Abstract：
BACKGROUND: There is an imbalance between goal-directed and habitual-learning system in patients with obsessive-compulsive disorder (OCD). At present, the relationship between cognitive behavior therapy (CBT) as a first-line therapy and goal-directed and habitual-learning disorder is still unclear. We attempted to discuss the effect of CBT treatment in patients with OCD, using abnormalities in goal-directed and habitual-learning-related brain regions at baseline as predictive factors.
METHODS: A total of 71 subjects, including 35 OCD patients and 36 healthy controls, were recruited. The OCD patients underwent 8 weeks of CBT. These patients were divided into two groups based on treatment response (Nresponders = 18, Nnonresponders = 17). Further subgroup analysis was conducted based on disease duration (Nshort = 17, Nlong = 18) and age of onset (Nearly = 14, Nlate = 21). We collected resting-state ROI-ROI functional connectivity data and apply repeated-measures linear mixed-effects models to investigate the differences of different subgroups.
RESULTS: CBT led to symptom improvement in OCD patients, with varying degrees of effectiveness across subgroups. The orbitofrontal cortex (OFC) and insula, key regions for goal-directed behavior and habitual-learning, respectively, showed significant impacts on CBT efficacy in subgroups with different disease durations and ages of onset.
CONCLUSIONS: The findings suggest that the goal-directed system may influence the efficacy of CBT through goal selection, maintenance, and emotion regulation. Furthermore, we found that disease duration and age of onset may affect treatment outcomes by modulating functional connectivity between goal-directed and habitual-learning brain regions.
METHODS: A total of 71 subjects, including 35 OCD patients and 36 healthy controls, were recruited. The OCD patients underwent 8 weeks of CBT. These patients were divided into two groups based on treatment response (Nresponders = 18, Nnonresponders = 17). Further subgroup analysis was conducted based on disease duration (Nshort = 17, Nlong = 18) and age of onset (Nearly = 14, Nlate = 21). We collected resting-state ROI-ROI functional connectivity data and apply repeated-measures linear mixed-effects models to investigate the differences of different subgroups.
RESULTS: CBT led to symptom improvement in OCD patients, with varying degrees of effectiveness across subgroups. The orbitofrontal cortex (OFC) and insula, key regions for goal-directed behavior and habitual-learning, respectively, showed significant impacts on CBT efficacy in subgroups with different disease durations and ages of onset.
CONCLUSIONS: The findings suggest that the goal-directed system may influence the efficacy of CBT through goal selection, maintenance, and emotion regulation. Furthermore, we found that disease duration and age of onset may affect treatment outcomes by modulating functional connectivity between goal-directed and habitual-learning brain regions.
摘要：
背景：强迫症（OCD）患者的目标导向和习惯性学习系统之间存在不平衡。目前,认知行为疗法(CBT)作为一线疗法与目标导向型和习惯性学习障碍之间的关系尚不清楚.我们试图讨论CBT治疗对强迫症患者的影响，使用基线时目标导向和习惯性学习相关脑区的异常作为预测因子.
方法：共有71名受试者，包括35名强迫症患者和36名健康对照，被招募。强迫症患者接受了8周的认知行为治疗（CBT）。根据治疗反应将这些患者分为两组（无反应者=18，无反应者=17）。根据疾病持续时间（Nshort=17，Nlong=18）和发病年龄（Elast=14，Nlate=21）进行进一步的亚组分析。我们收集了静息状态ROI-ROI功能连接数据，并应用重复测量的线性混合效应模型来研究不同亚组的差异。
结果：CBT导致OCD患者症状改善，不同亚组的有效性程度不同。眶额皮质（OFC）和脑岛，目标导向行为和习惯性学习的关键区域，分别,在不同疾病持续时间和发病年龄的亚组中显示出对CBT疗效的显着影响。
结论：研究结果表明，目标导向系统可能通过目标选择影响CBT的疗效，维护,和情绪调节。此外，我们发现,疾病持续时间和发病年龄可能通过调节目标导向脑区和习惯性学习脑区之间的功能连接而影响治疗结果.
方法：共有71名受试者，包括35名强迫症患者和36名健康对照，被招募。强迫症患者接受了8周的认知行为治疗（CBT）。根据治疗反应将这些患者分为两组（无反应者=18，无反应者=17）。根据疾病持续时间（Nshort=17，Nlong=18）和发病年龄（Elast=14，Nlate=21）进行进一步的亚组分析。我们收集了静息状态ROI-ROI功能连接数据，并应用重复测量的线性混合效应模型来研究不同亚组的差异。
结果：CBT导致OCD患者症状改善，不同亚组的有效性程度不同。眶额皮质（OFC）和脑岛，目标导向行为和习惯性学习的关键区域，分别,在不同疾病持续时间和发病年龄的亚组中显示出对CBT疗效的显着影响。
结论：研究结果表明，目标导向系统可能通过目标选择影响CBT的疗效，维护,和情绪调节。此外，我们发现,疾病持续时间和发病年龄可能通过调节目标导向脑区和习惯性学习脑区之间的功能连接而影响治疗结果.
