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 患有身体营养不良障碍（BDD）的人的外表很明显 有缺陷或有缺陷，dospite这些不明显或对他人显得微不足道。有信念 毁容和丑陋，他们通常具有贫穷的洞察力或妄想信念，痴迷的思想和 强迫行为，焦虑和抑郁。这些导致工作难度很大， 抑郁症，自杀未遂（25％）和精神病住院（50％）。尽管如此，对 神经生物学和很少的治疗研究已经进行。这强调了对 基于对 病理生理机制。以前的研究已经发现了可能有助于 感知扭曲，包括视觉处理系统中的明显异常。这些做出了贡献 以减少全球/整体处理和增强本地/详细处理的模型，归因于 “自下而上”和“自上而下”的灾难。先前使用心理物理测试的实验， 新型的行为视觉调制技术和功能磁共振成像（fMRI）具有 探究了负责全球和本地处理的大脑视觉系统，并找到了早期证据 它们可能在BDD中进行修改。这项研究将测试是否可以使用无创的进一步修改 具有重复的经颅磁刺激（TMS）的神经调节。这样的调制可能是必要的 为了增强行为调制的影响，并引起了所需的功能变化的幅度 在患有BDD的人的感知体验方面，实现有意义的改善。提议 实验将确定运动和抑制性TMS是否分别增强和抑制 行为视觉调制策略对大脑连接性和全局视觉处理的影响 心理物理任务。这将在临床BDD和亚临床BDD的个体中进行测试。 结果将有助于异常视觉信息处理的全面机械模型 核心症状领域的基础是出现误解。此外，结果对 神经调节和新型感知再培训的未来组合的开发和优化 治疗。