Cognitive behavioral therapy (CBT) is an established treatment for obsessive-compulsive disorder (OCD). It is equal or perhaps superior to pharmacotherapy.

Now researchers from the University of California at Los Angeles and San Diego have identified changes in the brain that might explain how this happens.

First, the details.

  • Brain scans were obtained on 10 OCD patients before and after 4 weeks of CBT.
  • CBT consisted of 90-minute individual sessions, 5 days a week, plus 4 hours of homework daily.
  • Also, 12 people without OCD were scanned twice, several weeks apart.

And, the results.

  • OCD symptoms, depression, anxiety, and overall functioning improved with treatment.
  • Improvement was associated with a distinct and significant pattern of changes in regional brain function. For example…
  • Regional glucose metabolism was normalized.
  • There was a significant increase in right dorsal anterior cingulate cortex activity that correlated with the degree of improvement in OCD symptoms
    • The cingulate cortex is active in a variety of cognitive (reasoning) and emotional tasks.
  • There was also a normalization of thalamic metabolism.
    • That’s the part of the brain that regulates the perception of touch, pain, and temperature.

The bottom line?
The authors state that brief intensive CBT significantly improves OCD symptoms in as little as 4 weeks. However, it was thought that longer treatment was needed to produce the changes in the brain.

Now we learn that “The rapid response of OCD to intensive CBT is mediated by a distinct pattern of changes in regional brain function.”

And the changes occur quickly with therapy.

2/16/08 11:08 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.