A 65-year old woman expressed symptoms of Cotard's Syndrome that was linked to fronto-temporal atrophy and bilateral insular cortex (IC). This means that the patient has loss of neutrons and the connections between them in the frontal/temporal lobes of her brain, and the insular cortex seems to have a relation to the development of Cotard's Syndrome.
The insular cortex plays an important role in interoception, or the conscious awareness of internal sensations. The anterior (AIC) and posterior (PIC) parts of the IC have two different roles in the processing of internal sensations. The AIC supports primary or objective mapping of sensory signals, and the PIC is responsible for subjective access. The AIC is also cloesly connected to the Anterior Cingulate Cortex (ACC) which contains von Economom Neuron (VEN) which is responsible for the conscious experience of selfhood. The connection between the AIC and the VEN means that the AIC is essential to experience body ownership. This means that damage to, or malfunction, of the IC would result in the main symptoms of Cotard's Syndrome as patients dissociate from themselves and believe themselves to be dead.
The insular cortex plays an important role in interoception, or the conscious awareness of internal sensations. The anterior (AIC) and posterior (PIC) parts of the IC have two different roles in the processing of internal sensations. The AIC supports primary or objective mapping of sensory signals, and the PIC is responsible for subjective access. The AIC is also cloesly connected to the Anterior Cingulate Cortex (ACC) which contains von Economom Neuron (VEN) which is responsible for the conscious experience of selfhood. The connection between the AIC and the VEN means that the AIC is essential to experience body ownership. This means that damage to, or malfunction, of the IC would result in the main symptoms of Cotard's Syndrome as patients dissociate from themselves and believe themselves to be dead.
In this particular case of Cotard's Syndrome the patient presented "textbook case" symptoms. The patient expressed depressive symptoms (low mood, lethargy, losing interest in daily activities, hopelessness, worthlessness, suicidal thoughts) and complained about having cancer in her head and abdomen. She stated that her brain is completely rotten due to the cancer, and she showed extreme fears of infecting her family with her "infectious" disease. She believed that not only she was dad, but that her family was also going to die from the disease she gave them. The patient also she failed to recognize her close acquaintances, and she showed significant reduction in her speech output and motor activity.
After testing the patient, doctor's found that she was severely depressed (she scored a 19 on the Hamilton Scale for Depression). After examining the patient's brain the MRI showed fronto-temporal atrophy and bilateral insular cortex.
This patient is a prime example of how the IC plays a role in the development of Cotard's Syndrome as well as the risk factors of age and other illnesses affecting the brain, such as dementia.
After testing the patient, doctor's found that she was severely depressed (she scored a 19 on the Hamilton Scale for Depression). After examining the patient's brain the MRI showed fronto-temporal atrophy and bilateral insular cortex.
This patient is a prime example of how the IC plays a role in the development of Cotard's Syndrome as well as the risk factors of age and other illnesses affecting the brain, such as dementia.
Sources:
Chatterjee, Seshadri Sekhar, and Sayantanava Mitra. "“I Do Not Exist”—Cotard Syndrome in Insular Cortex Atrophy." Biological Psychiatry 77.11 (2015). Researchgate.net. ResearchGate. Web. June 2015.
Chatterjee, Seshadri Sekhar, and Sayantanava Mitra. "“I Do Not Exist”—Cotard Syndrome in Insular Cortex Atrophy." Biological Psychiatry 77.11 (2015). Researchgate.net. ResearchGate. Web. June 2015.