Bipolar disorder complicated by selfmutilation: neurofunctional changes demonstrated by Tc99mHMPAO Neuro SPECT

ABSTRACT

We report neurofunctional changes in patients with selfmutilation and bipolar disorder. We compared a sample of 29 patients with selfmutilation and bipolar disorder with a group of 20 patients with bipolar disorder without selfmutilation. Furthermore we had an additional control of 22 patients with Major Depression without selfmutilation. Among the findings in selfmutilation, increased anterior dorsal-ventral thalamic perfusion stands out, this is associated with decreased perfusion in the perilimbic area (areas 24, 32 and 23 of Brodmann). There are multiple reports relating in animals and humans selfmutilation with hypoalgesia, anesthesia and disestesias; an hypothesis can be formulated relating self mutilation phenomena with a dysfunction of thalamus and perilimbic circuits associated with nosoceptive circuits and somato-psychic conscience.