Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-28T17:26:37.508Z Has data issue: false hasContentIssue false
  • English
  • Français

Brain connectivity in body dysmorphic disorder compared with controls: a diffusion tensor imaging study

Published online by Cambridge University Press:  11 March 2013

B. G. Buchanan ,
S. L. Rossell ,
J. J. Maller ,
W. L. Toh ,
S. Brennan  and
D. J. Castle
B. G. Buchanan*
Affiliation:
Monash Alfred Psychiatry Research Centre, School of Psychology and Psychiatry, Faculty of Medicine, Nursing and Health Sciences, Monash University and The Alfred Hospital, Melbourne, Australia
S. L. Rossell
Affiliation:
Monash Alfred Psychiatry Research Centre, School of Psychology and Psychiatry, Faculty of Medicine, Nursing and Health Sciences, Monash University and The Alfred Hospital, Melbourne, Australia Brain and Psychological Sciences Research Centre (BPsyC), Faculty of Life and Social Sciences, Swinburne University of Technology, Melbourne, Australia Departments of Psychiatry and Behavioural Science, The University of Melbourne, Melbourne, Australia
J. J. Maller
Affiliation:
Monash Alfred Psychiatry Research Centre, School of Psychology and Psychiatry, Faculty of Medicine, Nursing and Health Sciences, Monash University and The Alfred Hospital, Melbourne, Australia
W. L. Toh
Affiliation:
Monash Alfred Psychiatry Research Centre, School of Psychology and Psychiatry, Faculty of Medicine, Nursing and Health Sciences, Monash University and The Alfred Hospital, Melbourne, Australia Departments of Psychiatry and Behavioural Science, The University of Melbourne, Melbourne, Australia
S. Brennan
Affiliation:
Monash Alfred Psychiatry Research Centre, School of Psychology and Psychiatry, Faculty of Medicine, Nursing and Health Sciences, Monash University and The Alfred Hospital, Melbourne, Australia Brain and Psychological Sciences Research Centre (BPsyC), Faculty of Life and Social Sciences, Swinburne University of Technology, Melbourne, Australia
D. J. Castle
Affiliation:
Departments of Psychiatry and Behavioural Science, The University of Melbourne, Melbourne, Australia Psychiatry, St Vincent's Hospital, MelbourneAustralia
*
*Address for correspondence: Mr B. G. Buchanan, School of Psychology and Psychiatry, General Office, Room 405, Building 17, Clayton Campus, Monash University, Victoria 3800, Australia. (Email: Buchanan.ben@gmail.com)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Several neuroimaging studies have investigated brain grey matter in people with body dysmorphic disorder (BDD), showing possible abnormalities in the limbic system, orbitofrontal cortex, caudate nuclei and temporal lobes. This study takes these findings forward by investigating white matter properties in BDD compared with controls using diffusion tensor imaging. It was hypothesized that the BDD sample would have widespread significantly reduced white matter connectivity as characterized by fractional anisotropy (FA).

Method

A total of 20 participants with BDD and 20 healthy controls matched on age, gender and handedness underwent diffusion tensor imaging. FA, a measure of water diffusion within a voxel, was compared between groups on a voxel-by-voxel basis across the brain using tract-based spatial statistics within the FSL package.

Results

Results showed that, compared with healthy controls, BDD patients demonstrated significantly lower FA (p < 0.05) in most major white matter tracts throughout the brain, including in the superior longitudinal fasciculus, inferior fronto-occipital fasciculus and corpus callosum. Lower FA levels could be accounted for by increased radial diffusivity as characterized by eigenvalues 2 and 3. No area of higher FA was found in BDD.

Conclusions

This study provided the first evidence of compromised white matter integrity within BDD patients. This suggests that there are inefficient connections between different brain areas, which may explain the cognitive and emotion regulation deficits within BDD patients.

