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在美读书笔记之二：诱发幻象影子人的启示
人工诱发幻像影子人
（在美一方据《自然》杂志原文摘述， 并说明如下：
1． 由于摘述者对原文中一些医学名词的中文说法不甚熟悉 ，若有疑问，请以原文为准，或请教医学中文比较好的专家；
2． 此摘述并非逐字句的翻译，部分小标题为摘述者所加；
3． 原文附后。“实验方法和结果简述”之4和5取自原文的补充材料。由于补充材料是PDF格式，在此并未一起给出。
4． 有需原文、插图、和补充材料并且不能自行从《自然》下载的坛友，请通过乡哥向本人索取。）
摘要：对人脑左半球一个部位的刺激激发了一种有人在身边的奇怪感觉。
关于身边无人却感到有人在身边的这种奇怪感觉的现象在精神病人、神经科病人和健康人中都有报道，但是目前人们尚不了解这种幻觉是如何由大脑激发的。作者在本文中报道了对一例病人用电刺激大脑左侧颞顶结反复诱发这种幻觉的实验。实验中所诱发的幻象人紧随病人自身体位和姿态的变化而改变。这些（对虚无幻象的）感知可能是来源于对大脑颞顶结部位信息处理过程的干扰，大脑颞顶结部位的这种信息处理是多感受器对身体和自我的感知。
实验方法和结果简述：
在一位22岁的女病人大脑上述部位植入了多个硬膜下电极。
1． 病人取卧位，电刺激电流强度10.0~11.1mA。44次电刺激均可重复诱发幻象人感觉。病人感到有人在她身后，她描述到此人年轻且性别不明。而且此“影子人”不说话也不动，正好位于她背部下方，并采取和她一样的体位；
2． 病人取坐位，双臂环抱膝盖，11.0mA，1次电刺激。病人感到“那人”现在也坐着，还用双臂箍着她，让她感觉不舒服；
3． 病人取坐位，右手拿卡片做命名任务（语言测试），11.0mA，2次电刺激。病人感到“那人”现在坐在她右后方，并试图干扰她完成（语言测试）任务。她描述到：“他要拿走那卡片”、“他不让我读（卡片）”；
4． 病人取右侧卧位，11.0mA，1次电刺激。病人感到“那人”现在也是右侧卧位，“用和我一样的体位，（躺）在和我一样的地方”；
5． 病人取左侧卧位，11.0mA，1次电刺激。病人说到“有人触摸我右侧大腿”。当被问到她是否知道是谁在触摸她时，她说“也许是那同一个人，但这更模糊”。此体位的实验在第二天又重复了若干次。
作者评论：
由于幻象影子人可以被刺激大脑颞顶结部位而反复诱发，又由于诱发的幻象人紧密地跟随病人的体位和姿势，作者认为这例病人是在感知她自己的身体。电刺激分裂了大脑颞顶结部位的多感受器和/或感知运动的功能（或处理过程），由此在体外近处诱发出了一个对自己身体的幻象。作者发现，尽管他们的病人注意到了幻象人和她本人在体位和姿态上的相似性，她并未发现那其实是对她自己身体的幻象。
摘述者体会：
对大脑特定部位的电刺激可以重复性地诱发人体对自身的幻象，在本文报道的实验中，被刺激者并未察觉她感知到的其实是她自己。那么可以推知，对大脑这个或其它部位的电或其它形式的刺激，比如压力（脑压异常）、化学（血气或血药变化）等等，有很大的可能会诱发出诸如濒死体验(NDE- Near death experience)和出体体验(OBE-out of body experience) 之类的幻象。
http://web.wenxuecity.com/BBSView.php?SubID=religion&MsgID=269994
Brief Communications
Nature 443, 287(21 September 2006) | doi:10.1038/443287a; Received 19 July 2006; Accepted 25 August 2006; Published online 20 September 2006
Induction of an illusory shadow person
Shahar Arzy1,3, Margitta Seeck2,3, Stephanie Ortigue3,4, Laurent Spinelli2 and Olaf Blanke1,3
Abstract
Stimulation of a site on the brain's left hemisphere prompts the creepy feeling that somebody is close by.
