TY - JOUR
T1 - The anatomo-clinical picture of the pathological embodiment over someone else's body part after stroke
AU - Pia, Lorenzo
AU - Fossataro, Carlotta
AU - Burin, Dalila
AU - Bruno, Valentina
AU - Spinazzola, Lucia
AU - Gindri, Patrizia
AU - Fotopoulou, Katerina
AU - Berti, Anna
AU - Garbarini, Francesca
N1 - Funding Information:
This work has been funded by MIUR-SIR 2014 grant ( RBSI146V1D ), a San Paolo Foundation 2016 grant ( CSTO165140 ) to F.G, and by a 2014–2016 Turin University Grant (ex 60%) to L.P.
Funding Information:
This work has been funded by MIUR-SIR 2014 grant (RBSI146V1D), a San Paolo Foundation 2016 grant (CSTO165140) to F.G, and by a 2014?2016 Turin University Grant (ex 60%) to L.P.
Publisher Copyright:
© 2020 Elsevier Ltd
PY - 2020/9
Y1 - 2020/9
N2 - Recently, a monothematic delusion of body ownership due to brain damage (i.e., the embodiment of someone else's body part within the patient's sensorimotor system) has been extensively investigated. Here we aimed at defining in-depth the clinical features and the neural correlates of the delusion. Ninety-six stroke patients in a sub-acute or chronic phase of the illness were assessed with a full ad-hoc protocol to evaluate the embodiment of an alien arm under different conditions. A sub-group of seventy-five hemiplegic patients was also evaluated for the embodiment of the movements of the alien arm. Fifty-five patients were studied to identify the neural bases of the delusion by means of voxel-based lesion-symptom mapping approach. Our results show that, in forty percent of the whole sample, simply viewing the alien arm triggered the delusion, but only if it was a real human arm and that was seen from a 1st person perspective in an anatomically-correct position. In the hemiplegic sub-group, the presence of the embodiment of the alien arm was always accompanied by the embodiment of its passive and active movements. Furthermore, the delusion was significantly associated to primary proprioceptive deficits and to damages of the corona radiata and the superior longitudinal fasciculus. To conclude, we show that the pathological embodiment of an alien arm is well-characterized by recurrent and specific features and might be explained as a disconnection deficit, mainly involving white matter tracts. The proposed exhaustive protocol can be successfully employed to assess stroke-induced disorders of body awareness, unveiling even their more undetectable or covert clinical forms.
AB - Recently, a monothematic delusion of body ownership due to brain damage (i.e., the embodiment of someone else's body part within the patient's sensorimotor system) has been extensively investigated. Here we aimed at defining in-depth the clinical features and the neural correlates of the delusion. Ninety-six stroke patients in a sub-acute or chronic phase of the illness were assessed with a full ad-hoc protocol to evaluate the embodiment of an alien arm under different conditions. A sub-group of seventy-five hemiplegic patients was also evaluated for the embodiment of the movements of the alien arm. Fifty-five patients were studied to identify the neural bases of the delusion by means of voxel-based lesion-symptom mapping approach. Our results show that, in forty percent of the whole sample, simply viewing the alien arm triggered the delusion, but only if it was a real human arm and that was seen from a 1st person perspective in an anatomically-correct position. In the hemiplegic sub-group, the presence of the embodiment of the alien arm was always accompanied by the embodiment of its passive and active movements. Furthermore, the delusion was significantly associated to primary proprioceptive deficits and to damages of the corona radiata and the superior longitudinal fasciculus. To conclude, we show that the pathological embodiment of an alien arm is well-characterized by recurrent and specific features and might be explained as a disconnection deficit, mainly involving white matter tracts. The proposed exhaustive protocol can be successfully employed to assess stroke-induced disorders of body awareness, unveiling even their more undetectable or covert clinical forms.
KW - Bodily self
KW - Body ownership
KW - Brain-damaged patients
KW - Delusional body ownership
KW - Sense of agency
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U2 - 10.1016/j.cortex.2020.05.002
DO - 10.1016/j.cortex.2020.05.002
M3 - Article
C2 - 32679408
AN - SCOPUS:85087741609
VL - 130
SP - 203
EP - 219
JO - Cortex
JF - Cortex
SN - 0010-9452
ER -