ORBITOFRONTAL THICKNESS AS A MEASURE FOR TREATMENT RESPONSE PREDICTION IN OBSESSIVE–COMPULSIVE DISORDER
Corresponding Author
Marcelo Q. Hoexter M.D., Ph.D.
Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Department of Psychiatry, Interdisciplinary Laboratory for Clinical Neuroscience, Federal University of São Paulo, São Paulo, Brazil
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Correspondence to: Marcelo Q. Hoexter, Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, Rua Ovídio Pires de Campos 785, 3° Andar Ala Norte, Sala 9 (PROTOC), CEP 05403-010, São Paulo, SP, Brazil.
E-mail: [email protected]
Search for more papers by this authorJuliana B. Diniz M.D., Ph.D.
Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Search for more papers by this authorAntonio C. Lopes M.D., Ph.D
Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Search for more papers by this authorMarcelo C. Batistuzzo Ph.D.
Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Search for more papers by this authorRoseli G. Shavitt M.D., Ph.D.
Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Search for more papers by this authorDarin D. Dougherty M.D.
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Search for more papers by this authorFabio L. S. Duran Ph.D.
Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Search for more papers by this authorRodrigo A. Bressan M.D., Ph.D.
Department of Psychiatry, Interdisciplinary Laboratory for Clinical Neuroscience, Federal University of São Paulo, São Paulo, Brazil
Search for more papers by this authorGeraldo F. Busatto M.D., Ph.D.
Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Search for more papers by this authorEuripides C. Miguel M.D., Ph.D.
Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Search for more papers by this authorJoao R. Sato Ph.D.
Center of Mathematics, Computation, and Cognition, Federal University of the ABC, Santo André, Brazil
Search for more papers by this authorCorresponding Author
Marcelo Q. Hoexter M.D., Ph.D.
Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Department of Psychiatry, Interdisciplinary Laboratory for Clinical Neuroscience, Federal University of São Paulo, São Paulo, Brazil
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Correspondence to: Marcelo Q. Hoexter, Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, Rua Ovídio Pires de Campos 785, 3° Andar Ala Norte, Sala 9 (PROTOC), CEP 05403-010, São Paulo, SP, Brazil.
E-mail: [email protected]
Search for more papers by this authorJuliana B. Diniz M.D., Ph.D.
Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Search for more papers by this authorAntonio C. Lopes M.D., Ph.D
Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Search for more papers by this authorMarcelo C. Batistuzzo Ph.D.
Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Search for more papers by this authorRoseli G. Shavitt M.D., Ph.D.
Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Search for more papers by this authorDarin D. Dougherty M.D.
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Search for more papers by this authorFabio L. S. Duran Ph.D.
Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Search for more papers by this authorRodrigo A. Bressan M.D., Ph.D.
Department of Psychiatry, Interdisciplinary Laboratory for Clinical Neuroscience, Federal University of São Paulo, São Paulo, Brazil
Search for more papers by this authorGeraldo F. Busatto M.D., Ph.D.
Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Search for more papers by this authorEuripides C. Miguel M.D., Ph.D.
Department of Psychiatry, Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
Search for more papers by this authorJoao R. Sato Ph.D.
Center of Mathematics, Computation, and Cognition, Federal University of the ABC, Santo André, Brazil
Search for more papers by this authorContract grant sponsor: Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, São Paulo Research Foundation); Contract grant numbers: 2011/21357-9 (to Dr. Miguel), 2013/16864-4 (to Dr. Hoexter), 2013/10498-6 and 2013/00506-1 (to Dr. Sato).
Abstract
Background
Early prediction of treatment response could reduce exposure to ineffective treatments and optimize the use of medical resources. Neuroimaging techniques have been used to identify biomarkers that are predictive of outcomes. The aims of this study were to investigate orbitofrontal cortex (OFC) thickness as a potential morphometric biomarker to discriminate outcomes in obsessive–compulsive disorder (OCD) and then to reexamine this biomarker in an independent cohort
Methods
Using a logistic regression model based on the mean baseline thickness of subregions of the OFC, we estimated the probability of treatment response in 29 treatment-naïve OCD patients who participated in a clinical trial. That algorithm was then tested in an independent cohort of 12 patients with a confirmed diagnosis of refractory OCD
Results
Among the treatment-naïve OCD patients, measures of OFC thickness statistically significantly differentiated responders (n = 13) and nonresponders (n = 16), with an overall classification accuracy of ≈80%, a sensitivity of 77% (10/13), and a specificity of 81% (13/16). Of the refractory OCD patients in the second independent cohort, 67% were correctly classified as nonresponders. The most discriminative measures in the initial cohort of treatment-naïve patients were the thicknesses of the left and right medial OFC (P = .009 and P = .028, respectively)
Conclusions
We found OFC thickness to be a strong predictor of treatment response in treatment-naïve OCD patients. Although there are not yet any brain imaging biomarkers with clinical utility, our results highlight the potential of these measures as tools for predicting treatment outcomes in OCD.
Supporting Information
Disclaimer: Supplementary materials have been peer-reviewed but not copyedited.
| Filename | Description |
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| da22380-sup-0001-Table1.docx71.6 KB | table 1. Distribution of Comorbid Psychiatric Conditions between the Treatment-naive Responders and Non-responders |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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