Neurochemical properties measured by H-1 magnetic resonance spectroscopy may predict cognitive behaviour therapy outcome in paediatric OCD: a pilot study: a pilot study

Tord Ivarsson; Karin Melin; Åsa Carlsson; Maria Ljungberg; Eva Forssell-Aronsson; Göran Starck; Guðmundur Ágúst Skarphéðinsson

doi:10.1007/s00702-021-02407-y

Neurochemical properties measured by H-1 magnetic resonance spectroscopy may predict cognitive behaviour therapy outcome in paediatric OCD: a pilot study: a pilot study

Tord Ivarsson, Karin Melin, Åsa Carlsson, Maria Ljungberg, Eva Forssell-Aronsson, Göran Starck, Guðmundur Ágúst Skarphéðinsson

Faculty of Psychology

University of Iceland

Research output: Contribution to journal › Article › peer-review

Abstract

To identify neurochemical factors measured pre-treatment that may predict cognitive behavioural treatment (CBT) outcome, aiming at understanding possible causes of poor CBT response. 1H magnetic resonance spectroscopy was used before treatment with CBT in treatment naïve 11–18 year-old patients with moderate–severe OCD. Diagnoses and assessment of OCD severity were based on semi-structured interviews. Linear mixed effects models were used to analyse the association between metabolite level and treatment outcome. Worse CBT outcome was associated with higher concentration of glutamine and glutamate combined (Glx) in middle cingulate cortex (MCC) (F = + 3.35, p = 0.004) and of N-acetylaspartate and N-acetylaspartylglutamate combined (tNAA) (F = + 2.59, p = 0.019). Also, we noted a tendency towards higher thalamic Glx concentration (F = + 1.91, p = 0.077) to be associated with worse CBT outcome. In general, the findings of the current pilot study are compatible with the hypothesis of an overweight of excitatory to inhibitory factors in brain circuits driving goal-directed behaviours (GDB). Higher MCC Glx and tNAA may be involved in the selection of GDB. A more detailed understanding of how these brain areas function in health and illness is needed.

Original language	English
Pages (from-to)	1361-1370
Number of pages	10
Journal	Journal of Neural Transmission
Volume	128
Issue number	9
DOIs	https://doi.org/10.1007/s00702-021-02407-y
Publication status	Published - 20 Aug 2021

Bibliographical note

Funding Information: We thank Lars Jönsson, MD, for radiological advice on the definition of MRS volumes, Mikael Montelius, MSc for the segmentation program for partial volume corrections, Henric Rydén, MSc for Matlab-programming for efficient data-handling and Philip Healthcare Clinical Science Group for support. Financial support. This research was supported by the Swedish Research Council (14039), “Västra Götalandsregionen”, “Grants from the state under the LUA/ALF agreement”, “Frimurare Barnhusdirektionen in Göteborg”, “The Arvid Carlsson Foundation” and “Wilhelm and Martina Lundgrens research fund”. Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.

Other keywords

Adolescent
Child
Cognitive Behavioral Therapy
Hugræn atferlismeðferð
Humans
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Obsessive-Compulsive Disorder/diagnostic imaging
Pilot Projects

Access to Document

10.1007/s00702-021-02407-y

Cite this

Ivarsson, T., Melin, K., Carlsson, Å., Ljungberg, M., Forssell-Aronsson, E., Starck, G., & Skarphéðinsson, G. Á. (2021). Neurochemical properties measured by H-1 magnetic resonance spectroscopy may predict cognitive behaviour therapy outcome in paediatric OCD: a pilot study: a pilot study. Journal of Neural Transmission, 128(9), 1361-1370. https://doi.org/10.1007/s00702-021-02407-y

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title = "Neurochemical properties measured by H-1 magnetic resonance spectroscopy may predict cognitive behaviour therapy outcome in paediatric OCD: a pilot study: a pilot study",

abstract = "To identify neurochemical factors measured pre-treatment that may predict cognitive behavioural treatment (CBT) outcome, aiming at understanding possible causes of poor CBT response. 1H magnetic resonance spectroscopy was used before treatment with CBT in treatment na{\"i}ve 11–18 year-old patients with moderate–severe OCD. Diagnoses and assessment of OCD severity were based on semi-structured interviews. Linear mixed effects models were used to analyse the association between metabolite level and treatment outcome. Worse CBT outcome was associated with higher concentration of glutamine and glutamate combined (Glx) in middle cingulate cortex (MCC) (F = + 3.35, p = 0.004) and of N-acetylaspartate and N-acetylaspartylglutamate combined (tNAA) (F = + 2.59, p = 0.019). Also, we noted a tendency towards higher thalamic Glx concentration (F = + 1.91, p = 0.077) to be associated with worse CBT outcome. In general, the findings of the current pilot study are compatible with the hypothesis of an overweight of excitatory to inhibitory factors in brain circuits driving goal-directed behaviours (GDB). Higher MCC Glx and tNAA may be involved in the selection of GDB. A more detailed understanding of how these brain areas function in health and illness is needed.",

keywords = "Adolescent, Child, Cognitive Behavioral Therapy, Hugr{\ae}n atferlisme{\dh}fer{\dh}, Humans, Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy, Obsessive-Compulsive Disorder/diagnostic imaging, Pilot Projects",

author = "Tord Ivarsson and Karin Melin and {\AA}sa Carlsson and Maria Ljungberg and Eva Forssell-Aronsson and G{\"o}ran Starck and Skarph{\'e}{\dh}insson, \{Gu{\dh}mundur {\'A}g{\'u}st\}",

note = "Funding Information: We thank Lars J{\"o}nsson, MD, for radiological advice on the definition of MRS volumes, Mikael Montelius, MSc for the segmentation program for partial volume corrections, Henric Ryd{\'e}n, MSc for Matlab-programming for efficient data-handling and Philip Healthcare Clinical Science Group for support. Financial support. This research was supported by the Swedish Research Council (14039), “V{\"a}stra G{\"o}talandsregionen”, “Grants from the state under the LUA/ALF agreement”, “Frimurare Barnhusdirektionen in G{\"o}teborg”, “The Arvid Carlsson Foundation” and “Wilhelm and Martina Lundgrens research fund”. Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.",

