I cannot picture it in my mind: acquired aphantasia after autologous stem cell transplantation for multiple myeloma
DOI: 10.1093/omcr/omab019
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
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.
Authors
- Adam L Bumgardner1
- Kyle Yuan1
- Alden V Chiu1
Overview/Introduction
Aphantasia is a rare condition where a person loses the ability to visualize images in their mind. This condition is even more uncommon when it is acquired rather than present from birth. In a groundbreaking case, researchers have documented the first known instance of acquired aphantasia following a medical procedure. The subject, a 62-year-old man with multiple myeloma, developed this condition after undergoing an autologous stem cell transplant (ASCT) and experiencing a complex hospital stay. The exact cause of his aphantasia remains unclear, but the study explores possible explanations related to his treatment and subsequent complications.
Methodology
The research involved a detailed case study of the patient, who was treated for multiple myeloma with high-dose melphalan followed by ASCT. During his hospital stay, he faced several complications, including infections and a pneumothorax (collapsed lung). The patient reported an inability to visualize images in his mind, which was assessed using the Vividness of Visual Imagery Questionnaire (VVIQ). This tool measures how vividly a person can imagine scenarios, and the patient scored the lowest possible, confirming his aphantasia.
Key Findings
- The patient developed aphantasia shortly after his ASCT, during a period of severe medical complications.
- Despite some subjective improvement, his condition persisted, with only slight improvement over six months.
- The study suggests several potential causes for his aphantasia:
- Hypoxemia: Reduced oxygen levels in the brain due to his medical complications.
- Psychogenic Factors: The stress and psychological impact of his medical condition and treatment.
- Gut Dysbiosis: Changes in gut bacteria due to extensive antibiotic use, potentially affecting brain function.
Implications
This case highlights the need for further research into aphantasia, especially when acquired due to medical treatments. Understanding the potential neurological and psychological impacts of complex medical procedures like ASCT can help improve patient care and outcomes. The findings suggest that healthcare providers should be aware of the possibility of cognitive changes following such treatments and consider monitoring and supporting patients accordingly.
Limitations
The study is limited by its focus on a single case, making it difficult to generalize the findings. The exact cause of the patient's aphantasia remains speculative, as comprehensive neurological evaluations were not conducted. Future research should include more extensive diagnostic tools, such as brain imaging and cerebrospinal fluid analysis, to better understand the underlying mechanisms.
In conclusion, this case sheds light on a rare and intriguing condition, urging the medical community to consider the broader cognitive effects of intensive treatments and the importance of holistic patient care.