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Abnormalities of object visual processing in body dysmorphic disorder

Published online by Cambridge University Press:  18 April 2011

J. D. Feusner*
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
E. Hembacher
Affiliation:
Department of Psychology, University of California, Davis, CA, USA
H. Moller
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
T. D. Moody
Affiliation:
Center for Cognitive Neuroscience, University of California, Los Angeles, CA, USA
*
*Address for correspondence: J. D. Feusner, M.D., 300 UCLA Medical Plaza, Suite 2345, Los Angeles, CA 90095, USA. (Email: [email protected])

Abstract

Background

Individuals with body dysmorphic disorder (BDD) may have perceptual distortions for their appearance. Previous studies suggest imbalances in detailed relative to configural/holistic visual processing when viewing faces. No study has investigated the neural correlates of processing non-symptom-related stimuli. The objective of this study was to determine whether individuals with BDD have abnormal patterns of brain activation when viewing non-face/non-body object stimuli.

Method

Fourteen medication-free participants with DSM-IV BDD and 14 healthy controls participated. We performed functional magnetic resonance imaging (fMRI) while participants matched photographs of houses that were unaltered, contained only high spatial frequency (HSF, high detail) information or only low spatial frequency (LSF, low detail) information. The primary outcome was group differences in blood oxygen level-dependent (BOLD) signal changes.

Results

The BDD group showed lower activity in the parahippocampal gyrus, lingual gyrus and precuneus for LSF images. There were greater activations in medial prefrontal regions for HSF images, although no significant differences when compared to a low-level baseline. Greater symptom severity was associated with lower activity in the dorsal occipital cortex and ventrolateral prefrontal cortex for normal spatial frequency (NSF) and HSF images.

Conclusions

Individuals with BDD have abnormal brain activation patterns when viewing objects. Hypoactivity in visual association areas for configural and holistic (low detail) elements and abnormal allocation of prefrontal systems for details are consistent with a model of imbalances in global versus local processing. This may occur not only for appearance but also for general stimuli unrelated to their symptoms.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2011

