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Wong WW, Peel H, Cabeen R, Diaz-Fong JP, Feusner JD. Visual system structural and functional connections during face viewing in body dysmorphic disorder. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.07.12.603273. [PMID: 39071433 PMCID: PMC11275846 DOI: 10.1101/2024.07.12.603273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Background Individuals with body dysmorphic disorder (BDD) perceive distortions in their appearance, which could be due to imbalances in global and local visual processing. The vertical occipital fasciculus connects dorsal and ventral visual stream regions, integrating global and local information, yet the role of this structural connection in BDD has not been explored. Here, we investigated the vertical occipital fasciculus's white matter microstructure in those with BDD and healthy controls and tested associations with psychometric measures and effective connectivity while viewing their face during fMRI. Methods We analyzed diffusion MRI and fMRI data in 17 unmedicated adults with BDD and 21 healthy controls. For diffusion MRI, bundle-specific analysis was performed, enabling quantitative estimation of neurite density and orientation dispersion of the vertical occipital fasciculus. For task fMRI, participants naturalistically viewed photos of their own face, from which we computed effective connectivity from dorsal to ventral visual regions. Results In BDD, neurite density was negatively correlated with appearance dissatisfaction and negatively correlated with effective connectivity. Further, those with weaker effective connectivity while viewing their face had worse BDD symptoms and worse insight. In controls, no significant relationships were found between any of the measures. There were no significant group differences in neurite density or orientation dispersion. Conclusion Those with BDD with worse appearance dissatisfaction have a lower fraction of tissue having axons or dendrites along the vertical occipital fasciculus bundle, possibly reflecting impacting the degree of integration of global and local visual information between the dorsal and ventral visual streams. These results provide early insights into how the vertical occipital fasciculus's microstructure relates to the subjective experience of one's appearance, as well as the possibility of distinct functional-structural relationships in BDD.
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Affiliation(s)
- Wan-wa Wong
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong, China
| | - Hayden Peel
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- La Trobe University, Melbourne, VIC, Australia
| | - Ryan Cabeen
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | | | - Jamie D. Feusner
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
- Department of Psychiatry, Division of Neurosciences & Clinical Translation, University of Toronto, Toronto, ON, Canada
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
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Wang Z, Tan Q, Frank SM, Sasaki Y, Sheinberg D, Phillips KA, Watanabe T. Learning of the same task subserved by substantially different mechanisms between patients with body dysmorphic disorder and healthy individuals. Cereb Cortex 2024; 34:bhae215. [PMID: 38798001 PMCID: PMC11128689 DOI: 10.1093/cercor/bhae215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 04/18/2024] [Accepted: 05/10/2024] [Indexed: 05/29/2024] Open
Abstract
It has remained unclear whether individuals with psychiatric disorders involving altered visual processing employ similar neuronal mechanisms during perceptual learning of a visual task. We investigated this question by training patients with body dysmorphic disorder, a psychiatric disorder characterized by distressing or impairing preoccupation with nonexistent or slight defects in one's physical appearance, and healthy controls on a visual detection task for human faces with low spatial frequency components. Brain activation during task performance was measured with functional magnetic resonance imaging before the beginning and after the end of behavioral training. Both groups of participants improved performance on the trained task to a similar extent. However, neuronal changes in the fusiform face area were substantially different between groups such that activation for low spatial frequency faces in the right fusiform face area increased after training in body dysmorphic disorder patients but decreased in controls. Moreover, functional connectivity between left and right fusiform face area decreased after training in patients but increased in controls. Our results indicate that neuronal mechanisms involved in perceptual learning of a face detection task differ fundamentally between body dysmorphic disorder patients and controls. Such different neuronal mechanisms in body dysmorphic disorder patients might reflect the brain's adaptations to altered functions imposed by the psychiatric disorder.
