Decreased inter- and intra-network connectivity after group cognitive behavioral therapy in patients with unmedicated obsessive-compulsive disorder

doi:10.5498/wjp.v15.i8.107860

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 15, Issue 8

This Article

Academic Content and Language Evaluation of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Supplementary Materials of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (364)

All Articles published online

The chart showing PDF series, HTML series, Figures (1-1) series, Tables (1-7) series.

Item

Count

PDF

HTML

155

Figures (1-1)

Tables (1-7)

Sum=249

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

Download

Sum=100

Aug 19, 2025 (publication date) through Aug 19, 2025

Times Cited of This Article

Times Cited (0)

Journal Information of This Article

Publication Name

World Journal of Psychiatry

ISSN

2220-3206

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

World J Psychiatry. Aug 19, 2025; 15(8): 107860
Published online Aug 19, 2025. doi: 10.5498/wjp.v15.i8.107860

Table 1 Comparison of general demographic information between groups

mean ± SD	OCD (n = 33)	HC (n = 26)	t/χ²	P value
Sex (male)	16	11	0.15	0.78
Age	32.24 ± 7.38	28.23 ± 7.36	1.98	0.06
Education	15.18 ± 2.07	15.45 ± 1.76	-0.93	0.61
Age at onset	24.56 ± 9.15	/	/	/
Duration (months)	84.12 ± 79.15	/	/	/
Y-BOCS total	25.81 ± 4.78	/	/	/
Y-BOCS obsession	13.03 ± 2.91	/	/	/
Y-BOCS compulsion	12.88 ± 3.48	/	/	/
HAMD	12.94 ± 5.80	1.09 ± 1.44	11.06	0.000^b
HAMA	9.42 ± 3.80	0.77 ± 1.11	11.34	0.000^b

^bP < 0.001, differences were considered statistically significant.

Y-BOCS: Yale-Brown Obsessive-Compulsive Scale; HAMD: Hamilton Depression Scale; HAMA: Hamilton Anxiety Scale.

Table 2 Seed points of the default mode, dorsal attention, frontoparietal, and salience networks

	Abbreviation	X (L/R)	Y (L/R)	Z (L/R)
DMN
Dorsal medial prefrontal cortex	dmPFC	-8	50	34
Ventral medial prefrontal cortex	vmPFC	-2	44	-12
Posterior cingulate cortex	PCC	-2	-48	28
Precuneus	Pcu	-2	-60	50
Superior frontal gyrus	SFG	-8/12	20/18	62/62
Inferior frontal gyrus	IFG	-42/50	26/30	-14/-6
DAN
Frontal eye fields	FEF	-24/24	2/-2	62/56
Superior occipital gyrus	SOG	-18/26	-66/-64	50/54
FPN
Anterior inferior parietal lobule	aIPL	-54/50	-48/-44	48/46
Dorsolateral prefrontal cortex	DLPFC	-38/44	32/42	30/26
SAN
Anterior insula	aINS	-30/32	20/20	-2/-4
Dorsal anterior cingulate cortex	dACC	6	30	40

DMN: Default mode network; DAN: Dorsal attention network; FPN: Frontoparietal network; SAN: Salience network; dmPFC: Dorsomedial prefrontal; vmPFC: Ventral medial prefrontal; PCC: Posterior cingulate cortex; Pcu: Precuneus; SFG: Superior frontal gyrus; IFG: Inferior frontal gyrus; FEF: Frontal eye field; SOG: Superior occipital gyrus; aIPL: Inferior parietal lobule; DLPFC: Dorsolateral prefrontal cortex; aINS: Anterior insula; dACC: Dorsal anterior cingulate cortex; L: Left; R: Right.

Table 3 Comparison of demographic information before and after group cognitive-behavioral therapy treatment

	Before (n = 33)	After (n = 21)	t	P value
Sex (male)	16	11	/	/
Age	32.24 ± 7.38	32.50 ± 7.22	-0.315	0.75
Education	15.18 ± 2.07	16.04 ± 1.85	0.17	0.87
Age at onset	24.56 ± 9.15	24.32 ± 9.07	-0.37	0.72
Y-BOCS total	25.81 ± 4.78	16.41 ± 6.70	6.65	0.000^b
Y-BOCS obsession	13.03 ± 2.91	8.59 ± 3.11	5.40	0.000^b
Y-BOCS compulsion	12.88 ± 3.48	7.82 ± 4.47	5.37	0.000^b
HAMD	12.94 ± 5.80	6.83 ± 4.50	2.91	0.005^a
HAMA	9.42 ± 3.80	5.11 ± 3.25	3.41	0.001^a

^aP < 0.05, differences were considered statistically significant.

