BIID A neurological mechanism
Posted: Thu Feb 28, 2013 10:56 am
Some recent research by Peter Brugger and his colleagues at University Hospital Zurich helps to explain the neurological mechanism behind BIID. Their article has been accepted for publication in Brain, and will probably be in print in the next issue. While their clinical sample was 15 males wanting amputation of one or both legs, the article seems to indicate that the most desired amputations would be left lateral (arm or leg) or genitals.
It takes a long time to go from neurological research findings to medical practice, but there may be eventual hope for those with BIID who want their penis and/or testicles removed safely by a surgeon. Its certainly far easier to alter the body than the brain.
Other neuroanatomists have explored the brain mechanisms behind gender dysphoria and Dick Swaab, of the Netherlands Institute for Neuroscience, (among others) has stated that results indicate that the sex of the brain need not be either male or female, but that intersex brains are definitely possible. Eunuch is a distinct possibility for the brain in a brain-body mismatch. If so, then altering the body is, again, certainly easier than trying to modify the brainif it is even possible to modify the sex of the brain. MtF and FtM are already accepted. We just need more work to get Male-to-Eunuch widely accepted as well.
The desire for healthy limb amputation: structural brain correlates and clinical features of xenomelia
Leonie Maria Hilti (http://brain.oxfordjournals.org/search? ... mit=Submit), Jürgen Hänggi (http://brain.oxfordjournals.org/search? ... mit=Submit), Deborah Ann Vitacco (http://brain.oxfordjournals.org/search? ... mit=Submit), Bernd Kraemer (http://brain.oxfordjournals.org/search? ... mit=Submit), Antonella Palla (http://brain.oxfordjournals.org/search? ... mit=Submit), Roger Luechinger (http://brain.oxfordjournals.org/search? ... mit=Submit), Lutz Jäncke (http://brain.oxfordjournals.org/search? ... mit=Submit) and Peter Brugger (http://brain.oxfordjournals.org/search? ... mit=Submit)
Brain
Online: 20 Dec 2012 (not yet in print)
DOI: 10.1093/brain/aws316
ABSTRACT: Xenomelia is the oppressive feeling that one or more limbs of ones body do not belong to ones self. We present the results of a thorough examination of the characteristics of the disorder in 15 males with a strong desire for amputation of one or both legs. The feeling of estrangement had been present since early childhood and was limited to a precisely demarcated part of the leg in all individuals. Neurological status examination and neuropsychological testing were normal in all participants, and psychiatric evaluation ruled out the presence of a psychotic disorder. In 13 individuals and in 13 pair-matched control participants, magnetic resonance imaging was performed, and surface-based morphometry revealed significant group differences in cortical architecture. In the right hemisphere, participants with xenomelia showed reduced cortical thickness in the superior parietal lobule and reduced cortical surface area in the primary and secondary somatosensory cortices, in the inferior parietal lobule, as well as in the anterior insular cortex. A cluster of increased thickness was located in the central sulcus. In the left hemisphere, affected individuals evinced a larger cortical surface area in the inferior parietal lobule and secondary somatosensory cortex. Although of modest size, these structural correlates of xenomelia appear meaningful when discussed against the background of some key clinical features of the disorder. Thus, the predominantly right-sided cortical abnormalities are in line with a strong bias for left-sided limbs as the target of the amputation desire, evident both in our sample and in previously described populations with xenomelia. We also propose that the higher incidence of lower compared with upper limbs (∼80% according to previous investigations) may explain the erotic connotations typically associated with xenomelia, also in the present sample. These may have their roots in the proximity of primary somatosensory cortex for leg representation, whose surface area was reduced in the participants with xenomelia, with that of the genitals. Alternatively, the spatial adjacency of secondary somatosensory cortex for leg representation and the anterior insula, the latter known to mediate sexual arousal beyond that induced by direct tactile stimulation of the genital area, might play a role. Although the right hemisphere regions of significant neuroarchitectural correlates of xenomelia are part of a network reportedly subserving body ownership, it remains unclear whether the structural alterations are the cause or rather the consequence of the long-standing and pervasive mismatch between body and self.
http://brain.oxfordjournals.org/content ... 6.abstract
It takes a long time to go from neurological research findings to medical practice, but there may be eventual hope for those with BIID who want their penis and/or testicles removed safely by a surgeon. Its certainly far easier to alter the body than the brain.
