{
  "abstract": "BackgroundIndividuals with body dysmorphic disorder (BDD) misperceive defects in their appearance. Evidence suggests that visual processing abnormalities may underlie this core symptom. Previous studies testing perceptual and attentional interventions and non-invasive neuromodulation suggest these abnormalities may be modifiable, but their combined effects on neural connectivity and perceptual processing remain unclear.\n\nMethodsUnmedicated participants with BDD or subclinical BDD received one session each of intermittent and continuous theta burst stimulation (TBS) targeting the lateral parietal cortex, combined with a visual attention modification paradigm during functional magnetic resonance imaging, in a crossover design. Dynamic effective connectivity within dorsal and ventral visual stream pathways was calculated, and global visual processing biases were assessed using the face inversion effect before and after each session.\n\nResultsThe analytic sample comprised 38 participants (60.5% female). Intermittent TBS increased connectivity in higher-level dorsal pathways during naturalistic viewing following attention modification ({beta} = 0.079, p = .008), whereas continuous TBS reduced connectivity in lower-level dorsal pathways ({beta} = -0.118, p < .001) and increased connectivity in ventral pathways (higher: {beta} = 0.239, p < .001; lower: {beta} = 0.079, p = .014). These changes were accompanied by differential effects on global visual processing.\n\nConclusionsCombined neuromodulation and visual attention modification modulate visual system connectivity and perceptual processing in individuals with BDD symptoms. These findings support a mechanistic link between dorsal-ventral stream dynamics and perceptual biases. Integrating neuromodulation with perceptual retraining may represent a viable approach for targeting distorted appearance perception.\n\nClinicalTrials.gov: NCT05607121",
  "abstract_shown": true,
  "affiliations": [
    "Centre for Addiction and Mental Health"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "name": "J. P. Diaz-Fong"
    },
    {
      "name": "H. J. Peel"
    },
    {
      "name": "K. Zhang"
    },
    {
      "name": "J. Qian"
    },
    {
      "name": "M. Lewis"
    },
    {
      "name": "W.-W. Wong"
    },
    {
      "name": "A. F. Leuchter"
    },
    {
      "name": "R. Tadayonnejad"
    },
    {
      "name": "D. Voineskos"
    },
    {
      "name": "G. Konstantinou"
    },
    {
      "name": "E. Lam"
    },
    {
      "name": "D. M. Blumberger"
    },
    {
      "affs": [
        0
      ],
      "name": "J. D. Feusner"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/csjbfzvdnm2rk.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.05.25.26354053",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.05.25.26354053v2.full",
  "id": "csjbfzvdnm2rk",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.05.25.26354053v2",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "psychiatry and clinical psychology"
    ],
    [
      "openalex",
      "3203|Body Image and Dysmorphia Studies"
    ]
  ],
  "openalex": "W7162469542",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.05.25.26354053v2.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-05-25",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/csjbfzvdnm2rk.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:48Z",
      "native_id": "10.64898/2026.05.25.26354053",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.05.25.26354053v2"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:psychiatry and clinical psychology",
      "subfield": "psychiatry"
    }
  ],
  "title": "Effects of theta burst stimulation on neural connectivity and visual perception following attention modification of own-face viewing in body dysmorphic disorder",
  "title_text": "Effects of theta burst stimulation on neural connectivity and visual perception following attention modification of own-face viewing in body dysmorphic disorder",
  "type": "preprint",
  "updated_at": "2026-10-30T12:17:48Z",
  "url": "https://research.draconitic.com/paper/csjbfzvdnm2rk",
  "venue": "medRxiv",
  "versions": []
}