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Reward processing in trichotillomania and skin picking disorder

Reward processing in trichotillomania and skin picking disorder
Reward processing in trichotillomania and skin picking disorder
Trichotillomania (hair pulling disorder) and skin picking disorder are common and often debilitating mental health conditions, grouped under the umbrella term of body focused repetitive behaviors (BFRBs). Although the pathophysiology of BFRBs is incompletely understood, reward processing dysfunction has been implicated in the etiology and sustention of these disorders. The purpose of this study was to probe reward processing in BFRBs. 159 adults (125 with a BFRB [83.2% (n = 104) female] and 34 healthy controls [73.5% (n = 25) female]) were recruited from the community for a multi-center between-group comparison using a functional imaging (fMRI) monetary reward task. Differences in brain activation during reward anticipation and punishment anticipation were compared between BFRB patients and controls, with stringent correction for multiple comparisons. All group level analyses controlled for age, sex and scanning site. Compared to controls, BFRB participants showed marked hyperactivation of the bilateral inferior frontal gyrus (pars opercularis and pars triangularis) compared to controls. In addition, BFRB participants exhibited increased activation in multiple areas during the anticipation of loss (right fusiform gyrus, parahippocampal gyrus, cerebellum, right inferior parietal lobule; left inferior frontal gyrus). There were no significant differences in the win-lose contrast between the two groups. These data indicate the existence of dysregulated reward circuitry in BFRBs. The identified pathophysiology of reward dysfunction may be useful to tailor future treatments.
fMRI, Imaging, Neurobiology, Reward, Skin picking disorder, Trichotillomania
1931-7557
Grant, Jon E.
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Peris, Tara S.
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Ricketts, Emily J.
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Bethlehem, Richard A.I.
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Chamberlain, Samuel R.
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O’Neill, Joseph
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Scharf, Jeremiah M.
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Dougherty, Darin D.
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Deckersbach, Thilo
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Woods, Douglas W.
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Piacentini, John
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Keuthen, Nancy J.
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Grant, Jon E.
07372bd5-8a0d-42b4-b41b-e376c652acf3
Peris, Tara S.
05ca7c10-65fa-4771-859f-4cfe86a9a135
Ricketts, Emily J.
b573106f-ac72-47c6-b899-5d6c8b08647e
Bethlehem, Richard A.I.
3ab67633-bcc8-47fa-9341-786fcd24ec76
Chamberlain, Samuel R.
8a0e09e6-f51f-4039-9287-88debe8d8b6f
O’Neill, Joseph
128a9ff0-4d16-45de-bb10-f4dc6e0d3037
Scharf, Jeremiah M.
1eb89212-4963-4751-a532-e11d4f568f0b
Dougherty, Darin D.
4f7d89a3-70ea-477f-95ae-a1d028811191
Deckersbach, Thilo
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Woods, Douglas W.
cc962e75-3658-441d-beff-ba7e0a852a43
Piacentini, John
54968ef8-87c1-43a7-b7ec-a3c4186cd46e
Keuthen, Nancy J.
3aac6a61-b2e2-4870-9762-a16a52227dda

Grant, Jon E., Peris, Tara S., Ricketts, Emily J., Bethlehem, Richard A.I., Chamberlain, Samuel R., O’Neill, Joseph, Scharf, Jeremiah M., Dougherty, Darin D., Deckersbach, Thilo, Woods, Douglas W., Piacentini, John and Keuthen, Nancy J. (2021) Reward processing in trichotillomania and skin picking disorder. Brain Imaging and Behavior. (doi:10.1007/s11682-021-00533-5).

