Common and Distinct Phenotypes of Body Dysmorphic Disorder and Anorexia Nervosa

身体畸形障碍和神经性厌食症的常见和独特表型

• 批准号: 8087974
• 负责人: Jamie Feusner
• 金额: $ 34.65万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2015-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8087974
• 关键词: Adult; Affective; Age; Amygdaloid structure; Anorexia Nervosa; Anxiety; Appearance; Behavior; Body Dysmorphic Disorder; Body Image; Brain; Categories; Classification Scheme; Clinical; Corpus striatum structure; Data; Deltastab; Development; Diagnostic; Disease; Dorsal; Eating Disorders; Emotional; Emotions; Enrollment; Exhibits; Face; Facial Expression; Foundations; Frequencies; Fright; Functional Magnetic Resonance Imaging; Future; Gender; Goals; Hippocampus (Brain); Housing; Hyperactive behavior; Image; Individual; Label; Left; Limbic System; Maps; Medial; Mediating; Mental disorders; Morbidity - disease rate; Neurobiology; Neurocognitive; Neuropsychological Tests; Pattern; Perception; Perceptual distortions; Persons; Phenotype; Prefrontal Cortex; Process; Regulation; Relative (related person); Research; Self Perception; Severities; Side; Stimulus; Stream; Surface; Symptoms; System; Techniques; Testing; Visual; Visual Cortex; Visual Perception; Visuospatial; Weight; Weight Gain; base; clinical phenotype; depressive symptoms; early childhood; effective therapy; emotion regulation; emotional stimulus; follow-up; food restriction; high risk; mortality; neural circuit; neuroimaging; novel therapeutics; psychologic; relating to nervous system; research study; therapy development; trait; visual process; visual processing

DESCRIPTION (provided by applicant): 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.

描述（由申请人提供）：本研究的目的是使用一组功能性神经成像实验表征与身体畸形障碍（BDD）和厌食性神经（AN）相关的共同脑回路。 BDD和神经性厌食症是严重且残疾的精神疾病，具有许多临床特征，例如扭曲的身体形象和自我价值的外观高估，但目前已分为单独的诊断类别。尽管它们的发病率和死亡率很高，但几乎没有进行比较和对比这些疾病的研究，以了解共享和独特的临床表型的潜在神经生物学。 BDD中的一个重要的共享临床表型，A是外观的感知失真，这可能导致身体形象扭曲。有早期的证据表明，在临床上和神经心理学测试中证明了类似的，在视觉感知和视觉空间处理中的障碍和视觉空间处理的常见表型。但是，对于介导这些过程的基本神经生物学过程知之甚少。 BDD成年人的初步功能磁共振成像（fMRI）研究表明，在查看他人的脸时，左半球区域的激活异常。在BDD中进行的一项最新研究表明，在观看自己的面时，原发性情绪处理区域没有异常。另一方面，除了对体重增加的极端恐惧外，AN通常还具有早期，儿童期焦虑的特征。但是，尚无研究在一个或将其与BDD进行比较的恐惧处理中专门研究。拟议的研究的目的是定义BDD中视觉和情感处理的常见，独特和表型，并将其映射到特定的大脑系统上。这项研究将招募25名BDD受试者，25名具有重量恢复的AN和25个健康对照，年龄在18-30岁。功能磁共振成像（fMRI）将用于识别与视觉和情感处理相关的大脑系统中的关键异常。根据BDD的先前FMRI研究以及我们的试验数据和先前的研究表明，AN中的细节处理异常，本研究将使用不同类型的视觉图像来调查其他类型的视觉图像，这些视觉图像使用不同类型的视觉图像来研究其他类型的视觉图像。为了比较情绪处理的模式和对比模式，本研究将使用可怕的面部刺激来理解与情绪反应，调节和习惯相关的常见或独特的大脑活动模式。 。 公共卫生相关性：这项研究将表征与这些严重和残疾的身体形象疾病相关的脑电路和情绪处理相关的，以建立其共同且独特的临床特征的神经基础。这将有助于基于对潜在的大脑机制的理解，而不仅仅是表面症状和行为的理解。它还将为未来的新型治疗剂（例如知觉再培训和情绪调节技术）的发展奠定基础。