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 postmortem brains.
Methods
We analyzed T1-weighted magnetic resonance imaging data from 133 unmedicated male
and female participants (BDD: n = 65; healthy control subjects: 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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References
- Diagnostic and Statistical Manual of Mental Disorders.5th Edition (DSM-5). American Psychiatric Publishing, Washington, DC2013
- The prevalence of body dysmorphic disorder: A population-based survey.Psychol Med. 2006; 36: 877-885
- Updates on the prevalence of body dysmorphic disorder: A population-based survey.Psychiatry Res. 2010; 178: 171-175
- The prevalence of body dysmorphic disorder in the United States adult population.CNS Spectr. 2008; 13: 316-322
- Classification of body dysmorphic disorder—What is the advantage of the new DSM-5 criteria?.J Psychosom Res. 2015; 78: 223-227
- A review of body dysmorphic disorder and its presentation in different clinical settings.Prim Care Companion CNS Disord. 2013; 15 (PCC.12r01464)
- Suicidality in body dysmorphic disorder: A prospective study.Am J Psychiatry. 2006; 163: 1280-1282
- Delusional versus nondelusional body dysmorphic disorder: Recommendations for DSM-5.CNS Spectr. 2014; 19: 10-20
- A systematic review of visual processing and associated treatments in body dysmorphic disorder.Acta Psychiatr Scand. 2017; 136: 16-36
- Body dysmorphic disorder: Neurobiological features and an updated model.Z Klin Psychol Psychother (Gott). 2013; 42: 184-191
- Visual processing in anorexia nervosa and body dysmorphic disorder: Similarities, differences, and future research directions.J Psychiatr Res. 2013; 47: 1483-1491
- Characteristics of memory dysfunction in body dysmorphic disorder.J Int Neuropsychol Soc. 2000; 6: 673-681
- Inverted face processing in body dysmorphic disorder.J Psychiatr Res. 2010; 44: 1088-1094
- Superior face recognition in body dysmorphic disorder.J Obsessive Compuls Relat Disord. 2012; 1: 175-179
- Discrimination of facial appearance stimuli in body dysmorphic disorder.J Abnorm Psychol. 2008; 117: 435-443
- Abnormalities in visual processing amongst students with body image concerns.Adv Cogn Psychol. 2014; 10: 39-48
- Parameters of visual processing abnormalities in adults with body image concerns.PLoS One. 2018; 13e0207585
- Abnormalities of visual processing and frontostriatal systems in body dysmorphic disorder.Arch Gen Psychiatry. 2010; 67: 197-205
- Visual information processing of faces in body dysmorphic disorder.Arch Gen Psychiatry. 2007; 64: 1417-1425
- Anorexia nervosa and body dysmorphic disorder are associated with abnormalities in processing visual information.Psychol Med. 2015; 45: 2111-2122
- Abnormalities of object visual processing in body dysmorphic disorder.Psychol Med. 2011; 41: 2385-2397
- Brain activation and connectivity in anorexia nervosa and body dysmorphic disorder when viewing bodies: Relationships to clinical symptoms and perception of appearance.Brain Imaging Behav. 2021; 15: 1235-1252
- Brain morphology of patients with body dysmorphic disorder.J Affect Disord. 2010; 123: 258-263
- Regional brain volumes in body dysmorphic disorder compared to controls.Aust N Z J Psychiatry. 2014; 48: 654-662
- Reduced cortical thickness in body dysmorphic disorder.Psychiatry Res Neuroimaging. 2017; 259: 25-28
- A preliminary morphometric magnetic resonance imaging study of regional brain volumes in body dysmorphic disorder.Psychiatry Res. 2003; 122: 13-19
- Regional brain volumes and symptom severity in body dysmorphic disorder.Psychiatry Res. 2009; 172: 161-167
- Cortical thickness and brain volumetric analysis in body dysmorphic disorder.Psychiatry Res. 2015; 232: 115-122
- Reduced age-related degeneration of the hippocampal subiculum in long-term meditators.Psychiatry Res. 2015; 232: 214-218
- The impact of aging on subregions of the hippocampal complex in healthy adults.Neuroimage. 2017; 163: 296-300
- Sexual dimorphism of Broca’s region: More gray matter in female brains in Brodmann areas 44 and 45.J Neurosci Res. 2017; 95: 626-632
- Integrating cytoarchitectonic probabilities with MRI-based signal intensities to calculate regional volumes of interest.in: Spalletta G. Piras F. Gili T. Brain Morphometry. Springer, New York2018: 121-129
- Meditation effects within the hippocampal complex revealed by voxel-based morphometry and cytoarchitectonic probabilistic mapping.Front Psychol. 2013; 4: 398
- Brodmann’s areas 17 and 18 brought into stereotaxic space-where and how variable?.Neuroimage. 2000; 11: 66-84
- Cytoarchitectonic mapping of the human dorsal extrastriate cortex.Brain Struct Funct. 2013; 218: 157-172
- Ventral visual cortex in humans: Cytoarchitectonic mapping of two extrastriate areas.Hum Brain Mapp. 2007; 28: 1045-1059
- Functional connectivity for face processing in individuals with body dysmorphic disorder and anorexia nervosa.Psychol Med. 2015; 45: 3491-3503
