Exogenous Modulation of Visual Perception And Connectivity in Body Dysmorphic Disorder (EMPAC-BDD)

身体变形障碍中视觉感知和连接的外源调节（EMPAC-BDD）

• 批准号: 10355356
• 负责人: Jamie Feusner
• 金额: $ 13.64万
• 依托单位: CENTRE FOR ADDICTION AND MENTAL HEALTH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10355356
• 关键词: Anxiety; Appearance; Area; Behavioral; Belief; Bilateral; Body Dysmorphic Disorder; Brain; Clinical; Compulsive Behavior; Data; Defect; Depression and Suicide; Development; Distress; Dorsal; Elements; Emotions; Face; Functional Magnetic Resonance Imaging; Fusiform gyrus; Future; Head; Hospitalization; Image; Impairment; Individual; Inferior; Intervention; Lateral; Link; Lobule; Magnetic Resonance Imaging; Measures; Mental Depression; Modeling; Modification; Neurobiology; Neuronavigation; Neuropsychology; Parietal; Participant; Pattern; Perception; Perceptual distortions; Performance; Prevalence; Psychophysics; Research; Scanning; Stimulus; Stream; Structure of inferior temporal gyrus; Suicide attempt; Symptoms; System; Techniques; Testing; Thinking; Transcranial magnetic stimulation; Visual; Visual Perception; Visual attention; Visual system structure; attentional bias; attentional modulation; base; brain behavior; comorbid depression; convict; experience; experimental study; extrastriate visual cortex; information processing; insight; neuroimaging; neuroregulation; noninvasive brain stimulation; novel; phenomenological models; repetitive transcranial magnetic stimulation; sample fixation; selective attention; severe psychiatric disorder; therapy development; visual information; visual processing; visual tracking

PROJECT SUMMARY Individuals with body dysmorphic disorder (BDD) misperceive aspects of their appearance to be conspicuously flawed or defective, despite these being unnoticeable or appearing miniscule to others. With convictions of disfigurement and ugliness, they typically have poor insight or delusional beliefs, obsessive thoughts and compulsive behaviors, anxiety, and depression. These result in significant difficulties in functioning, depression, suicide attempts (25%), and psychiatric hospitalization (50%). Despite this, relatively few studies of the neurobiology, and few treatment studies, have been conducted. This underscores a critical need for research to identify novel targets for intervention based on a comprehensive understanding of the pathophysiological mechanisms. Previous research has uncovered mechanisms that may contribute to perceptual distortions, including prominent abnormalities in visual processing systems. These have contributed to a model of diminished global/holistic processing and enhanced local/detailed processing, attributed to “bottom-up” and “top-down” disturbances in perception. Previous experiments using psychophysical tests, novel behavioral visual modulation techniques, and functional magnetic resonance imaging (fMRI) have probed the brain’s visual systems responsible for global and local processing and found early evidence that they may be modifiable in BDD. This study will test if further modification could be achieved using noninvasive neuromodulation with repetitive transcranial magnetic stimulation (TMS). Such modulation may be necessary to enhance the effects of behavioral modulation and induce the magnitude of functional changes necessary to achieve clinically meaningful improvements in perceptual experiences in those with BDD. The proposed experiment will determine whether excitatory and inhibitory TMS enhances and inhibits, respectively, the effects of a behavioral visual modulation strategy on brain connectivity and on global visual processing on a psychophysical task. This will be tested in individuals with clinical BDD and in individuals with subclinical BDD. Results will contribute to a comprehensive mechanistic model of abnormal visual information processing underlying the core symptom domain of misperceptions of appearance. Further, results will be critical for the development and optimization of future combinations of neuromodulation and novel perceptual retraining treatments.

项目摘要 患有身体畸形恐惧症（BDD）的人错误地认为他们的外表是明显的， 有瑕疵或缺陷的，尽管这些在别人看来是不明显的或微不足道的。被判有罪 他们通常有不良的洞察力或妄想的信念，强迫性的想法， 强迫行为焦虑和抑郁这导致运作上的重大困难， 抑郁症、自杀企图（25%）和精神病住院（50%）。尽管如此，相对较少的研究 进行了神经生物学和少数治疗研究。这突出表明，迫切需要 研究，以确定新的干预目标的基础上，全面了解 病理生理机制以前的研究已经揭示了可能有助于 知觉失真，包括视觉处理系统的显著异常。这些都有助于 一种减少整体/整体处理和增强局部/细节处理的模型，归因于 "自下而上"和"自上而下"的干扰。以前的实验使用心理物理测试， 新的行为视觉调节技术和功能性磁共振成像（fMRI）已经 探索负责全局和局部处理的大脑视觉系统，并发现了早期证据， 它们可以在BDD中修改。这项研究将测试是否可以实现进一步的修改， 重复经颅磁刺激（TMS）的神经调节。这种调制可能是必要的 增强行为调节的效果，并诱导必要的功能变化的幅度， 在BDD患者的感知体验中实现临床上有意义的改善。拟议 实验将确定兴奋性和抑制性TMS是否分别增强和抑制， 行为视觉调节策略对大脑连接和整体视觉处理的影响 心理物理任务这将在临床BDD个体和亚临床BDD个体中进行测试。 研究结果将有助于建立一个全面的异常视觉信息加工机制模型 这是对外表误解的核心症状领域的基础。此外，结果对于 神经调节和新感知再训练的未来组合的开发和优化 治疗。