Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Aug 19, 2025; 15(8): 107860
Published online Aug 19, 2025. doi: 10.5498/wjp.v15.i8.107860
Decreased inter- and intra-network connectivity after group cognitive behavioral therapy in patients with unmedicated obsessive-compulsive disorder
Zong-Feng Zhang, Yan He, Yu-Qiu Su, Ji-Meng Liu
Zong-Feng Zhang, Yan He, Yu-Qiu Su, Ji-Meng Liu, Department of Psychiatry, The Affiliated Kangning Hospital of Ningbo University, Ningbo 315201, Zhejiang Province, China
Zong-Feng Zhang, Yan He, Yu-Qiu Su, Ji-Meng Liu, Department of Psychiatry, Ningbo Kangning Hospital, Ningbo 315201, Zhejiang Province, China
Co-first authors: Zong-Feng Zhang and Yan He.
Author contributions: Zhang ZF and He Y contributed to data analysis and manuscript drafting; Liu JM was responsible for research design and overall supervision; and Su YQ conducted the research implementation and sample evaluations; All authors advised upon, edited, and reviewed the manuscript.
Supported by the Pharmaceutical Science and Technology Project of Zhejiang Province, No. 2023RC266; and the Natural Science Foundation of Ningbo, No. 202003N4266.
Institutional review board statement: The study was approved by the Ethics Committee of the Affiliated Kangning Hospital of Ningbo University (NBKNYY-2021-LC-5).
Informed consent statement: All participants were signed informed consent forms.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: The datasets utilized and examined in this investigation are available from the corresponding author upon reasonable request at 13216645323@163.com.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ji-Meng Liu, MD, Chief Physician, Department of Psychiatry, The Affiliated Kangning Hospital of Ningbo University, No. 1 Zhuangyu South Road, Zhuangshi Sub-District, Ningbo 315201, Zhejiang Province, China. 13216645323@163.com
Received: April 22, 2025
Revised: May 20, 2025
Accepted: June 13, 2025
Published online: August 19, 2025
Processing time: 108 Days and 1.5 Hours
Abstract
BACKGROUND

Group cognitive behavioral therapy (GCBT) is increasingly being used to treat obsessive-compulsive disorder (OCD) because of its high efficiency, economy, and interaction among group members. However, the changes in network functional connectivity (FC) in patients with OCD with GCBT remain unclear.

AIM

To investigate inter- and intra-network resting-state FC (rs-FC) abnormalities before and after GCBT in unmedicated patients with OCD and validate the efficacy of GCBT.

METHODS

Overall, 33 individuals with OCD and 26 healthy controls underwent resting-state functional magnetic resonance imaging. The patients were rescanned 12 weeks after GCBT. Four cognition-related networks-default mode network (DMN), dorsal attention network (DAN), salience network (SAN), and frontoparietal network (FPN)-were selected to examine FC abnormalities within and between OCD networks before and after GCBT. Neuropsychological assessments including memory, executive function, speech, attention, and visuospatial ability were reassessed following GCBT. Pearson’s correlations were used to analyze the relationship between aberrant FC in cognition-related networks and altered neuropsychological assessments in patients.

RESULTS

Rs-FC within the DMN and DAN decreased significantly. Additionally, rs-FC between the DMN-DAN, DMN-FPN, DMN-SAN, and DAN-SAN also decreased. Significant improvements were observed in cognitive functions, such as memory, executive function, attention, and visuospatial ability. Furthermore, reduced rs-FC within the DMN correlated with visuospatial ability and executive function; DAN positively correlated with Shape Trails Test (STT)-A test elapsed time; DMN-DAN negatively correlated with Rey-Osterrieth Complex Figure (Rey-O) mimicry time and the three elapsed times of the tower of Hanoi; DMN-SAN negatively correlated with Rey-O imitation time and positively correlated with STT-A test elapsed time; and DMN-FPN negatively correlated with Auditory Word Learning Test N1 and N4 scores.

CONCLUSION

Decreased rs-FC within the DMN and DAN, which correlated with executive function post-treatment, has potential as a neuroimaging marker to predict treatment response to GCBT in patients with OCD.

Keywords: Cognitive networks; Default mode network; Dorsal attention network; Frontoparietal network; Group cognitive behavioral therapy; Obsessive-compulsive disorder; Resting-state functional connectivity; Salience network

Core Tip: This study demonstrated that group cognitive behavioral therapy (GCBT) reduced resting-state functional connectivity (rs-FC) within and between the default mode (DMN) and dorsal attention networks (DAN) in patients with unmedicated obsessive-compulsive disorder (OCD). These connectivity changes correlated with improved executive function, memory, and visuospatial abilities, suggesting reduced DMN/DAN rs-FC as a potential neuroimaging marker for predicting GCBT efficacy in OCD treatment.