Madsen Sarah K, Zai Alex, Pirnia Tara, Arienzo Donatello, Zhan Liang, Moody Teena D, Thompson Paul M, Feusner Jamie D
Imaging Genetics Center, Institute for Neuroimaging & Informatics, Department of Neurology, University of Southern California, Marina del Rey, CA, USA; Departments of Neurology, Psychiatry, Radiology, Pediatrics, Engineering, & Ophthalmology, University of Southern California, Los Angles, CA, USA.
Department of Neurology, University of California Los Angeles, Los Angeles, CA, USA.
Psychiatry Res. 2015 Apr 30;232(1):115-22. doi: 10.1016/j.pscychresns.2015.02.003. Epub 2015 Feb 26.
Individuals with body dysmorphic disorder (BDD) suffer from preoccupations with perceived defects in physical appearance, causing severe distress and disability. Although BDD affects 1-2% of the population, the neurobiology is not understood. Discrepant results in previous volumetric studies may be due to small sample sizes, and no study has investigated cortical thickness in BDD. The current study is the largest neuroimaging analysis of BDD. Participants included 49 medication-free, right-handed individuals with DSM-IV BDD and 44 healthy controls matched by age, sex, and education. Using high-resolution T1-weighted magnetic resonance imaging, we computed vertex-wise gray matter (GM) thickness on the cortical surface and GM volume using voxel-based morphometry. We also computed volumes in cortical and subcortical regions of interest. In addition to group comparisons, we investigated associations with symptom severity, insight, and anxiety within the BDD group. In BDD, greater anxiety was significantly associated with thinner GM in the left superior temporal cortex and greater GM volume in the right caudate nucleus. There were no significant differences in cortical thickness, GM volume, or volumes in regions of interest between BDD and control subjects. Subtle associations with clinical symptoms may characterize brain morphometric patterns in BDD, rather than large group differences in brain structure.
患有躯体变形障碍（BDD）的个体因过度关注自身外貌上被感知到的缺陷而痛苦，这会导致严重的困扰和功能障碍。尽管BDD影响着1%至2%的人群，但其神经生物学机制尚不清楚。先前体积研究结果存在差异可能是由于样本量小，且尚无研究对BDD患者的皮质厚度进行调查。当前这项研究是对BDD进行的最大规模的神经影像学分析。参与者包括49名未服用药物、惯用右手且符合《精神疾病诊断与统计手册》第四版（DSM-IV）中BDD诊断标准的个体，以及44名在年龄、性别和教育程度上与之匹配的健康对照者。我们使用高分辨率T1加权磁共振成像，通过基于体素的形态测量法计算皮质表面的逐点灰质（GM）厚度和GM体积。我们还计算了感兴趣的皮质和皮质下区域的体积。除了进行组间比较外，我们还在BDD组内研究了与症状严重程度、自知力和焦虑的相关性。在BDD患者中，更高的焦虑程度与左侧颞上皮质更薄的GM以及右侧尾状核更大的GM体积显著相关。BDD患者与对照者在皮质厚度、GM体积或感兴趣区域的体积方面没有显著差异。BDD患者大脑形态测量模式的特征可能是与临床症状存在细微关联，而非大脑结构上的显著组间差异。
