The Desire for Amputation or Paralyzation: Evidence for Structural Brain Anomalies in Body Integrity Identity Disorder (BIID).
BACKGROUND
Body Integrity Identity Disorder (BIID) is a condition in which individuals perceive a mismatch between their internal body scheme and physical body shape, resulting in an absolute desire to be either amputated or paralyzed. The condition is hypothesized to be of congenital nature, but evidence for a neuro-anatomical basis is sparse.


METHODS
We collected T1-weighted structural magnetic resonance imaging scans on a 3T scanner in eight individuals with BIID and 24 matched healthy controls, and analyzed the data using voxel-based morphometry.


RESULTS
The results showed reduced grey matter volume in the left dorsal and ventral premotor cortices and larger grey matter volume in the cerebellum (lobule VIIa) in individuals with BIID compared to controls.


CONCLUSIONS
The premotor cortex and cerebellum are thought to be crucial for the experience of body-ownership and the integration of multisensory information. Our results suggest that BIID is associated with structural brain anomalies and might result from a dysfunction in the integration of multisensory information, leading to the feeling of disunity between the mental and physical body shape.
Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Rianne M
http://orcid.org/0000-0002-9070-5025
RM
Blom
Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|Brain Imaging Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Guido A
GA
van Wingen
Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Sija J
SJ
van der Wal
Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|Brain Imaging Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Judy
J
Luigjes
Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY, United States of America.
Milenna T
MT
van Dijk
Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.
H Steven
HS
Scholte
Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|Brain Imaging Center, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands.
Damiaan
D
Denys
D000328:Adult; D000671:Amputation, Surgical; D057215:Body Dysmorphic Disorders / Q000209:etiology* / Q000473:pathology; D001828:Body Image; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping / Q000379:methods; D002531:Cerebellum / Q000473:pathology; D005260:Female; D066128:Gray Matter / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009044:Motor Cortex / Q000473:pathology; D010243:Paralysis / Q000209:etiology / Q000473:pathology; D010296:Parietal Lobe / Q000473:pathology