^bP < 0.001.

Y-BOCS: Yale-Brown Obsessive-Compulsive Scale; HAMD: Hamilton Depression Scale; HAMA: Hamilton Anxiety Scale.

Table 4 Comparison of neuropsychological assessment results between groups

		OCD (n = 33)	HC (n = 26)	t	P value
MoCA-B	MoCA-B	27.79 ± 1.59	29.00 ± 0.87	-3.25	0.002^a
Visuospatial ability	Rey-O emulation time (second)	160 ± 80.67	128.63 ± 48.44	1.67	0.100
	Rey-O recall time (second)	79.57 ± 40.10	87.63 ± 25.01	-0.84	0.404
	Rey-O recall score	15.26 ± 7.97	21.27 ± 6.18	-2.99	0.004^a
	Rey-O recall organization score	4.53 ± 1.77	5.41 ± 1.10	-2.27	0.027^a
Memory	AVLT-N1	4.12 ± 1.60	4.36 ± 1.22	-0.60	0.548
	AVLT-N2	5.94 ± 2.01	7.18 ± 1.26	-2.81	0.007^a
	AVLT-N3	7.00 ± 2.19	8.55 ± 1.99	-2.65	0.011^a
	AVLT-N4 short-delayed recall	5.73 ± 2.18	7.36 ± 2.01	-2.81	0.007^a
	AVLT-N5 long-delayed recall	5.30 ± 2.42	7.05 ± 2.06	-2.77	0.008^a
	AVLT-N6	5.45 ± 2.47	7.36 ± 1.89	-3.07	0.008^a
	AVLT-reaccreditation	9.82 ± 2.11	10.91 ± 1.07	-2.52	0.015^a
Attention	SDMT-correct count	53.03 ± 12.47	61.18 ± 7.71	-2.99	0.004^a
	SDMT-error count	0.30 ± 0.63	0.72 ± 1.24	-1.47	0.150
	PASAT-correct count	32.79 ± 4.13	35.77 ± 2.93	-2.93	0.005^a
	DST-recite along	9.61 ± 1.32	9.59 ± 1.01	0.05	0.964
	DST-recite backwards	5.94 ± 1.69	7.05 ± 1.79	-2.32	0.024^a
	DST total score	15.54 ± 2.67	16.64 ± 2.42	-1.54	0.129
Executive function	SCWT-A (second)	21.27 ± 4.83	19.96 ± 3.43	1.18	0.24
	SCWT-B (second)	34.27 ± 10.86	28.32 ± 3.75	2.90	0.006^a
	SCWT-C (second)	63.76 ± 22.39	56.45 ± 9.93	1.44	0.157
	SCWT-C error count	0.46 ± 1.30	0.73 ± 2.33	-0.56	0.581
	STT-A practice (second)	7.33 ± 3.27	7.09 ± 3.54	0.26	0.791
	STT-A test (second)	39.30 ± 12.59	32.18 ± 8.80	2.30	0.025^a
	STT-B practice (second)	13.18 ± 5.04	10.59 ± 1.99	2.67	0.011^a
	STT-B test (second)	85.21 ± 22.79	70.96 ± 13.62	2.90	0.005^a
	CCST spontaneous classification	4.36 ± 1.24	6.22 ± 1.02	-5.83	0.000^b
	CCST classification of leads	8.79 ± 1.53	7.86 ± 1.81	1.97	0.056
	CCST total classification	13.15 ± 2.09	14.09 ± 2.07	-1.63	0.107
	Tower of Hanoi: Three discs moving steps	12.31 ± 4.46	8.82 ± 2.38	3.72	0.001^a
	Time (second)	40.50 ± 20.35	23.36 ± 17.39	3.22	0.002^a
	Tower of Hanoi: Four discs moving steps	23.97 ± 5.99	22.09 ± 6.93	1.06	0.293
	Time (second)	82.03 ± 33.93	62.04 ± 32.24	2.17	0.035^a
	Tower of Hanoi: Five discs moving steps	52.42 ± 9.67	42.23 ± 6.29	4.32	0.000^b
	Time (second)	171.16 ± 58.92	111.91 ± 29.40	4.81	0.000^b
Speech	Surname and city alternate correct number	26.81 ± 5.85	34.18 ± 5.79	-4.56	0.000^b
	Surname correct number	13.22 ± 3.47	17.77 ± 4.43	-4.23	0.000^b
	City correct number	13.59 ± 3.91	16.41 ± 4.46	-2.46	0.017^a
	Number of errors	1.22 ± 2.15	0.91 ± 1.63	0.57	0.570
	Repetition number	2.91 ± 4.60	1.36 ± 2.17	1.65	0.106
	Animal and fruit alternate correct number	15.97 ± 3.40	18.14 ± 3.06	-2.41	0.020^a
	Number of errors	0.21 ± 0.48	0.55 ± 0.91	-1.57	0.127
	Repetition number	0.09 ± 0.29	0.41 ± 1.10	-1.32	0.197

^aP < 0.05, differences were considered statistically significant.

