了解使人們想截肢的罕見情況

了解使人們想截肢的罕見情況

For some, the universal human desire for wholeness mayonly be fulfilled by an act of excision.

對某些人來說，人類對整體性的普遍渴望可能只能通過切除的行為來實(shí)現(xiàn)。

New science is showing how specific parts of the brain may differ in those with the rare disorder known as body integrity dysphoria, or BID.

最新的科學(xué)研究表明，大腦的某些特定部位與那些患有罕見的身體完整性障礙(簡稱BID)的人有何不同。

Those with BID appear by objective standards to have healthy bodies, but they cannot shake an insatiable feeling of incompleteness: In order to be their full selves, they must remove or amputate a limb or other body part.

以客觀的標(biāo)準(zhǔn)來看，有缺陷的人似乎擁有健康的身體，但他們無法擺脫一種永不滿足的不完整感:為了實(shí)現(xiàn)完整的自我，他們必須切除或切除肢體或身體的其他部分。

The condition is believed to be driven by a mismatch between someone's mental picture of their body image and their actual physical self.

這種情況被認(rèn)為是由一個人對自己身體形象的心理描述和實(shí)際的身體自我之間的不匹配造成的。

One way to explain it physiologically is that in BID, the part of the brain associated with body image has less functional connectivity with other parts of the brain, according to a studypublished Thursday in the journal Current Biology.

根據(jù)周四發(fā)表在《當(dāng)代生物學(xué)》雜志上的一項(xiàng)研究，從生理學(xué)角度解釋這一現(xiàn)象的一種方法是，在BID中，大腦中與身體形象相關(guān)的部分與大腦其他部分的功能聯(lián)系較少。

Researchers recruited 16 men who want to remove their healthy left legs from a support group website for people with BID and compared scans of their brains to 16 men without the condition.

研究人員從一個支持組織網(wǎng)站上招募了16名有BID的男性志愿者，他們想要切除自己健康的左腿，并將他們的大腦掃描結(jié)果與16名沒有這種情況的男性進(jìn)行了比較。

Those with BID have less brain connectivity in specific areas

患有BID的人在特定區(qū)域與大腦連接較少

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

蘇黎世大學(xué)神經(jīng)病學(xué)和神經(jīng)精神病學(xué)教授彼得·布魯格說:“我們發(fā)現(xiàn)，精神狀態(tài)與大腦結(jié)構(gòu)和功能的變化之間存在明顯的聯(lián)系。”

Those with BID had noticeably 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.

患有BID的人在大腦的副中央小葉有明顯不同的神經(jīng)結(jié)構(gòu)，這部分大腦控制我們?nèi)绾胃杏X和解釋來自下肢的反饋。這個區(qū)域減少了與大腦其他區(qū)域的連接。

"The feeling that a limb belongs to us relies on the extent to which the sensorimotor limb area is functionally connected to all the other brain regions," said the study's main author Gianluca Saetta, a doctoral student at the University of Zurich.

研究的主要作者、蘇黎世大學(xué)博士生吉安盧卡·薩埃塔說：“肢體屬于我們的感覺取決于感覺運(yùn)動肢體區(qū)域在多大程度上與所有其他大腦區(qū)域的功能聯(lián)系。”

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

在大腦的右頂葉區(qū)域有足夠的灰質(zhì)對于在空間中創(chuàng)造一個健康的身體感知是必要的。

"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 acted as if they were amputees," Saetta said.

“有趣的是，我們發(fā)現(xiàn)，大腦右頂葉區(qū)域的灰質(zhì)越少，截肢的欲望就越強(qiáng)烈，而且更多的人表現(xiàn)得好像他們是截肢者，” 薩埃塔說。

There are only about 200 cases of BID recorded in the medical literature, but it's expected to be included in the 11th edition of the International Classification of Diseases (ICD-11), the researchers said.The new revision is set to take effect in January 2022.

據(jù)醫(yī)學(xué)文獻(xiàn)記載，僅有約200例BID病例，但研究人員表示，這種疾病有望被列入第11版《國際疾病分類》(ICD-11)。新的修訂將于2022年1月生效。

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

布魯格第一次對這種障礙感興趣是在觀察到一個類似的現(xiàn)象，即人們對四肢的感覺從未完全發(fā)展起來。

"In the case of a woman born without arms and legs, we could show that arms and legs are nevertheless represented in the brain," Brugger said. "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 may lack this signature despite regular physical development."

布魯格說：“對于一個天生沒有胳膊和腿的女性而言，我們可以證明，胳膊和腿在大腦中仍然有代表性。”如果這樣的事情是可能的——你的大腦中有一個從未出現(xiàn)過的肢體的特征——那么我們認(rèn)為，盡管身體正常發(fā)育，大腦也可能缺少這個特征。”

At the moment, there isn't a known cure or treatment, but Saetta noted that for those who did achieve amputations, they "only regret to not have it done sooner."

目前，還沒有一種已知的治療方法，但是薩埃塔指出，對于那些已經(jīng)截肢的人來說，他們“只是后悔沒有早點(diǎn)做。”

Yet many don't have the option for amputation, living through the discomfort.

然而，許多人沒有選擇截肢，只能忍受痛苦。

"Some seek transient relief in pretending to be an amputee, for instance by using crutches or wheelchairs," he said.

他說:“有些人假扮成截肢者來尋求暫時的解脫，比如用拐杖或輪椅。”

Those with BID commonly stay silent, and outside of people who join online forums self-identifying as sufferers, it's been difficult for researchers to get a read on how many people may have the condition.

那些有BID的人通常保持沉默，除了那些自認(rèn)為患有這種疾病的人之外，研究人員很難了解有多少人可能患有這種疾病。

"Any estimation of how common BID is, first requires the definition of precise diagnostic criteria," Brugger said. "Our findings will be helpful for the definition of these criteria. This will, in turn, assist the development of potential rehabilitative treatments."

布魯格說：“任何對BID有多普遍的估計(jì)，首先都需要定義精確的診斷標(biāo)準(zhǔn)。”我們的發(fā)現(xiàn)將有助于這些標(biāo)準(zhǔn)的定義。反過來，這將有助于開發(fā)潛在的康復(fù)治療。”

He and Brugger hopeto find non-surgical ways to treat those with BID.

他和布魯格希望找到非手術(shù)方法來治療那些患有BID的人。

Stimulating brain cells has shown success in treatment-resistant depression, by activating parts of the brain that have diminished activity, according to the Mayo Clinic.

梅奧診所稱，通過激活大腦中活動減弱的部分，刺激腦細(xì)胞在治療難治性抑郁癥方面取得了成功。