Out-of-body experience, heautoscopy, and autoscopic hallucination of neurological origin

Autoscopic phenomena: case report and review of literature

BACKGROUND

Autoscopic phenomena are psychic illusory visual experiences consisting of the perception of the image of one's own body or face within space, either from an internal point of view, as in a mirror or from an external point of view. Descriptions based on phenomenological criteria distinguish six types of autoscopic experiences: autoscopic hallucination, he-autoscopy or heautoscopic proper, feeling of a presence, out of body experience, negative and inner forms of autoscopy.

METHODS AND RESULTS

We report a case of a patient with he-autoscopic seizures. EEG recordings during the autoscopic experience showed a right parietal epileptic focus. This finding confirms the involvement of the temporo-parietal junction in the abnormal body perception during autoscopic phenomena. We discuss and review previous literature on the topic, as different localization of cortical areas are reported suggesting that out of body experience is generated in the right hemisphere while he-autoscopy involves left hemisphere structures.

How to integrate dreaming into a general theory of consciousness--a critical review of existing positions and suggestions for future research

In this paper, we address the different ways in which dream research can contribute to interdisciplinary consciousness research. As a second global state of consciousness aside from wakefulness, dreaming is an important contrast condition for theories of waking consciousness. However, programmatic suggestions for integrating dreaming into broader theories of consciousness, for instance by regarding dreams as a model system of standard or pathological wake states, have not yielded straightforward results. We review existing proposals for using dreaming as a model system, taking into account concerns about the concept of modeling and the adequacy and practical feasibility of dreaming as a model system. We conclude that existing modeling approaches are premature and rely on controversial background assumptions. Instead, we suggest that contrastive analysis of dreaming and wakefulness presents a more promising strategy for integrating dreaming into a broader research context and solving many of the problems involved in the modeling approach.

Abnormal self-location and vestibular vertigo in a patient with right frontal lobe epilepsy

We describe the case of a 33-year-old man with complex partial seizures characterized by the feeling of being projected outside his body, including dissociation of "mind and self from body" (disembodiment), followed by vestibular vertigo due to right frontal lobe epilepsy caused by an oligodendroglioma. We distinguish the patient's ictal symptoms with respect to autoscopic phenomena (out-of-body experience, heautoscopy, autoscopic hallucinations) and vestibular phenomena of epileptic origin, and we discuss their neural origin with respect to vestibular and multisensory cortical mechanisms of bodily self-consciousness in temporoparietal and frontal cortex.

Where are your body parts? A pure case of heterotopagnosia following left parietal stroke

We studied the involvement of the parietal cortex in interpersonal body representation in a left parietal stroke patient. We used tasks assessing different types of body representations and localization of object parts. The patient performed normally on all tasks of body knowledge. However, she was unable to locate body parts on another person or on body representations. In contrast, she pointed correctly to the same body parts on herself or object representations. The data support the important role of the left parietal cortex in the transformation of intrinsic spatial coding of body parts localization in extrinsic body part coordinates.

The timing of temporoparietal and frontal activations during mental own body transformations from different visuospatial perspectives

The perspective from where the world is perceived is an important aspect of the bodily self and may break down in neurological conditions such as out-of-body experiences (OBEs). These striking disturbances are characterized by disembodiment, an external perspective and have been observed after temporoparietal damage. Using mental own body imagery, recent neuroimaging work has linked perspectival changes to the temporoparietal cortex. Because the disembodied perspective during OBEs is elevated in the majority of cases, we tested whether an elevated perspective will interfere with such temporoparietal mechanisms mental own body imagery. We designed stimuli of life-sized humans rotated around the vertical axis and rendered as if viewed from three different perspectives: elevated, lowered, and normal. Reaction times (RTs) in an own body transformation task, but not the control condition, were dependent on the rotation angle. Furthermore, RTs were shorter for the elevated as compared with the normal or lowered perspective. Using high-density EEG and evoked potential (EP) mapping, we found a bilateral temporoparietal and frontal activation at approximately 330-420 ms after stimulus onset that was dependent on the rotation angle, but not on the perspective. This activation was also found in response-locked EPs. In the time period approximately 210-330 ms we found a temporally distinct posterior temporal activation with its duration being dependent on the perspective, but not the rotation angle. Collectively, the present findings suggest that temporoparietal and frontal as well as posterior temporal activations and their timing are crucial neuronal correlates of the bodily self as studied by mental imagery.