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References

Aguirre, GK, Zarahn, E, D'Esposito, M (1998). The variability of human, BOLD hemodynamic responses. NeuroImage 8, 360369.CrossRefGoogle ScholarPubMed
Andrews-Hanna, JR, Reidler, JS, Huang, C, Buckner, RL (2010). Evidence for the default network's role in spontaneous cognition. Journal of Neurophysiology 104, 322335.CrossRefGoogle ScholarPubMed
APA (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. American Psychiatric Association: Washington, DC.Google Scholar
Beckmann, M, Jenkinson, M, Smith, S (2003). General multi-level linear modeling for group analysis in FMRI. NeuroImage 20, 10521063.CrossRefGoogle Scholar
Bird, G, Catmur, C, Silani, G, Frith, C, Frith, U (2006). Attention does not modulate neural responses to social stimuli in autism spectrum disorders. NeuroImage 31, 16141624.CrossRefGoogle Scholar
Buckner, RL, Andrews-Hanna, JR, Schacter, DL (2008). The brain's default network: anatomy, function, and relevance to disease. Annals of the New York Academy of Sciences 1124, 138.Google Scholar
Buhlmann, U, Glaesmer, H, Mewes, R, Fama, JM, Wilhelm, S, Brahler, E, Rief, W (2010). Updates on the prevalence of body dysmorphic disorder: a population-based survey. Psychiatry Research 178, 171175.Google Scholar
Cabeza, R, Nyberg, L (2000). Imaging cognition. II: An empirical review of 275 PET and fMRI studies. Journal of Cognitive Neuroscience 12, 147.CrossRefGoogle Scholar
Castelli, F, Happe, F, Frith, U, Frith, C (2000). Movement and mind: a functional imaging study of perception and interpretation of complex intentional movement patterns. NeuroImage 12, 314325.CrossRefGoogle ScholarPubMed
Catani, M, Howard, RJ, Pajevic, S, Jones, DK (2002). Virtual in vivo interactive dissection of white matter fasciculi in the human brain. NeuroImage 17, 7794.CrossRefGoogle ScholarPubMed
Cavanna, AE, Trimble, MR (2006). The precuneus: a review of its functional anatomy and behavioural correlates. Brain 129, 564583.CrossRefGoogle ScholarPubMed
Corbetta, M, Miezin, FM, Dobmeyer, S, Shulman, GL, Petersen, SE (1991). Selective and divided attention during visual discriminations of shape, color, and speed: functional anatomy by positron emission tomography. Journal of Neuroscience 11, 23832402.CrossRefGoogle ScholarPubMed
Costen, NP, Parker, DM, Craw, I (1996). Effects of high-pass and low-pass spatial filtering on face identification. Perception and Psychophysics 58, 602612.CrossRefGoogle ScholarPubMed
Deckersbach, T, Savage, C, Phillips, K, Wilhelm, S, Buhlmann, U, Rauch, S, Baer, L, Jenike, M (2000). Characteristics of memory dysfunction in body dysmorphic disorder. Journal of the International Neuropsychological Society 6, 673681.CrossRefGoogle ScholarPubMed
Durand, JB, Nelissen, K, Joly, O, Wardak, C, Todd, JT, Norman, JF, Janssen, P, Vanduffel, W, Orban, GA (2007). Anterior regions of monkey parietal cortex process visual 3D shape. Neuron 55, 493505.Google Scholar
Epstein, R, Harris, A, Stanley, D, Kanwisher, N (1999). The parahippocampal place area: recognition, navigation, or encoding? Neuron 23, 115125.CrossRefGoogle ScholarPubMed
Ewbank, MP, Schluppeck, D, Andrews, TJ (2005). fMR-adaptation reveals a distributed representation of inanimate objects and places in human visual cortex. NeuroImage 28, 268279.CrossRefGoogle ScholarPubMed
Faravelli, C, Salvatori, S, Galassi, F, Aiazzi, L, Drei, C, Cabras, P (1997). Epidemiology of somatoform disorders: a community survey in Florence. Social Psychiatry and Psychiatric Epidemiology 32, 2429.CrossRefGoogle ScholarPubMed
Farivar, R (2009). Dorsal-ventral integration in object recognition. Brain Research and Reviews 61, 144153.Google Scholar
Feusner, JD, Moody, T, Townsend, J, McKinley, M, Hembacher, E, Moller, H, Bookheimer, S (2010). Abnormalities of visual processing and fronto-striatal systems in body dysmorphic disorder. Archives of General Psychiatry 67, 197205.CrossRefGoogle Scholar
Feusner, JD, Townsend, J, Bystritsky, A, Bookheimer, S (2007 a). Correlation between symptoms of body dysmorphic disorder and brain activation patterns with visual processing: preliminary results [Poster presentation]. Organization for Human Brain Mapping 13th Annual Meeting, Chicago, IL.Google Scholar
Feusner, JD, Townsend, J, Bystritsky, A, Bookheimer, S (2007 b). Visual information processing of faces in body dysmorphic disorder. Archives of General Psychiatry 64, 14171425.CrossRefGoogle ScholarPubMed
Grady, CL, Horwitz, B, Pietrini, P, Mentis, MJ, Ungerleider, LG, Rapoport, SI, Haxby, JV (1996). Effect of task difficulty on cerebral blood flow during perceptual matching of faces. Human Brain Mapping 4, 227239.3.0.CO;2-5>CrossRefGoogle ScholarPubMed
Gunstad, J, Phillips, KA (2003). Axis I comorbidity in body dysmorphic disorder. Comprehensive Psychiatry 44, 270276.CrossRefGoogle ScholarPubMed
