A critical review of congenital phantom limb cases and a developmental theory for the basis of body image

Price, Elfed Huw

doi:10.1016/j.concog.2005.07.003

Cited by 61 publications

(31 citation statements)

References 30 publications

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“…With respect to this laterality issue, we note the surprisingly low interest by embryologists, teratologists and developmental neuroscientist in this issue and plead for a closer collaboration across the different medical and psychological disciplines. Fetal determination of congenital phantom limbs is also considered in the four-component theory introduced by Price (2006). This thoughtful theory offers an alternative to the genetic hardwiring of body form by delineating the importance of prenatal and postnatal factors, the incorporation of prostheses, and visual factors related to the observation of other people moving their limbs.…”

Section: Phantoms Of Congenitally Absent Limbs As Manifestations Of Amentioning

confidence: 99%

Incarnation and animation: physical versus representational deficits of body integrity

Hilti

Brugger

2009

Exp Brain Res

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Hilti, L; Brugger, P (2010). Incarnation and animation: physical versus representational deficits of body integrity. Experimental Brain Research, 204(3) AbstractTwo apparently disparate phenomena of defective body integrity are reviewed. The first concerns dysmelia, characterized by the congenital absence or deformation of limbs, and the focus of the review is on phantom sensations of people with this kind of physical integrity disorder. The second phenomenon consists of non-psychotic individuals' desire to have a healthy limb amputated, which is interpreted as a mismatch between the physical integrity of a particular limb and its representation in multimodal cortical areas of the brain. We outlined commonalities and differences between the two conditions and note the absence, in both areas of research, of a unified theory that would account for the reported phenomenology. Phantom limbs in dysmelia and the desire for limb amputation most likely are the consequence of very early developmental dissociations between physical and phenomenal body shapes. They are mirror images of one another in that the former constitutes an "animation without incarnation" and, the latter, an "incarnation without animation". Keywords-body integrity identity disorder (BIID) -paraphilias -parietal lobes -body image, body schema -borderlands of psychiatry and neurology 2 This paper examines two apparently disparate phenomena of corporeal awareness. In both, the completeness or integrity of one's own body is hampered. The first is the occurrence of phantom limbs in individuals born with an "incomplete" body, in which the physical body is incomplete, but the missing limb seems to be represented in the subject's brain, at least as can be inferred from its phenomenal presence. The second phenomenon is the strong desire, by non-psychotic and otherwise well-adjusted healthy individuals, to have a fully functional limb removed. In this condition, it can be argued that despite the physical presence of a limb, the lack of acceptance is due to some underrepresentation in the subject's brain. We review the literature on both conditions and propose that phantom sensations of physically absent limbs and the request for removal of normally developed extremities may be mirror images of one another on the conceptual level: an animation without incarnation and an incarnation without animation, respectively.

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Section: Phantoms Of Congenitally Absent Limbs As Manifestations Of Amentioning

confidence: 99%

Incarnation and animation: physical versus representational deficits of body integrity

Hilti

Brugger

2009

Exp Brain Res

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“…One theory presented by Price (2006) takes different prenatal and postnatal factors into account, including muscle activity and sensory and proprioceptive feedback in utero, visual experience of observing intact limb movements in other persons, and prosthesis usage in early life. Based on Berlucchi and Aglioti (1997), Giummarra et al (2007) noted that "the brain may be genetically predisposed to represent a prototypical human body, regardless of the correspondence or lack thereof between the ideal model and the actual body".…”

Section: Introductionmentioning

confidence: 99%

The functional architecture of the human body: assessing body representation by sorting body parts and activities

2010

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The functional architecture of the human body: assessing body representation by sorting body parts and activitiesBläsing, B; Schack, T; Brugger, P Bläsing, B; Brugger, P (2010 The functional architecture of the human body: assessing body representation by sorting body parts and activities. Abstract We investigated mental representations of body parts and body-related activities in two subjects with congenitally absent limbs (one with, the other without phantom sensations), a wheelchair sports group of paraplegic participants, and two groups of participants with intact limbs. To analyse mental representation structures, we applied Structure Dimensional Analysis. Verbal labels indicating body parts and related activities were presented in randomized lists that had to be sorted according to a hierarchical splitting paradigm. Participants were required to group the items according to whether or not they were considered related, based on their own body perception. Results of the groups of physically intact and paraplegic participants revealed separate clusters for the lower body, upper body, Wngers and head. The participant with congenital phantom limbs also showed a clear separation between upper and lower body (but not between Wngers and hands). In the participant without phantom sensations of the absent arms, no such modularity emerged, but the speciWc practice of his right foot in communication and daily routines was reXected. Sorting verbal labels of body parts and activities appears a useful method to assess body representation in individuals with special body anatomy or function and leads to conclusions largely compatible with other assessment procedures.2

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“…We readily admit that the present findings cannot directly elucidate the mechanisms that lead to the emergence of phantoms of congenitally absent limbs. As long as not more persons born with hand amelia and phantom sensations will be available, the field will probably remain plagued with speculations (Price, 2006; see also footnote 1).…”

mentioning

confidence: 99%

Mental rotation of congenitally absent hands

Funk

Brugger

2007

J Int Neuropsychol Soc

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We compared motor imagery performance of normally limbed individuals with that of individuals with one or both hands missing since birth (i.e., hand amelia). To this aim, 14 unilaterally and 2 bilaterally amelic participants performed a task requiring the classification of hands depicted in different degrees of rotation as either a left or a right hand. On the same task, 24 normally limbed participants recapitulated previously reported effects; that is, that the hand motor dominance and, more generally, a lifelong use of hands are important determinants of left-right decisions. Unilaterally amelic participants responded slower to hands corresponding to their absent, compared with their existing, hand. Moreover, left and right hand amelic participants showed prolonged reaction times to hands (whether left or right) depicted in unnatural orientations compared with natural orientations. Among the bilateral amelics, the individual with phantom sensations, but not the one without, showed similar differentiation. These findings demonstrate that the visual recognition of a hand never physically developed is prolonged, but still modulated by different rotation angles. They are further compatible with the view that phantom limbs in hand amelia may constrain motor imagery as much as do amputation phantoms. (JINS, 2008, 14, 81-89.)

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A critical review of congenital phantom limb cases and a developmental theory for the basis of body image

Cited by 61 publications

References 30 publications

Incarnation and animation: physical versus representational deficits of body integrity

Incarnation and animation: physical versus representational deficits of body integrity

The functional architecture of the human body: assessing body representation by sorting body parts and activities

Mental rotation of congenitally absent hands

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