Some patients experience skin sensations of infestation and contamination that are elusive to proximate
dermatological explanation. We undertook a functional magnetic resonance imaging study of the brain
to demonstrate, for the first time, that central processing of infestation-relevant stimuli is altered in
patients with such abnormal skin sensations. We show differences in neural activity within amygdala,
insula, middle temporal lobe and frontal cortices. Patients also demonstrated altered measures of selfrepresentation,
with poorer sensitivity to internal bodily (interoceptive) signals and greater susceptibility
to take on an illusion of body ownership: the rubber hand illusion. Together, these findings highlight a
potential model for the maintenance of abnormal skin sensations, encompassing heightened threat
processing within amygdala, increased salience of skin representations within insula and compromised
prefrontal capacity for self-regulation and appraisal.
Some patients experience skin sensations of infestation and contamination that are elusive to proximatedermatological explanation. We undertook a functional magnetic resonance imaging study of the brainto demonstrate, for the first time, that central processing of infestation-relevant stimuli is altered inpatients with such abnormal skin sensations. We show differences in neural activity within amygdala,insula, middle temporal lobe and frontal cortices. Patients also demonstrated altered measures of selfrepresentation,with poorer sensitivity to internal bodily (interoceptive) signals and greater susceptibilityto take on an illusion of body ownership: the rubber hand illusion. Together, these findings highlight apotential model for the maintenance of abnormal skin sensations, encompassing heightened threatprocessing within amygdala, increased salience of skin representations within insula and compromisedprefrontal capacity for self-regulation and appraisal.
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