NEUROANATOMICAL ASPECTS OF COGNITIVE-BEHAVIORAL THERAPY RESPONSE IN OBSESSIVE-COMPULSIVE DISORDER - AN EVOLVING PERSPECTIVE ON BRAIN AND BEHAVIOR

Background Recent research has demonstrated th at cognitive-behavioura l therapy (CBT)for obsessive-compulsive disorder (OCD)can systematical ly modify cerebral metabolic activity in a manner which is significant ly related to clinical outcome. Method A substantial body of research is reviewed which supports an involvement of neu rai circuitry connect ing the orbitofrontal cortex. cingulate gyrus and basal ganglia in the expression of the symptoms of OCD. Results Data are presented which e xpand upon previous work demonstrating effects of CBT on functional in teractions between limbic cortex and the basal ganglia. Conclusions Th e relevance of these effects of CBT on brain function is discussed in the context of recent advances in our knowledge of cortical-basal gang lia physiology. The clinical importance of these data is best apprecia ted when they are seen to reflect the interactive nature of the relati onships between cognitive choice, behavioural output and brain activit y.