Visual bias of unseen hand position with a mirror: spatial and temporal factors

Women show enhanced proprioceptive target estimation through visual-proprioceptive conflict resolution

To form a unified and coherent perception of the organism's state and its relationship with the surrounding environment, the nervous system combines information from various sensory modalities through multisensory integration processes. Occasionally, data from two or more sensory channels may provide conflicting information. This is particularly evident in experiments using the mirror-guided drawing task and the mirror-box illusion, where there is conflict between positional estimates guided by vision and proprioception. This study combined two experimental protocols (the mirror-box and the mirror-guided drawing tasks) to examine whether the learned resolution of visuo-proprioceptive conflicts in the mirror-guided drawing task would improve proprioceptive target estimation of men and women during the mirror-box test. Our results confirm previous findings of visual reaching bias produced by the mirror-box illusion and show that this effect is progressively reduced by improvement in the mirror drawing task performance. However, this was only observed in women. We discuss these findings in the context of possible gender differences in multisensory integration processes as well as in embodiment.

Through the looking-glass: Mirror feedback modulates temporal and spatial aspects of bimanual coordination

Mirror therapy has become an effective and recommended intervention for a range of conditions affecting the upper limb (e.g. hemiparesis following stroke). However, little is known about how mirror feedback affects the control of bimanual movements (as performed during mirror therapy). In this study, in preparation for future clinical investigations, we examined the kinematics of bimanual circle drawing in unimpaired participants both with (Experiment 1) and without (Experiment 2) a visual template to guide movement. In both experiments, 15 unimpaired right-handed participants performed self-paced continuous bimanual circle-drawing movements with a mirror/symmetrical coordination pattern. For the mirror condition, vision was directed towards the mirror in order to monitor the reflected limb. In the no mirror condition, the direction of vision was unchanged, but the mirror was replaced with an opaque screen. Movements of both hands were recorded using motion capture apparatus. In both experiments, the most striking feature of movements was that the hand behind the mirror drifted spatially during the course of individual trials. Participants appeared to be largely unaware of this marked positional change of their unseen hand, which was most pronounced when a template to guide movement was visible (Experiment 1). Temporal asynchrony between the limbs was also affected by mirror feedback in both experiments; in the mirror condition, illusory vision of the unseen hand led to a relative phase lead for that limb. Our data highlight the remarkable impact that the introduction of a simple mirror can have on bimanual coordination. Modulation of spatial and temporal features is consistent with the mirror inducing a rapid and powerful visual illusion, the latter appearing to override proprioceptive signals.

Multisensory Integration in Body Representation

To be aware of and to move one's body, the brain must maintain a coherent representation of the body. While the body and the brain are connected by dense ascending and descending sensory and motor pathways, representation of the body is not hardwired. This is demonstrated by the well-known rubber hand illusion in which a visible fake hand is erroneously felt as one's own hand when it is stroked in synchrony with the viewer's unseen actual hand. Thus, body representation in the brain is not mere maps of tactile and proprioceptive inputs, but a construct resulting from the interpretation and integration of inputs across sensory modalities.

Augmented Visual Feedback for Complex Motor Skill Acquisition: A Demonstration with Healthy Young Adults

Mirror therapy (MT) is a treatment for improving motor function after stroke. Video therapy (VT) training combines observation and imitation of video clips, and it has been used to conduct efficient occupational therapy. We sought to determine the effects of MT and VT on tool-use with healthy young adults. We assigned participants to three different training groups in which they used their non-dominant left hands to move a ball with chopsticks: (a) a self-paced MT group (N = 14), (b) an MT group who moved the ball while looking at the mirror image of the right hand with a sound cue (4-second intervals) (N = 12), and (c) a group who imitated a video demonstration (4-second intervals) (N = 13). The ball-moving time was significantly reduced after training in all three groups: MT group (p < .001), MT-R group (p = .010), and VT group (p = .014), but the video group showed significantly greater relative improvements in motion variability (p = .030) and object prediction (p = .008).We concluded that MT was as effective as VT in improving movement speed, but, with these healthy young adults, MT was less effective than VT in learning speed control or hand pre-shaping to refine task movements for tool use.

