Can behavior therapy effect functional changes in dysfunctional pathological neuronal activation patterns of obsessive-compulsive disorder?

Introduction: Compared to the large number of studies investigating the effects of psychopharmacotherapeutic treatment on the neuronal activity patterns of obsessive-compulsive disorder (OCD), only a few research projects have evaluated the effects of psychotherapy on the neuronal systems. Method: A literature search was carried out in the medical database PubMed/Medline for publications until December 2010 that studied the effects of behavior therapy (BT) on the neurobiological correlates of OCD via functional imaging. Results: The systematic literature search identified a total number of 12 relevant publications. The most important findings of these studies concern a reduction in activity in the caudate nucleus after successful BT. The before-after comparisons in studies using the Stroop test as a psychological stimulation paradigm reveal an increase in activity in cortex areas that play an important role in cognitive processes, such as the cerebellum and the dorsolateral prefrontal cortex (DLPFC), the dorsal anterior cingulate cortex (ACC) and the cerebellum. Discussion: The results of the studies that were examined reveal that psychotherapy can change patterns of neuronal activity. Dysfunctional pathological neuronal control loops can be resolved by psychotherapeutic interventions. Those brain structures in which the neuronal restructurings stimulated by psychotherapy take place appear to be the same as the ones on which the effects of medication are focused.