Brain functional correlates of emotional face processing in body dysmorphic disorder

Tiana Borgers; Marla Kürten; Anna Kappelhoff; Verena Enneking; Anne Möllmann; Johanna Schulte; Melissa Klug; Elisabeth J Leehr; Katharina Dohm; Dominik Grotegerd; Philine Krause; Esther Zwiky; Udo Dannlowski; Ulrike Buhlmann; Ronny Redlich

doi:10.1016/j.jpsychires.2022.01.007

Brain functional correlates of emotional face processing in body dysmorphic disorder

J Psychiatr Res. 2022 Mar:147:103-110. doi: 10.1016/j.jpsychires.2022.01.007. Epub 2022 Jan 7.

Authors

Affiliations

¹ Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany. Electronic address: borgerst@uni-muenster.de.
² Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany; Institute of Psychology, University of Münster, Fliednerstrasse 21, 48149, Münster, Germany. Electronic address: kuertenma@gmail.com.
³ Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany. Electronic address: anna@kappelhoff-ol.de.
⁴ Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany. Electronic address: venneking@wwu.de.
⁵ Institute of Psychology, University of Bremen, Grazer Strasse 2, 28359, Bremen, Germany. Electronic address: moellmann@uni-bremen.de.
⁶ Institute of Psychology, University of Münster, Fliednerstrasse 21, 48149, Münster, Germany. Electronic address: j.schulte@wwu.de.
⁷ Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany. Electronic address: m_klug06@wwu.de.
⁸ Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany. Electronic address: leehr@wwu.de.
⁹ Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany. Electronic address: k_dohm02@wwu.de.
¹⁰ Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany. Electronic address: dominik.grotegerd@wwu.de.
¹¹ Institute of Psychology, University of Halle, Emil Abderhaldenstraße 26, 06108, Halle, Germany. Electronic address: philine.krause@psych.uni-halle.de.
¹² Institute of Psychology, University of Halle, Emil Abderhaldenstraße 26, 06108, Halle, Germany. Electronic address: esther.zwiky@psych.uni-halle.de.
¹³ Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany. Electronic address: dannlow@wwu.de.
¹⁴ Institute of Psychology, University of Münster, Fliednerstrasse 21, 48149, Münster, Germany. Electronic address: ulrike.buhlmann@wwu.de.
¹⁵ Institute for Translational Psychiatry, University of Münster, Albert-Schweitzer-Campus 1, Building A9, 48149, Münster, Germany; Institute of Psychology, University of Halle, Emil Abderhaldenstraße 26, 06108, Halle, Germany. Electronic address: r.redlich@wwu.de.

PMID: 35030511
DOI: 10.1016/j.jpsychires.2022.01.007

Abstract

Previous neuroimaging studies in body dysmorphic disorder (BDD) have focused on discordances in visual processing systems. However, little is known about brain functional aberrations in individuals with BDD during emotional face processing. An fMRI paradigm with negative emotional faces was employed in 20 individuals with BDD and 43 mentally healthy controls (HC). We compared functional activity and whole-brain connectivity patterns of the amygdala and the fusiform gyrus (FFG) between both groups. Regression analyses were performed for associations of body dysmorphic symptoms with brain activity and connectivity. Individuals with BDD exhibited higher activity in the left amygdala compared to HC (p_FWE = .04) as well as increased functional connectivity of the left amygdala with a network including frontostriatal and temporal regions (p_FWE < .05). The FFG revealed increased functional connectivity in individuals with BDD, mapping to brain areas such as the cingulate cortex and temporo-limbic regions (p_FWE < .05). In HC, higher levels of body dysmorphic symptoms were associated with higher functional amygdala and FFG activity (p_FWE < .05). Individuals with BDD show aberrant functional activity and connectivity patterns within the amygdala and the FFG for negative emotional face processing. Body dysmorphic symptoms in HC are associated with a mild pattern of brain functional alterations, which could emphasize the relevance of a dimensional approach in addition to diagnosis. Treatments for BDD could benefit from targeting visual misperception and evaluation processes upon confrontation with emotional information.

Keywords: Body dysmorphic disorder; Body dysmorphic symptoms; Connectivity; Emotional face processing; Functional magnetic resonance imaging.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Body Dysmorphic Disorders* / diagnostic imaging
Brain / diagnostic imaging
Brain Mapping
Emotions
Facial Recognition*
Humans
Magnetic Resonance Imaging