^bP < 0.001, uncorrected.

MoCA: Montreal Cognitive Assessment; Rey-O: Rey-Osterrieth Complex Figure; ROCF complex image test; AVLT: Auditory-verbal learning test; SDMT: Symbol Digit Modalities Test; PASAT: Paced Auditory Serial Addition Test; DST: Digit Span Test; SCWT: Stroop Color Word Test; STT-A: Shape Trails Test A; STT-B: Shape Trails Test B; CCST: California Card Sorting Test.

Table 5 Changes in neuropsychological assessments before and after treatment

Cognitive function	Test	Before GCBT	After GCBT	t	P value
Visuospatial ability	Rey-O emulation time (second)	160.73 ± 80.67	87.56 ± 21.48	2.67	0.000^b
Visuospatial ability	Rey-O recall score	15.26 ± 7.97	21.00 ± 5.45	-2.03	0.049
Memory	ALVT-N1	4.12 ± 1.60	6.11 ± 1.62	-3.31	0.002
	ALVT-N2	5.94 ± 2.01	7.56 ± 1.94	-2.15	0.038
	ALVT-N3	7.00 ± 2.19	9.22 ± 1.64	-2.82	0.007
	ALVT-N4	5.73 ± 2.18	8.56 ± 1.67	-3.60	0.001
	ALVT-N5	5.30 ± 2.42	8.11 ± 1.69	-3.26	0.002
	ALVT-N6	5.45 ± 2.48	8.33 ± 1.73	-3.26	0.002
Attention	SDMT correct number	53.03 ± 12.47	63.33 ± 12.07	-2.21	0.033
Executive function	STT-A time (second)	39.30 ± 12.59	29.89 ± 10.00	2.07	0.045
	CCST total score	13.15 ± 2.09	15.22 ± 1.30	-2.81	0.008
	Time taken to move four discs (second)	82.03 ± 33.93	33.44 ± 11.29	6.86	0.000^b

^bP < 0.001, uncorrected.

Rey-O: Rey-O: Rey-Osterrieth Complex Figure; ROCF Complex Image Test; AVLT: Auditory verbal learning test; SDMT: Symbol Digit Modalities Test; STT-A: STT-A: Shape Trails Test A; CCST: California Card Sorting Test; GCBT: Group cognitive-behavioral therapy.

Table 6 Comparison of default mode network, dorsal attention network, frontoparietal network, and salience network intra- and inter-network functional connectivity before and after group cognitive-behavioral therapy

	Before-GCBT	After-GCBT	t	P value
Intra-network
DMN
dmPFC-vmPFC	0.38 ± 0.24	0.22 ± 0.23	2.37	0.022
vmPFC-LSFG	0.22 ± 0.20	0.09 ± 0.20	2.18	0.035
vmPFC-LIFG	0.33 ± 0.24	0.13 ± 0.26	2.68	0.010
Pcu-RIFG	0.23 ± 0.22	0.06 ± 0.20	2.70	0.010
LIFG-RIFG	0.62 ± 0.25	0.43 ± 0.18	3.00	0.004
DAN
LFEF-LSOG	0.50 ± 0.28	0.35 ± 0.24	2.04	0.047
LFEF-RSOG	0.37 ± 0.26	0.15 ± 0.25	3.01	0.003^a
Inter-network
DMN-DAN
vmPFC-RFEF	0.13 ± 0.22	-0.04 ± 0.16	2.99	0.004^a
vmPFC-RSOG	0.16 ± 0.22	0.04 ± 0.15	2.17	0.035
RIFG-LFEF	0.20 ± 0.26	0.04 ± 0.24	2.03	0.048
RIFG-RFEF	0.25 ± 0.27	0.10 ± 0.19	2.17	0.035
RIFG-RSOG	0.22 ± 0.21	0.08 ± 0.21	2.26	0.028
DMN-FPN
LSFG-LDLPFC	0.03 ± 0.24	-0.13 ± 0.23	2.26	0.029
RIFG-RaIPL	0.20 ± 0.26	-0.01 ± 0.26	2.62	0.012
RIFG-LDLPFC	0.24 ± 0.28	-0.00 ± 0.26	3.02	0.004
RIFG-RDLPFC	0.04 ± 0.21	-0.19 ± 0.21	3.85	0.000^b
RIFG-RDLPFC	0.04 ± 0.21	-0.19 ± 0.21	3.85	0.000^b
DMN-SAN
LSFG-dACC	0.20 ± 0.25	0.03 ± 0.21	2.47	0.017
LIFG-LaINS	0.24 ± 0.24	0.11 ± 0.19	2.11	0.040
RIFG-LaINS	0.07 ± 0.17	0.34 ± 0.28	5.13	0.000^b
RIFG-RaINS	0.34 ± 0.28	0.09 ± 0.19	3.53	0.001^a
RIFG-dACC	0.34 ± 0.29	0.09 ± 0.26	3.13	0.003^a
DAN-SAN
RFEF-RaINS	0.34 ± 0.20	0.20 ± 0.13	2.91	0.005^a
LSOG-LaINS	0.29 ± 0.23	0.12 ± 0.26	2.38	0.022
LSOG-RaINS	0.24 ± 0.20	0.11 ± 0.23	2.09	0.043

