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Claire_C · 10-20-2007, 09:25 PM

Kaitlin your sincere interest in learning more has me back for one last post.

There is another document that you might find very interesting:

Can vestibular caloric stimulation be used to trea...[Med Hypotheses. 2007] - PubMed Result

Can vestibular caloric stimulation be used to treat apotemnophilia?

Ramachandran VS, McGeoch P.

Center for brain and cognition, UCSD, La Jolla, CA 9209, United States.

Apotemnophilia, or body integrity image disorder (BIID), is characterised by a feeling of mismatch between the internal feeling of how one's body should be and the physical reality of how it actually is. Patients with this condition have an often overwhelming desire for an amputation- of a specific limb at a specific level. Such patients are not psychotic or delusional, however, they do express an inexplicable emotional abhorrence to the limb they wish removed. It is also known that such patients show a left-sided preponderance for their desired amputation. Often they take drastic action to be rid of the offending limb. Given the left-sided bias, emotional rejection and specificity of desired amputation, we suggest that there are clear similarities to be drawn between BIID and somatoparaphrenia. In this rare condition, which follows a right parietal stroke, the patient rejects (usually) his left arm as "alien". We go on to hypothesis that a dysfunction of the right parietal lobe is also the cause of BIID. We suggest that this leads to an uncoupling of the construct of one's body image in the right parietal lobe from how one's body physically is. This hypothesis would be amenable to testing by response to cold-water vestibular caloric stimulation, which is known to temporarily treat somatoparaphrenia. It could also be investigated using functional brain imaging and skin conductance response. If correct our hypothesis not only suggests why BIID arises, but also, in caloric stimulation a therapeutic avenue for this chronic and essentially untreatable condition.

PMID: 17292561 [PubMed - indexed for MEDLINE]

A couple notes on this. First, Ramachandran is one of the foremost neurologists in the world. He has written books (see the great reviews for his work at Amazon.com) and hosted BBC radio shows on the subject. Google his name and you'll find all kinds of ground-breaking research that he has conducted.

Secondly, I actually participated in this study. They examined me and performed tests on me and it was their opinion that my kind of BIID is essentially the same condition as the more common desire for amputation. The vestibular caloric stimulation did seem to work for about 24 hours. That made sense because VCS works for about 24 hours on people with somatoparaphrenia as well. But I was sick for much of those 24 hours and so it's not really a viable treatment option and I'm not terribly sure that I wasn't simply distracted by the nausea. But it's a starting point and we'll hopefully know more about it once they have a lot of data to compare.

(Note that Ramachandran changed the second I of BIID from Identity to Image - he believes it's a question of body image)

Here is my blog entry on my trip to see Ramachandran and McGeoch:

Vestibular Caloric Stimulation » transabled.org » Blogging about BIID

Thanks Kaitlin for your sincere interest.

10-20-2007, 09:25 PM	#68 (permalink)
Claire_C Registered User Join Date: Oct 2007 Posts: 8	Kaitlin your sincere interest in learning more has me back for one last post. There is another document that you might find very interesting: Can vestibular caloric stimulation be used to trea...[Med Hypotheses. 2007] - PubMed Result Can vestibular caloric stimulation be used to treat apotemnophilia? Ramachandran VS, McGeoch P. Center for brain and cognition, UCSD, La Jolla, CA 9209, United States. Apotemnophilia, or body integrity image disorder (BIID), is characterised by a feeling of mismatch between the internal feeling of how one's body should be and the physical reality of how it actually is. Patients with this condition have an often overwhelming desire for an amputation- of a specific limb at a specific level. Such patients are not psychotic or delusional, however, they do express an inexplicable emotional abhorrence to the limb they wish removed. It is also known that such patients show a left-sided preponderance for their desired amputation. Often they take drastic action to be rid of the offending limb. Given the left-sided bias, emotional rejection and specificity of desired amputation, we suggest that there are clear similarities to be drawn between BIID and somatoparaphrenia. In this rare condition, which follows a right parietal stroke, the patient rejects (usually) his left arm as "alien". We go on to hypothesis that a dysfunction of the right parietal lobe is also the cause of BIID. We suggest that this leads to an uncoupling of the construct of one's body image in the right parietal lobe from how one's body physically is. This hypothesis would be amenable to testing by response to cold-water vestibular caloric stimulation, which is known to temporarily treat somatoparaphrenia. It could also be investigated using functional brain imaging and skin conductance response. If correct our hypothesis not only suggests why BIID arises, but also, in caloric stimulation a therapeutic avenue for this chronic and essentially untreatable condition. PMID: 17292561 [PubMed - indexed for MEDLINE] A couple notes on this. First, Ramachandran is one of the foremost neurologists in the world. He has written books (see the great reviews for his work at Amazon.com) and hosted BBC radio shows on the subject. Google his name and you'll find all kinds of ground-breaking research that he has conducted. Secondly, I actually participated in this study. They examined me and performed tests on me and it was their opinion that my kind of BIID is essentially the same condition as the more common desire for amputation. The vestibular caloric stimulation did seem to work for about 24 hours. That made sense because VCS works for about 24 hours on people with somatoparaphrenia as well. But I was sick for much of those 24 hours and so it's not really a viable treatment option and I'm not terribly sure that I wasn't simply distracted by the nausea. But it's a starting point and we'll hopefully know more about it once they have a lot of data to compare. (Note that Ramachandran changed the second I of BIID from Identity to Image - he believes it's a question of body image) Here is my blog entry on my trip to see Ramachandran and McGeoch: Vestibular Caloric Stimulation » transabled.org » Blogging about BIID Thanks Kaitlin for your sincere interest.