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Anorexia nervosa and body dysmorphic disorder are associated with abnormalities in processing visual information

Published online by Cambridge University Press:  05 February 2015

W. Li*
Affiliation:
Interdepartmental Neuroscience Program, University of California, Los Angeles, CA, USA
T. M. Lai
Affiliation:
Department of Psychology, University of California, Los Angeles, CA, USA
C. Bohon
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
S. K. Loo
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
D. McCurdy
Affiliation:
University of California, Los Angeles, CA, USA
M. Strober
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
S. Bookheimer
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
J. Feusner
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
*
*Address for correspondence: W. Li, University of California, 760 Westwood Plaza C8-832, Los Angeles, CA 90024, USA. (Email: weili15@ucla.edu)

Abstract

Background

Anorexia nervosa (AN) and body dysmorphic disorder (BDD) are characterized by distorted body image and are frequently co-morbid with each other, although their relationship remains little studied. While there is evidence of abnormalities in visual and visuospatial processing in both disorders, no study has directly compared the two. We used two complementary modalities – event-related potentials (ERPs) and functional magnetic resonance imaging (fMRI) – to test for abnormal activity associated with early visual signaling.

Method

We acquired fMRI and ERP data in separate sessions from 15 unmedicated individuals in each of three groups (weight-restored AN, BDD, and healthy controls) while they viewed images of faces and houses of different spatial frequencies. We used joint independent component analyses to compare activity in visual systems.

Results

AN and BDD groups demonstrated similar hypoactivity in early secondary visual processing regions and the dorsal visual stream when viewing low spatial frequency faces, linked to the N170 component, as well as in early secondary visual processing regions when viewing low spatial frequency houses, linked to the P100 component. Additionally, the BDD group exhibited hyperactivity in fusiform cortex when viewing high spatial frequency houses, linked to the N170 component. Greater activity in this component was associated with lower attractiveness ratings of faces.

Conclusions

Results provide preliminary evidence of similar abnormal spatiotemporal activation in AN and BDD for configural/holistic information for appearance- and non-appearance-related stimuli. This suggests a common phenotype of abnormal early visual system functioning, which may contribute to perceptual distortions.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2015 

