e., comparable to participants from the Down-group in
the asynchronous body condition). The present lesion data from a group of OBE-patients put previous anecdotal data about abnormal self-location INCB018424 research buy and first-person perspective on solid grounds. They also show that the detailed analysis of such clinical neuroanatomical data on self-consciousness translate to functional neuroimaging data on self-consciousness in healthy participants, highlighting collectively the significance of the TPJ as an important brain structure for self-consciousness related to self-location and the first-person perspective (Figure 5C). There are only a few carefully analyzed case studies in neurological patients with OBEs due Selleck Dinaciclib to focal brain damage or electrical brain stimulation. In addition, previous work has associated OBEs with many different brain structures, such as the right and left TPJ (Blanke et al., 2002, Blanke et al., 2004, Brandt et al., 2005 and Maillard et al., 2004), and several structures within the TPJ: posterior superior temporal gyrus (Blanke et al., 2004), angular gyrus (Blanke et al., 2002 and Brandt et al., 2005; Heydrich et al., 2011), and supramarginal gyrus (De Ridder et al., 2007 and Maillard et al., 2004), but also the precuneus (De Ridder
et al., 2007) and fronto-temporal cortex (Devinsky et al., 1989). Here we lateralized and localized brain damage in OBE-patients to the right TPJ. The right TPJ is the classical lesion site and side associated with visuo-spatial neglect (Halligan et al., 2003 and Karnath et al., 2001), a clinical condition shown to disturb the patient’s egocentric spatial relationship with extrapersonal space, visuo-spatial perspective taking (Farrell and Robertson, 2000), and own body perception such Phosphoprotein phosphatase as somatoparaphrenia (Vallar and Ronchi, 2009). A bilateral, but right lateralized, implication of the TPJ has also been observed during egocentric visuo-spatial
perspective taking (Maguire et al., 1998 and Ruby and Decety, 2001), multisensory integration, as well as imagined changes in self-location (Arzy et al., 2006, Blanke et al., 2005 and Schwabe et al., 2009) in healthy subjects. Despite the present strongly right-lateralized lesion data, our fMRI data reveal that self-location and first-person perspective likely depends on cortical processing in both TPJs. One of our patients suffered from OBEs due to left TPJ involvement. It may thus be that OBEs following interference with the left TPJ may be less reported by patients, potentially due to interference with the language cortex at the left TPJ. More data in larger patient samples in patients with OBEs will be necessary to clarify this. The TPJ is an excellent candidate for self-consciousness.
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