The body in the brain revisited

Corporeal awareness is a difficult concept which refers to perception, knowledge and evaluation of one's own body as well as of other bodies. We discuss here some controversies regarding the significance of the concepts of body schema and body image, as variously entertained by different authors, for the understanding of corporeal awareness, and consider some newly proposed alternatives. We describe some recent discoveries of cortical areas specialized for the processing of bodily forms and bodily actions, as revealed by neuroimaging, neurophysiological, and lesion studies. We further describe new empirical and theoretical evidence for the importance of interoception, in addition to exteroception and proprioception, for corporeal awareness, and discuss how itch, a typical interoceptive input, has been wrongly excluded from the classic concept of the proprioceptive-tactile body schema. Finally, we consider the role of the insular cortex as the terminal cortical station of interoception and other bodily signals, along with Craig's proposal that the human insular cortex sets our species apart from other species by supporting consciousness of the body and the self. We conclude that corporeal awareness depends on the spatiotemporally distributed activity of many bodies in the brain, none of which is isomorphic with the actual body.

Keeping in touch with one's self: multisensory mechanisms of self-consciousness

BACKGROUND

The spatial unity between self and body can be disrupted by employing conflicting visual-somatosensory bodily input, thereby bringing neurological observations on bodily self-consciousness under scientific scrutiny. Here we designed a novel paradigm linking the study of bodily self-consciousness to the spatial representation of visuo-tactile stimuli by measuring crossmodal congruency effects (CCEs) for the full body.

METHODOLOGY/PRINCIPAL FINDINGS

We measured full body CCEs by attaching four vibrator-light pairs to the trunks (backs) of subjects who viewed their bodies from behind via a camera and a head mounted display (HMD). Subjects made speeded elevation (up/down) judgments of the tactile stimuli while ignoring light stimuli. To modulate self-identification for the seen body subjects were stroked on their backs with a stick and the felt stroking was either synchronous or asynchronous with the stroking that could be seen via the HMD. We found that (1) tactile stimuli were mislocalized towards the seen body (2) CCEs were modulated systematically during visual-somatosensory conflict when subjects viewed their body but not when they viewed a body-sized object, i.e. CCEs were larger during synchronous than during asynchronous stroking of the body and (3) these changes in the mapping of tactile stimuli were induced in the same experimental condition in which predictable changes in bodily self-consciousness occurred.

CONCLUSIONS/SIGNIFICANCE

These data reveal that systematic alterations in the mapping of tactile stimuli occur in a full body illusion and thus establish CCE magnitude as an online performance proxy for subjective changes in global bodily self-consciousness.

Walking on a line: a motor paradigm using rotation and reflection symmetry to study mental body transformations

Researchers have recently reintroduced the own-body in the center of the social interaction theory. From the discovery of the mirror neurons in the ventral premotor cortex of the monkey's brain, a human embodied model of interindividual relationship based on simulation processes has been advanced, according to which we tend to embody spontaneously the other individuals' behavior when interacting. Although the neurocognitive mechanisms of the embodiment process have started being described, the mechanisms of self-location during embodiment are still less known. Here, we designed a motor paradigm which allows investigating in ecologically more valid conditions whether we embody another person's intransitive action with an embodied or disembodied self-location. Accordingly, we propose a phenomenological model of self-other interaction showing how perspective-taking mechanisms may relate on mental body transformation and offering a promising way to investigate the different sorts of intersubjectivity.

The vestibular component in out-of-body experiences: a computational approach

Neurological evidence suggests that disturbed vestibular processing may play a key role in triggering out-of-body experiences (OBEs). Little is known about the brain mechanisms during such pathological conditions, despite recent experimental evidence that the scientific study of such experiences may facilitate the development of neurobiological models of a crucial aspect of self-consciousness: embodied self-location. Here we apply Bayesian modeling to vestibular processing and show that OBEs and the reported illusory changes of self-location and translation can be explained as the result of a mislead Bayesian inference, in the sense that ambiguous bottom-up signals from the vestibular otholiths in the supine body position are integrated with a top-down prior for the upright body position, which we measure during natural head movements. Our findings have relevance for self-location and translation under normal conditions and suggest novel ways to induce and study experimentally both aspects of bodily self-consciousness in healthy subjects.

