Neural underpinnings of body image and body schema disturbances

Abstract The sense of our body is fundamental to human self-consciousness. Many neurological and psychiatric disorders involve atypical corporeal awareness with symptomatology that might be very heterogeneous, affecting various aspects of the bodily self. A common dichotomy divides disorders of the bodily self into disorders affecting predominantly the body schema and disorders predominantly affecting the body image. Yet, increasing evidence suggests that body schema and body image are mutually dependent, making a clear categorization of most disorders difficult. This interdependence is illustrated with examples of a few selected disorders that encompass an atypical sense of the bodily self. A special focus is placed on underlying neural alterations in various body-related brain regions. While body schema-related disorders might rather be linked to a disruption in the integration of multisensory information into a coherent body representation, especially in premotor and posterior parietal areas, body image disturbances, particularly their affective and cognitive aspects, might be linked to a broader network centred around cortical midline structures that are crucially involved in self-referential processes.