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References

Aguirre, GK, Farah, MJ (1998). Human visual object recognition: what have we learned from neuroimaging? Psychobiology 26, 322332.CrossRefGoogle Scholar
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Publishing: Washington, DC, p. 991.Google Scholar
Bartlett, J, Searcy, J, Abdi, H (2003). What are the routes to face recognition? In Perception of Faces, Objects, and Scenes: Analytic and Holistic Processes (ed. Peterson, M. and Rhodes, G.), pp. 2152. Oxford University Press: Oxford.Google Scholar
Bentin, S, Allison, T, Puce, A, Perez, E, McCarthy, G (1996). Electrophysiological studies of face perception in humans. Journal of Cognitive Neuroscience 8, 551565.CrossRefGoogle ScholarPubMed
Booth, R, Charlton, R, Hughes, C, Happé, F, Happe, F (2003). Disentangling weak coherence and executive dysfunction: planning drawing in autism and attention − deficit/hyperactivity disorder. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences 358, 387392.Google Scholar
Buhlmann, U, Etcoff, NL, Wilhelm, S (2006). Emotion recognition bias for contempt and anger in body dysmorphic disorder. Journal of Psychiatric Research 40, 105111.Google Scholar
Buhlmann, U, McNally, RJ, Etcoff, NL, Tuschen-Caffier, B, Wilhelm, S (2004). Emotion recognition deficits in body dysmorphic disorder. Journal of Psychiatric Research 38, 201206.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, 289298.CrossRefGoogle ScholarPubMed
Calhoun, VD, Adali, T, Pearlson, GD, Kiehl, KA (2006). Neuronal chronometry of target detection: fusion of hemodynamic and event-related potential data. NeuroImage 30, 544553.Google Scholar
Castro-Fornieles, J, Bargalló, N, Lázaro, L, Andrés, S, Falcon, C, Plana, MT, Junqué, C (2009). A cross-sectional and follow-up voxel-based morphometric MRI study in adolescent anorexia nervosa. Journal of Psychiatric Research 43, 331340.CrossRefGoogle ScholarPubMed
Costen, NP, Parker, DM, Craw, I (1996). Effects of high-pass and low-pass spatial filtering on face identification. Perception & Psychophysics 58, 602612.CrossRefGoogle ScholarPubMed
Danner, UN, Sanders, N, Smeets, PAM, van Meer, F, Adan, RAH, Hoek, HW, van Elburg, AA (2012). Neuropsychological weaknesses in anorexia nervosa: set-shifting, central coherence, and decision making in currently ill and recovered women. International Journal of Eating Disorders 45, 685694.Google Scholar
Desjardins, JA, Segalowitz, SJ (2013). Deconstructing the early visual electrocortical responses to face and house stimuli. Journal of Vision 13, 118.CrossRefGoogle ScholarPubMed
Eisen, JL, Phillips, KA, Baer, L, Beer, DA, Atala, KD, Rasmussen, SA (1998). The Brown Assessment of Beliefs Scale: reliability and validity. American Journal of Psychiatry 155, 102108.Google Scholar
Epstein, R, Kanwisher, N (1998). A cortical representation of the local visual environment. Nature 392, 598601.Google Scholar
Fairburn, CG, Cooper, Z, Connor, MO (2008). Eating disorder examination (Edition 16.0D). In Cognitive Behavior Therapy and Eating Disorders, pp. 19. Guilford Press: New York.Google Scholar
Favaro, A, Santonastaso, P, Manara, R, Bosello, R, Bommarito, G, Tenconi, E, Di Salle, F (2012). Disruption of visuospatial and somatosensory functional connectivity in anorexia nervosa. Biological Psychiatry 72, 864870.Google Scholar
Feusner, J, Hembacher, E, Moller, H, Moody, TD (2011). Abnormalities of object visual processing in body dysmorphic disorder. Psychological Medicine 18, 23852397.Google Scholar
Feusner, JD, Bystritsky, A, Hellemann, G, Bookheimer, S (2010a). Impaired identity recognition of faces with emotional expressions in body dysmorphic disorder. Psychiatry Research 179, 318323.CrossRefGoogle ScholarPubMed
Feusner, JD, Moller, H, Altstein, L, Sugar, C, Bookheimer, S, Yoon, J, Hembacher, E (2010b). Inverted face processing in body dysmorphic disorder. Journal of Psychiatric Research 44, 10881094.Google Scholar
Feusner, JD, Moody, T, Hembacher, E, Townsend, J, McKinley, M, Moller, H, Bookheimer, S (2010c). Abnormalities of visual processing and frontostriatal systems in body dysmorphic disorder. Archives of General Psychiatry 67, 197205.Google Scholar
Feusner, JD, Townsend, J, Bystritsky, A, Bookheimer, S (2007). Visual information processing of faces in body dysmorphic disorder. Archives of General Psychiatry 64, 14171425.CrossRefGoogle ScholarPubMed
Filippini, N, MacIntosh, BJ, Hough, MG, Goodwin, GM, Frisoni, GB, Smith, SM, Matthews, PM, Beckmann, CF, Mackay, CE (2009). Distinct patterns of brain activity in young carriers of the APOE-epsilon4 allele. Proceedings of the National Academy of Sciences USA 106, 72097214.Google Scholar
Fonville, L, Lao-Kaim, NP, Giampietro, V, Van den Eynde, F, Davies, H, Lounes, N, Andrew, C, Dalton, J, Simmons, A, Williams, SCR, Baron-Cohen, S, Tchanturia, K (2013). Evaluation of enhanced attention to local detail in anorexia nervosa using the embedded figures test: an FMRI study. PLoS ONE 8, e63964.Google Scholar
Friston, KJ, Williams, S, Howard, R, Frackowiak, RS, Turner, R (1996). Movement-related effects in fMRI time-series. Magnetic Resonance in Medicine 35, 346355.CrossRefGoogle ScholarPubMed
Hamilton, M (1960). A Rating Scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 5663.Google Scholar
