了解使人们想截肢的罕见情况

了解使人们想截肢的罕见情况

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

对某些人来说，人类对整体性的普遍渴望可能只能通过切除的行为来实现。

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.

最新的科学研究表明，大脑的某些特定部位与那些患有罕见的身体完整性障碍(简称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.

以客观的标准来看，有缺陷的人似乎拥有健康的身体，但他们无法摆脱一种永不满足的不完整感:为了实现完整的自我，他们必须切除或切除肢体或身体的其他部分。

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

这种情况被认为是由一个人对自己身体形象的心理描述和实际的身体自我之间的不匹配造成的。

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.

根据周四发表在《当代生物学》杂志上的一项研究，从生理学角度解释这一现象的一种方法是，在BID中，大脑中与身体形象相关的部分与大脑其他部分的功能联系较少。

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.

研究人员从一个支持组织网站上招募了16名有BID的男性志愿者，他们想要切除自己健康的左腿，并将他们的大脑扫描结果与16名没有这种情况的男性进行了比较。

Those with BID have less brain connectivity in specific areas

患有BID的人在特定区域与大脑连接较少

"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.

苏黎世大学神经病学和神经精神病学教授彼得·布鲁格说:“我们发现，精神状态与大脑结构和功能的变化之间存在明显的联系。”

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的人在大脑的副中央小叶有明显不同的神经结构，这部分大脑控制我们如何感觉和解释来自下肢的反馈。这个区域减少了与大脑其他区域的连接。

"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、苏黎世大学博士生吉安卢卡·萨埃塔说：“肢体属于我们的感觉取决于感觉运动肢体区域在多大程度上与所有其他大脑区域的功能联系。”

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

在大脑的右顶叶区域有足够的灰质对于在空间中创造一个健康的身体感知是必要的。

"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，我们发现，大脑右顶叶区域的灰质越少，截肢的欲望就越强烈，而且更多的人表现得好像他们是截肢者，” 萨埃塔说。

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.

据医学文献记载，仅有约200例BID病例，但研究人员表示，这种疾病有望被列入第11版《国际疾病分类》(ICD-11)。新的修订将于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.

布鲁格第一次对这种障碍感兴趣是在观察到一个类似的现象，即人们对四肢的感觉从未完全发展起来。

"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."

布鲁格说：“对于一个天生没有胳膊和腿的女性而言，我们可以证明，胳膊和腿在大脑中仍然有代表性。”如果这样的事情是可能的——你的大脑中有一个从未出现过的肢体的特征——那么我们认为，尽管身体正常发育，大脑也可能缺少这个特征。”

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，还没有一种已知的治疗方法，但是萨埃塔指出，对于那些已经截肢的人来说，他们“只是后悔没有早点做。”

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

然而，许多人没有选择截肢，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.

他说:“有些人假扮成截肢者来寻求暂时的解脱，比如用拐杖或轮椅。”

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，除了那些自认为患有这种疾病的人之外，研究人员很难了解有多少人可能患有这种疾病。

"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."

布鲁格说：“任何对BID有多普遍的估计，首先都需要定义精确的诊断标准。”我们的发现将有助于这些标准的定义。反过来，这将有助于开发潜在的康复治疗。”

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

他和布鲁格希望找到非手术方法来治疗那些患有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.

梅奥诊所称，通过激活大脑中活动减弱的部分，刺激脑细胞在治疗难治性抑郁症方面取得了成功。