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影像实验来表征与身体变形障碍（BDD）和神经性厌食症（AN）相关的共享和独特的大脑回路。 BDD 和神经性厌食症 AN 是严重的致残性精神疾病，具有许多共同的临床特征，例如扭曲的身体形象和高估自我价值的外表，但它们目前被分为不同的诊断类别。尽管其发病率和死亡率很高，但很少有研究来比较和对比这些疾病，以了解共同和独特的临床表型的潜在神经生物学。 BDD 和 AN 的一个重要的共同临床表型是外观知觉扭曲，这可能导致身体形象扭曲。临床和神经心理学测试证明，早期证据表明 BDD 和 AN 的视觉感知和视觉空间处理障碍具有相似且常见的表型。然而，人们对介导这些的潜在神经生物学过程知之甚少。对患有 BDD 的成年人进行的一项初步功能磁共振成像 (fMRI) 研究表明，在观看他人面部时负责高细节处理的左半球区域存在异常激活。最近的一项 BDD 研究表明，在观看自己的面孔时，主要情绪处理区域没有异常。另一方面，AN 的特点通常是早期、儿童期发作的焦虑以及对体重增加的极度恐惧。然而，没有研究专门检查 AN 中的恐惧处理过程，也没有将其与 BDD 进行比较。这项研究的目标是定义 BDD 和 AN 中视觉和情感处理的常见和独特表型，映射到特定的大脑系统。这项研究将招募 25 名患有 BDD 的受试者、25 名患有体重恢复的 AN 的受试者以及 25 名年龄在 18-30 岁之间的健康对照者。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的关键异常。基于之前 BDD 的功能磁共振成像研究，以及我们的试点数据和之前表明 AN 细节处理异常的研究，本研究将使用传达高、低或正常细节水平的不同类型的视觉图像来研究他人的面部、身体和非面部物体（房屋）的视觉处理。为了比较和对比情绪处理的模式，本研究将使用恐惧的面部刺激来了解与情绪反应、调节和习惯相关的常见或独特的大脑活动模式。 。 公共健康相关性：这项研究将描述这些严重和致残的身体意象障碍中与知觉扭曲和情绪处理相关的大脑回路，为其共同和独特的临床特征建立神经基础。这将有助于基于对大脑潜在机制的理解而不仅仅是表面症状和行为来完善分类方案。它还将为未来发展感知再训练和情绪调节技术等新型疗法奠定基础。