Iidaka, T, Matsumoto, A, Haneda, K, Okada, T, Sadato, N (2006). Hemodynamic and electrophysiological relationship involved in human face processing: evidence from a combined fMRI-ERP study. Brain and Cognition 60, 176186.CrossRefGoogle ScholarPubMed
Itier, RJ, Taylor, MJ (2004). Source analysis of the N170 to faces and objects. Neuroreport 15, 15.Google Scholar
Jefferies, K, Laws, KR, Fineberg, NA (2012). Superior face recognition in body dysmorphic disorder. Journal of Obsessive-Compulsive and Related Disorders 1, 175179.Google Scholar
Jolliffe, T, Baron-Cohen, S (1997). Are people with autism and Asperger syndrome faster than normal on the Embedded Figures Test? Journal of Child Psychology and Psychiatry, and Allied Disciplines 38, 527534.Google Scholar
Kerwin, L, Hovav, S, Hellemann, G, Feusner, JD (2014). Impairment in local and global processing and set-shifting in body dysmorphic disorder. Journal of Psychiatric Research 57, 4150.CrossRefGoogle ScholarPubMed
Kim, Y-R, Lim, S-J, Treasure, J (2011). Different patterns of emotional eating and visuospatial deficits whereas shared risk factors related with social support between anorexia nervosa and bulimia nervosa. Psychiatry Investigation 8, 914.Google Scholar
Lee, T, Sejnowski, TJ (1997). Independent component analysis for mixed Sub-Gaussian and Super-Gaussian sources. In 4th Joint Symposium on Neural Computation Proceedings, pp. 132139.Google Scholar
Li, W, Lai, TM, Moody, T, Loo, S, Strober, M, Bookheimer, SY, Feusner, JD (2013). Study of Visual Processing Deficits in BDD using EEG. In Society for Neuroscience.Google Scholar
Lopez, C, Tchanturia, K, Stahl, D, Treasure, J (2008). Central coherence in eating disorders: a systematic review. Psychological Medicine 38, 13931404.Google Scholar
Lopez, C, Tchanturia, K, Stahl, D, Treasure, J (2009). Weak central coherence in eating disorders: a step towards looking for an endophenotype of eating disorders. Journal of Clinical and Experimental Neuropsychology 31, 117125.Google Scholar
Madsen, SK, Bohon, C, Feusner, JD (2013). Visual processing in anorexia nervosa and body dysmorphic disorder: similarities, differences, and future research directions. Journal of Psychiatric Research 47, 19.Google Scholar
Monzani, B, Krebs, G, Anson, M, Veale, D, Mataix-Cols, D (2013). Holistic versus detailed visual processing in body dysmorphic disorder: testing the inversion, composite and global precedence effects. Psychiatry Research 210, 994999.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 159B, 376382.Google Scholar
Mundy, ME, Sadusky, A (2014). Abnormalities in visual processing amongst students with body image concerns. Advances in Cognitive Psychology 10, 3948.Google Scholar
Pascual-Marqui, RD (1999). Review of methods for solving the EEG inverse problem. International Journal of Bioelectromagnetism 1, 7586.Google Scholar
Phillips, KA (2005). Clinical features and treatment of body dysmorphic disorder. Journal of Lifelong Learning in Psychiatry 3, 179183.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, 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 Scholar
Rauch, SL, Phillips, KA, Segal, E, Makris, N, Shin, LM, Whalen, PJ, Jenike, MA, Caviness, VS, Kennedy, DN (2003). A preliminary morphometric magnetic resonance imaging study of regional brain volumes in body dysmorphic disorder. Psychiatry Research 122, 1319.Google Scholar
Roberts, ME, Tchanturia, K, Treasure, JL (2013). Is attention to detail a similarly strong candidate endophenotype for anorexia nervosa and bulimia nervosa? The World Journal of Biological Psychiatry 14, 452463.Google Scholar
Sheehan, D, Lecrubier, Y, Sheehan, H, 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, 2233.Google Scholar
Sherman, BJ, Savage, CR, Eddy, KT, Blais, MA, Deckersbach, T, Jackson, SC, Franko, DL, Rauch, SL, Herzog, DB (2006). Strategic memory in adults with anorexia nervosa: are there similarities to obsessive compulsive spectrum disorders? International Journal of Eating Disorders 39, 468476.Google Scholar
Stedal, K, Rose, M, Frampton, I, Landrø, NI, Lask, B (2012). The neuropsychological profile of children, adolescents, and young adults with anorexia nervosa. Archives of Clinical Neuropsychology 27, 329337.Google Scholar
Suchan, B, Busch, M, Schulte, D, Grönemeyer, D, Grönermeyer, D, Herpertz, S, Vocks, S (2010). Reduction of gray matter density in the extrastriate body area in women with anorexia nervosa. Behavioural Brain Research 206, 6367.Google Scholar
Tenconi, E, Santonastaso, P, Degortes, D, Bosello, R, Titton, F, Mapelli, D, Favaro, A (2010). Set-shifting abilities, central coherence, and handedness in anorexia nervosa patients, their unaffected siblings and healthy controls: exploring putative endophenotypes. The World Journal of Biological Psychiatry 11, 813823.CrossRefGoogle ScholarPubMed
Urgesi, C, Fornasari, L, Canalaz, F, Perini, L, Cremaschi, S, Faleschini, L, Thyrion, EZ, Zuliani, M, Balestrieri, M, Fabbro, F, Brambilla, P (2013). Impaired configural body processing in anorexia nervosa: evidence from the body inversion effect. British Journal of Psychology 105, 123.Google Scholar
Williams, JBW, Kobak, KA (2008). Development and reliability of a structured interview guide for the Montgomery Asberg Depression Rating Scale (SIGMA). British Journal of Psychiatry 192, 5258.Google Scholar

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