Mindfulness-based cognitive therapy neurobiology in treatment-resistant obsessive-compulsive disorder: A domain-related resting-state networks approach.
Víctor De la Peña-arteaga, Marta Cano, Daniel Porta-casteràs, Muriel Vicent-gil, Neus Miquel-giner, Ignacio Martínez-zalacaín, Lorea Mar-barrutia, Marina López-solà, Jessica R Andrews-hanna, Carles Soriano-mas, Pino Alonso, Maria Serra-blasco, Clara López-solà, Narcís Cardoner
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology May 1, 2024 DOI: 10.1016/j.euroneuro.2024.02.011
Summary
Distinct brain connectivity patterns are linked to clinical symptoms in obsessive-compulsive disorder (OCD) patients undergoing mindfulness-based cognitive therapy (MBCT). In a study of 12 participants, unique resting-state networks were identified for positive affect, negative affect, anxiety sensitivity, and rumination. Notably, the ventral default mode network and frontostriatal network showed significant associations with these symptoms. This suggests that specific neurobiological markers could guide personalized treatment approaches, enhancing the effectiveness of MBCT by identifying which patients may benefit most from this intervention.
Abstract
Mindfulness-based cognitive therapy (MBCT) stands out as a promising augmentation psychological therapy for patients with obsessive-compulsive disorder (OCD). To identify potential predictive and response biomarkers, this study examines the relationship between clinical domains and resting-state network connectivity in OCD patients undergoing a 3-month MBCT programme. Twelve OCD patients underwent two resting-state functional magnetic resonance imaging sessions at baseline and after the MBCT programme. We assessed four clinical domains: positive affect, negative affect, anxiety sensitivity, and rumination. Independent component analysis characterised resting-state networks (RSNs), and multiple regression analyses evaluated brain-clinical associations. At baseline, distinct network connectivity patterns were found for each clinical domain: parietal-subcortical, lateral prefrontal, medial prefrontal, and frontal-occipital. Predictive and response biomarkers revealed significant brain-clinical associations within two main RSNs: the ventral default mode network (vDMN) and the frontostriatal network (FSN). Key brain nodes -the precuneus and the frontopolar cortex- were identified within these networks. MBCT may modulate vDMN and FSN connectivity in OCD patients, possibly reducing symptoms across clinical domains. Each clinical domain had a unique baseline brain connectivity pattern, suggesting potential symptom-based biomarkers. Using these RSNs as predictors could enable personalised treatments and the identification of patients who would benefit most from MBCT.