Neurobiological correlates of the psychotherapy of obsessive-compulsive disorders

Obsessive-compulsive disorders are associated with different neuropsychological impairments concerning executive functions, error monitoring, decision making and other basic functionalities. Contemporary neurocircuitry models emphasize the dysfunction of the fronto-striato-thalamo-cortical network related to parietal regions, the orbitofrontal cortex, the anterior cingulate cortex and other limbic structures. In brief, studies on the functional neuroanatomy of psychotherapy effects realized by positron emission tomography (PET) and functional magnetic resonance imaging (fMRI) are reported. Perspectives concern combined process-outcome research with repeated neuroimaging and highly resolved (daily) self-ratings focussing the nonlinear dynamics of psychotherapeutic change processes. New therapeutic approaches could explore the combination of psychotherapy with fMRI-based real-time neurofeedback and noninvasive neuromodulation with coordinated reset stimulation focusing on the desynchronization of pathologically oversynchronized neural populations and networks.