Keywords

Body dysmorphic disorderdiffusion tensor imagingneuroimagingobsessive–compulsive spectrumwhite matter
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 12 , December 2013 , pp. 2513 - 2521
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Atmaca, M, Bingol, I, Aydin, A, Yildirim, H, Okur, I, Yildirim, M, Mermi, O, Gurok, M (2010). Brain morphology of patients with body dysmorphic disorder. Journal of Affective Disorders 123, 258–263.CrossRefGoogle ScholarPubMed
Barrett, LF, Bliss-Moreau, E, Dunca, SL, Rauch, SL, Wright, CI (2007). The amygdala and the experience of affect. Social Cognitive and Affective Neuroscience 2, 73–83.CrossRefGoogle ScholarPubMed
Basser, PJ, Mattiello, J, LeBihan, D (1994). MR diffusion tensor spectroscopy and imaging. Biophysical Journal 66, 259–267.CrossRefGoogle ScholarPubMed
Basser, PJ, Pierpaoli, C (1996). Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI. Journal of Magnetic Resonance Series B 111, 209–219.CrossRefGoogle ScholarPubMed
Biggs, JT, Wylie, LT, Ziegler, VE (1978). Validity of the Zung Self-rating Depression Scale. British Journal of Psychiatry 132, 381–385.CrossRefGoogle ScholarPubMed
Bora, E, Harrison, B, Fornito, A, Cocchi, L, Pujol, J, Fontenelle, L, Velakoulis, D, Pantelis, C, Ycel, M (2011). White matter microstructure in patients with obsessive–compulsive disorder. Journal of Psychiatry and Neuroscience 36, 42–46.CrossRefGoogle ScholarPubMed
Brown, EJ, Turovsky, J, Heimberg, RG, Juster, HR, Brown, TA, Barlow, DH (1997). Validation of the Social Interaction Anxiety Scale and the Social Phobia Scale across the anxiety disorders. Psychological Assessment 9, 21.CrossRefGoogle Scholar
Buchanan, BG, Rossell, SL, Castle, DJ (2011). Body dysmorphic disorder: a review of nosology, cognition and neurobiology. Neuropsychiatry 1, 71–80.CrossRefGoogle Scholar
Buhlmann, U, Glaesmer, H, Mewes, R, Fama, JM, Wilhelm, S, Brähler, E, Rief, W (2010). Updates on the prevalence of body dysmorphic disorder: a population-based survey. Psychiatry Research 178, 171–175.CrossRefGoogle ScholarPubMed
Buhlmann, U, McNally, RJ, Etcoff, NL, Tuschen-Caffier, B, Wilhelm, S (2004). Emotion recognition deficits in body dysmorphic disorder. Journal of Psychiatric Research 38, 201–206.CrossRefGoogle ScholarPubMed
Buhlmann, U, McNally, RJ, Wilhelm, S, Florin, I (2002). Selective processing of emotional information in body dysmorphic disorder. Journal of Anxiety Disorders 16, 289–298.CrossRefGoogle ScholarPubMed
Carey, P, Seedat, S, Warwick, J, van Heerden, B, Stein, DJ (2004). SPECT imaging of body dysmorphic disorder. Journal of Neuropsychiatry and Clinical Neurosciences 16, 357–359.CrossRefGoogle ScholarPubMed
Coles, ME, Phillips, K, Menard, W, Pagano, ME, Fay, C, Weisberg, RB, Stout, RL (2006). Body dysmorphic disorder and social phobia: cross-sectional and prospective data. Depression and Anxiety 23, 26–33.CrossRefGoogle ScholarPubMed
Deckersbach, T, Savage, CR, Phillips, K, Wilhelm, S, Buhlmann, U, Rauch, SL, Baer, L, Jenike, MA (2000). Characteristics of memory dysfunction in body dysmorphic disorder. Journal of the International Neuropsychological Society 6, 673–681.CrossRefGoogle ScholarPubMed
Dunai, J, Labuschagne, I, Castle, D, Kyrios, M, Rossell, S (2009). Executive function in body dysmorphic disorder. Psychological Medicine 40, 1541–1548.CrossRefGoogle ScholarPubMed
Feusner, J, Moller, H, Altstein, L, Suger, C, Bookheimer, S, Woon, J, Hembacher, E (2010 a). Inverted face processing in body dysmorphic disorder. Journal of Psychiatric Research 44, 1088–1094.CrossRefGoogle ScholarPubMed
