Loss of the sense of self-ownership for perceptions of objects in a case of right inferior temporal, parieto-occipital and precentral hypometabolism.

Abstract

Philosophers define the 'minimal self' as the immediate awareness of being the agent and owner of one's actions and perceptions. Here, we describe a patient with a selective loss of one part of this 'minimal self', namely the immediate sense of self-ownership for perceptions of objects. In contrast, his sense of self-ownership for body perceptions and for self-agency during actions remained intact. 18-Fluorodeoxyglucose positron emission tomography revealed predominantly right inferior temporal hypometabolism in comparison with healthy controls (parahippocampal and fusiform gyri). In addition, dysfunction of the right parieto-occipital junction and precentral cortex were detected. Taken together, we demonstrate selective changes in the quality of the sense of self-ownership for perceptions of objects but not actions and an intact sense of self-agency, which points to anatomically separable systems underpinning different aspects of the 'minimal self'. The associated hypometabolism in inferior temporal, parieto-occipital and motor regions, but not in medial prefrontal areas most consistently associated with self-referential processing, are most parsimoniously explained when self-consciousness is not assumed to be an anatomically localized cognitive function, but instead is conceived as emerging from integration across anatomically distributed networks of regions with different functional specializations, not all of which need to be special for the 'self'.