The purpose of this study is to characterize shared and unique brain circuits associated with Body Dysmorphic Disorder (BDD) and Anorexia Nervosa (AN) using a set of functional neuroimaging experiments. BDD and anorexia nervosa AN are severe and disabling psychiatric disorders that share many clinical features such as distorted body image and overvaluation of appearance for self-worth, yet they are currently classified in separate diagnostic categories. Despite their significant morbidity and mortality, very little research has been conducted to compare and contrast these disorders in order to understand the underlying neurobiology of shared and unique clinical phenotypes. An important shared clinical phenotype in BDD and AN is perceptual distortion of appearance, which may contribute to distorted body image. There is early evidence of similar, common phenotypes of disturbances in visual perception and visuospatial processing in BDD and AN, as evidenced clinically and from neuropsychological testing. However, little is known of the underlying neurobiological processes that mediate these. A preliminary functional magnetic resonance imaging (fMRI) study in adults with BDD demonstrated abnormal activation in left hemisphere regions responsible for high-detail processing when viewing others' faces. A more recent study in BDD demonstrated no abnormalities of primary emotional processing regions when viewing own-faces. AN, on the other hand, is often characterized by early, childhood-onset anxiety in addition to extreme fears of weight gain. However, no study has specifically examined fear processing in AN nor compared it to BDD. The goal of the proposed study is to define the common and distinct and phenotypes of visual and emotional processing in BDD and AN that map onto specific brain systems. This study will enroll 25 subjects with BDD, 25 with weight-restored AN, and 25 healthy controls, ages 18-30. Functional magnetic resonance imaging (fMRI) will be used to identify key abnormalities in brain systems associated with visual and emotional processing. Based on previous fMRI research in BDD, and our pilot data and previous studies suggesting abnormalities of detail-processing in AN, this study will investigate visual processing of others' faces, bodies, and non-face objects (houses) using different types of visual images that convey high, low, or normal level of detail. To compare and contrast patterns of emotional processing, this study will use fearful face stimuli to understand common or distinct brain activity patterns associated with emotional reactivity, regulation, and habituation. .

Public Health Relevance

This study will characterize brain circuitry associated with perceptual distortions and emotional processing in these severe and disabling disorders of body image to establish the neural basis for their shared and distinct clinical features. This will assist in refining classification schemes based on an understanding of underlying brain mechanisms and not merely surface symptoms and behaviors. It will also lay the foundation for future development of novel therapeutics such as perceptual retraining and emotion regulation techniques.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH093535-05
Application #
8802773
Study Section
Adult Psychopathology and Disorders of Aging Study Section (APDA)
Program Officer
Chavez, Mark
Project Start
2011-04-01
Project End
2015-12-31
Budget Start
2015-01-01
Budget End
2015-12-31
Support Year
5
Fiscal Year
2015
Total Cost
$346,500
Indirect Cost
$121,500
Name
University of California Los Angeles
Department
Psychiatry
Type
Schools of Medicine
DUNS #
092530369
City
Los Angeles
State
CA
Country
United States
Zip Code
90095
Khalsa, Sahib S; Hassanpour, Mahlega S; Strober, Michael et al. (2018) Interoceptive Anxiety and Body Representation in Anorexia Nervosa. Front Psychiatry 9:444
Harrison, Theresa M; McLaren, Donald G; Moody, Teena D et al. (2017) Generalized Psychophysiological Interaction (PPI) Analysis of Memory Related Connectivity in Individuals at Genetic Risk for Alzheimer's Disease. J Vis Exp :
Moody, Teena D; Shen, Vivian W; Hutcheson, Nathan L et al. (2017) Appearance evaluation of others' faces and bodies in anorexia nervosa and body dysmorphic disorder. Int J Eat Disord 50:127-138
Feusner, Jamie D; Lidström, Andreas; Moody, Teena D et al. (2017) Intrinsic network connectivity and own body perception in gender dysphoria. Brain Imaging Behav 11:964-976
Khalsa, Sahib S; Kumar, Rajesh; Patel, Vandan et al. (2016) Mammillary body volume abnormalities in anorexia nervosa. Int J Eat Disord 49:920-929
Beucke, Jan C; Sepulcre, Jorge; Buhlmann, Ulrike et al. (2016) Degree connectivity in body dysmorphic disorder and relationships with obsessive and compulsive symptoms. Eur Neuropsychopharmacol 26:1657-66
Zhang, A; Leow, A; Zhan, L et al. (2016) Brain connectome modularity in weight-restored anorexia nervosa and body dysmorphic disorder. Psychol Med 46:2785-97
Armstrong, Casey C; Moody, Teena D; Feusner, Jamie D et al. (2016) Graph-theoretical analysis of resting-state fMRI in pediatric obsessive-compulsive disorder. J Affect Disord 193:175-84
Hassanpour, Mahlega S; Yan, Lirong; Wang, Danny J J et al. (2016) How the heart speaks to the brain: neural activity during cardiorespiratory interoceptive stimulation. Philos Trans R Soc Lond B Biol Sci 371:
Khalsa, Sahib S; Feinstein, Justin S; Li, Wei et al. (2016) Panic Anxiety in Humans with Bilateral Amygdala Lesions: Pharmacological Induction via Cardiorespiratory Interoceptive Pathways. J Neurosci 36:3559-66

Showing the most recent 10 out of 25 publications