The strange sensation that somebody is nearby when no one is actually present has been described by psychiatric and neurological patients, as well as by healthy subjects, but it is not understood how the illusion is triggered by the brain1, 2. Here we describe the repeated induction of this sensation in a patient who was undergoing presurgical evaluation for epilepsy treatment, as a result of focal electrical stimulation of the left temporoparietal junction: the illusory person closely 'shadowed' changes in the patient's body position and posture. These perceptions may have been due to a disturbance in the multisensory processing of body and self at the temporoparietal junction.
The patient was a 22-year-old woman of normal psychiatric history who was undergoing evaluation for surgical treatment of epilepsy (see supplementary information). We identified an area on the left temporoparietal junction in her brain (Fig. 1a) where focal electrical stimulation repeatedly produced a feeling of the presence of another person in her extrapersonal space.
Figure 1: Me and my shadow.
a, Three-dimensional surface reconstruction of the left hemisphere of the brain from magnetic resonance imaging. Subdural electrodes were implanted in the brain of an epileptic patient undergoing presurgical evaluation10. The locations at which focal electrical stimulation evoked different responses are shown (red, motor; blue, somatosensory; green, language; pink, site where 'feeling of a presence' could be induced (arrow)); stars indicate the epileptic focus. Since undergoing a left-temporal lobectomy, the patient has been free of seizures. b–d, Drawings showing relative positions and postures of the patient's body (white) and that of the illusory person (shaded) during cortical stimulation (illustrations, M. Boyer).
High resolution image and legend (20K)
When stimulated at this region (for methods, see supplementary information; current amplitude, 10.0 mA) in a supine position, the patient had the impression that somebody was behind her. Further stimulation (10.0–11.0 mA; n = 43) induced the same experience, with the patient describing the "person" as young and of indeterminate sex, a "shadow" who did not speak or move, and whose position beneath her back was identical to her own ("He is behind me, almost at my body, but I do not feel it"; Fig. 1b).
During the next stimulation (11.0 mA; n = 1), the patient sat and embraced her knees with her arms (Fig. 1c). She noted that the "man" was now also sitting and that he was clasping her in his arms, which she described as an unpleasant feeling. Further stimulations (11.0 mA; n = 2) were applied while the seated patient performed a naming (language-testing) task using a card held in her right hand (Fig. 1d): she again reported the presence of the sitting "person", this time displaced behind her to her right and attempting to interfere with the execution of her task ("He wants to take the card"; "He doesn't want me to read"). Similar effects were observed for different positions and postures (see supplementary information) when stimuli exceeding 10 mA were applied to the same site on the left temporoparietal junction.
The sensation of a presence, as reported by this patient, has been described in people with psychiatric and neurological disorders1, 2, 3, 4. Because it was possible to induce this feeling repeatedly from the temporoparietal junction, and because the illusory person closely mimicked the patient's body posture and position, we conclude that the patient was experiencing a perception of her own body1, 4.
The temporoparietal junction is known to be involved in self-processing, self–other distinction, the integration of multisensory body-related information, and other illusory own-body perceptions5, 6. We therefore propose that electrical stimulation of this area in our patient disturbed multisensory (proprioceptive and tactile) and sensorimotor integration of information with respect to her body, leading to the appearance of a first-rank schneiderian symptom of schizophrenia in a person with no psychiatric history. It is notable that hyperactivity in the temporoparietal cortex of patients with schizophrenia may lead to the misattribution of their own actions to other people7.
In conclusion, we argue that multisensory and/or sensorimotor disintegration8 at the temporoparietal junction due to electrical stimulation may lead to an own-body illusion of another person in near extrapersonal space. Although our patient was aware of the similarity between her own postural and positional features and those of the illusory person, she did not recognize that that person was an illusion of her own body, like many deluded schizophrenic patients3, 8, 9. Our findings may be a step towards understanding the mechanisms behind psychiatric manifestations such as paranoia, persecution and alien control. They also highlight the importance of multimodal mechanisms at the temporoparietal junction in human self-attribution.
Competing interests statement:
The authors declared no competing interests.
