Xenomelia: a new right parietal lobe syndrome
Xenomelia: a new right parietal lobe syndrome
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DOI：
10.1136/jnnp-2011-300224
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发表时间：
2011-12-01
影响因子：
11
通讯作者：
Ramachandran, V. S.
中科院分区：
文献类型：
--
作者：
McGeoch, Paul D.;Brang, David;Ramachandran, V. S.
背景 长期以来，右顶叶损伤与各种身体意象障碍有关。作者最近提出，一种不寻常的行为状况，在这种情况下，理性的人希望截肢健康的肢体也可能是由右顶叶功能障碍引起的。 方法 招募了四名希望截肢健康腿的受试者（两条右腿，一条左腿，一条，首先是双侧，然后只有左腿），并在对所需截肢线上方和下方部位进行触觉刺激时进行脑磁图（MEG）扫描。使用 FreeSurfer 软件定义每个半球的感兴趣区域 (ROI)（顶上小叶 (SPL)、顶下小叶、S1、M1、岛叶、前运动皮层和楔前叶）。 结果 使用非配对 t 检验对刺激后 40-140 ms 时间范围内的平均 MEG 活性进行分析。这表明，与受试者未受影响的腿和对照组相比，仅受试者受影响腿的右侧 SPL ROI 的激活显着减少。 结论 右侧 SPL 是一个皮层区域，它的位置非常理想，可以统一不同的感觉输入，以创建具有身体的连贯感。作者提出，右侧 SPL 激活不充分会导致不自然的情况，患者可以感觉到有问题的肢体被触摸，但实际上并没有融入他们的身体形象，从而产生截肢的愿望。作者将“xenomelia”一词引入为比截肢癖或身体完整性认同障碍更合适的名称，因为它似乎是一种未被识别的右顶叶综合征。
Background Damage to the right parietal lobe has long been associated with various disorders of body image. The authors have recently suggested that an unusual behavioural condition in which otherwise rational individuals desire the amputation of a healthy limb might also arise from right parietal dysfunction.Methods Four subjects who desired the amputation of healthy legs (two right, one left and one, at first, bilateral and then left only) were recruited and underwent magnetoencephalography (MEG) scans during tactile stimulation of sites above and below the desired amputation line. Regions of interest (ROIs) in each hemisphere (superior parietal lobule (SPL), inferior parietal lobule, S1, M1, insula, premotor cortex and precuneus) were defined using FreeSurfer software.Results Analysis of average MEG activity across the 40-140 ms post-stimulation timeframe was carried out using an unpaired t test. This revealed significantly reduced activation only in the right SPL ROI for the subjects' affected legs when compared with both subjects' unaffected legs and that of controls.Conclusions The right SPL is a cortical area that appears ideally placed to unify disparate sensory inputs to create a coherent sense of having a body. The authors propose that inadequate activation of the right SPL leads to the unnatural situation in which the sufferers can feel the limb in question being touched without it actually incorporating into their body image, with a resulting desire for amputation. The authors introduce the term 'xenomelia' as a more appropriate name than apotemnophilia or body integrity identity disorder, for what appears to be an unrecognised right parietal lobe syndrome.