Gusnard, DA, Akbudak, E, Shulman, GL, Raichle, ME (2001). Medial prefrontal cortex and self-referential mental activity: relation to a default mode of brain function. Proceedings of the National Academy of Sciences USA 98, 42594264.CrossRefGoogle ScholarPubMed
Hamilton, M (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry 23, 5662.CrossRefGoogle ScholarPubMed
Hamilton, M (1969). Diagnosis and rating of anxiety. British Journal of Psychiatry 3, 7679.Google Scholar
Hanes, K (1998). Neuropsychological performance in body dysmorphic disorder. Journal of the International Neuropsychological Society 4, 167171.CrossRefGoogle ScholarPubMed
Haxby, JV, Horwitz, B, Ungerleider, LG, Maisog, JM, Pietrini, P, Grady, CL (1994). The functional organization of human extrastriate cortex: a PET-rCBF study of selective attention to faces and locations. Journal of Neuroscience 14, 63366353.CrossRefGoogle ScholarPubMed
Haxby, JV, Ungerleider, LG, Horwitz, B, Rapoport, SI, Grady, CL (1995). Hemispheric differences in neural systems for face working memory: a PET-rCBF study. Human Brain Mapping 3, 6882.CrossRefGoogle Scholar
Iidaka, T, Yamashita, K, Kashikura, K, Yonekura, Y (2004). Spatial frequency of visual image modulates neural responses in the temporo-occipital lobe. An investigation with event-related fMRI. Cognitive Brain Research 18, 196204.Google Scholar
Ishai, A, Ungerleider, LG, Martin, A, Haxby, JV (2000). The representation of objects in the human occipital and temporal cortex. Journal of Cognitive Neuroscience 12 (Suppl. 2), 3551.CrossRefGoogle ScholarPubMed
Ishai, A, Ungerleider, LG, Martin, A, Schouten, JL, Haxby, JV (1999). Distributed representation of objects in the human ventral visual pathway. Proceedings of the National Academy of Sciences USA 96, 93799384.Google Scholar
Jung, WH, Gu, BM, Kang, DH, Park, JY, Yoo, SY, Choi, CH, Lee, JM, Kwon, JS (2009). BOLD response during visual perception of biological motion in obsessive-compulsive disorder: an fMRI study using the dynamic point-light animation paradigm. European Archives of Psychiatry and Clinical Neuroscience 259, 4654.CrossRefGoogle ScholarPubMed
Koran, LM, Abujaoude, E, Large, MD, Serpe, RT (2008). The prevalence of body dysmorphic disorder in the United States adult population. CNS Spectrums 13, 316322.CrossRefGoogle ScholarPubMed
Kosslyn, SM, Alpert, NM, Thompson, WL, Chabris, CF, Rauch, SL, Anderson, AK (1994). Identifying objects seen from different viewpoints. A PET investigation. Brain 117, 10551071.Google Scholar
Kwon, JS, Kim, JJ, Lee, DW, Lee, JS, Lee, DS, Kim, MS, Lyoo, IK, Cho, MJ, Lee, MC (2003). Neural correlates of clinical symptoms and cognitive dysfunctions in obsessive-compulsive disorder. Psychiatry Research 122, 3747.CrossRefGoogle ScholarPubMed
Mancuso, SG, Knoesen, NP, Castle, DJ (2010). Delusional versus nondelusional body dysmorphic disorder. Comprehensive Psychiatry 51, 177182.CrossRefGoogle ScholarPubMed
Mataix-Cols, D, Alonso, P, Hernandez, R, Deckersbach, T, Savage, CR, Manuel Menchon, J, Vallejo, J (2003). Relation of neurological soft signs to nonverbal memory performance in obsessive-compulsive disorder. Journal of Clinical and Experimental Neuropsychology 25, 842851.CrossRefGoogle ScholarPubMed
McGuire, PK, Paulesu, E, Frackowiak, RS, Frith, CD (1996). Brain activity during stimulus independent thought. Neuroreport 7, 20952099.Google Scholar
McIntosh, AR, Grady, CL, Haxby, JV, Ungerleider, LG, Horwitz, B (1996). Changes in limbic and prefrontal functional interactions in a working memory task for faces. Cerebral Cortex 6, 571584.CrossRefGoogle Scholar
Nordahl, TE, Benkelfat, C, Semple, WE, Gross, M, King, AC, Cohen, RM (1989). Cerebral glucose metabolic rates in obsessive compulsive disorder. Neuropsychopharmacology 2, 2328.Google Scholar
Norman, J, Ehrlich, S (1987). Spatial frequency filtering and target identification. Vision Research 27, 8796.CrossRefGoogle ScholarPubMed
Oldfield, RC (1971). The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia 9, 97–113.Google Scholar
Otto, MW, Wilhelm, S, Cohen, LS, Harlow, BL (2001). Prevalence of body dysmorphic disorder in a community sample of women. American Journal of Psychiatry 158, 20612063.Google Scholar
Petrides, M (1996). Specialized systems for the processing of mnemonic information within the primate frontal cortex. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences 351, 14551461; discussion 1461–1462.Google ScholarPubMed
Peuskens, H, Claeys, KG, Todd, JT, Norman, JF, Van Hecke, P, Orban, GA (2004). Attention to 3-D shape, 3-D motion, and texture in 3-D structure from motion displays. Journal of Cognitive Neuroscience 16, 665682.CrossRefGoogle ScholarPubMed
Phillips, KA (2005). The Broken Mirror. Oxford University Press: New York.Google Scholar
Phillips, KA, Atala, KD, Pope, HG Jr. (1995). Diagnostic instruments for body dysmorphic disorder. In American Psychiatric Association 148th Annual Meeting, Miami, FL. American Psychiatric Association, p. 157.Google Scholar
