Body integrity dysphoria: understanding the rare condition that causes people to amputate their limbs

A patient with a bandaged leg following an amputation

New science is demonstrating how specific parts of the brain may differ from those with the rare but fascinating disorder known as body integrity dysphoria or BID.

Those with BID appear to have healthy body standards, but they cannot shake an insatiable feeling of incompleteness: to be completely themselves, they must remove or amputate a limb or other part of the body.

The condition is believed to be driven by a discrepancy between someone’s mental image of their body image and their real physical self.

One way to explain it physiologically is that in BID, the part of the brain associated with the body image has less functional connectivity with other parts of the brain, according to a she studies published Thursday in Current Biology magazine.
The researchers recruited 16 men who want to remove healthy healthy legs from a support group website for people with BID and compared their brain scans with 16 men without the condition.

Those with BID have less brain connectivity in specific areas

“We show clear associations between a mental state and changes in brain structure and function,” said Peter Brugger, professor of neurology and neuropsychiatry at the University of Zurich.

Those with BID had remarkably different neural architecture in the paracentral lobule, the part of the brain that controls how we feel and interpret feedback from the lower limbs. The area had reduced connectivity to other areas of the brain.

The right upper parietal lobule, an area used to build your total body image, also had reduced connectivity and reduced gray density it matters, it indicates less neuron activities.

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“The feeling that a limb belongs to us depends on the extent to which the sensorimotor limb area is functionally connected to all other brain regions,” said lead study author Gianluca Saetta, a doctoral student at University of Zurich.

Having enough gray matter in the right parietal region of the brain is necessary to create a healthy perception of the body in space.

“Interestingly, we found that the less gray matter in the right parietal region of the brain, the stronger the desire for amputation, and the more BID individuals behaved as if they were amputated,” said Lightning.

The disturbance is rare

There are only about 200 cases of BID recorded in the medical literature, but it should be included in the 11th edition of the International Classification of Diseases (ICD-11), as a “body anxiety disorder or body experience disorder”, the researchers She said. The new revision is set to It takes effect in January 2022.

Brugger first became interested in the disorder after observing similar phenomena in which people have limb sensations that have never fully developed.

“In the case of a woman born without arms and legs, we could demonstrate that arms and legs are still represented in the brain,” said Brugger. “If such a thing is possible – your brain contains the signature of a limb that has never been there – then we thought it might also be possible that a brain misses this signature despite regular physical development.”

At the moment, there is no known cure or treatment, but Saetta has noted that for those who have had amputations “they only regret not having done so before”.

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Yet many do not have the option for amputation, living through hardship.

“Some seek temporary relief by pretending to be an amputee, for example by using crutches or tendons,” he said.

Those with BID usually remain silent and outside of people joining online forums that identify themselves as sick, it was difficult for researchers to have a reading of how many people might have the condition.

“Any estimate of how common BID is requires first of all defining precise diagnostic criteria,” said Brugger. “Our results will be useful for defining these criteria. This, in turn, will help the development of potential rehabilitation treatments.”

He and Brugger hope to find non-surgical ways to treat those with BID, such as transcranial magnetic stimulation or “deep brain stimulation with implanted electrodes”.

Stimulating brain cells has shown success in treatment-resistant depression, activating parts of the brain that have reduced activity, second at the Mayo Clinic.

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