Feusner, J, Moody, T, Hembacher, E, Townsend, J, McKinley, M, Moller, H, Bookheimer, S (2010 b). Abnormalities of visual processing and frontostriatal systems in body dysmorphic disorder. Archives of General Psychiatry 67, 197–205.CrossRefGoogle ScholarPubMed
Feusner, J, Townsend, J, Bystritsky, A, Bookheimer, S (2007). Visual information processing of faces in body dysmorphic disorder. Archives of General Psychiatry 64, 1417–1426.CrossRefGoogle ScholarPubMed
Feusner, J, Townsend, J, Bystritsky, A, McKinley, M, Moller, H, Bookheimer, S, Feusner, JD, Townsend, J, Bystritsky, A, McKinley, M, Moller, H, Bookheimer, S (2009). Regional brain volumes and symptom severity in body dysmorphic disorder. Psychiatry Research 172, 161–167.CrossRefGoogle ScholarPubMed
Frare, F, Perugi, G, Ruffolo, G, Toni, C (2004). Obsessive–compulsive disorder and body dysmorphic disorder: a comparison of clinical features. European Psychiatry 19, 292–298.CrossRefGoogle ScholarPubMed
Garibotto, V, Scifo, P, Gorini, A, Alonso, C, Brambati, S, Bellodi, L, Perani, D (2010). Disorganization of anatomical connectivity in obsessive compulsive disorder: a multi-parameter diffusion tensor imaging study in a subpopulation of patients. Neurobiology of Disease 37, 468–476.CrossRefGoogle Scholar
Hanes, KR (1998). Neuropsychological performance in body dysmorphic disorder. Journal of the International Neuropsychological Society 4, 167–171.CrossRefGoogle ScholarPubMed
Labuschagne, I, Castle, DJ, Rossell, SL (2011). What the cognitive deficits in body dysmorphic disorder tell us about the underlying neurobiology: an investigation of three cases. International Journal of Cognitive Therapy 4, 21–33.CrossRefGoogle Scholar
Lochner, C, Fouché, JP, du Plessis, S, Fineberg, N, Chamberlain, SR, Stein, DJ (2012). Evidence for fractional anisotropy and mean diffusivity white matter abnormalities in the internal capsule and cingulum in patients with obsessive–compulsive disorder. Journal of Psychiatry and Neuroscience 37, 110059.CrossRefGoogle ScholarPubMed
Makris, N, Kennedy, DN, McInerney, S, Sorensen, AG, Wang, R, Caviness, VS Jr, Pandya, DN (2005). Segmentation of subcomponents within the superior longitudinal fascicle in humans: a quantitative, in vivo, DT-MRI study. Cerebral Cortex 15, 854–869.CrossRefGoogle ScholarPubMed
McKay, D, Neziroglu, F, Yaryura-Tobias, JA (1997). Comparison of clinical characteristics in obsessive–compulsive disorder and body dysmorphic disorder. Journal of Anxiety Disorders 11, 447–454.CrossRefGoogle ScholarPubMed
Menzies, L, Williams, GB, Chamberlain, SR, Ooi, C, Fineberg, N, Suckling, J, Sahakian, BJ, Robbins, TW, Bullmore, ET (2008). White matter abnormalities in patients with obsessive–compulsive disorder and their first-degree relatives. American Journal of Psychiatry 165, 1308–1315.CrossRefGoogle ScholarPubMed
Monzani, B, Rijsdijk, F, Iervolino, AC, Anson, M, Cherkas, L, Mataix-Cols, D (2012). Evidence for a genetic overlap between body dysmorphic concerns and obsessive–compulsive symptoms in an adult female community twin sample. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics 159B, 376–382.CrossRefGoogle Scholar
Mori, S, Wakana, S, Nagae-Poetscher, L, Van Zijl, PCM (2005). MRI Atlas of Human White Matter. Elsevier: Amsterdam.Google Scholar
Murphy, C, Gunning Dixon, F, Hoptman, M, Lim, K, Ardekani, B, Shields, J, Hrabe, J, Kanellopoulos, D, Shanmugham, B, Alexopoulos, G (2007). White-matter integrity predicts Stroop performance in patients with geriatric depression. Biological Psychiatry 61, 1007–1010.CrossRefGoogle ScholarPubMed
Ochsner, K, Bunge, S, Gross, J, Gabrieli, J (2002). Rethinking feelings: an fMRI study of the cognitive regulation of emotion. Journal of Cognitive Neuroscience 14, 1215–1229.CrossRefGoogle ScholarPubMed