Supplementary information accompanies this paper.
References
2. Brugger, P. , Regard, M. & Landis, T. Neuropsychiatr. Neuropsychol. Behav. Neurol. 9, 114–122 (1996).
3. Critchley, M. Acta Psychiatr. Neurol. Scand. 30, 155–168 (1955). | PubMed | ChemPort |
4. Jaspers, K. General Psychopathology (Manchester Univ. Press, Manchester, 1972).
5. Blanke, O. , Ortigue, S. , Coeytaux, A. , Martory, M. D. & Landis, T. Neurocase 9, 329–339 (2003). | Article | PubMed |
6. Blanke, O. , Landis, T. , Spinelli, L. & Seeck, M. Brain 127, 243–258 (2004). | Article | PubMed |
7. Ruby, P. & Decety, J. Nature Neurosci. 4, 546–550 (2001).http://www.nature.com.ezproxy.galter.northwestern.edu/neuro/journal/v4/n5/abs/nn0501_546.html
8. Farrer, C. et al. Psychiatr. Res. 131, 31–44 (2004).
9. Blakemore, S.-J. , Wolpert, D. M. & Frith, C. D. Trends Cogn. Sci. 6, 237–242 (2002). | Article | PubMed | ISI |
10. Thompson, C. Br. J. Psychiatr. 141, 628–630 (1982). | ChemPort |
11. Blanke, O. , Perrig, S. , Thut, G. , Landis, T. & Seeck, M. J. Neurol. Neurosurg. Psychiatr. 69, 553–556 (2000). | Article | PubMed | ISI | ChemPort |
1. Laboratory of Cognitive Neuroscience, École Polytechnique Fédérale de Lausanne, Lausanne 1015, Switzerland
2. Presurgical Epilepsy Evaluation Unit, University Hospital, Geneva 1211, Switzerland
3. Department of Neurology, University Hospital, Geneva 1211, Switzerland
4. Center for Cognitive Neuroscience, Dartmouth College, Dartmouth, New Hampshire 03755, USA
Correspondence to: Olaf Blanke1,3 Email: olaf.blanke@epfl.ch
人工诱发幻像影子人
（在美一方据《自然》杂志原文摘述， 并说明如下：
1． 由于摘述者对原文中一些医学名词的中文说法不甚熟悉 ，若有疑问，请以原文为准，或请教医学中文比较好的专家；
2． 此摘述并非逐字句的翻译，部分小标题为摘述者所加；
3． 原文附后。“实验方法和结果简述”之4和5取自原文的补充材料。由于补充材料是PDF格式，在此并未一起给出。
4． 有需原文、插图、和补充材料并且不能自行从《自然》下载的坛友，请通过乡哥向本人索取。）
摘要：对人脑左半球一个部位的刺激激发了一种有人在身边的奇怪感觉。
关于身边无人却感到有人在身边的这种奇怪感觉的现象在精神病人、神经科病人和健康人中都有报道，但是目前人们尚不了解这种幻觉是如何由大脑激发的。作者在本文中报道了对一例病人用电刺激大脑左侧颞顶结反复诱发这种幻觉的实验。实验中所诱发的幻象人紧随病人自身体位和姿态的变化而改变。这些（对虚无幻象的）感知可能是来源于对大脑颞顶结部位信息处理过程的干扰，大脑颞顶结部位的这种信息处理是多感受器对身体和自我的感知。
实验方法和结果简述：
在一位22岁的女病人大脑上述部位植入了多个硬膜下电极。
1． 病人取卧位，电刺激电流强度10.0~11.1mA。44次电刺激均可重复诱发幻象人感觉。病人感到有人在她身后，她描述到此人年轻且性别不明。而且此“影子人”不说话也不动，正好位于她背部下方，并采取和她一样的体位；
2． 病人取坐位，双臂环抱膝盖，11.0mA，1次电刺激。病人感到“那人”现在也坐着，还用双臂箍着她，让她感觉不舒服；
3． 病人取坐位，右手拿卡片做命名任务（语言测试），11.0mA，2次电刺激。病人感到“那人”现在坐在她右后方，并试图干扰她完成（语言测试）任务。她描述到：“他要拿走那卡片”、“他不让我读（卡片）”；
4． 病人取右侧卧位，11.0mA，1次电刺激。病人感到“那人”现在也是右侧卧位，“用和我一样的体位，（躺）在和我一样的地方”；
5． 病人取左侧卧位，11.0mA，1次电刺激。病人说到“有人触摸我右侧大腿”。当被问到她是否知道是谁在触摸她时，她说“也许是那同一个人，但这更模糊”。此体位的实验在第二天又重复了若干次。
作者评论：
由于幻象影子人可以被刺激大脑颞顶结部位而反复诱发，又由于诱发的幻象人紧密地跟随病人的体位和姿势，作者认为这例病人是在感知她自己的身体。电刺激分裂了大脑颞顶结部位的多感受器和/或感知运动的功能（或处理过程），由此在体外近处诱发出了一个对自己身体的幻象。作者发现，尽管他们的病人注意到了幻象人和她本人在体位和姿态上的相似性，她并未发现那其实是对她自己身体的幻象。
摘述者体会：
对大脑特定部位的电刺激可以重复性地诱发人体对自身的幻象，在本文报道的实验中，被刺激者并未察觉她感知到的其实是她自己。那么可以推知，对大脑这个或其它部位的电或其它形式的刺激，比如压力（脑压异常）、化学（血气或血药变化）等等，有很大的可能会诱发出诸如濒死体验(NDE- Near death experience)和出体体验(OBE-out of body experience) 之类的幻象。