Age-related changes in visuo-proprioceptive processing in perceived body position

This study investigated age-related change in visuo-proprioceptive processing in the perceived body position using mirror hand/foot illusions, focusing on its temporal characteristics, its dependency on body parts, and its association with older adults’ fall risk. Either immediately or 15 s after the exposure to the mirror-induced inconsistency of visuo-proprioceptive signals regarding the right hand or foot position, participants performed a reaching task using the unseen, illusion-affected hand or foot. Results showed clear age group differences. Specifically, older adults exhibited larger reaching errors than younger adults in the hand condition, and after the 15 s delay in the foot condition. Further, the reaching errors were constant across time for older adults but decreased after the delay in young adults, regardless of the tested body part. Particularly, older adults’ risk of falling, which was assessed by the timed up-and-go test, was negatively correlated with the reduction of reaching error across time. This suggests that older adults, especially those with a high risk of falling, face difficulties in appropriately processing visual and proprioceptive information for body perception in accordance with their external environment.

Did My Hand Move in a Mirror? Body Ownership Induced by the Mirror Hand Illusion

Although the illusion that the mirror image of a hand or limb could be recognized as a part of one’s body behind the mirror, the effect of adding tactile stimulation to this illusion remains unknown. We, therefore, examined how the timing of tactile stimulation affects the induction of body ownership on the mirror image. Twenty-one healthy, right-handed participants (mean age = 23.0 ± 1.0 years, no medical history of neurological and/or psychiatric disorders) were enrolled and a crossover design was adopted in this study. Participants’ right and left hands were placed on the front and back sides of the mirror, respectively, then they were asked to keep looking at their right hand in the mirror. All participants experienced two experiments; one was with tactile stimulation that was synchronized with the movement of a mirror image (synchronous condition), and the other one was with tactile stimulation that was not synchronized (asynchronous condition). The qualitative degree of body ownership for the mirrored hand was evaluated by a questionnaire. Proprioceptive drift (PD), an illusory shift of the felt position of the real hand toward the mirrored hand was used for quantitative evaluation of body ownership and measured at “baseline,” “immediately after stimulation,” “2 min after stimulation,” and “4 min after stimulation.” The results of the questionnaire revealed that some items of body ownership rating were higher in the synchronous condition than in the asynchronous condition (p < 0.05). We found that PD occurred from immediately after to 4 min after stimulation in both conditions (p < 0.01) and there was no difference in the results between the conditions. From the dissociation of these results, we interpreted that body ownership could be elicited by different mechanisms depending on the task demand. Our results may contribute to the understanding of the multisensory integration mechanism of visual and tactile stimulation during mirror illusion induction.

Joint Position Accuracy Is Influenced by Visuoproprioceptive Congruency in Virtual Reality

Weighted integration of visual and proprioceptive information is important in movement planning and execution. The present study used a virtual reality system to determine how upper limb movement consistency and accuracy are altered when (a) vision of the limb is removed and (b) proprioception and vision of the limb are misaligned. A one degree of freedom upper limb movement task was performed under three visual conditions of the limb; accurate vision, no vision, and offset vision. Movement consistency was unaltered by the change in visual condition. Compared to the accurate vision condition, movement accuracy was unchanged in the no vision condition but decreased with a visual offset. When available, vision was relied upon more heavily than proprioception for task completion.

Visuomotor impairments in complex regional pain syndrome during pointing tasks

ABSTRACT

Complex regional pain syndrome (CRPS) is thought to be characterized by cognitive deficits affecting patients' ability to represent, perceive, and use their affected limb as well as its surrounding space. This has been tested, among others, by straight-ahead tasks testing oneself's egocentric representation, but such experiments lead to inconsistent results. Because spatial cognitive abilities encompass various processes, we completed such evaluations by varying the sensory inputs used to perform the task. Complex regional pain syndrome and matched control participants were asked to assess their own body midline either visually (ie, by means of a moving visual cue) or manually (ie, by straight-ahead pointing with one of their upper limbs) and to reach and point to visual targets at different spatial locations. Although the 2 former tasks only required one single sensory input to be performed (ie, either visual or proprioceptive), the latter task was based on the ability to coordinate perception of the position of one's own limb with visuospatial perception. However, in this latter task, limb position could only be estimated by proprioception, as vision of the limb was prevented. Whereas in the 2 former tasks CRPS participants' performance was not different from that of controls, they made significantly more deviations errors during the visuospatial task, regardless of the limb used to point or the direction of pointing. Results suggest that CRPS patients are not specifically characterized by difficulties in representing their body but, more particularly, in integrating somatic information (ie, proprioception) during visually guided movements of the limb.