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Ivarsson, T, Melin, K, Carlsson, Å, Ljungberg, M, Forssell-Aronsson, E, Starck, G & Skarphéðinsson, GÁ 2021, 'Neurochemical properties measured by H-1 magnetic resonance spectroscopy may predict cognitive behaviour therapy outcome in paediatric OCD: a pilot study: a pilot study', Journal of Neural Transmission, vol. 128, no. 9, pp. 1361-1370. https://doi.org/10.1007/s00702-021-02407-y

Neurochemical properties measured by H-1 magnetic resonance spectroscopy may predict cognitive behaviour therapy outcome in paediatric OCD: a pilot study: a pilot study. / Ivarsson, Tord; Melin, Karin; Carlsson, Åsa et al.
In: Journal of Neural Transmission, Vol. 128, No. 9, 20.08.2021, p. 1361-1370.

Research output: Contribution to journal › Article › peer-review

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T2 - a pilot study

AU - Ivarsson, Tord

AU - Melin, Karin

AU - Carlsson, Åsa

AU - Ljungberg, Maria

AU - Forssell-Aronsson, Eva

AU - Starck, Göran

AU - Skarphéðinsson, Guðmundur Ágúst

N1 - Funding Information: We thank Lars Jönsson, MD, for radiological advice on the definition of MRS volumes, Mikael Montelius, MSc for the segmentation program for partial volume corrections, Henric Rydén, MSc for Matlab-programming for efficient data-handling and Philip Healthcare Clinical Science Group for support. Financial support. This research was supported by the Swedish Research Council (14039), “Västra Götalandsregionen”, “Grants from the state under the LUA/ALF agreement”, “Frimurare Barnhusdirektionen in Göteborg”, “The Arvid Carlsson Foundation” and “Wilhelm and Martina Lundgrens research fund”. Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.

PY - 2021/8/20

Y1 - 2021/8/20

N2 - To identify neurochemical factors measured pre-treatment that may predict cognitive behavioural treatment (CBT) outcome, aiming at understanding possible causes of poor CBT response. 1H magnetic resonance spectroscopy was used before treatment with CBT in treatment naïve 11–18 year-old patients with moderate–severe OCD. Diagnoses and assessment of OCD severity were based on semi-structured interviews. Linear mixed effects models were used to analyse the association between metabolite level and treatment outcome. Worse CBT outcome was associated with higher concentration of glutamine and glutamate combined (Glx) in middle cingulate cortex (MCC) (F = + 3.35, p = 0.004) and of N-acetylaspartate and N-acetylaspartylglutamate combined (tNAA) (F = + 2.59, p = 0.019). Also, we noted a tendency towards higher thalamic Glx concentration (F = + 1.91, p = 0.077) to be associated with worse CBT outcome. In general, the findings of the current pilot study are compatible with the hypothesis of an overweight of excitatory to inhibitory factors in brain circuits driving goal-directed behaviours (GDB). Higher MCC Glx and tNAA may be involved in the selection of GDB. A more detailed understanding of how these brain areas function in health and illness is needed.

AB - To identify neurochemical factors measured pre-treatment that may predict cognitive behavioural treatment (CBT) outcome, aiming at understanding possible causes of poor CBT response. 1H magnetic resonance spectroscopy was used before treatment with CBT in treatment naïve 11–18 year-old patients with moderate–severe OCD. Diagnoses and assessment of OCD severity were based on semi-structured interviews. Linear mixed effects models were used to analyse the association between metabolite level and treatment outcome. Worse CBT outcome was associated with higher concentration of glutamine and glutamate combined (Glx) in middle cingulate cortex (MCC) (F = + 3.35, p = 0.004) and of N-acetylaspartate and N-acetylaspartylglutamate combined (tNAA) (F = + 2.59, p = 0.019). Also, we noted a tendency towards higher thalamic Glx concentration (F = + 1.91, p = 0.077) to be associated with worse CBT outcome. In general, the findings of the current pilot study are compatible with the hypothesis of an overweight of excitatory to inhibitory factors in brain circuits driving goal-directed behaviours (GDB). Higher MCC Glx and tNAA may be involved in the selection of GDB. A more detailed understanding of how these brain areas function in health and illness is needed.

KW - Adolescent

KW - Child

KW - Cognitive Behavioral Therapy

KW - Hugræn atferlismeðferð

KW - Humans

KW - Magnetic Resonance Imaging

KW - Magnetic Resonance Spectroscopy

KW - Obsessive-Compulsive Disorder/diagnostic imaging

KW - Pilot Projects

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DO - 10.1007/s00702-021-02407-y

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ER -

Neurochemical properties measured by H-1 magnetic resonance spectroscopy may predict cognitive behaviour therapy outcome in paediatric OCD: a pilot study: a pilot study

Abstract

Bibliographical note

Other keywords

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