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J Am Acad Child Adolesc Psychiatry. 2018 Oct 30. pii: S0890-8567(18)31909-9. doi: 10.1016/j.jaac.2018.07.897. [Epub ahead of print]

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

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University of Minnesota, Minneapolis, MN. Electronic address:
University of Minnesota, Minneapolis, MN.



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 (RSFC) in cortico-striatal-thalamic-cortical circuits in pediatric OCD.


Medication-free youths with OCD (n=14) and healthy controls (n=14) were examined at baseline and 12 weeks with resting-state fMRI. Between scan sessions, participants with OCD received 12 weeks of sertraline. For each scan, we conducted seed-based whole-brain RSFC analyses with 6 striatal seeds. Analysis of variance (ANOVA) 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.


Two significant group x time effects in the OCD group showed increased striatal connectivity from baseline to 12 weeks compared with controls. Circuits demonstrating this pattern included right putamen with left frontal cortex/insula and left putamen with left frontal cortex and pre- and post-central cortices. Increase in connectivity in left putamen circuit was significantly correlated with clinical improvement on Children's Yale-Brown Obsessive-Compulsive Scale (r = -0.58, p = .03).


Sertraline appears to affect specific striatal-based circuits in pediatric OCD, and in part, these changes may 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.


SSRIs; functional MRI; neuroimaging; obsessive-compulsive disorder


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