Differential effects of minified and magnified mirror visual feedback on the underlying misperception of hand size

Perception of the size of body parts, for instance the hand, has been shown to be distorted in healthy participants, with over- and underestimations of width and length, respectively. Illusory manipulations of body shape and size have highlighted the flexibility of the body representation and have also been found to update immediate perceptions of body size and surrounding objects. Here, we examined whether underlying misperceptions of hand width and length can be modified through exposure to illusory changes in hand size using a mirror visual feedback (MVF) paradigm. While questionnaire responses indicated subjective susceptibility to both magnified and minified manipulations, objective hand size estimates only showed significant differences following exposure to minifying mirrors. These variations might reflect differences in the way that stored representations are accessed or updated in response to size manipulations. Secondly, the findings further reinforce differences between subjective and objective outcomes of illusions on subsequent body perception.

Higher-Order Cognition Does Not Affect Multisensory Distractor Processing

Multisensory processing is required for the perception of the majority of everyday objects and events. In the case of irrelevant stimuli, the multisensory processing of features is widely assumed to be modulated by attention. In the present study, we investigated whether the processing of audiovisual distractors is also modulated by higher-order cognition. Participants fixated a visual distractor viewed via a centrally-placed mirror and responded to a laterally-presented audiovisual target. Critically, a distractor tone was presented from the same location as the mirror, while the visual distractor feature was presented at an occluded location, visible only indirectly via mirror reflection. Consequently, it appeared as though the visual and auditory features were presented from the same location though, in fact, they actually originated from different locations. Nevertheless, the results still revealed that the visual and auditory distractor features were processed together just as in the control condition, in which the audiovisual distractor features were both actually presented from fixation. Taken together, these results suggest that the processing of irrelevant multisensory information is not influenced by higher-order cognition.

Transcranial Direct Current Stimulation Effect on Virtual Hand Illusion

Virtual reality (VR) is effectively used to evoke the mirror illusion, and transcranial direct current stimulation (tDCS) synergistically facilitates this illusion. This study investigated whether a mirror virtual hand illusion (MVHI) induced by an immersive, first-person-perspective, virtual mirror system could be modulated by tDCS of the primary motor cortex. Fourteen healthy adults (average age 21.86 years ±0.47, seven men and seven women) participated in this study, and they experienced VR with and without tDCS-the tDCS and sham conditions, each of which takes ∼30 minutes-on separate days to allow the washout of the tDCS effect. While experiencing VR, the movements of the virtual left hand reflected the flexion and extension of the real right hand. Subsequently, electroencephalogram was recorded, the magnitude of the proprioceptive shift was measured, and the participants provided responses to a questionnaire regarding hand ownership. A significant difference in the proprioceptive shift was observed between the tDCS and sham conditions. In addition, there was significant suppression of the mu power in Pz, and augmentation of the beta power in the Pz, P4, O1, and O2 channels. The difference in proprioceptive deviation between the two conditions showed significant negative correlation with mu suppression over the left frontal lobe in the tDCS condition. Finally, the question "I felt that the virtual hand was my own hand" received a significantly higher score under the tDCS condition. In short, applying tDCS over the motor cortex facilitates the MVHI by activating the attentional network over the parietal and frontal lobes such that the MVHI induces more proprioceptive drift, which suggests that the combination of VR and tDCS can enhance the immersive effect in VR. This result provides better support for the use of the MVHI paradigm in combination with tDCS for recovery from illnesses such as stroke.

