The study, published in Frontiers in Psychiatry, is the first to use brain connectivity to predict the progression of a condition after treatment, as well as being the first to assess the impact of cognitive behavioral therapy (CBT) on brain network connectivity.

“The efficiency of brain network connectivity before treatment predicts the worsening of symptoms after treatment,” states study author Jamie Feusner, an associate professor psychiatry at the University of California, Los Angeles (UCLA).

Between 1-2% of the American population is estimated to have obsessive-compulsive disorder (OCD). The disorder is characterized by frequent upsetting thoughts that patients will try to control through the repetition of certain rituals and behaviors.

Not only can OCD be a profoundly distressing condition but it can also severely disrupt the everyday routines of those who experience it, adversely affecting the ability to learn, work or maintain relationships.

CBT is frequently used as a form of treatment for OCD, teaching patients different ways of reacting to situations that cause distress without having obsessive thoughts or acting compulsively.

Unfortunately, CBT is not effective for every patient. In fact, the authors of the study state that in an estimated 20% of patients, the symptoms of OCD eventually return after a course of CBT has finished.

Understanding what factors help predict who will relapse after CBT has long been a goal for psychiatry researchers. The new study, conducted by researchers at UCLA and colleagues, indicates that functional magnetic resonance imaging (fMRI) could help.

For the study, the researchers examined the brains of 17 participants with OCD aged 21-50. Each participant received a 4-week course of CBT, and fMRI scans were taken of their brains both before and after the therapy. Over the following 12 months, doctors monitored their clinical symptoms.

“We found that cognitive behavioral therapy itself results in more densely connected local brain networks, which likely reflects more efficient brain activity,” says Feusner.