The transliminal brain at rest: baseline EEG, unusual experiences, and access to unconscious mental activity

Transliminality reflects individual differences in the threshold at which unconscious processes or external stimuli enter into consciousness. Individuals high in transliminality possess characteristics such as magical ideation, belief in the paranormal, and creative personality traits, and also report the occurrence of manic/mystic experiences. The goal of the present research was to determine if resting brain activity differs for individuals high versus low in transliminality. We compared baseline EEG recordings (eyes-closed) between individuals high versus low in transliminality, assessed using The Revised Transliminality Scale of Lange et al. (2000). Identifying reliable differences at rest between high- and low-transliminality individuals would support a predisposition for transliminality-related traits. Individuals high in transliminality exhibited lower alpha, beta, and gamma power than individuals low in transliminality over left posterior association cortex and lower high alpha, low beta, and gamma power over the right superior temporal region. In contrast, when compared to individuals low in transliminality, individuals high in transliminality exhibited greater gamma power over the frontal-midline region. These results are consistent with prior research reporting reductions in left temporal/parietal activity, as well as the desynchronization of right temporal activity in schizotypy and related schizophrenia spectrum disorders. Further, differences between high- and low-transliminality groups extend existing theories linking altered hemispheric asymmetries in brain activity to a predisposition toward schizophrenia, paranormal beliefs, and unusual experiences.

Visualizing out-of-body experience in the brain

An out-of-body experience was repeatedly elicited during stimulation of the posterior part of the superior temporal gyrus on the right side in a patient in whom electrodes had been implanted to suppress tinnitus. Positron-emission tomographic scanning showed brain activation at the temporoparietal junction--more specifically, at the angular-supramarginal gyrus junction and the superior temporal gyrus-sulcus on the right side. Activation was also noted at the right precuneus and posterior thalamus, extending into the superior vermis. We suggest that activation of these regions is the neural correlate of the disembodiment that is part of the out-of-body experience.

Video ergo sum: manipulating bodily self-consciousness

Humans normally experience the conscious self as localized within their bodily borders. This spatial unity may break down in certain neurological conditions such as out-of-body experiences, leading to a striking disturbance of bodily self-consciousness. On the basis of these clinical data, we designed an experiment that uses conflicting visual-somatosensory input in virtual reality to disrupt the spatial unity between the self and the body. We found that during multisensory conflict, participants felt as if a virtual body seen in front of them was their own body and mislocalized themselves toward the virtual body, to a position outside their bodily borders. Our results indicate that spatial unity and bodily self-consciousness can be studied experimentally and are based on multisensory and cognitive processing of bodily information.

Duration and not strength of activation in temporo-parietal cortex positively correlates with schizotypy

Impaired self- and own body processing in patients with schizophrenia and individuals along the schizophrenia spectrum have been associated with dysfunctional cortical activation at the temporo-parietal junction. Here we investigated whether strength or duration of temporo-parietal junction activation during an own body processing task correlates with level of abnormal self-processing in healthy subjects as measured by the frequency of spontaneously experienced schizotypal body schema alterations (perceptual aberrations) and dissociative experiences. Participants carried out a mental imagery task with respect to their own body. Behavioral data and high density EEG were measured. EEG data were analyzed using evoked potential mapping and electrical neuroimaging. Participants completed two validated self-report questionnaires, one asking about perceptual aberration and one about dissociative experiences. The own body transformation task activated the right temporo-parietal junction at 310-390 ms. Participants' reaction times and duration of activation at the right temporo-parietal junction, but not its strength, were found to correlate positively with perceptual aberration scores. No relationship was found with dissociative experiences scores. Brain activations proceeding and following activation of the right temporo-parietal junction did not correlate with scores on either scale. The positive correlation between performance and right temporo-parietal activation in an own body transformation task with perceptual aberrations scores in our healthy population suggests that disturbances in self- and body processing in individuals along the schizophrenia spectrum might be due to prolonged, rather than stronger activation of the right temporo-parietal junction. We argue that this might reflect local pathology, pathologies in cortico-cortical connections and/or re-entry of top-down processing.

Mental representation of space: Insights from an oblique distribution of hallucinations

Three-dimensional spatial distributions of hypnagogic and hypnopompic hallucinations associated with sleep paralysis were used to investigate the internal representation of space. Left-right asymmetries in human preferences and abilities are well established. Parallel effects are also observed as lower-upper asymmetries. These parallels could reflect common underlying mechanisms or additive effects of independently evolved horizontal and vertical asymmetries. This study adds to the growing literature on multidimensional spatial biases in a context free from the influence of task-related factors. We present evidence of an oblique bias in the projection of both sensory and motor hallucinations toward lower-left and especially upper-right external space exceeding that accounted for by an additive model of separate horizontal and vertical biases. These observations are consistent with theories regarding a systematic functional relation of hemispheric with ventral and dorsal cerebral organization.