Modality-specific attention attenuates visual-tactile integration and recalibration effects by reducing prior expectations of a common source for vision and touch

At any moment in time, streams of information reach the brain through the different senses. Given this wealth of noisy information, it is essential that we select information of relevance - a function fulfilled by attention - and infer its causal structure to eventually take advantage of redundancies across the senses. Yet, the role of selective attention during causal inference in cross-modal perception is unknown. We tested experimentally whether the distribution of attention across vision and touch enhances cross-modal spatial integration (visual-tactile ventriloquism effect, Expt. 1) and recalibration (visual-tactile ventriloquism aftereffect, Expt. 2) compared to modality-specific attention, and then used causal-inference modeling to isolate the mechanisms behind the attentional modulation. In both experiments, we found stronger effects of vision on touch under distributed than under modality-specific attention. Model comparison confirmed that participants used Bayes-optimal causal inference to localize visual and tactile stimuli presented as part of a visual-tactile stimulus pair, whereas simultaneously collected unity judgments - indicating whether the visual-tactile pair was perceived as spatially-aligned - relied on a sub-optimal heuristic. The best-fitting model revealed that attention modulated sensory and cognitive components of causal inference. First, distributed attention led to an increase of sensory noise compared to selective attention toward one modality. Second, attending to both modalities strengthened the stimulus-independent expectation that the two signals belong together, the prior probability of a common source for vision and touch. Yet, only the increase in the expectation of vision and touch sharing a common source was able to explain the observed enhancement of visual-tactile integration and recalibration effects with distributed attention. In contrast, the change in sensory noise explained only a fraction of the observed enhancements, as its consequences vary with the overall level of noise and stimulus congruency. Increased sensory noise leads to enhanced integration effects for visual-tactile pairs with a large spatial discrepancy, but reduced integration effects for stimuli with a small or no cross-modal discrepancy. In sum, our study indicates a weak a priori association between visual and tactile spatial signals that can be strengthened by distributing attention across both modalities.

Cortical Regions Encoding Hardness Perception Modulated by Visual Information Identified by Functional Magnetic Resonance Imaging With Multivoxel Pattern Analysis

Recent studies have revealed that hardness perception is determined by visual information along with the haptic input. This study investigated the cortical regions involved in hardness perception modulated by visual information using functional magnetic resonance imaging (fMRI) and multivoxel pattern analysis (MVPA). Twenty-two healthy participants were enrolled. They were required to place their left and right hands at the front and back, respectively, of a mirror attached to a platform placed above them while lying in a magnetic resonance scanner. In conditions SFT, MED, and HRD, one of three polyurethane foam pads of varying hardness (soft, medium, and hard, respectively) was presented to the left hand in a given trial, while only the medium pad was presented to the right hand in all trials. MED was defined as the control condition, because the visual and haptic information was congruent. During the scan, the participants were required to push the pad with the both hands while observing the reflection of the left hand and estimate the hardness of the pad perceived by the right (hidden) hand based on magnitude estimation. Behavioral results showed that the perceived hardness was significantly biased toward softer or harder in >73% of the trials in conditions SFT and HRD; we designated these trials as visually modulated (SFTvm and HRDvm, respectively). The accuracy map was calculated individually for each of the pair-wise comparisons of (SFTvm vs. MED), (HRDvm vs. MED), and (SFTvm vs. HRDvm) by a searchlight MVPA, and the cortical regions encoding the perceived hardness with visual modulation were identified by conjunction of the three accuracy maps in group analysis. The cluster was observed in the right sensory motor cortex, left anterior intraparietal sulcus (aIPS), bilateral parietal operculum (PO), and occipito-temporal cortex (OTC). Together with previous findings on such cortical regions, we conclude that the visual information of finger movements processed in the OTC may be integrated with haptic input in the left aIPS, and the subjective hardness perceived by the right hand with visual modulation may be processed in the cortical network between the left PO and aIPS.

Kinaesthetic illusion shapes the cortical plasticity evoked by action observation

KEY POINTS

The combination of action observation (AO) and a peripheral nerve stimulation has been shown to induce plasticity in the primary motor cortex (M1). However, using peripheral nerve stimulation little is known about the specificity of the sensory inputs. The current study, using muscle tendon vibration to stimulate muscle spindles and transcranial magnetic stimulation to assess M1 excitability, investigated whether a proprioceptive stimulation leading to a kinaesthetic illusion of movement (KI) was able to evoke M1 plasticity when combined with AO. M1 excitability increased immediately and up to 60 min after AO-KI stimulation as a function of the vividness of the perceived illusion, and only when the movement directions of AO and KI were congruent. Tactile stimulation coupled with AO and KI alone were not sufficient to induce M1 plasticity. This methodology might be proposed to subjects during a period of immobilization to promote M1 activity without requiring any voluntary movement.

