Abstract #4217

Aberrant fronto-limbic effective connectivity during repeated fearful face stimuli in body dysmorphic disorder and anorexia nervosa

D Rangaprakash^1,2, Nathan L Hutcheson¹, Katherine E Lawrence¹, Teena D Moody¹, Sarah Madsen^1,3, Sahib Khalsa^1,4,5, Michael Strober¹, Cara Bohon⁶, and Jamie D Feusner¹

¹Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States, ²AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, United States, ³Imaging Genetics Center, Department of Neurology, University of Southern California, Los Angeles, CA, United States, ⁴Oxley College of Health Sciences, University of Tulsa, Tulsa, OK, United States, ⁵Laureate Institute for Brain Research, University of Tulsa, Tulsa, OK, United States, ⁶Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States

Anorexia nervosa (AN) and body dysmorphic disorder (BDD) share distorted perception of appearance, anxiety, and depression, yet their common and distinguishing neural phenotypes of emotion processing remain unknown. To address this, we studied fronto-limbic connectivity using functional MRI data obtained while participants (N=94) viewed fearful faces and rated their own subjectively experienced fearfulness. Healthy controls exhibited, as predicted, significant bidirectional medial prefrontal (mPFC)-amygdala connectivity, which increased across blocks. However, BDD participants exhibited significant mPFC-to-amygdala but not amygdala-to-mPFC connectivity (indicating limbic hypo-responsiveness), while AN exhibited no significant prefrontal-amygdala connectivity. This study suggests distinct, aberrant fronto-limbic modulatory connectivity in AN and BDD.

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