^aP < 0.05, differences were considered statistically significant, uncorrected.

^bP < 0.001, uncorrected.

DMN: Default mode network; DAN: Dorsal attention network; FPN: Frontoparietal network; SAN: Salience network; dmPFC: Dorsomedial prefrontal cortex; vmPFC: Ventral medial prefrontal cortex; PCC: Posterior cingulate cortex; Pcu: Precuneus; SFG: Superior frontal gyrus; IFG: Inferior frontal gyrus; FEF: Frontal eye field; SOG: Superior occipital gyrus; aIPL: Inferior parietal lobule; DLPFC: Dorsolateral prefrontal cortex; aINS: Anterior insula; dACC: Dorsal anterior cingulate cortex; L: Left; R: Right; GCBT: Group cognitive-behavioral therapy.

Table 7 Correlations between functional connectivity and neuropsychological assessments after group cognitive-behavioral therapy

	dmPFC-vmPFC		VmPFC-RSOG		LIFG-LaINS		RIFG-LDLPFC		vmPFC-LIFG		LFEF-LSOG		LSOG-LaINS		LIFG-RIFG
	DMN		DMN-DAN		DMN-SAN		DMN-FPN		DMN		DAN		DAN-SAN		DMN
	r	P value	r	P value	r	P value	r	P value	r	P value	r	P value	r	P value	r	P value
Rey-O emulation time			-0.84	0.010	-0.87	0.005^a
Rey-O recall score	-0.73	0.042^a					-0.86	0.006^a
AVLT-N1							-0.87	0.005^a
AVLT-N4							-0.79	0.019^a
SDMT correct number	-0.76	0.028^a							-0.77	0.025^a
STT-A test	0.70	0.050									0.78	0.022^a	0.77	0.024^a
CCST score	-0.80	0.016^a							-0.76	0.024^a
Tower of Hanoi: Three discs moving steps			-0.73	0.040^a	-0.89	0.003^a	0.74	0.036^a
Time taken to move the three discs (second)															0.86	0.006^a
Tower of Hanoi: Four discs moving steps															0.77	0.024^a
Time taken to move the four discs (second)															0.85	0.007^a

^aP < 0.05, differences were considered statistically significant, uncorrected.

DMN: Default mode network; DAN: Dorsal attention network; FPN: Frontoparietal network; SAN: Salience network; dmPFC: Dorsal medial prefrontal cortex; vmPFC: Ventral medial prefrontal cortex; PCC: Posterior cingulate cortex; Pcu: Precuneus; SFG: Superior frontal gyrus; IFG: Inferior frontal gyrus; FEF: Frontal eye field; SOG: Superior occipital gyrus; aIPL: Inferior parietal lobule; DLPFC: Dorsolateral prefrontal cortex; aINS: Anterior insula; dACC: Dorsal anterior cingulate cortex; L: Left; R: Right; AVLT: Auditory Verbal Learning Test, Auditory Word Learning Test; SDMT: Symbol Digit Modalities Test, Symbol Digit Transformation Mode Test; STT-A: Shape Trails Test A, Shape Connectivity Test A; CCST: California Card Sorting Test; GCBT: Group cognitive-behavioral therapy.

Citation: Zhang ZF, He Y, Su YQ, Liu JM. Decreased inter- and intra-network connectivity after group cognitive behavioral therapy in patients with unmedicated obsessive-compulsive disorder. World J Psychiatry 2025; 15(8): 107860
URL: https://www.wjgnet.com/2220-3206/full/v15/i8/107860.htm
DOI: https://dx.doi.org/10.5498/wjp.v15.i8.107860