ABSTRACT

Physical practice is crucial to evoke cortical plasticity, but motor cognition techniques, such as action observation (AO), have shown their potentiality in promoting it when associated with peripheral afferent inputs, without the need of performing a movement. Here we investigated whether the combination of AO and a proprioceptive stimulation, able to evoke a kinaesthetic illusion of movement (KI), induced plasticity in the primary motor cortex (M1). In the main experiment, the role of congruency between the observed action and the illusory movement was explored together with the importance of the specificity of the sensory input modality (proprioceptive vs. tactile stimulation) to induce plasticity in M1. Further, a control experiment was carried out to assess the role of the mere kinaesthetic illusion on M1 excitability. Results showed that the combination of AO and KI evoked plasticity in M1, with an increase of the excitability immediately and up to 60 min after the conditioning protocol (P always <0.05). Notably, a significant increase in M1 excitability occurred only when the directions of the observed and illusory movements were congruent. Further, a significant positive linear relationship was found between the amount of M1 excitability increase and the vividness of the perceived illusion (P = 0.03). Finally, the tactile stimulation coupled with AO was not sufficient to induce changes in M1 excitability as well as the KI alone. All these findings indicate the importance of combining different sensory input signals to induce plasticity in M1, and that proprioception is the most suitable sensory modality to allow it.

Seeing Your Foot Move Changes Muscle Proprioceptive Feedback

Multisensory effects are found when the input from single senses combines, and this has been well researched in the brain. Presently, we examined in humans the potential impact of visuo-proprioceptive interactions at the peripheral level, using microneurography, and compared it with a similar behavioral task. We used a paradigm where participants had either proprioceptive information only (no vision) or combined visual and proprioceptive signals (vision). We moved the foot to measure changes in the sensitivity of single muscle afferents, which can be altered by the descending fusimotor drive. Visual information interacted with proprioceptive information, where we found that for the same passive movement, the response of muscle afferents increased when the proprioceptive channel was the only source of information, as compared with when visual cues were added, regardless of the attentional level. Behaviorally, when participants looked at their foot moving, they more accurately judged differences between movement amplitudes, than in the absence of visual cues. These results impact our understanding of multisensory interactions throughout the nervous system, where the information from different senses can modify the sensitivity of peripheral receptors. This has clinical implications, where future strategies may modulate such visual signals during sensorimotor rehabilitation.

Effects of Hand and Hemispace on Multisensory Integration of Hand Position and Visual Feedback

The brain generally integrates a multitude of sensory signals to form a unified percept. Even in cursor control tasks, such as reaching while looking at rotated visual feedback on a monitor, visual information on cursor position and proprioceptive information on hand position are partially integrated (sensory coupling), resulting in mutual biases of the perceived positions of cursor and hand. Previous studies showed that the strength of sensory coupling (sum of the mutual biases) depends on the experience of kinematic correlations between hand movements and cursor motions, whereas the asymmetry of sensory coupling (difference between the biases) depends on the relative reliabilities (inverse of variability) of hand-position and cursor-position estimates (reliability rule). Furthermore, the precision of movement control and perception of hand position are known to differ between hands (left, right) and workspaces (ipsilateral, contralateral), and so does the experience of kinematic correlations from daily life activities. Thus, in the present study, we tested whether strength and asymmetry of sensory coupling for the endpoints of reaches in a cursor control task differ between the right and left hand and between ipsilateral and contralateral hemispace. No differences were found in the strength of sensory coupling between hands or between hemispaces. However, asymmetry of sensory coupling was less in ipsilateral than in contralateral hemispace: in ipsilateral hemispace, the bias of the perceived hand position was reduced, which was accompanied by a smaller variability of the estimates. The variability of position estimates of the dominant right hand was also less than for the non-dominant left hand, but this difference was not accompanied by a difference in the asymmetry of sensory coupling – a violation of the reliability rule, probably due a stronger influence of visual information on right-hand movements. According to these results, the long-term effects of the experienced kinematic correlation between hand movements and cursor motions on the strength of sensory coupling are generic and not specific for hemispaces or hands, whereas the effects of relative reliabilities on the asymmetry of sensory coupling are specific for hemispaces but not for hands.

