Measuring the sense of self in brain-damaged patients

Hiromitsu, Kentaro; Asai, Tomohisa; Saito, Shoko; Shigemune, Yayoi; Hamamoto, Kanako; Shinoura, Nobusada; Yamada, Ryoji; Midorikawa, Akira

doi:10.1097/md.0000000000012156

Cited by 5 publications

(2 citation statements)

References 36 publications

(52 reference statements)

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“…It also appears to be specifically related to both interoceptive and exteroceptive perception, including sense of self-location and direction (Guterstam et al, 2015), and altered states of bodily awareness, such as body illusions . A case study found that a tumor in the PCC was associated with symptoms consistent with depersonalization (Hiromitsu et al, 2020) and similarly, stimulation of the region has been associated with the perception of limb movement when at rest (Popa et al, 2019). The isthmus is adjacent and posterior to the PCC; it connects the PCC to the parahippocampal gyrus.…”

Section: Discussionmentioning

confidence: 99%

Neurobiological and genetic correlates of the dissociative subtype of posttraumatic stress disorder.

Wolf¹,

Hawn²,

Sullivan³

et al. 2023

Journal of Psychopathology and Clinical Sci

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Approximately 10%–30% of individuals with posttraumatic stress disorder (PTSD) exhibit a dissociative subtype of the condition defined by symptoms of depersonalization and derealization. This study examined the psychometric evidence for the dissociative subtype of PTSD in a sample of young, primarily male post-9/11-era Veterans (n = 374 at baseline and n = 163 at follow-up) and evaluated its biological correlates with respect to resting state functional connectivity (default mode network [DMN]; n = 275), brain morphology (hippocampal subfield volume and cortical thickness; n = 280), neurocognitive functioning (n = 337), and genetic variation (n = 193). Multivariate analyses of PTSD and dissociation items suggested a class structure was superior to dimensional and hybrid ones, with 7.5% of the sample comprising the dissociative class; this group showed stability over 1.5 years. Covarying for age, sex, and PTSD severity, linear regression models revealed that derealization/depersonalization severity was associated with: decreased DMN connectivity between bilateral posterior cingulate cortex and right isthmus (p = .015; adjusted-p [padj] = .097); increased bilateral whole hippocampal, hippocampal head, and molecular layer head volume (p = .010–.034; padj = .032–.053); worse self-monitoring (p = .018; padj = .079); and a candidate genetic variant (rs263232) in the adenylyl cyclase 8 gene (p = .026), previously associated with dissociation. Results converged on biological structures and systems implicated in sensory integration, the neural representation of spatial awareness, and stress-related spatial learning and memory, suggesting possible mechanisms underlying the dissociative subtype of PTSD.

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Section: Discussionmentioning

confidence: 99%

Neurobiological and genetic correlates of the dissociative subtype of posttraumatic stress disorder.

Wolf¹,

Hawn²,

Sullivan³

et al. 2023

Journal of Psychopathology and Clinical Sci

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“…Awake craniotomies for meningioma resection may not only maximize the safety of the resection but also result in earlier patient recovery, a reduced length of the hospital stay, ands well as costs (Bakhshi et al, 2021). Shinoura et al routinely use awake surgery not only for meningiomas compressing cranial nerves (Shinoura et al, 2019) but also in cases with perilolandic tumors and describe a beneficial effect of this technique in terms of less postoperative deficits (Shinoura et al, 2013). Chakravarthi et al (2021) routinely incorporate 3D tractography during surgery of anterior skull base meningiomas.…”

Section: Surgery Of Meningiomas With Cns Invasionmentioning

confidence: 99%

Meningiomas with CNS invasion

2023

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CNS invasion has been included as an independent criterion for the diagnosis of a high-grade (WHO and CNS grade 2 and 3) meningioma in the 2016 and more recently in the 2021 WHO classification. However, the prognostic role of brain invasion has recently been questioned. Also, surgical treatment for brain invasive meningiomas may pose specific challenges. We conducted a systematic review of the 2016–2022 literature on brain invasive meningiomas in Pubmed, Scopus, Web of Science and the Cochrane Library. The prognostic relevance of brain invasion as a stand-alone criterion is still unclear. Additional and larger studies using robust definitions of histological brain invasion and addressing the issue of sampling errors are clearly warranted. Although the necessity of molecular profiling in meningioma grading, prognostication and decision making in the future is obvious, specific markers for brain invasion are lacking for the time being. Advanced neuroimaging may predict CNS invasion preoperatively. The extent of resection (e.g., the Simpson grading) is an important predictor of tumor recurrence especially in higher grade meningiomas, but also – although likely to a lesser degree – in benign tumors, and therefore also in brain invasive meningiomas with and without other histological features of atypia or malignancy. Hence, surgery for brain invasive meningiomas should follow the principles of maximal but safe resections. There are some data to suggest that safety and functional outcomes in such cases may benefit from the armamentarium of surgical adjuncts commonly used for surgery of eloquent gliomas such as intraoperative monitoring, awake craniotomy, DTI tractography and further advanced intraoperative brain tumor visualization.

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