Peters, L (2000). Discriminant validity of the Social Phobia and Anxiety Inventory (SPAI), the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS). Behaviour Research and Therapy 38, 943–950.CrossRefGoogle ScholarPubMed
Phillips, K, 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, 717–722.CrossRefGoogle ScholarPubMed
Phillips, K, Didie, ER, Menard, W (2007 a). Clinical features and correlates of major depressive disorder in individuals with body dysmorphic disorder. Journal of Affective Disorders 97, 129–135.CrossRefGoogle ScholarPubMed
Phillips, K, Hollander, E, Rasmussen, S, Aronowitz, B, DeCaria, C, Goodman, W (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, 17–22.Google ScholarPubMed
Phillips, K, Menard, W, Fay, C, Weisberg, R (2005 b). Demographic characteristics, phenomenology, comorbidity, and family history in 200 individuals with body dysmorphic disorder. Psychosomatics 46, 317–325.CrossRefGoogle ScholarPubMed
Phillips, K, Pinto, A, Menard, W, Eisen, JL, Mancebo, M, Rasmussen, SA (2007 b). Obsessive–compulsive disorder versus body dysmorphic disorder: a comparison study of two possibly related disorders. Depression and Anxiety 24, 399–409.CrossRefGoogle ScholarPubMed
Rauch, SL (2000). Neuroimaging research and the neurobiology of obsessive–compulsive disorder: where do we go from here? Biological Psychiatry 47, 168–170.CrossRefGoogle Scholar
Rauch, SL, Phillips, K, Segal, E, Makris, N, Shin, LM, Whalen, PJ, Jenike, MA, Caviness, VS Jr, Kennedy, DN (2003). A preliminary morphometric magnetic resonance imaging study of regional brain volumes in body dysmorphic disorder. Psychiatry Research: Neuroimaging 122, 13–19.CrossRefGoogle ScholarPubMed
Rotge, JY, Langbour, N, Guehl, D, Bioulac, B, Jaafari, N, Allard, M, Aouizerate, B, Burbaud, P (2010). Gray matter alterations in obsessive–compulsive disorder: an anatomic likelihood estimation meta-analysis. Biological Psychiatry 35, 686–691.Google ScholarPubMed
Sheehan, D, Lecrubier, Y, Sheehan, K, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R, Dunbar, G (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), 22–57.Google ScholarPubMed
Smith, SM, Jenkinson, M, Johansen-Berg, H, Rueckert, D, Nichols, TE, Mackay, CE, Watkins, KE, Ciccarelli, O, Cader, MZ, Matthews, PM, Behrens, TEJ (2006). Tract-based spatial statistics: voxelwise analysis of multi-subject diffusion data. Neuroimage 31, 1487–1505.CrossRefGoogle ScholarPubMed
Smith, SM, Nichols, TE (2009). Threshold-free cluster enhancement: addressing problems of smoothing, threshold dependence and localisation in cluster inference. Neuroimage 44, 83–98.CrossRefGoogle ScholarPubMed
Stewart, S, Stack, DE, Wilhelm, S (2008). Severe obsessive–compulsive disorder with and without body dysmorphic disorder: clinical correlates and implications. Annals of Clinical Psychiatry 20, 33–38.CrossRefGoogle ScholarPubMed
Szeszko, P, Ardekani, B, Ashtari, M, Malhotra, A, Robinson, D, Bilder, R, Lim, K (2005). White matter abnormalities in obsessive–compulsive disorder: a diffusion tensor imaging study. Archives of General Psychiatry 62, 782–790.CrossRefGoogle ScholarPubMed
van den Heuvel, O, Veltman, D, Groenewegen, H, Witter, M, Merkelbach, J, Cath, D, van Balkom, A, van Oppen, P, van Dyck, R (2005). Disorder-specific neuroanatomical correlates of attentional bias in obsessive–compulsive disorder, panic disorder, and hypochondriasis. Archives of General Psychiatry 62, 922–933.CrossRefGoogle ScholarPubMed
Whiteside, S, Port, J, Abramowitz, J (2004). A meta-analysis of functional neuroimaging in obsessive–compulsive disorder. Psychiatry Research 132, 69–79.CrossRefGoogle ScholarPubMed
Zung, WW (1965). A self-rating depression scale. Archives of General Psychiatry 12, 63–70.CrossRefGoogle ScholarPubMed