Affective certainty and congruency of touch modulate the experience of the rubber hand illusion

Our sense of body ownership relies on integrating different sensations according to their temporal and spatial congruency. Nevertheless, there is ongoing controversy about the role of affective congruency during multisensory integration, i.e. whether the stimuli to be perceived by the different sensory channels are congruent or incongruent in terms of their affective quality. In the present study, we applied a widely used multisensory integration paradigm, the Rubber Hand Illusion, to investigate the role of affective, top-down aspects of sensory congruency between visual and tactile modalities in the sense of body ownership. In Experiment 1 (N = 36), we touched participants with either soft or rough fabrics in their unseen hand, while they watched a rubber hand been touched synchronously with the same fabric or with a 'hidden' fabric of 'uncertain roughness'. In Experiment 2 (N = 50), we used the same paradigm as in Experiment 1, but replaced the 'uncertainty' condition with an 'incongruent' one, in which participants saw the rubber hand being touched with a fabric of incongruent roughness and hence opposite valence. We found that certainty (Experiment 1) and congruency (Experiment 2) between the felt and vicariously perceived tactile affectivity led to higher subjective embodiment compared to uncertainty and incongruency, respectively, irrespective of any valence effect. Our results suggest that congruency in the affective top-down aspects of sensory stimulation is important to the multisensory integration process leading to embodiment, over and above temporal and spatial properties.

Impaired anticipatory vision and visuomotor coordination affects action planning and execution in children with hemiplegic cerebral palsy

BACKGROUND

Action-planning and execution deficits in children with hemiplegic cerebral palsy (HCP) are potentially due to deficits in the integration of sensory information, such as vision, with motor output.

AIMS

To determine differences in anticipatory visual patterns in children with HCP compared to typically developing (TD) children, and to assess visuomotor coordination in children with HCP.

METHODS AND PROCEDURES

We included 13 children with HCP (Age = 6.8 + 2.9 yrs) and 15 TD children (Age = 5.8 + 1.1 yrs). The experimental task used in this study is a valid action-planning task, which consisted of initially reaching and grasping an object placed at a fixed position, followed by placing the object in a random target position. Visual patterns were recorded using a head-mounted eye-tracker system and arm movements were recorded using motion capture (120 Hz).

OUTCOMES AND RESULTS

Children with HCP had delayed anticipatory gaze time and longer latency than TD children during the planning and execution phases. Children with HCP also had a higher frequency of gaze shifts, longer reaction times (RT) and movement times (MT) than TD children.

CONCLUSIONS AND IMPLICATIONS

Children with HCP may have deficits in anticipatory vision, which potentially affected planning and executing a goal-directed action. Therapeutic interventions focusing on improving visuomotor coordination may improve the motor performance in children with HCP.

Vision-Driven Kinesthetic Illusion in Mirror Visual Feedback

In the paradigm of mirror visual feedback, it remains unclear how images of the mirrored hand directly affect the sense of motion of the hidden hand (kinesthetic illusion). To examine this question, we created an original mirror visual feedback setup using a horizontal mechanism of motion for the mirror and the hidden hand, each of which could independently be given a specific velocity. It should be noted that this setup can cause the hand viewed in the mirror to move without the involvement of the visible hand. In the experiment, the participants reported the felt direction of the hidden hand's displacement (left/right) after 4 s dual movements with quasi-randomized velocities. It was found that the subjective direction of motion of the hidden hand was strongly biased toward the direction of the mirror. Further, anatomical congruency was found to affect kinesthetic illusion for cases where the mirror approaches the visible hand.

