The desire for healthy limb amputation: structural brain correlates and clinical features of xenomelia

Xenomelia is the oppressive feeling that one or more limbs of one's body do not belong to one's self. We present the results of a thorough examination of the characteristics of the disorder in 15 males with a strong desire for amputation of one or both legs. The feeling of estrangement had been present since early childhood and was limited to a precisely demarcated part of the leg in all individuals. Neurological status examination and neuropsychological testing were normal in all participants, and psychiatric evaluation ruled out the presence of a psychotic disorder. In 13 individuals and in 13 pair-matched control participants, magnetic resonance imaging was performed, and surface-based morphometry revealed significant group differences in cortical architecture. In the right hemisphere, participants with xenomelia showed reduced cortical thickness in the superior parietal lobule and reduced cortical surface area in the primary and secondary somatosensory cortices, in the inferior parietal lobule, as well as in the anterior insular cortex. A cluster of increased thickness was located in the central sulcus. In the left hemisphere, affected individuals evinced a larger cortical surface area in the inferior parietal lobule and secondary somatosensory cortex. Although of modest size, these structural correlates of xenomelia appear meaningful when discussed against the background of some key clinical features of the disorder. Thus, the predominantly right-sided cortical abnormalities are in line with a strong bias for left-sided limbs as the target of the amputation desire, evident both in our sample and in previously described populations with xenomelia. We also propose that the higher incidence of lower compared with upper limbs (∼80% according to previous investigations) may explain the erotic connotations typically associated with xenomelia, also in the present sample. These may have their roots in the proximity of primary somatosensory cortex for leg representation, whose surface area was reduced in the participants with xenomelia, with that of the genitals. Alternatively, the spatial adjacency of secondary somatosensory cortex for leg representation and the anterior insula, the latter known to mediate sexual arousal beyond that induced by direct tactile stimulation of the genital area, might play a role. Although the right hemisphere regions of significant neuroarchitectural correlates of xenomelia are part of a network reportedly subserving body ownership, it remains unclear whether the structural alterations are the cause or rather the consequence of the long-standing and pervasive mismatch between body and sel

Structural and functional hyperconnectivity within the sensorimotor system in xenomelia

INTRODUCTION Xenomelia is a rare condition characterized by the persistent and compulsive desire for the amputation of one or more physically healthy limbs. We highlight the neurological underpinnings of xenomelia by assessing structural and functional connectivity by means of whole-brain connectome and network analyses of regions previously implicated in empirical research in this condition. METHODS We compared structural and functional connectivity between 13 xenomelic men with matched controls using diffusion tensor imaging combined with fiber tractography and resting state functional magnetic resonance imaging. Altered connectivity in xenomelia within the sensorimotor system has been predicted. RESULTS We found subnetworks showing structural and functional hyperconnectivity in xenomelia compared with controls. These subnetworks were lateralized to the right hemisphere and mainly comprised by nodes belonging to the sensorimotor system. In the connectome analyses, the paracentral lobule, supplementary motor area, postcentral gyrus, basal ganglia, and the cerebellum were hyperconnected to each other, whereas in the xenomelia-specific network analyses, hyperconnected nodes have been found in the superior parietal lobule, primary and secondary somatosensory cortex, premotor cortex, basal ganglia, thalamus, and insula. CONCLUSIONS Our study provides empirical evidence of structural and functional hyperconnectivity within the sensorimotor system including those regions that are core for the reconstruction of a coherent body image. Aberrant connectivity is a common response to focal neurological damage. As exemplified here, it may affect different brain regions differentially. Due to the small sample size, our findings must be interpreted cautiously and future studies are needed to elucidate potential associations between hyperconnectivity and limb disownership reported in xenomelia

Colorful brains: 14 years of display practice in functional neuroimaging

Neuroimaging results are typically graphically rendered and color-coded, which influences the process of knowledge generation within neuroscience as well as the public perception of brain research. Analyzing these issues requires empirical information on the display practice in neuroimaging. In our study we evaluated more than 9000 functional images (fMRI and PET) published between 1996 and 2009 with respect to the use of color, image structure, image production software and other factors that may determine the display practice. We demonstrate a variety of display styles despite a remarkable dominance of few image production sites and software systems, outline some tendencies of standardization, and identify shortcomings with respect to color scale explication in neuroimages. We discuss the importance of the finding for knowledge production in neuroimaging, and we make suggestions to improve the display practice in neuroimaging, especially on regimes of color coding

