Aphantasia presenting as Cotard’s syndrome
Abstract
Aphantasia is defined as the absence or marked reduction of conscious, wakeful imagery. Most of the people with aphantasia live normal lives with intact attention, memory, and intelligence. We are presenting a case of acquired aphantasia presenting as Cotard’s syndrome. A 55-year-old woman presented with a long-standing complaint that she had lost her mind. Formal testing showed absence of visual and sensory imagery and poor theory of mind skills. MRI brain showed subcortical and deep cerebral white matter lesions in the bilateral frontal and parietal lobes. This patient raises the question of how a person subjectively knows that he or she has a mind. And how the clinician can understand whether a person is having a subjective experience of mind-the philosophical problem of other minds.
Authors
- Rajith Ravindren1
- Ratheesh S R1
- Prasad Thotton Veedu1
What This Study Is About
How They Studied It
What They Found
- Mental Gymnastics: She couldn't do "mental rotation"—like trying to imagine the letter 'b' flipping over to become a 'd' in her mind.
- Dreaming vs. Waking: Surprisingly, she still had vivid dreams! This suggests her brain could still create images automatically while she slept, even if she couldn't do it on purpose while awake.
- Brain Scars: The MRI showed small areas of damage in the front and middle parts of her brain, which act like the "control centers" for thinking and attention.