Figure 1.

A pretreatment brain imaging predictor of long-term treatment response of OCD.

Notes: (A) Values of the resting-state fMRI (rsfMRI) graph theory parameter small-worldness (a metric of brain information transfer efficiency) in a pilot sample of 17 adult OCD patients within 1 week before (pre; open symbols) and 1 week after (post; filled symbols), 4 weeks of intensive daily CBT. Sixteen of 17 patients (2 minimally) exhibited pre-to-post increase in small-worldness (group-mean 7.5%, P<0.05 permutation testing). (B) For same sample, change in Y-BOCS total score measuring severity of core OCD symptoms, expressed as score at post-CBT follow-up minus score immediately after completing CBT. This is plotted as a function of pre-CBT small-worldness. Patients with higher pre-CBT small-worldness had worsening of OCD symptoms (positive change) at follow-up while patients with initially low small-worldness had improvement in symptoms (negative change) (r=0.65, P<0.005). Relapsers (≥5-point increase in Y-BOCS; triangles) had above-average pre-CBT small-worldness. Thus, rsfMRI graph theory may have some ability to predict long-term treatment response in OCD.

Abbreviations: AUC, area under the curve; BOLD, blood oxygen level-dependent; OCD, obsessive-compulsive disorder; rsfMRI, resting-state functional magnetic resonance imaging; fMRI, functional magnetic resonance imaging; CBT, cognitive-behavioral therapy; Y-BOCS, Yale-Brown Obsessive-Compulsive Scale.