In patients with obsessive-compulsive disorder (OCD) undergoing a 3-month mindfulness-based cognitive therapy (MBCT) programme, distinct baseline brain connectivity patterns were associated with four clinical domains: positive affect, negative affect, anxiety sensitivity, and rumination. Key brain nodes—the precuneus and frontopolar cortex—within the ventral default mode network and frontostriatal network showed predictive and response associations with clinical changes. MBCT may modulate connectivity in these networks, potentially reducing symptoms across domains. These network-based biomarkers could help personalize treatment and identify patients most likely to benefit from MBCT.
About 40-50% of patients with obsessive-compulsive disorder (OCD) continue to experience obsessions and compulsions after first-line treatments. Mindfulness-based cognitive therapy (MBCT) is proposed as an augmentation strategy to help patients decentre from distressful thoughts, potentially increasing non-reactivity and reducing compulsions. This randomized clinical trial of 60 OCD patients who did not respond to first-line treatments will compare an MBCT program (10 weekly 120-minute sessions) with treatment as usual. The primary outcome is change in OCD severity, measured by clinician and self-reported assessments. Comprehensive evaluations will include comorbid clinical variables, neuropsychological functioning, thought content, and structural and functional neuroimaging at baseline and post-intervention. This is the first RCT in this population to examine clinical, neuropsychological, and neuroimaging variables together to identify neural patterns associated with MBCT response.
Mindfulness-based cognitive therapy (MBCT) added to usual treatment reduces obsessive-compulsive disorder (OCD) symptoms more than usual treatment alone. In a trial of 68 moderately symptomatic adults, those receiving MBCT showed a 31.73% reduction on the Yale-Brown Obsessive-Compulsive Scale compared to 8.07% in the treatment-as-usual group. MBCT also lowered depressive symptoms, rumination, and perceived stress, and improved quality of life. No changes in resting-state brain connectivity were detected after treatment, but lower baseline connectivity in fronto-striatal, salience, and default mode networks predicted greater symptom reduction, suggesting a neural basis for MBCT response.