Phillips, KA, Coles, ME, Menard, W, Yen, S, Fay, C, Weisberg, RB (2005 a). Suicidal ideation and suicide attempts in body dysmorphic disorder. Journal of Clinical Psychiatry 66, 717725.CrossRefGoogle ScholarPubMed
Phillips, KA, Diaz, SF (1997). Gender differences in body dysmorphic disorder. Journal of Nervous and Mental Disorders 185, 570577.CrossRefGoogle ScholarPubMed
Phillips, KA, Hollander, E, Rasmussen, SA, Aronowitz, BR, DeCaria, C, Goodman, WK (1997). A severity rating scale for body dysmorphic disorder: development, reliability, and validity of a modified version of the Yale-Brown Obsessive Compulsive Scale. Psychopharmacology Bulletin 33, 1722.Google ScholarPubMed
Phillips, KA, McElroy, SL, Keck, Jr. PE, Pope, Jr. HG, Hudson, JI (1993). Body dysmorphic disorder: 30 cases of imagined ugliness. American Journal of Psychiatry 150, 302308.Google ScholarPubMed
Phillips, KA, Menard, W, Fay, C, Weisberg, R (2005 b). Demographic characteristics, phenomenology, comorbidity, and family history in 200 individuals with body dysmorphic disorder. Psychosomatics 46, 317325.CrossRefGoogle ScholarPubMed
Poldrack, R (2007). Region of interest analysis for fMRI. Social Cognitive and Affective Neuroscience 2, 6770.Google Scholar
Pourtois, G, Schwartz, S, Seghier, ML, Lazeyras, F, Vuilleumier, P (2005). View-independent coding of face identity in frontal and temporal cortices is modulated by familiarity: an event-related fMRI study. NeuroImage 24, 12141224.Google Scholar
Pourtois, G, Schwartz, S, Spiridon, M, Martuzzi, R, Vuilleumier, P (2009). Object representations for multiple visual categories overlap in lateral occipital and medial fusiform cortex. Cerebral Cortex 19, 18061819.CrossRefGoogle ScholarPubMed
Rief, W, Buhlmann, U, Wilhelm, S, Borkenhagen, A, Brahler, E (2006). The prevalence of body dysmorphic disorder: a population-based survey. Psychological Medicine 36, 877885.CrossRefGoogle ScholarPubMed
Rushworth, MF, Nixon, PD, Eacott, MJ, Passingham, RE (1997). Ventral prefrontal cortex is not essential for working memory. Journal of Neuroscience 17, 48294838.CrossRefGoogle Scholar
Savage, C, Deckersbach, T, Wilhelm, S, Rauch, S, Baer, L, Reid, T, Jenike, M (2000). Strategic processing and episodic memory impairment in obsessive-compulsive disorder. Neuropsychology 14, 141151.CrossRefGoogle ScholarPubMed
Schyns, P, Oliva, A (1999). Dr. Angry and Mr. Smile: when categorization flexibly modifies the perception of faces in rapid visual presentations. Cognition 69, 243265.Google Scholar
Sereno, ME, Trinath, T, Augath, M, Logothetis, NK (2002). Three-dimensional shape representation in monkey cortex. Neuron 33, 635652.CrossRefGoogle ScholarPubMed
Sergent, J (1985). Influence of task and input factors on hemispheric involvement in face processing. Journal of Experimental Psychology: Human Perception Performance 11, 846861.Google ScholarPubMed
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R, Dunbar, GC (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry 59 (Suppl. 20), 2233; quiz 34–57.Google ScholarPubMed
Sherman, B, Savage, C, Eddy, K, Blais, M, Deckersbach, T, Jackson, S, Franko, D, Rauch, S, Herzog, D (2006). Strategic memory in adults with anorexia nervosa: are there similarities to obsessive compulsive spectrum disorders? International Journal of Eating Disorders 39, 468476.CrossRefGoogle ScholarPubMed
Ungerleider, LG, Mishkin, M (1982). Two cortical visual systems. In Analysis of Visual Behavior(ed. Ingle, D. J., Goodale, M. A. and Mansfield, R. J. W.), pp. 549586. MIT Press: Cambridge.Google Scholar
Veale, D, Boocock, A, Gournay, K, Dryden, W, Shah, F, Willson, R, Walburn, J (1996). Body dysmorphic disorder. A survey of fifty cases. British Journal of Psychiatry 169, 196201.CrossRefGoogle ScholarPubMed
Webster, MJ, Bachevalier, J, Ungerleider, LG (1994). Connections of inferior temporal areas TEO and TE with parietal and frontal cortex in macaque monkeys. Cerebral Cortex 4, 470483.CrossRefGoogle ScholarPubMed
Woolrich, M, Behrens, T, Beckmann, M, Jenkinson, M, Smith, S (2004). Multi-level linear modeling for FMRI group analysis using Bayesian inference. NeuroImage 21, 17321747.CrossRefGoogle Scholar
Woolrich, M, Brady, M, Smith, S (2001). Hierarchical fully Bayesian spatio-temporal analysis of FMRI data. In Seventh International Conference on Functional Mapping of the Human Brain, Brighton, UK.Google Scholar
Worsley, KJ, Evans, AC, Marrett, S, Neelin, P (1992). A three-dimensional statistical analysis for CBF activation studies in human brain. Journal of Cerebral Blood Flow and Metabolism 12, 900918.CrossRefGoogle Scholar
Yaryura-Tobias, J, Neziroglu, F, Chang, R, Lee, S, Pinto, A, Donohue, L (2002). Computerized perceptual analysis of patients with body dysmorphic disorder. CNS Spectrums 7, 444446.Google Scholar
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