decreased significantly with symptom improvement.

Methods
Nine patients with obsessive-compulsive disorder were studied with positron emission tomography before and after 10 weeks of structured exposure and response prevention behavioral and cognitive treatment. Results were analyzed both alone and combined with those from nine similar subjects from the previous study.

Results
Behavior therapy responders had significant (P<.05) bilateral decreases in caudate glucose metabolic rates that were greater than those seen in poor responders to treatment. Before treatment, there were significant correlations of brain activity between the orbital gyri and the head of the caudate nucleus and the orbital gyri and the thalamus on the right. These correlations decreased significantly after effective treatment.

Conclusions
These results replicate and extend previous findings of changes in caudate nucleus function with behavior therapy for obsessive-compulsive disorder. A prefrontal cortico-striato-thalamic brain system is implicated in mediation of symptoms of obsessivecompulsive disorder.

Author Affiliations
From the Departments of Psychiatry (Drs Schwartz, Stoessel, and Baxter and Ms Martin) and Pharmacology (Drs Baxter and Phelps), The Brain Research Institute (Dr Baxter), and the Laboratory of Nuclear Medicine (Drs Baxter and Phelps), UCLA School of Medicine, Los Angeles, Calif.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Disrupting Disordered Neurocircuitry: Treating Refractory Psychiatric Illness With Neuromodulation
Tye et al.
Mayo Clin Proc. 2009;84:522-532.
ABSTRACT | FULL TEXT  

Special Section: On Looking Inward: Revisiting the Role of Introspection in Neuroscientific and Psychiatric Research
den Boer et al.
Theory Psychology 2008;18:380-403.
ABSTRACT  

The Girl Who Ate Her House Pica as an Obsessive-Compulsive Disorder: A Case Report
Baheretibeb et al.
Clinical Case Studies 2008;7:3-11.
ABSTRACT  

Changes in Brain Electrical Activity After Cognitive Behavioral Therapy for Posttraumatic Stress Disorder in Patients Injured in Motor Vehicle Accidents
Rabe et al.
Psychosom. Med. 2008;70:13-19.
ABSTRACT | FULL TEXT  

High-Frequency Deep Brain Stimulation of the Nucleus Accumbens Region Suppresses Neuronal Activity and Selectively Modulates Afferent Drive in Rat Orbitofrontal Cortex In Vivo
McCracken and Grace
J. Neurosci. 2007;27:12601-12610.
ABSTRACT | FULL TEXT  

Brief Review of Habit Reversal Training for Tourette Syndrome
Himle et al.
J Child Neurol 2006;21:719-725.
ABSTRACT  

Quantum physics in neuroscience and psychology: a neurophysical model of mind-brain interaction
Schwartz et al.
Phil Trans R Soc B 2005;360:1309-1327.
ABSTRACT | FULL TEXT  

Toward a Neurobiology of Psychotherapy: Basic Science and Clinical Applications
Etkin et al.
J. Neuropsychiatry Clin. Neurosi. 2005;17:145-158.
ABSTRACT | FULL TEXT  

Cerebral Glucose Metabolism in Obsessive-Compulsive Hoarding
Saxena et al.
Am. J. Psychiatry 2004;161:1038-1048.
ABSTRACT | FULL TEXT  

Recruitment of U.S. Medical Graduates Into Psychiatry: Reasons for Optimism, Sources of Concern
Sierles et al.
Acad. Psychiatry 2003;27:252-259.
ABSTRACT | FULL TEXT  

The Emerging Dialogue Between Psychoanalysis and Neuroscience: Neuroimaging Perspectives
Beutel et al.
J Am Psychoanal Assoc 2003;51:773-801.
ABSTRACT  

Buddhism, Behavior Change, and OCD
Olson
J Holist Nurs 2003;21:149-162.
ABSTRACT  

Differential Brain Metabolic Predictors of Response to Paroxetine in Obsessive-Compulsive Disorder Versus Major Depression
Saxena et al.
Am. J. Psychiatry 2003;160:522-532.
ABSTRACT | FULL TEXT  

Anxiety and Genetically Engineered Mice
Diller et al.
NEJM 2002;347:1626-1626.
FULL TEXT  

Nonreductive Physicalism and Soul: Finding Resonance Between Theology and Neuroscience
BROWN
American Behavioral Scientist 2002;45:1812-1821.
ABSTRACT  