Dynamic updating of distributed neural representations using forward models

In this paper, we present a continuous attractor network model that we hypothesize will give some suggestion of the mechanisms underlying several neural processes such as velocity tuning to visual stimulus, sensory discrimination, sensorimotor transformations, motor control, motor imagery, and imitation. All of these processes share the fundamental characteristic of having to deal with the dynamic integration of motor and sensory variables in order to achieve accurate sensory prediction and/or discrimination. Such principles have already been described in the literature by other high-level modeling studies (Decety and Sommerville in Trends Cogn Sci 7:527-533, 2003; Oztop et al. in Neural Netw 19(3):254-271, 2006; Wolpert et al. in Philos Trans R Soc 358:593-602, 2003). With respect to these studies, our work is more concerned with biologically plausible neural dynamics at a population level. Indeed, we show that a relatively simple extension of the classical neural field models can endow these networks with additional dynamic properties for updating their internal representation using external commands. Moreover, an analysis of the interactions between our model and external inputs also shows interesting properties, which we argue are relevant for a better understanding of the neural processes of the brain.

A case of illusory own-body perceptions after transcranial magnetic stimulation of the cerebellum

Illusory own-body perceptions are 'body in space' misinterpretations of the brain and belong to the class of out-of-body experiences wherein the angular gyrus seems importantly implicated. In the present study additional cerebellum involvement in illusory own-body perceptions was investigated in a healthy young female right-handed volunteer. Transcranial magnetic stimulation (TMS) was applied over the cerebellum. Placebo cerebellum TMS and occipital TMS served as control conditions. Illusory own-body perceptions accompanied by electric brain activity over the somatosensory cortex were only observed after cerebellum TMS. The data provide the first evidence that the cerebellum might be involved in a neuronal network underlying illusory own-body perceptions.

Neural basis of embodiment: distinct contributions of temporoparietal junction and extrastriate body area

Embodiment, the sense of being localized within one's physical body, is a fundamental aspect of the self. Recently, researchers have started to show that self and body processing require distinct brain mechanisms, suggesting two posterior brain regions as key loci: the temporoparietal junction (TPJ), which is involved in self processing and multisensory integration of body-related information; and the extrastriate body area (EBA), which responds selectively to human bodies and body parts. Here we used evoked potential mapping and a distributed linear inverse solution to show that activations in EBA and TPJ code differentially for embodiment and self location, because the location and timing of brain activation depended on whether mental imagery is performed with mentally embodied (EBA) or disembodied (TPJ) self location. In a second experiment, we showed that only EBA activation, related to embodied self location, but not TPJ activation, related to disembodied self location, was modified by the subjects' body position during task performance (supine or sitting). This suggests that embodied self location and actual body location share neural mechanisms. Collectively, these data show that distributed brain activity at the EBA and TPJ as well as their timing are crucial for the coding of the self as embodied and as spatially situated within the human body.

Perceptual aberrations impair mental own-body transformations

Dysfunctional self and bodily processing have been reported from the schizophrenia spectrum. Here, the authors tested 72 students (40 women) to determine whether performance in a mental own-body transformation task relates to self-rated frequency of spontaneously experienced schizotypal body schema alterations (perceptual aberration). Participants provided speeded left-right decisions concerning the body of a visually depicted human figure (front view vs. back view). For men, reaction times to disembodied perspectives increased with increasing scores on a validated perceptual aberration scale. This finding constitutes behavioral evidence for the clinically postulated association between aberrant bodily experiences during everyday life and aberrant processing in a mental own-body transformation task arguably reflecting mild dysfunction at the temporo-parietal junction.

Functional and Neural Mechanisms of Embodiment: Importance of the Vestibular System and the Temporal Parietal Junction

Embodiment, the sense of being localized within one's physical body, is a fundamental aspect of the self. Recent research shows that self and body processing as well as embodiment require distinct brain mechanisms. Here, we review recent clinical and neuroimaging research on multisensory perception and integration as well as mental imagery, pointing out their importance for the coding of embodiment at the temporo-parietal junction (TPJ). Special reference is given to vestibular mechanisms that are relevant for self and embodiment and to methods that interfere experimentally with normal embodiment. We conclude that multisensory and vestibular coding at the TPJ mediates humans' experience as being embodied and spatially situated, and argue that pathologies concerning the disembodied self, such as out-of-body experience or other autoscopic phenomena, are due to deficient multisensory integration at the TPJ.