Record type: Article

Abstract

Trichotillomania (hair pulling disorder) and skin picking disorder are common and often debilitating mental health conditions, grouped under the umbrella term of body focused repetitive behaviors (BFRBs). Although the pathophysiology of BFRBs is incompletely understood, reward processing dysfunction has been implicated in the etiology and sustention of these disorders. The purpose of this study was to probe reward processing in BFRBs. 159 adults (125 with a BFRB [83.2% (n = 104) female] and 34 healthy controls [73.5% (n = 25) female]) were recruited from the community for a multi-center between-group comparison using a functional imaging (fMRI) monetary reward task. Differences in brain activation during reward anticipation and punishment anticipation were compared between BFRB patients and controls, with stringent correction for multiple comparisons. All group level analyses controlled for age, sex and scanning site. Compared to controls, BFRB participants showed marked hyperactivation of the bilateral inferior frontal gyrus (pars opercularis and pars triangularis) compared to controls. In addition, BFRB participants exhibited increased activation in multiple areas during the anticipation of loss (right fusiform gyrus, parahippocampal gyrus, cerebellum, right inferior parietal lobule; left inferior frontal gyrus). There were no significant differences in the win-lose contrast between the two groups. These data indicate the existence of dysregulated reward circuitry in BFRBs. The identified pathophysiology of reward dysfunction may be useful to tailor future treatments.

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e-pub ahead of print date: 19 August 2021
Published date: 19 August 2021
Additional Information: Funding Information: This study was funded by the Body-Focused Precision Medicine Initiative Granted by The TLC Foundation for Body-Focused Repetitive Behaviors to University of Chicago (Dr. Grant), Massachusetts General Hospital (MGH)/Harvard (Dr. Keuthen), and University of California, Los Angeles (UCLA) (Dr. Piacentini). Dr. Chamberlain’s involvement in this study was funded by a Wellcome Trust Clinical Fellowship (Refs. 110049/Z/15/Z & 110049/Z/15/A). The TLC Foundation for Body-Focused Repetitive Behaviors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. This study was completed with support from the REDCap project at the University of Chicago, which is hosted and managed by the Center for Research Informatics and funded by the Biological Sciences Division and by the Institute for Translational Medicine, CTSA Grant Number UL1 TR000430 from the National Institutes of Health. Funding Information: Dr. Grant has received research grants from Biohaven, Promentis, and Otsuka Pharmaceuticals. Dr. Grant receives yearly compensation from Springer Publishing for acting as Editor-in-Chief of the Journal of Gambling Studies and has received royalties from Oxford University Press, American Psychiatric Publishing, Inc., Norton Press, and McGraw Hill. Dr. Chamberlain consults for Promentis; and receives stipends from Elsevier for editorial journal work. The other authors report no conflicts. Dr. Dougherty receives research support and honoraria from Medtronic, Inc. Dr. Woods has received royalties from Oxford University Press and Springer Press. Dr. Piacentini has received research grants from NIMH, the Tourette Association of America, and Pfizer. He receives travel support and honoraria from the Tourette Association of America and the International OCD Foundation and book royalties from Guilford Publications and Oxford University Press. Dr Keuthen has received prior research grants from The TLC Foundation for Body-Focused Repetitive Behaviors and royalties from New Harbinger, Inc. The remaining authors have nothing to disclose. Publisher Copyright: © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
Keywords: fMRI, Imaging, Neurobiology, Reward, Skin picking disorder, Trichotillomania

Identifiers

Local EPrints ID: 453559
URI: http://eprints.soton.ac.uk/id/eprint/453559
ISSN: 1931-7557
PURE UUID: 9f71c6f8-89fc-40ba-9378-1679f41d0c77
ORCID for Samuel R. Chamberlain: ORCID iD orcid.org/0000-0001-7014-8121

Catalogue record

Date deposited: 19 Jan 2022 18:04
Last modified: 30 Aug 2024 04:01

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Contributors

Author: Jon E. Grant
Author: Tara S. Peris
Author: Emily J. Ricketts
Author: Richard A.I. Bethlehem
Author: Samuel R. Chamberlain ORCID iD
Author: Joseph O’Neill
Author: Jeremiah M. Scharf
Author: Darin D. Dougherty
Author: Thilo Deckersbach
Author: Douglas W. Woods
Author: John Piacentini
Author: Nancy J. Keuthen

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