Judging the position of the artificial hand induces a "visual" drift towards the real one during the rubber hand illusion

When subjects look at a rubber hand being brush-stroked synchronously with their own hidden hand, they might feel a sense of ownership over the rubber hand. The perceived mislocalization of the own hand towards the rubber hand (proprioceptive drift) would reflect an implicit marker of this illusion occurring through the dominance of vision over proprioception. This account, however, contrasts with principles of multisensory integration whereby percepts result from a "statistical sum" of different sensory afferents. In this case, the most-known proprioceptive drift should be mirrored by complementary visual drift of the rubber hand in the opposite direction. We investigated this issue by designing two experiments in which subjects were not only requested to localize their own hand but also the rubber hand and further explored the subjective feeling of the illusion. In both experiments, we demonstrated a (visual) drift in the opposite direction of the proprioceptive drift, suggesting that both hands converge toward each other. This might suggest that the spatial representations of the two hands are integrated in a common percept placed in between them, contradicting previous accounts of substitution of the real hand by the rubber hand.

Abstract spatial, but not body-related, visual information guides bimanual coordination

Visual spatial information is paramount in guiding bimanual coordination, but anatomical factors, too, modulate performance in bimanual tasks. Vision conveys not only abstract spatial information, but also informs about body-related aspects such as posture. Here, we asked whether, accordingly, visual information induces body-related, or merely abstract, perceptual-spatial constraints in bimanual movement guidance. Human participants made rhythmic, symmetrical and parallel, bimanual index finger movements with the hands held in the same or different orientations. Performance was more accurate for symmetrical than parallel movements in all postures, but additionally when homologous muscles were concurrently active, such as when parallel movements were performed with differently rather than identically oriented hands. Thus, both perceptual and anatomical constraints were evident. We manipulated visual feedback with a mirror between the hands, replacing the image of the right with that of the left hand and creating the visual impression of bimanual symmetry independent of the right hand’s true movement. Symmetrical mirror feedback impaired parallel, but improved symmetrical bimanual performance compared with regular hand view. Critically, these modulations were independent of hand posture and muscle homology. Thus, visual feedback appears to contribute exclusively to spatial, but not to body-related, anatomical movement coding in the guidance of bimanual coordination.

Dissociating explicit and implicit measures of sensed hand position in tool use: Effect of relative frequency of judging different objects

In a cursor-control task, the sensed positions of cursor and hand are biased toward each other. We previously found different characteristics of implicit and explicit measures of the bias of sensed hand position toward the position of the cursor, suggesting the existence of distinct neural representations. Here we further explored differences between the two types of measure by varying the proportions of trials with explicit hand-position (H) and cursor-position (C) judgments (C20:H80, C50:H50, and C80:H20). In each trial, participants made a reaching movement to a remembered target, with the visual feedback being rotated randomly, and subsequently they judged the hand or the cursor position. Both the explicitly and implicitly measured biases of sensed hand position were stronger with a low proportion (C80:H20) than with a high proportion (C20:H80) of hand-position judgments, suggesting that both measures place more weight on the sensory modality relevant for the more frequent judgment. With balanced proportions of such judgments (C50:H50), the explicitly assessed biases were similar to those observed with a high proportion of cursor-position judgments (C80:H20), whereas the implicitly assessed biases were similar to those observed with a high proportion of hand-position judgments (C20:H80). Because strong weights of cursor-position or hand-position information may be difficult to increase further but are easy to reduce, the findings suggest that the implicit measure of the bias of sensed hand position places a relatively stronger weight on proprioceptive hand-position information, which is increased no further by a high proportion of hand-position judgments. Conversely, the explicit measure places a relatively stronger weight on visual cursor-position information.

Contrasting effects of adaptation to a visuomotor rotation on explicit and implicit measures of sensory coupling

We previously investigated sensory coupling of the sensed positions of cursor and hand in a cursor-control task and found differential characteristics of implicit and explicit measures of the bias of sensed hand position toward the position of the cursor. The present study further tested whether adaptation to a visuomotor rotation differentially affects these two measures. Participants made center-out reaching movements to remembered targets while looking at a rotated feedback cursor. After sets of practice trials with constant (adaptation condition) or random (control condition) visuomotor rotations, test trials served to assess sensory coupling. In these trials, participants judged the position of the hand at the end of the center-out movement, and the deviation of these judgments from the physical hand positions served as explicit measure of the bias of sensed hand position toward the position of the cursor, whereas the implicit measure was based on the direction of the return movement. The results showed that inter-individual variability of explicitly assessed biases of sensed hand position toward the cursor position was less in the adaptation condition than in the control condition. Conversely, no such changes were observed for the implicit measure of the bias of sensed hand position, revealing contrasting effects of adaptation on the explicit and implicit measures. These results suggest that biases of explicitly sensed hand position reflect sensory coupling of neural representations that are altered by visuomotor adaptation. In contrast, biases of implicitly sensed hand position reflect sensory coupling of neural representations that are unaffected by adaptation.

