Neural mechanisms of perceptual abnormalities and their malleability in body dysmorphic disorder

身体变形障碍知觉异常的神经机制及其可塑性

• 批准号: 10457082
• 负责人: Jamie Feusner
• 金额: $ 46.8万
• 依托单位: CENTRE FOR ADDICTION AND MENTAL HEALTH
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-23 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10457082
• 关键词: Adult; Anxiety; Appearance; Area; Arousal; Attention; Behavior; Behavioral; Belief; Body Dysmorphic Disorder; Brain; Clinical; Compulsive Behavior; Computer software; Data; Defect; Depression and Suicide; Detection; Dimensions; Dorsal; Emotional; Enrollment; Eye; Eye Abnormalities; Face; Functional Magnetic Resonance Imaging; Future; Global Change; Hospitalization; Individual; Intervention; Least-Squares Analysis; Link; Measures; Mediating; Mediator of activation protein; Mental Depression; Modeling; Neurobiology; Neuropsychology; Participant; Perception; Perceptual distortions; Performance; Phenotype; Psychophysics; Research; Scanning; Stimulus; Stream; Suicide attempt; Symptoms; System; Techniques; Testing; Thinking; Visual; Visual system structure; Visuospatial; attentional bias; attentional modulation; base; brain behavior; convict; experimental study; frontal eye fields; gaze; information processing; insight; lifetime risk; model design; neuroimaging; neuromechanism; novel; potential biomarker; relapse risk; relating to nervous system; sample fixation; suicide rate; translational approach; visual information; visual processing; visual stimulus; visual tracking

PROJECT SUMMARY Individuals with body dysmorphic disorder (BDD) misperceive specific aspects of their appearance to be conspicuously flawed or defective, despite these being unnoticeable or appearing miniscule to others. With convictions of disfigurement and ugliness, they typically have poor insight or delusional beliefs, obsessive thoughts and compulsive behaviors, anxiety, and depression. These result in significant difficulties in functioning, depression, suicide attempts (25%), and psychiatric hospitalization (50%). Despite this, relatively few studies of the neurobiology, and few treatment studies, have been conducted. This underscores a critical need for research to identify novel targets for intervention based on a comprehensive understanding of the pathophysiological mechanisms. Neuropsychological, behavioral, and neurobiological research by our group and others have uncovered mechanisms that may contribute to perceptual distortions, including prominent abnormalities in visual processing systems. These have contributed to a model of diminished global/holistic processing and enhanced local/detailed processing, attributed to “bottom-up” and “top-down” disturbances in perception. Using psychophysical experiments and novel visual modulation techniques, we have probed the brain’s visual systems responsible for global and local processing and found early evidence that they may be modifiable in BDD. These techniques include a “top-down” attentional modulation and a “bottom-up” perceptual modulation strategy. Abnormal eye gaze and emotional arousal when viewing faces may further contribute to abnormal perception. Whether these brain and behavior abnormalities are directly linked to abnormal perception remains to be understood. Accordingly, this study will determine a) if abnormalities in neural activation and connectivity in BDD when viewing one’s appearance are directly associated with abnormalities in perceptual functioning; and b) if changes in neural activation and connectivity from these visual modulation strategies are linked to changes in perceptual functioning, thus representing potential biomarkers. We will also determine how attentional systems, eye gaze behaviors and emotional arousal interact with brain functioning in visual systems, and with global and local perceptual functioning. We will enroll 80 participants with BDD, 40 with subclinical BDD, and 40 healthy controls who will undergo functional magnetic resonance imaging while viewing photographs of their, and others’, faces. We will obtain measures of global and local visual processing, emotional arousal while viewing their face, and eye gaze behaviors using eye tracking. To understand the malleability of global/local perception, and the neural mechanisms of these changes, we will determine whether repeated visual modulation using top-down and bottom-up strategies results in alterations of perceptual functioning and brain activity/connectivity, and relationships between them. Results will provide a comprehensive mechanistic model of abnormal visual information processing underlying the core symptom domain of misperceptions of appearance. This will lay the groundwork for next-step translational approaches.

项目摘要 患有身体营养不良疾病（BDD）外观的特定方面的人 明显存在缺陷或有缺陷，dospite这些不明显或对他人显得很小。和 对毁容和丑陋的信念，它们通常具有贫穷的洞察力或妄想信念 思想和强迫性行为，焦虑和沮丧。这些导致很大的困难 功能，抑郁，自杀未遂（25％）和精神病住院（50％）。尽管如此，相对 很少有关于神经生物学和几乎没有治疗研究的研究。这强调了关键 需要研究以全面理解对干预的新颖目标来确定新颖的目标 病理生理机制。我们小组的神经心理学，行为和神经生物学研究 其他人则具有未发现的机制，可能导致感知扭曲，包括突出的机制 视觉处理系统异常。这些促成了一个全球/整体减少的模型 处理和增强的本地/详细处理，归因于“自下而上”和“自上而下”的灾难 洞察力。使用心理物理实验和新颖的视觉调制技术，我们证明了 大脑的视觉系统负责全球和本地处理，并发现了早期证据表明它们可能是 在BDD中进行修改。这些技术包括“自上而下”的注意调制和“自下而上”的感知 调制策略。当观看面孔时，异常的眼睛目光和情绪唤醒可能会进一步促进 绝对感知。这些大脑和行为异常是否与异常有关 感知还有待理解。根据这项研究，将确定a）是否中性异常 观看外观时BDD中的激活和连通性与异常直接相关 在感知功能中； b）如果这些视觉调制的神经元激活和连通性的变化 策略与感知功能的变化有关，从而代表潜在的生物标志物。我们也会 确定注意力系统，眼睛凝视行为和情绪唤醒与大脑功能的相互作用 视觉系统，以及全球和局部感知功能。我们将参加BDD的80名参与者，40名参与者 使用亚临床BDD和40个健康对照，将进行功能性磁共振成像，而 查看他们和其他人的脸的照片。我们将获得全球和本地视觉处理的度量， 在观看脸部时，情绪唤醒，并使用眼睛跟踪的眼睛凝视行为。理解 全球/地方感知的延展性以及这些变化的神经机制，我们将确定是否确定是否是否 使用自上而下和自下而上的策略重复进行视觉调制导致感知的改变 功能和大脑活动/连通性以及它们之间的关系。结果将提供 核心症状基础的异常视觉信息处理的综合机械模型 外观误解的领域。这将为下一步的翻译方法奠定基础。