Cytoarchitectonically-defined volumes of early extrastriate visual cortex in unmedicated adults with body dysmorphic disorder

  • Jamie D. Feusner
    Correspondence
    Correspondence should be addressed to: Jamie Feusner, M.D. 250 College St. Toronto, ON M5T 1R8 Canada
    Affiliations
    Centre for Addiction and Mental Health, Toronto, Canada

    Department of Psychiatry, University of Toronto, Toronto, Canada

    Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden

    Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California Los Angeles, Los Angeles, USA
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  • Florian Kurth
    Affiliations
    School of Psychology, University of Auckland, Auckland, New Zealand
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  • Eileen Luders
    Affiliations
    School of Psychology, University of Auckland, Auckland, New Zealand

    Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden

    Laboratory of Neuro Imaging, School of Medicine, University of Southern California, Los Angeles, USA
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  • Ronald Ly
    Affiliations
    Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California Los Angeles, Los Angeles, USA
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  • Wan-wa Wong
    Affiliations
    Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California Los Angeles, Los Angeles, USA
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Published:October 21, 2021DOI:https://doi.org/10.1016/j.bpsc.2021.10.008

      Abstract

      Background

      Individuals with body dysmorphic disorder (BDD) misperceive that they have prominent defects in their appearance, resulting in preoccupations, time-consuming rituals, and distress. Previous neuroimaging studies have found abnormal activation patterns in the extrastriate visual cortex, which may underlie experiences of distorted perception of appearance. Correspondingly, we investigated gray matter volumes in individuals with BDD in the early extrastriate visual cortex using cytoarchitectonically-defined maps that were previously derived from post-mortem brains.

      Methods

      We analyzed T1-weighted MRI data from 133 unmedicated male and female participants (BDD: n=65; healthy controls: n=68). We used cytoarchitectonically-defined probability maps for the early extrastriate cortex, consisting of areas corresponding to V2, V3d, V3v/VP, V3a, and V4v. Gray matter volumes were compared between groups, supplemented by testing associations with clinical symptoms.

      Results

      The BDD group exhibited significantly larger gray matter volumes in the left and right early extrastriate cortex. Region-specific follow-up analyses revealed multiple subregions showing larger volumes in BDD, significant in the left V4v. There were no significant associations after corrections for multiple comparisons between gray matter volumes in early extrastriate cortex and BDD symptoms, comorbid symptoms, or duration of illness.

      Conclusions

      Greater volumes of the early extrastriate visual cortex were evident in those with BDD, which aligns with outcomes of prior studies revealing BDD-specific functional abnormalities in these regions. Enlarged volumes of the extrastriate cortex in BDD might manifest during neurodevelopment, which could predispose individuals to aberrant visual perception and contribute to the core phenotype of distortion of perception for appearance.

      Keywords

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