Effects of cognitive behavioral therapy on white matter fibers of patients with obsessive-compulsive disorder as assessed by diffusion tensor imaging: study protocol for a parallel group, controlled trial

Background: Short-duration cognitive behavioral therapy is an effective method for the treatment of obsessive-compulsive disorder. It alters the functions of multiple brain regions or tissues, and improves symptoms. Imaging studies show changes in the microstructure of white matter fiber bundles of patients with obsessive-compulsive disorder. Methods/Design: We will conduct a single-blind, parallel, controlled trial in the Beijing Anding Hospital, Capital Medical University, China. A cohort of 60 patients with obsessive-compulsive disorder will undergo 12 weeks of cognitive behavioral therapy. An additional 60 healthy controls will comprise the control group. All participants will be evaluated before and after 12 weeks of treatment. The primary outcome will be fractional anisotropy values in the frontal-striatal-thalamic circuits assessed by diffusion tensor imaging. The secondary outcomes will be Yale-Brown Obsessive-Compulsive Scale, Hamilton Depression Rating Scale, and Hamilton Anxiety Scale scores. Discussion: This trial will assess the changes in white matter fibers of patients with obsessive-compulsive disorder after treatment with cognitive behavioral therapy using diffusion tensor imaging. This will hopefully reveal the neural mechanisms underlying the treatment of obsessive-compulsive disorder by cognitive behavioral therapy. It will also provide objective clinical evidence of its effectiveness, and for the development of individual treatment strategies. Trial registration: This trial was registered with the Chinese Clinical Trial Registry (http://www.chictr.org.cn/) (ChiCTR-IOR-14005436) on 29 October 2014. Ethics: The study protocol was approved by the Ethics Committee of Beijing Anding Hospital of Capital Medical University of China on 17 June 2013, approval number (2013)Keyan(7). Informed consent: Written informed consent will be provided by participants and their guardians.