Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024-1759, USA.
UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA.
Brain Imaging Behav. 2021 Jun;15(3):1235-1252. doi: 10.1007/s11682-020-00323-5.
Anorexia nervosa (AN) and body dysmorphic disorder (BDD) are characterized by distorted perception of appearance, yet no studies have directly compared the neurobiology associated with body perception. We compared AN and BDD in brain activation and connectivity in relevant networks when viewing images of others' bodies and tested their relationships with clinical symptoms and subjective appearance evaluations. We acquired fMRI data from 64 unmedicated females (20 weight-restored AN, 23 BDD, 21 controls) during a matching task using unaltered or spatial-frequency filtered photos of others' bodies. Using general linear model and independent components analyses we compared brain activation and connectivity in visual, striatal, and parietal networks and performed univariate and partial least squares multivariate analyses to investigate relationships with clinical symptoms and appearance evaluations. AN and BDD showed partially overlapping patterns of hyperconnectivity in the dorsal visual network and hypoconnectivity in parietal network compared with controls. BDD, but not AN, demonstrated hypoactivity in dorsal visual and parietal networks compared to controls. Further, there were significant activity and connectivity differences between AN and BDD in both networks. In both groups, activity and/or connectivity were associated with symptom severity and appearance ratings of others' bodies. Thus, AN and BDD demonstrate both distinct and partially-overlapping aberrant neural phenotypes involved in body processing and visually encoding global features. Nevertheless, in each disorder, aberrant activity and connectivity show relationships to clinically relevant symptoms and subjective perception. These results have implications for understanding distinct and shared pathophysiology underlying perceptual distortions of appearance and may inform future novel treatment strategies.
神经性厌食症 (AN) 和身体变形障碍 (BDD) 的特征是对外貌的扭曲感知，但尚无研究直接比较与身体感知相关的神经生物学。我们比较了 AN 和 BDD 在观看他人身体图像时大脑激活和相关网络连接的差异，并测试了它们与临床症状和主观外貌评估的关系。我们招募了 64 名未经药物治疗的女性（20 名体重恢复的 AN 患者、23 名 BDD 患者和 21 名健康对照者），在匹配任务中使用未经改变或空间频率滤波的他人身体照片采集 fMRI 数据。使用一般线性模型和独立成分分析比较了视觉、纹状体和顶叶网络中的大脑激活和连接，并进行了单变量和偏最小二乘多元分析，以研究与临床症状和外貌评估的关系。与对照组相比，AN 和 BDD 显示出背侧视觉网络中部分重叠的过度连接模式和顶叶网络中的连接不足。与对照组相比，BDD 而非 AN 表现出背侧视觉和顶叶网络中的活动减少。此外，在这两个网络中，AN 和 BDD 之间存在显著的活动和连接差异。在这两个组中，活动和/或连接与症状严重程度和对他人身体的外貌评估有关。因此，AN 和 BDD 表现出涉及身体处理和视觉编码整体特征的异常神经表型，既有独特之处，也有部分重叠。然而，在每种疾病中，异常活动和连接都与临床相关症状和主观感知有关。这些结果对于理解外观感知扭曲的独特和共同病理生理学具有重要意义，并可能为未来的新型治疗策略提供信息。
