LAUSR

Background: Imaging data suggest that the overlapping dorsal and ventral cortico-striato-thalamocortical circuits underlying cognitive control and reward processing are structurally and functionally abnormal in adults with obsessive-compulsive disorder (OCD). Less is known about these circuits in pediatric OCD or how they change following the remission of symptoms. Methods: We are using HCP-compatible, multimodal MRI sequences to assess the function, connectivity, and organization of control and reward circuits in children and adolescents with OCD before and after CBT with exposure and response prevention. Thus far, we have collected baseline MRI data from 23 unmedicated youth with OCD (12.4 1/-3.2 years) and 12 matched healthy controls (HCs) and follow-up data from 12 OCD (following 16-20 weeks of CBT) and 6 HC participants (16-20 weeks from baseline scan). Results: Preliminary fMRI findings point to greater activation of left middle frontal gyrus in HC compared to OCD participants during correct responses to incongruent vs. congruent stimuli on the Simon task at baseline (p50.005; k570). Following CBT, increased activation of bilateral fronto-parietal regions (superior, bilateral inferior frontal and precentral gyri, and parietal cortices) was detected in OCD participants from pre to post treatment (p50.005; k570). Conclusions: These preliminary data suggest that the functioning of fronto-parietal control circuits is enhanced following CBT in pediatric OCD. Thus, these circuits may be potential targets for treatment response and the development of novel, early interventions for obsessions and compulsions in youth before OCD onset. Supported By: NIMH R21MH101441