Neurocorrelates of BDD and OCD

Patients suffering from Obsessive * Compulsive disorder (OCD) and Body
Dysmorphic Disorder (BDD) experience very similar problems. Both diseases are
characterized by recurring intrusive thoughts that cause anxiety and force the
patients to perform compulsive acts that often take hours. The content of the
intrusions is different however; OCD intrusions typically range from fear about
cleaning/contamination, incurring harm and fears to transgress societal mores
(fear to transgress can be oriented on sexual, aggressive or religious topics).
Patients with BDD instead fret over the perceived social rejection considering
certain aspects of their bodily appearance. However, these unrealistic fears
cause both groups of patients avoid the cause of the experienced fear and leads
to compulsively acts when exposed. The striking overlap between phenotypes has
lead researchers to propose that a novel diagnostic category, *Anxiety and
Obsessive-Compulsive spectrum disorders*, should be considered in an updated
version of the DSM (Phillips et al, 2010).
Although the clinical literature suggests that OCD and BDD are very similar
disorders, there is almost no imaging literature to support this hypothesis at
the level of the brain. We know from the functional Magnetic Resonance Imaging
(fMRI) literature that in OCD, the frontostriatal circuitry, comprised of the
basal ganglia, anterior cingulate cortex (ACC; Aouizerate et al., 2004) and
prefrontal cortex show different activity patterns. These brain regions are
associated with action selection, goal directed behaviors and performance
monitoring (Grundler et al., 2009; Harrison et al., 2009; Ridderinkhof et al.,
2004), brain functions that are disturbed in OCD and potentially also disturbed
in BDD. To investigate the rapid, cognitive dynamics we propose using the
electroencephalogram (EEG) to investigate how rapid interactions in brain
activity within the frontostriatal circuitry shapes the pathology in OCD and
BDD.

The main objective for this proposal is to investigate the neurophysiology of
BDD, and compare irregularities of BDD neurophysiology with OCD
neurophysiology.

Observational study with non-invasive measures

Using a very basic study design, risk associated with participation can be
considered negligible and the burden can be considered minimal. No
pharmacological nor (otherwise) invasive interventions are applied. No adverse
events are expected. There is no direct benefit for participants.