Lesions Causing Alice in Wonderland Syndrome Map to a Common Brain Network Linking Body and Size Perception

IF 8.1 1区医学 Q1 CLINICAL NEUROLOGY

Annals of Neurology Pub Date : 2024-07-01 DOI:10.1002/ana.27015

Maximilian U. Friedrich MD, Elijah C. Baughan BS, Isaiah Kletenik MD, Ellen Younger MS, Charlie W. Zhao MD, Calvin Howard MD, Michael A. Ferguson PhD, Frederic L.W.V.J. Schaper MD, PhD, Amalie Chen MD, Daniel Zeller MD, Claudia Piervincenzi PhD, Silvia Tommasin PhD, Patrizia Pantano MD, Olaf Blanke MD, PhD, Sashank Prasad MD, Jared A. Nielsen PhD, Michael D. Fox MD, PhD

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引用次数: 0

Abstract

Objective

Alice in Wonderland syndrome (AIWS) profoundly affects human perception of size and scale, particularly regarding one's own body and the environment. Its neuroanatomical basis has remained elusive, partly because brain lesions causing AIWS can occur in different brain regions. Here, we aimed to determine if brain lesions causing AIWS map to a distributed brain network.

Methods

A retrospective case–control study analyzing 37 cases of lesion-induced AIWS identified through systematic literature review was conducted. Using resting-state functional connectome data from 1,000 healthy individuals, the whole-brain connections of each lesion were estimated and contrasted with those from a control dataset comprising 1,073 lesions associated with 25 other neuropsychiatric syndromes. Additionally, connectivity findings from lesion-induced AIWS cases were compared with functional neuroimaging results from 5 non-lesional AIWS cases.

Results

AIWS-associated lesions were located in various brain regions with minimal overlap (≤33%). However, the majority of lesions (≥85%) demonstrated shared connectivity to the right extrastriate body area, known to be selectively activated by viewing body part images, and the inferior parietal cortex, involved in size and scale judgements. This pattern was uniquely characteristic of AIWS when compared with other neuropsychiatric disorders (family-wise error-corrected p < 0.05) and consistent with functional neuroimaging observations in AIWS due to nonlesional causes (median correlation r = 0.56, interquartile range 0.24).

Interpretation

AIWS-related perceptual distortions map to one common brain network, encompassing regions critical for body representation and size-scale processing. These findings lend insight into the neuroanatomical localization of higher-order perceptual functions, and may inform future therapeutic strategies for perceptual disorders. ANN NEUROL 2024;96:662–674

查看原文本刊更多论文

导致爱丽丝梦游仙境综合症的病变映射到连接身体和大小感知的共同脑网络。

目的：爱丽丝梦游仙境综合症（AIWS爱丽丝梦游仙境综合症（AIWS）严重影响人类对大小和尺度的感知，尤其是对自己身体和环境的感知。其神经解剖学基础一直难以捉摸，部分原因是导致爱丽丝梦游仙境综合症的脑损伤可能发生在不同的脑区。在此，我们旨在确定导致AIWS的脑损伤是否映射到一个分布式大脑网络：方法：我们进行了一项回顾性病例对照研究，分析了通过系统性文献回顾发现的37例病变诱发的AIWS病例。利用来自1000名健康人的静息态功能连接组数据，对每个病灶的全脑连接进行了估算，并与来自对照数据集的全脑连接进行了对比，对照数据集由1073个与其他25种神经精神综合征相关的病灶组成。此外，还将病变诱发的 AIWS 病例的连接结果与 5 个非病变 AIWS 病例的功能神经成像结果进行了比较：结果：AIWS相关病变位于不同的脑区，重叠率极低（≤33%）。然而，大多数病变（≥85%）与右侧外侧身体区（已知观看身体部位图像时会选择性激活）和下顶叶皮层（参与尺寸和比例判断）有共同连接。与其他神经精神疾病相比，这种模式是 AIWS 的独特特征（经家族误差校正的 p 解释）：与 AIWS 相关的知觉失真映射到一个共同的大脑网络，其中包括对身体表征和大小尺度处理至关重要的区域。这些发现有助于深入了解高阶知觉功能的神经解剖定位，并为未来知觉障碍的治疗策略提供参考。ann neurol 2024.

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来源期刊

Annals of Neurology 医学-临床神经学

CiteScore

18.00

自引率

1.80%

发文量

270

审稿时长

3-8 weeks

期刊介绍： Annals of Neurology publishes original articles with potential for high impact in understanding the pathogenesis, clinical and laboratory features, diagnosis, treatment, outcomes and science underlying diseases of the human nervous system. Articles should ideally be of broad interest to the academic neurological community rather than solely to subspecialists in a particular field. Studies involving experimental model system, including those in cell and organ cultures and animals, of direct translational relevance to the understanding of neurological disease are also encouraged.

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