http://web.wenxuecity.com/BBSView.php?SubID=religion&MsgID=269994
Brief Communications
Nature 443, 287(21 September 2006) | doi:10.1038/443287a; Received 19 July 2006; Accepted 25 August 2006; Published online 20 September 2006
Induction of an illusory shadow person
Shahar Arzy1,3, Margitta Seeck2,3, Stephanie Ortigue3,4, Laurent Spinelli2 and Olaf Blanke1,3
Abstract
Stimulation of a site on the brain's left hemisphere prompts the creepy feeling that somebody is close by.
The strange sensation that somebody is nearby when no one is actually present has been described by psychiatric and neurological patients, as well as by healthy subjects, but it is not understood how the illusion is triggered by the brain1, 2. Here we describe the repeated induction of this sensation in a patient who was undergoing presurgical evaluation for epilepsy treatment, as a result of focal electrical stimulation of the left temporoparietal junction: the illusory person closely 'shadowed' changes in the patient's body position and posture. These perceptions may have been due to a disturbance in the multisensory processing of body and self at the temporoparietal junction.
The patient was a 22-year-old woman of normal psychiatric history who was undergoing evaluation for surgical treatment of epilepsy (see supplementary information). We identified an area on the left temporoparietal junction in her brain (Fig. 1a) where focal electrical stimulation repeatedly produced a feeling of the presence of another person in her extrapersonal space.
Figure 1: Me and my shadow.
a, Three-dimensional surface reconstruction of the left hemisphere of the brain from magnetic resonance imaging. Subdural electrodes were implanted in the brain of an epileptic patient undergoing presurgical evaluation10. The locations at which focal electrical stimulation evoked different responses are shown (red, motor; blue, somatosensory; green, language; pink, site where 'feeling of a presence' could be induced (arrow)); stars indicate the epileptic focus. Since undergoing a left-temporal lobectomy, the patient has been free of seizures. b–d, Drawings showing relative positions and postures of the patient's body (white) and that of the illusory person (shaded) during cortical stimulation (illustrations, M. Boyer).
High resolution image and legend (20K)
When stimulated at this region (for methods, see supplementary information; current amplitude, 10.0 mA) in a supine position, the patient had the impression that somebody was behind her. Further stimulation (10.0–11.0 mA; n = 43) induced the same experience, with the patient describing the "person" as young and of indeterminate sex, a "shadow" who did not speak or move, and whose position beneath her back was identical to her own ("He is behind me, almost at my body, but I do not feel it"; Fig. 1b).
