Sertraline Effects on Striatal Resting-State Functional Connectivity in Youth With OCD: A Pilot Study

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Objective: Foundational knowledge on neural circuitry underlying pediatric obsessive-compulsive disorder (OCD) and how it changes during standard treatment is needed to provide the basis for conceptualization and development of novel targeted treatments. This study explored the effects of sertraline, a selective serotonin reuptake inhibitor, on resting-state functional connectivity in cortico-striatal-thalamic-cortical circuits in pediatric OCD. Method: Medication-free youths with OCD (n = 14) and healthy controls (n = 14) were examined at baseline and 12 weeks with resting-state functional magnetic resonance imaging. Between scan sessions, participants with OCD received 12 weeks of sertraline. For each scan, seed-based whole-brain resting-state functional connectivity analyses were conducted with 6 striatal seeds. Analysis of variance examined the interaction between group and time on striatal connectivity, including cluster-based thresholding to correct for multiple tests. Connectivity changes within circuits identified in group analyses were correlated with clinical change. Results: Two significant group-by-time effects in the OCD group showed increased striatal connectivity from baseline to 12 weeks compared with controls. Circuits demonstrating this pattern included the right putamen with the left frontal cortex and insula and the left putamen with the left frontal cortex and pre- and post-central cortices. Increase in connectivity in the left putamen circuit was significantly correlated with clinical improvement on the Children's Yale-Brown Obsessive-Compulsive Scale score (r = −0.58, p =.03). Conclusion: Sertraline appears to affect specific striatal-based circuits in pediatric OCD, and these changes in part could account for clinical improvement. Future work is needed to confirm these preliminary findings, which would facilitate identification of circuit-based targets for novel treatment development. Clinical trial registration information: Effects of Sertraline on Brain Connectivity in Adolescents with OCD;; NCT02797808

Original languageEnglish (US)
Pages (from-to)486-495
Number of pages10
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number5
StatePublished - Jan 1 2019

Bibliographical note

Funding Information:
This study was supported by grants from the National Institutes of Health (R21MH101395 to G.A.B., K23MH103617 to C.A.C., P30NS076408, and P41EB015894). The work was carried out in part using computing resources at the University of Minnesota Supercomputing Institute. Disclosure: Drs. Bernstein, Cullen, Conelea, Zagoloff, Lee, and Mueller and Ms. Harris, and Ms. Carstedt report no biomedical financial interests or potential conflicts of interest.

Publisher Copyright:
© 2018 American Academy of Child and Adolescent Psychiatry


  • functional magnetic resonance imaging
  • neuroimaging
  • obsessive-compulsive disorder
  • selective serotonin reuptake inhibitors

PubMed: MeSH publication types

  • Journal Article
  • Clinical Trial
  • Research Support, N.I.H., Extramural

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