Other neuroanatomists have explored the brain mechanisms behind gender dysphoria and Dick Swaab, of the Netherlands Institute for Neuroscience, (among others) has stated that results indicate that the sex of the brain need not be either male or female, but that intersex brains are definitely possible. Eunuch is a distinct possibility for the brain in a brain-body mismatch. If so, then altering the body is, again, certainly easier than trying to modify the brainif it is even possible to modify the sex of the brain. MtF and FtM are already accepted. We just need more work to get Male-to-Eunuch widely accepted as well.
The desire for healthy limb amputation: structural brain correlates and clinical features of xenomelia
Leonie Maria Hilti (http://brain.oxfordjournals.org/search? ... mit=Submit), Jürgen Hänggi (http://brain.oxfordjournals.org/search? ... mit=Submit), Deborah Ann Vitacco (http://brain.oxfordjournals.org/search? ... mit=Submit), Bernd Kraemer (http://brain.oxfordjournals.org/search? ... mit=Submit), Antonella Palla (http://brain.oxfordjournals.org/search? ... mit=Submit), Roger Luechinger (http://brain.oxfordjournals.org/search? ... mit=Submit), Lutz Jäncke (http://brain.oxfordjournals.org/search? ... mit=Submit) and Peter Brugger (http://brain.oxfordjournals.org/search? ... mit=Submit)
Brain
Online: 20 Dec 2012 (not yet in print)
DOI: 10.1093/brain/aws316
ABSTRACT: Xenomelia is the oppressive feeling that one or more limbs of ones body do not belong to ones self. We present the results of a thorough examination of the characteristics of the disorder in 15 males with a strong desire for amputation of one or both legs. The feeling of estrangement had been present since early childhood and was limited to a precisely demarcated part of the leg in all individuals. Neurological status examination and neuropsychological testing were normal in all participants, and psychiatric evaluation ruled out the presence of a psychotic disorder. In 13 individuals and in 13 pair-matched control participants, magnetic resonance imaging was performed, and surface-based morphometry revealed significant group differences in cortical architecture. In the right hemisphere, participants with xenomelia showed reduced cortical thickness in the superior parietal lobule and reduced cortical surface area in the primary and secondary somatosensory cortices, in the inferior parietal lobule, as well as in the anterior insular cortex. A cluster of increased thickness was located in the central sulcus. In the left hemisphere, affected individuals evinced a larger cortical surface area in the inferior parietal lobule and secondary somatosensory cortex. Although of modest size, these structural correlates of xenomelia appear meaningful when discussed against the background of some key clinical features of the disorder. Thus, the predominantly right-sided cortical abnormalities are in line with a strong bias for left-sided limbs as the target of the amputation desire, evident both in our sample and in previously described populations with xenomelia. We also propose that the higher incidence of lower compared with upper limbs (∼80% according to previous investigations) may explain the erotic connotations typically associated with xenomelia, also in the present sample. These may have their roots in the proximity of primary somatosensory cortex for leg representation, whose surface area was reduced in the participants with xenomelia, with that of the genitals. Alternatively, the spatial adjacency of secondary somatosensory cortex for leg representation and the anterior insula, the latter known to mediate sexual arousal beyond that induced by direct tactile stimulation of the genital area, might play a role. Although the right hemisphere regions of significant neuroarchitectural correlates of xenomelia are part of a network reportedly subserving body ownership, it remains unclear whether the structural alterations are the cause or rather the consequence of the long-standing and pervasive mismatch between body and self.
http://brain.oxfordjournals.org/content ... 6.abstract