During the next stimulation (11.0 mA; n = 1), the patient sat and embraced her knees with her arms (Fig. 1c). She noted that the "man" was now also sitting and that he was clasping her in his arms, which she described as an unpleasant feeling. Further stimulations (11.0 mA; n = 2) were applied while the seated patient performed a naming (language-testing) task using a card held in her right hand (Fig. 1d): she again reported the presence of the sitting "person", this time displaced behind her to her right and attempting to interfere with the execution of her task ("He wants to take the card"; "He doesn't want me to read"). Similar effects were observed for different positions and postures (see supplementary information) when stimuli exceeding 10 mA were applied to the same site on the left temporoparietal junction.
The sensation of a presence, as reported by this patient, has been described in people with psychiatric and neurological disorders1, 2, 3, 4. Because it was possible to induce this feeling repeatedly from the temporoparietal junction, and because the illusory person closely mimicked the patient's body posture and position, we conclude that the patient was experiencing a perception of her own body1, 4.
The temporoparietal junction is known to be involved in self-processing, self–other distinction, the integration of multisensory body-related information, and other illusory own-body perceptions5, 6. We therefore propose that electrical stimulation of this area in our patient disturbed multisensory (proprioceptive and tactile) and sensorimotor integration of information with respect to her body, leading to the appearance of a first-rank schneiderian symptom of schizophrenia in a person with no psychiatric history. It is notable that hyperactivity in the temporoparietal cortex of patients with schizophrenia may lead to the misattribution of their own actions to other people7.
In conclusion, we argue that multisensory and/or sensorimotor disintegration8 at the temporoparietal junction due to electrical stimulation may lead to an own-body illusion of another person in near extrapersonal space. Although our patient was aware of the similarity between her own postural and positional features and those of the illusory person, she did not recognize that that person was an illusion of her own body, like many deluded schizophrenic patients3, 8, 9. Our findings may be a step towards understanding the mechanisms behind psychiatric manifestations such as paranoia, persecution and alien control. They also highlight the importance of multimodal mechanisms at the temporoparietal junction in human self-attribution.
Competing interests statement:
The authors declared no competing interests.
Supplementary information accompanies this paper.
References
2. Brugger, P. , Regard, M. & Landis, T. Neuropsychiatr. Neuropsychol. Behav. Neurol. 9, 114–122 (1996).
3. Critchley, M. Acta Psychiatr. Neurol. Scand. 30, 155–168 (1955). | PubMed | ChemPort |
4. Jaspers, K. General Psychopathology (Manchester Univ. Press, Manchester, 1972).
5. Blanke, O. , Ortigue, S. , Coeytaux, A. , Martory, M. D. & Landis, T. Neurocase 9, 329–339 (2003). | Article | PubMed |
6. Blanke, O. , Landis, T. , Spinelli, L. & Seeck, M. Brain 127, 243–258 (2004). | Article | PubMed |
7. Ruby, P. & Decety, J. Nature Neurosci. 4, 546–550 (2001).http://www.nature.com.ezproxy.galter.northwestern.edu/neuro/journal/v4/n5/abs/nn0501_546.html
8. Farrer, C. et al. Psychiatr. Res. 131, 31–44 (2004).
9. Blakemore, S.-J. , Wolpert, D. M. & Frith, C. D. Trends Cogn. Sci. 6, 237–242 (2002). | Article | PubMed | ISI |
10. Thompson, C. Br. J. Psychiatr. 141, 628–630 (1982). | ChemPort |
11. Blanke, O. , Perrig, S. , Thut, G. , Landis, T. & Seeck, M. J. Neurol. Neurosurg. Psychiatr. 69, 553–556 (2000). | Article | PubMed | ISI | ChemPort |
1. Laboratory of Cognitive Neuroscience, École Polytechnique Fédérale de Lausanne, Lausanne 1015, Switzerland
2. Presurgical Epilepsy Evaluation Unit, University Hospital, Geneva 1211, Switzerland
3. Department of Neurology, University Hospital, Geneva 1211, Switzerland
4. Center for Cognitive Neuroscience, Dartmouth College, Dartmouth, New Hampshire 03755, USA
Correspondence to: Olaf Blanke1,3 Email: olaf.blanke@epfl.ch
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