NSC151688

Children with attention deficit disorders (ADD) may have specific problems with response inhibition in the STOP task. This task requires that subjects stop responses to a primary task if a second signal follows. However, it is unclear whether these problems reflect an impairment of the stopping process per se, whether they are related to reduced frontal lobe activation and whether they are confined to severe and pervasive forms of ADD. In 11 ADD and nine control children, 32 channel event-related EEG potentials (ERPs) were recorded in a STOP and a delayed GO task. Mapping revealed that both tasks evoked a similar sequence of neuroelectric microstates, i.e. of time segments with stable map topography. Adaptive segmentation identified the transition between these microstates. Reliable group differences were found in several microstates and in both tasks despite matched performance. In the GO task, ADD children had topographically altered P2/N2 microstates and attenuated P300-type microstates. In the STOP task, a topographically altered N1 microstate which coincided with the onset of the stop signal preceded the stop failures of ADD children. The timing of this microstate is too early to reflect deficits in actual stop signal processing and instead suggests altered initial orienting of attention to the primary signal in ADD children. Imaging with low resolution tomography (LORETA) during this microstate to stop failures indicated mainly posterior activation for both groups and increased rather than reduced frontal activation in ADD children. For a later microstate (P550), LORETA indicated strong frontal activation after successful stopping, but no group differences. The results suggest that information processing of ADD children deviates during activation of posterior mechanisms which may be related to the orienting of attention and which precedes and partly determines inhibitory control problems in ADD

Colorful brains: 14 years of display practice in functional neuroimaging

Neuroimaging results are typically graphically rendered and color-coded, which influences the process of knowledge generation within neuroscience as well as the public perception of brain research. Analyzing these issues requires empirical information on the display practice in neuroimaging. In our study we evaluated more than 9000 functional images (fMRI and PET) published between 1996 and 2009 with respect to the use of color, image structure, image production software and other factors that may determine the display practice. We demonstrate a variety of display styles despite a remarkable dominance of few image production sites and software systems, outline some tendencies of standardization, and identify shortcomings with respect to color scale explication in neuroimages. We discuss the importance of the finding for knowledge production in neuroimaging, and we make suggestions to improve the display practice in neuroimaging, especially on regimes of color coding

The desire for healthy limb amputation: structural brain correlates and clinical features of xenomelia

Xenomelia is the oppressive feeling that one or more limbs of one's body do not belong to one's self. We present the results of a thorough examination of the characteristics of the disorder in 15 males with a strong desire for amputation of one or both legs. The feeling of estrangement had been present since early childhood and was limited to a precisely demarcated part of the leg in all individuals. Neurological status examination and neuropsychological testing were normal in all participants, and psychiatric evaluation ruled out the presence of a psychotic disorder. In 13 individuals and in 13 pair-matched control participants, magnetic resonance imaging was performed, and surface-based morphometry revealed significant group differences in cortical architecture. In the right hemisphere, participants with xenomelia showed reduced cortical thickness in the superior parietal lobule and reduced cortical surface area in the primary and secondary somatosensory cortices, in the inferior parietal lobule, as well as in the anterior insular cortex. A cluster of increased thickness was located in the central sulcus. In the left hemisphere, affected individuals evinced a larger cortical surface area in the inferior parietal lobule and secondary somatosensory cortex. Although of modest size, these structural correlates of xenomelia appear meaningful when discussed against the background of some key clinical features of the disorder. Thus, the predominantly right-sided cortical abnormalities are in line with a strong bias for left-sided limbs as the target of the amputation desire, evident both in our sample and in previously described populations with xenomelia. We also propose that the higher incidence of lower compared with upper limbs (∼80% according to previous investigations) may explain the erotic connotations typically associated with xenomelia, also in the present sample. These may have their roots in the proximity of primary somatosensory cortex for leg representation, whose surface area was reduced in the participants with xenomelia, with that of the genitals. Alternatively, the spatial adjacency of secondary somatosensory cortex for leg representation and the anterior insula, the latter known to mediate sexual arousal beyond that induced by direct tactile stimulation of the genital area, might play a role. Although the right hemisphere regions of significant neuroarchitectural correlates of xenomelia are part of a network reportedly subserving body ownership, it remains unclear whether the structural alterations are the cause or rather the consequence of the long-standing and pervasive mismatch between body and self