Body Dysmorphic Disorder Linked To Abnormal Brain Wiring
April 30, 2013

It’s Bad Brain Wiring, Not Extreme Vanity: The Roots Of BDD

Jedidiah Becker for — Your Universe Online

One of the most unusual and little understood psychiatric disorders is a condition known as body dysmorphic disorder, or BDD. Individuals afflicted with this disease believe they are disfigured or extremely unattractive despite appearing normal to other people. Now, researchers at UCLA have shed light on the neurological underpinnings of this bizarre disorder, and they say the condition arises from abnormal wiring across vast regions of the brain.

Led by Professor Jamie Feusner, director of UCLA´s Adult Obsessive-Compulsive Disorder Program and the Body Dysmorphic Disorder Research Program at UCLA, a team of research psychiatrists described the roots of the condition as resulting from “bad wiring” patterns across the brain as a whole. In addition to earlier studies of BDD that highlighted faulty wiring in the brain´s system for processing visual information, Feusner´s team has uncovered additional neurological abnormalities in regions of the brain associated with the processing of emotions.

A report of their findings will appear in the May edition of the journal Neuropsychopharmacology and suggests this combination of mixed-up wiring leads to broad aberrancies in how individuals with BDD process information.

"We found a strong correlation between low efficiency of connections across the whole brain and the severity of BDD," Feusner said. "The less efficient [the] patients' brain connections, the worse the symptoms, particularly for compulsive behaviors, such as checking mirrors."

Individuals with BDD are known to express symptoms similar to those observed in people who suffer from obsessive compulsive disorder, such as fixating on a small blemish on their face and failing to see their body as a whole. These compulsions are sometimes so strong they dominate the individuals´ lives to the point they refuse to leave their homes or even commit suicide. Though the condition is relatively unknown to the general public, it affects an estimated 2 out of every one hundred people, making it more common than both schizophrenia and bipolar disorders.

Feusner´s team set out to elucidate this tragic and unusual condition by performing brain scans on 14 individuals who have been diagnosed with BDD and comparing their results with those of 16 healthy individuals. The team wanted to create a map of the networks of white matter within the brain in order to better understand how these tissues are organized and how they transmit information between different regions of the cerebrum.

To study white matter, the research group used a specialized, highly sensitive type of MRI known as diffusion tensor imaging (DTI). Unlike standard MRI, DTI allows researcher to asses, measure and create maps of white matter and its structural integrity across different regions of the brain. Using graph theory analysis, they were then able to distinguish different patterns of connections and compare them with those found in normal individuals.

What Feusner´s team discovered was the individuals with BDD displayed abnormal patterns of network “clustering” in various parts of the brain, indicating they likely suffer from irregularities in how they are able to process “local” or detailed information. They also found those parts of the brain specifically connecting the processing of visual and emotional information were consistently abnormal across all individuals with BDD.

"How their brain regions are connected in order to communicate about what they see and how they feel is disturbed," explained Feusner.

"Their brains seem to be fine-tuned to be very sensitive to process minute details, but this pattern may not allow their brains to be well-synchronized across regions with different functions. This could affect how they perceive their physical appearance and may also result in them getting caught up in the details of other thoughts and cognitive processes."

As Feusner points out, the most significant contribution of his team´s study may be that it points to the concrete, physiological origins of BDD rather than to merely psychological disturbances.

"These abnormal brain networks could relate to how they perceive, feel and behave," he explains. "This is significant because it could possibly lead to us being able to identify early on if someone is predisposed to developing this problem."