- Degree connectivity in body dysmorphic disorder and relationships with obsessive and compulsive symptoms.Eur Neuropsychopharmacol. 2016; 26: 1657-1666
- Brain connectome modularity in weight-restored anorexia nervosa and body dysmorphic disorder.Psychol Med. 2016; 46: 2785-2797
- Aberrant dynamic connectivity for fear processing in anorexia nervosa and body dysmorphic disorder.Front Psychiatry. 2018; 9: 273
- Cross-diagnostic prediction of dimensional psychiatric phenotypes in anorexia nervosa and body dysmorphic disorder using multimodal neuroimaging and psychometric data.in: Stoyanov D. Graphs in Biomedical Image Analysis and Integrating Medical Imaging and Non-Imaging Modalities: Second International Workshop, GRAIL 2018 and First International Workshop, Beyond MIC 2018 Held in Conjunction With MICCAI 2018, Granada, Spain, September 20, 2018, Proceedings. Springer Nature Switzerland, Cham, Switzerland2018: 92-99
- Differentiating weight-restored anorexia nervosa and body dysmorphic disorder using neuroimaging and psychometric markers.PLoS One. 2019; 14e0213974
- Effects of visual attention modulation on dynamic functional connectivity during own-face viewing in body dysmorphic disorder.Neuropsychopharmacology. 2021; 46: 2030-2038
- Diagnostic instruments for body dysmorphic disorder.in: Presented at the American Psychiatric Association 148th Annual Meeting, May 5–25, Miami, Florida. 1995
- A severity rating scale for body dysmorphic disorder: Development, reliability, and validity of a modified version of the Yale-Brown Obsessive Compulsive Scale.Psychopharmacol Bull. 1997; 33: 17-22
- The mini international neuropsychiatric interview.Eur Psychiatry. 1998; 13: 198S
- Fast and robust parameter estimation for statistical partial volume models in brain MRI.Neuroimage. 2004; 23: 84-97
- Diffeomorphic registration using geodesic shooting and Gauss–Newton optimisation.Neuroimage. 2011; 55: 954-967
- Voxel-based morphometry—The methods.Neuroimage. 2000; 11: 805-821
- A voxel-based morphometric study of ageing in 465 normal adult human brains.Neuroimage. 2001; 14: 21-36
- A new SPM toolbox for combining probabilistic cytoarchitectonic maps and functional imaging data.Neuroimage. 2005; 25: 1325-1335
- A stereological approach to human cortical architecture: Identification and delineation of cortical areas.J Chem Neuroanat. 2000; 20: 31-47
- Quantitative architectural analysis: A new approach to cortical mapping.Anat Embryol (Berl). 2005; 210: 373-386
- Non-parametric procedures.in: Friston K.J. Ashburner J.T. Kiebel S.J. Nichols T.E. Penny W.D. Statistical Parametric Mapping: The Analysis of Functional Brain Images. Elsevier, Oxford, UK2007: 253-274
- Permutation inference for the general linear model.Neuroimage. 2014; 92: 381-397
- Whole brain size and general mental ability: A review.Int J Neurosci. 2009; 119: 691-731
- Calibrating BOLD fMRI activations with neurovascular and anatomical constraints.Cereb Cortex. 2013; 23: 255-263
- The variability of human, BOLD hemodynamic responses.Neuroimage. 1998; 8: 360-369
- Variation of BOLD hemodynamic responses across subjects and brain regions and their effects on statistical analyses.Neuroimage. 2004; 21: 1639-1651
- Errant gardeners: Glial-cell-dependent synaptic pruning and neurodevelopmental disorders.Nat Rev Neurosci. 2017; 18: 658-670
- From local to global processing: The development of illusory contour perception.J Exp Child Psychol. 2015; 131: 38-55
- Emergence of global shape processing continues through adolescence.Child Dev. 2009; 80: 162-177
- The development of contour interpolation: Evidence from subjective contours.J Exp Child Psychol. 2010; 106: 163-176
- Microgenesis and ontogenesis of perceptual organization: Evidence from global and local processing of hierarchical patterns.Psychol Sci. 2005; 16: 282-290
- Total and regional brain volumes in a population-based normative sample from 4 to 18 years: The NIH MRI Study of Normal Brain Development.Cereb Cortex. 2012; 22: 1-12
- Axis I comorbidity in body dysmorphic disorder.Compr Psychiatry. 2003; 44: 270-276
- The neurobiology of body dysmorphic disorder: A systematic review and theoretical model.Neurosci Biobehav Rev. 2017; 83: 83-96
- What causes BDD: Research findings and a proposed model.Psychiatr Ann. 2010; 40: 349-355
- Task-dependent functional organizations of the visual ventral stream.Sci Rep. 2019; 9: 9316
- Toward a unified theory of visual area V4.Neuron. 2012; 74: 12-29
- Cortical abnormalities associated with pediatric and adult obsessive-compulsive disorder: Findings from the ENIGMA Obsessive-Compulsive Disorder Working Group.Am J Psychiatry. 2018; 175: 453-462
Article info
Publication history
Published online: October 21, 2021
Accepted:
October 5,
2021
Received in revised form:
October 5,
2021
Received:
July 21,
2021
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2021 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.