I cannot picture it in my mind: acquired aphantasia after autologous stem cell transplantation for multiple myeloma

Bumgardner, Yuan and ChiuApril 2021

Abstract
What This Study Is About
How They Studied It
What They Found
What This Might Mean
One Interesting Detail
Authors
Cite this paper

Abstract

Aphantasia, the loss of mental imagery, is a rare disorder and even more infrequent when acquired. No previous cases have been identified that were caused by transplant-related treatment. We describe a case of acquired aphantasia in a 62-year-old male with refractory IgG kappa multiple myeloma after receiving an autologous stem cell transplant (ASCT) following high-dose melphalan with a complicated hospital admission. The etiology of aphantasia remains unidentified, but we provide viable explanations to include direct effects from ASCT treatment and indirect effects from transplant-related complications.

Our summary in plain words

What This Study Is About

Aphantasia is the inability to visualize in the mind's eye. It can be present from birth or acquired later, which is rarer; earlier acquired cases often followed direct brain damage such as a stroke. This case report describes a man who lost his imagery during a hospital stay for a stem cell transplant, the first case, the authors say, linked to transplant-related treatment.

How They Studied It

A single patient: a 62-year-old man with multiple myeloma (a blood cancer) that had not responded to treatment, admitted for a second autologous stem cell transplant, in which his own stem cells were returned after a high dose of the drug melphalan.

His stay was complicated. On Day 8 he moved to intensive care with fever and no neutrophils (infection-fighting white blood cells); he had a bloodstream infection, a suspected bowel inflammation and, on Day 9, a collapsed lung (pneumothorax).

Imagery was measured with a modified, 16-question Vividness of Visual Imagery Questionnaire (VVIQ), on which 16 is the lowest score, with follow-up at six months.

What They Found

On Day 9 he began to report an "inability to picture things in my head when I close my eyes." When he tried to see a recent meal or mentally practice his golf putts, he saw only blackness. He scored 16 on the VVIQ, and still 16 the day before he went home on Day 20. At six months he reported mild improvement but not recovery, with a score of 23.

What This Might Mean

The authors list possible causes: the transplant process (a study of 29 patients linked this treatment to later concentration and memory problems), changes in gut bacteria from more than five antibiotics, low blood oxygen from the collapsed lung and the infection, and a psychological cause, given his stress. They judge a brain injury from low oxygen most likely, and a reaction to the stem cell preservative DMSO possible but unlikely. The cause remains uncertain: this is one patient, and no fuller work-up, such as brain imaging, was done; they suggest one for future cases.

One Interesting Detail

Three days after the loss, back from intensive care, he said his imagery was improving because he now saw "constantly morphing shapes" when he closed his eyes. Yet his questionnaire score the day before discharge was still the minimum, 16.

This summary was written with AI and may contain errors. Check the original paper.

Authors

Adam L Bumgardner
Internal Medicine and Psychiatry Residency Program, National Capital Consortium, Bethesda, MD, USA
1 paper in the library
Kyle Yuan
F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
1 paper in the library
Alden V Chiu
Hematology-Oncology Service, Walter Reed National Military Medical Center, Bethesda, MD, USA; Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
1 paper in the library

Cite this paper

Bumgardner, A. L., Yuan, K., & Chiu, A. V. (2021). I cannot picture it in my mind: acquired aphantasia after autologous stem cell transplantation for multiple myeloma. Oxford Medical Case Reports, 2021(5). doi:10.1093/omcr/omab019

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Research Oxford Medical Case Reports

I cannot picture it in my mind: acquired aphantasia after autologous stem cell transplantation for multiple myeloma

Bumgardner, Yuan and ChiuApril 2021

Read the paper

Abstract
What This Study Is About
How They Studied It
What They Found
What This Might Mean
One Interesting Detail
Authors
Cite this paper

Abstract

Our summary in plain words

What This Study Is About

How They Studied It

A single patient: a 62-year-old man with multiple myeloma (a blood cancer) that had not responded to treatment, admitted for a second autologous stem cell transplant, in which his own stem cells were returned after a high dose of the drug melphalan.

His stay was complicated. On Day 8 he moved to intensive care with fever and no neutrophils (infection-fighting white blood cells); he had a bloodstream infection, a suspected bowel inflammation and, on Day 9, a collapsed lung (pneumothorax).

Imagery was measured with a modified, 16-question Vividness of Visual Imagery Questionnaire (VVIQ), on which 16 is the lowest score, with follow-up at six months.

What They Found

What This Might Mean

One Interesting Detail

This summary was written with AI and may contain errors. Check the original paper.

Authors

Adam L Bumgardner
Internal Medicine and Psychiatry Residency Program, National Capital Consortium, Bethesda, MD, USA
1 paper in the library
Kyle Yuan
F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
1 paper in the library
Alden V Chiu
Hematology-Oncology Service, Walter Reed National Military Medical Center, Bethesda, MD, USA; Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
1 paper in the library

Cite this paper

Topics

Acquired Aphantasia

Most-cited researchers

Recruit participants for your study

We can help you reach people across the imagery spectrum, from aphantasia to hyperphantasia.

Partner with us

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A short note from our founder, Tom Ebeyer, every other week, plus occasional news and invitations to take part in studies. Change what you get from any email.