Structural and functional brain changes in body dysmorphic disorder according to neuroimaging data

Body dysmorphic disorder (BDD) is characterized by an individual's preoccupation with imagined defects in their appearance that are barely noticeable or completely unnoticeable to others, leading to significant impairments in daily functioning. In BDD, the following have been described: functional disturbances in visual information processing in the fronto-striatal and limbic systems, reduced global efficiency of white matter connectivity, decreased cortical thickness in the temporal and parietal lobes, as well as correlations between neuroimaging findings and clinical manifestations such as symptom severity and level of insight. MRI reveals increased white matter volume and thalamic volume, decreased cortical thickness in the left temporal and parietal lobes, a reduction in total gray matter volume, and correlations between these abnormalities and clinical symptoms, severity, duration of BDD, and level of insight. Functional MRI demonstrates aberrant functional connectivity within the occipito-temporal network during face processing, hyperactivity of the fronto-striatal system and caudate nucleus, and regional brain hyperactivity during symptom provocation. Studies using single-photon emission computed tomography show perfusion abnormalities in the occipital regions with parietal lobe involvement. Structural, volumetric, and functional data obtained from neuroimaging studies of BDD may help illuminate the pathophysiology and neurobiological underpinnings of this condition. Future research should further investigate and utilize neuroimaging results as potential prognostic biomarkers for treatment efficacy and disease outcomes.