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“I Do Not Exist”—Cotard Syndrome in Insular Cortex Atrophy

Published:November 13, 2014DOI:https://doi.org/10.1016/j.biopsych.2014.11.005
      Cotard syndrome is a condition of multiple etiologies involving delusional beliefs that one is dead, dying, or nonexistent or is putrefying with nihilistic thoughts regarding specific body parts or the whole self. Neurobiology of Cotard syndrome is controversial, and hence a peek into it may be very enlightening. We present here a case of dementia, developing severe depression and Cotard syndrome during the course of illness, whose subsequent magnetic resonance imaging (MRI) revealed insular cortex atrophy. We then discuss the possible mechanistic association between the atrophy and symptomatology of nihilism.
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