Neural Correlates of Response to Pharmacotherapy in Obsessive-Compulsive Disorder: Individualized Cortical Morphology-Based Structural Covariance

• Published in: Progress in neuro-psychopharmacology & biological psychiatry Vol. 63; pp. 126 - 133
• Main Authors: Yun, Je-Yeon, Jang, Joon Hwan, Kim, Sung Nyun, Jung, Wi Hoon, Kwon, Jun Soo
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 03.12.2015
• Subjects: Adolescent; Adult; Brain Mapping; Cerebral Cortex - drug effects; Cerebral Cortex - pathology; Female; Follow-Up Studies; Humans; Imaging, Three-Dimensional; Magnetic Resonance Imaging; Male; Multivariate Analysis; obsessive-compulsive disorder; Obsessive-Compulsive Disorder - drug therapy; Obsessive-Compulsive Disorder - pathology; pharmacotherapy; Serotonin Uptake Inhibitors - therapeutic use; structural covariance network; Support Vector Machine; treatment response; Young Adult; obsessive-compulsive disorder; SVM; OCD-R; SRIs; CSA; structural covariance network; OCD; CT; support vector machine; pharmacotherapy; treatment response; ISC; HC; OCD-NR
• ISSN: 0278-5846; 1878-4216
• DOI: 10.1016/j.pnpbp.2015.06.009

Primary pharmacotherapy regimen for obsessive-compulsive disorder (OCD) named Serotonin reuptake inhibitors (SRIs) does not attain sufficient symptom improvement in 40-60% of OCD. We aimed to decode the differential profile of OCD-related brain pathology per subject in the context of cortical surface area (CSA) or thickness (CT)-based individualized structural covariance (ISC) and to demonstrate the potential of which as a biomarker of treatment response to SRI-based pharmacotherapy in OCD using the support vector machine (SVM). T1-weighted magnetic resonance imaging was obtained at 3T from 56 unmedicated OCD subjects and 75 healthy controls (HCs) at baseline. After 4months of SRI-based pharmacotherapy, the OCD subjects were classified as responders (OCD-R,N=25; ≥35% improvement) or nonresponders (OCD-NR,N=31; <35% improvement) according to the percentage change in the Yale-Brown Obsessive Compulsive Scale total score. Cortical ISCs sustaining between-group difference (p<.001) for every run of leave-one-out group-comparison were packaged as feature set for group classification using the SVM. An optimal feature set of the top 12 ISCs including a CT-ISC between the dorsolateral prefrontal cortex versus precuneus, a CSA-ISC between the anterior insula versus intraparietal sulcus, as well as perisylvian area-related ISCs predicted the initial prognosis of OCD as OCD-R or OCD-NR with an accuracy of 89.0% (sensitivity 88.4%, specificity 90.1%). Extended sets of ISCs distinguished the OCD subjects from the HCs with 90.7-95.6% accuracy (sensitivity 90.8-96.2%, specificity 91.1-95.0%). We showed the potential of cortical morphology-based ISCs, which reflect dysfunctional cortical maturation process, as a possible biomarker that predicts the clinical treatment response to SRI-based pharmacotherapy in OCD. •Cortical morphology-based individualized structural covariance features (ISCs) predicted the initial prognosis of OCD as pharmacotherapy responder (OCD-R) or nonresponder (OCD-NR) with an accuracy of 89.0%.•OCD-R showed decreased cortical thickness-based ISC between DLPFC versus precuneus.•OCD-NR revealed increased cortical surface area-based ISC between anterior insula versus intraparietal sulcus.•We showed the potential of cortical morphology-based ISCs as a possible biomarker that predicts the clinical treatment response to pharmacotherapy in OCD.