Neuroimaging findings in post-traumatic stress disorder: Systematic review
HULL
Br. J. Psychiatry 2002;181:102-110.
ABSTRACT | FULL TEXT  

Common Changes in Cerebral Blood Flow in Patients With Social Phobia Treated With Citalopram or Cognitive-Behavioral Therapy
Furmark et al.
Arch Gen Psychiatry 2002;59:425-433.
ABSTRACT | FULL TEXT  

Neuropsychiatry of the basal ganglia
Ring and Serra-Mestres
J. Neurol. Neurosurg. Psychiatry 2002;72:12-21.
ABSTRACT | FULL TEXT  

Functional Neuroanatomy of Psychiatric Disorders: A Didactic Course for Residents
Lane and Potter
Acad. Psychiatry 2001;25:148-155.
ABSTRACT | FULL TEXT  

Hacking's Reconciliation: Putting the Biological and Sociological Together in the Explanation of Mental Illness
Murphy
Philosophy of the Social Sciences 2001;31:139-162.
ABSTRACT  

Mind beyond the Net: Implications of Cognitive Neuroscience for Cultural Psychiatry
Henningsen and Kirmayer
Transcultural Psychiatry 2000;37:467-494.
ABSTRACT  

Neurology and psychiatry: Closing the great divide
Price et al.
Neurology 2000;54:8-8.
FULL TEXT  

Altered cortical excitability in obsessive-compulsive disorder
Greenberg et al.
Neurology 2000;54:142-142.
ABSTRACT | FULL TEXT  

Building Neural Representations of Habits
Jog et al.
Science 1999;286:1745-1749.
ABSTRACT | FULL TEXT  

Braincutting for Psychiatrists: The Time Is Ripe
Green et al.
J. Neuropsychiatry Clin. Neurosi. 1999;11:301-306.
ABSTRACT | FULL TEXT  

Is the Reduction of Mental Phenomena an Attainable Goal?
Sachdev
J. Neuropsychiatry Clin. Neurosi. 1999;11:274-279.
FULL TEXT  

Some Neurobiological Aspects of Psychotherapy: A Review
Liggan and Kay
J. Psychother. Pract. Res. 1999;8:103-114.
ABSTRACT | FULL TEXT  

Nature, Niche, and Nurture: The Role of Social Experience in Transforming Genotype Into Phenotype
Eisenberg
Acad. Psychiatry 1998;22:213-222.
ABSTRACT | FULL TEXT  

A Short Echo 1H Spectroscopy and Volumetric MRI Study of the Corpus Striatum in Patients With Obsessive- Compulsive Disorder and Comparison Subjects
Bartha et al.
Am. J. Psychiatry 1998;155:1584-1591.
ABSTRACT | FULL TEXT  

A New Intellectual Framework for Psychiatry
Kandel
Am. J. Psychiatry 1998;155:457-469.
ABSTRACT | FULL TEXT  

A Functional Magnetic Resonance Imaging Study of Tic Suppression in Tourette Syndrome
Peterson et al.
Arch Gen Psychiatry 1998;55:326-333.
ABSTRACT | FULL TEXT  

Electroencephalographic Sleep Profiles Before and After Cognitive Behavior Therapy of Depression
Thase et al.
Arch Gen Psychiatry 1998;55:138-144.
ABSTRACT | FULL TEXT  

Disputing Psychiatry's Redefinition
Clemens et al.
Am. J. Psychiatry 1997;154:1633--1634.
FULL TEXT  

A Century After Freud's Project: Is a Rapprochement Between Psychoanalysis and Neurobiology At Hand?
Schore
J Am Psychoanal Assoc 1997;45:807-840.
ABSTRACT  

Psychiatry
Marzuk and Barchas
JAMA 1997;277:1892-1894.
 

Pattern of Interictal Hypometabolism in PET Scans With Fludeoxyglucose F 18 Reflects Prior Seizure Types in Patients With Mesial Temporal Lobe Seizures
Savic et al.
Arch Neurol 1997;54:129-136.
ABSTRACT  

Olfactory Bedside Test: A Simple Approach to Identify Temporo-orbitofrontal Dysfunction
Savic et al.
Arch Neurol 1997;54:162-168.
ABSTRACT  

Neurobiology and Response to Psychotherapy
JWatch Psychiatry 1996;1996:1-1.
FULL TEXT