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Affiliation(s)
- Zhiyan Wang
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, 190 Thayer Street, Providence, RI 02912, United States
- Institute for Psychology, University of Regensburg, Universitätsstraße 31, Regensburg Bavaria 93053, Germany
| | - Qingleng Tan
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, 190 Thayer Street, Providence, RI 02912, United States
| | - Sebastian M Frank
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, 190 Thayer Street, Providence, RI 02912, United States
- Institute for Psychology, University of Regensburg, Universitätsstraße 31, Regensburg Bavaria 93053, Germany
| | - Yuka Sasaki
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, 190 Thayer Street, Providence, RI 02912, United States
| | - David Sheinberg
- Warren Alpert Medical School, Brown University, 222 Richmond Street, Providence, RI 02903, United States
- Department of Neuroscience, Brown University, 185 Meeting Street, Providence, RI 02912, United States
| | - Katharine A Phillips
- Warren Alpert Medical School, Brown University, 222 Richmond Street, Providence, RI 02903, United States
- Present address: Department of Psychiatry, Weill Cornell Medicine, Cornell University, 15 E 62nd Street 5th Floor, New York, NY 10065, United States
| | - Takeo Watanabe
- Department of Cognitive, Linguistic and Psychological Sciences, Brown University, 190 Thayer Street, Providence, RI 02912, United States
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Diaz-Fong JP, Feusner JD. Visual Perceptual Processing Abnormalities in Body Dysmorphic Disorder. Curr Top Behav Neurosci 2024. [PMID: 38691313 DOI: 10.1007/7854_2024_472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
Phenomenological observations of individuals with body dysmorphic disorder (BDD), coupled with evidence from neuropsychological, psychophysical, and neuroimaging studies, support a model of aberrant visual perception characterized by deficient global/holistic, enhanced detail/local processing, and selective visual-attentional biases. These features may contribute to the core symptomatology of distorted perception of their appearance, in addition to misinterpretation of others' facial expressions and poor insight regarding their misperceived appearance defects. Insights from visual processing studies can contribute to the development of novel interventions, such as perceptual retraining and non-invasive neuromodulation. However, much remains to be understood about visual perception in BDD. Future research should leverage brain imaging modalities with high temporal resolutions and employ study designs that induce conflicts in multisensory integration, thereby advancing our mechanistic understanding of distorted visual perception observed in BDD.
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Affiliation(s)
- Joel P Diaz-Fong
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jamie D Feusner
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
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Chicos L, Rangaprakash D, Barry R, Herr H. Resting state neurophysiology of agonist-antagonist myoneural interface in persons with transtibial amputation. RESEARCH SQUARE 2023:rs.3.rs-2362961. [PMID: 36798194 PMCID: PMC9934762 DOI: 10.21203/rs.3.rs-2362961/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The agonist-antagonist myoneural interface (AMI) is a novel amputation surgery that preserves sensorimotor signaling mechanisms of the central-peripheral nervous systems. Our first neuroimaging study investigating AMI subjects (Srinivasan et al., Sci. Transl. Med. 2020) focused on task-based neural signatures, and showed evidence of proprioceptive feedback to the central nervous system. The study of resting state neural activity helps non-invasively characterize the neural patterns that prime task response. In this first study on resting state fMRI in AMI subjects, we compared resting state functional connectivity in patients with transtibial AMI (n=12) and traditional (n=7) amputations, as well as biologically intact control subjects (n=10). We hypothesized that the AMI surgery will induce functional network reorganization that significantly differs from the traditional amputation surgery and also more closely resembles the neural configuration of controls. We found AMI subjects to have lower connectivity with salience and motor seed regions compared to traditional amputees. Additionally, with connections affected in traditional amputees, AMI subjects exhibited a connectivity pattern more closely resembling controls. Lastly, sensorimotor connectivity in amputee cohorts was significantly associated with phantom sensation (R2=0.7, p=0.0008). These findings provide researchers and clinicians with a critical mechanistic understanding of the effects of the AMI surgery on the brain at rest, spearheading future research towards improved prosthetic control and embodiment.
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Affiliation(s)
| | | | - Robert Barry
- Massachusetts General Hospital & Harvard Medical School
| | - Hugh Herr
- Massachusetts Institute of Technology
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Mapping the future of interventional psychiatry for the obsessive-compulsive related disorders: A scoping review. Psychiatry Res 2023; 319:115007. [PMID: 36525901 DOI: 10.1016/j.psychres.2022.115007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/28/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022]
Abstract
Body dysmorphic disorder (BDD), hoarding disorder (HD), skin-picking disorder (SPD), and hair-pulling disorder (HPD) are characterized by compulsive behaviours leading to distress and impairment. Current treatments attain only partial or non-response. Interventional psychiatric approaches may target specific regions of the brain for treatment. This scoping review maps the current literature and synthesizes key findings. Databases were searched up to June 27, 2022 for studies examining interventional psychiatric treatments for BDD, HD, SPD, and HPD, producing 910 results. Twenty were included; 16 were case reports, two were case series, and two were randomized controlled trials. Studies reported on electroconvulsive therapy (ECT) (n=7), deep brain stimulation (DBS) (n=1), and intermittent theta-burst stimulation repetitive transcranial magnetic stimulation (rTMS) (n=1) for BDD; rTMS (n=1) and transcranial direct current stimulation (n=1) for HD; gamma knife capsulotomy (n=1) and rTMS (n=1) for SPD; and rTMS (n=2) and ECT (n=1) for HPD. Four studies reported on DBS for other indications complicated by SPD or HPD. The current literature consists mainly of case reports. Future studies should be randomized, controlled, adequately powered and blinded, examining rTMS localized to the anatomical targets for each disorder. Presently, the mainstay of treatment remains disorder-specific psychotherapy with limited evidence for medications.
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Wong WW, Rangaprakash D, Moody TD, Feusner JD. Dynamic Effective Connectivity Patterns During Rapid Face Stimuli Presentation in Body Dysmorphic Disorder. Front Neurosci 2022; 16:890424. [PMID: 35685771 PMCID: PMC9172595 DOI: 10.3389/fnins.2022.890424] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/02/2022] [Indexed: 11/30/2022] Open
Abstract
In individuals with body dysmorphic disorder (BDD), perceptual appearance distortions may be related to imbalances in global vs. local visual processing. Understanding the mechanistic brain effects of potential interventions is crucial for rational treatment development. The dorsal visual stream (DVS) is tuned to rapid image presentation, facilitating global/holistic processing, whereas the ventral visual stream (VVS), responsible for local/detailed processing, reduces activation magnitude with shorter stimulus duration. This study tested a strategy of rapid, short-duration face presentation on visual system connectivity. Thirty-eight unmedicated adults with BDD and 29 healthy controls viewed photographs of their faces for short (125 ms, 250 ms, 500 ms) and long (3000 ms) durations during fMRI scan. Dynamic effective connectivity in DVS and VVS was analyzed. BDD individuals exhibited weaker connectivity from occipital to parietal DVS areas than controls for all stimuli durations. Short compared with long viewing durations (125 ms vs. 3,000 ms and 500 ms vs. 3,000 ms) resulted in significantly weaker VVS connectivity from calcarine cortex to inferior occipital gyri in controls; however, there was only a trend for similar results in BDD. The DVS to VVS ratio, representing a balance between global and local processing, incrementally increased with shorter viewing durations in BDD, although it was not statistically significant. In sum, visual systems in those with BDD are not as responsive as in controls to rapid face presentation. Whether rapid face presentation could reduce connectivity in visual systems responsible for local/detailed processing in BDD may necessitate different parameters or strategies. These results provide mechanistic insights for perceptual retraining treatment designs.
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Affiliation(s)
- Wan-wa Wong
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - D. Rangaprakash
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Teena D. Moody
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Jamie D. Feusner
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Psychiatry, Division of Neurosciences & Clinical Translation, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
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