Body Schema Illusions: A Study of the Link between the Rubber Hand and Kinesthetic Mirror Illusions through Individual Differences

Background

The well-known rubber hand paradigm induces an illusion by having participants feel the touch applied to a fake hand. In parallel, the kinesthetic mirror illusion elicits illusions of movement by moving the reflection of a participant's arm. Experimental manipulation of sensory inputs leads to emergence of these multisensory illusions. There are strong conceptual similarities between these two illusions, suggesting that they rely on the same neurophysiological mechanisms, but this relationship has never been investigated. Studies indicate that participants differ in their sensitivity to these illusions, which provides a possibility for studying the relationship between these two illusions.

Method

We tested 36 healthy participants to confirm that there exist reliable individual differences in sensitivity to the two illusions and that participants sensitive to one illusion are also sensitive to the other.

Results

The results revealed that illusion sensitivity was very stable across trials and that individual differences in sensitivity to the kinesthetic mirror illusion were highly related to individual differences in sensitivity to the rubber hand illusion.

Conclusions

Overall, these results support the idea that these two illusions may be both linked to a transitory modification of body schema, wherein the most sensitive people have the most malleable body schema.

Recovery of Proprioception in the Upper Extremity by Robotic Mirror Therapy: a Clinical Pilot Study for Proof of Concept

A novel robotic mirror therapy system was recently developed to provide proprioceptive stimulus to the hemiplegic arm during a mirror therapy. Validation of the robotic mirror therapy system was performed to confirm its synchronicity prior to the clinical study. The mean error angle range between the intact arm and the robot was 1.97 to 4.59 degrees. A 56-year-old male who had right middle cerebral artery infarction 11 months ago received the robotic mirror therapy for ten 30-minute sessions during 2 weeks. Clinical evaluation and functional magnetic resonance imaging (fMRI) studies were performed before and after the intervention. At the follow-up evaluation, the thumb finding test score improved from 2 to 1 for eye level and from 3 to 1 for overhead level. The Albert's test score on the left side improved from 6 to 11. Improvements were sustained at 2-month follow-up. The fMRI during the passive motion revealed a considerable increase in brain activity at the lower part of the right superior parietal lobule, suggesting the possibility of proprioception enhancement. The robotic mirror therapy system may serve as a useful treatment method for patients with supratentorial stroke to facilitate recovery of proprioceptive deficit and hemineglect.

Influence of the Body Schema on Multisensory Integration: Evidence from the Mirror Box Illusion

When placing one hand on each side of a mirror and making synchronous bimanual movements, the mirror-reflected hand feels like one’s own hand that is hidden behind the mirror. We developed a novel mirror box illusion to investigate whether motoric, but not spatial, visuomotor congruence is sufficient for inducing multisensory integration, and importantly, if biomechanical constraints encoded in the body schema influence multisensory integration. Participants placed their hands in a mirror box in opposite postures (palm up, palm down), creating a conflict between visual and proprioceptive feedback for the hand behind the mirror. After synchronous bimanual hand movements in which the viewed and felt movements were motorically congruent but spatially in the opposite direction, participants felt that the hand behind the mirror rotated or completely flipped towards matching the hand reflection (illusory displacement), indicating facilitation of multisensory integration by motoric visuomotor congruence alone. Some wrist rotations are more difficult due to biomechanical constraints. We predicted that these biomechanical constraints would influence illusion effectiveness, even though the illusion does not involve actual limb movement. As predicted, illusory displacement increased as biomechanical constraints and angular disparity decreased, providing evidence that biomechanical constraints are processed in multisensory integration.

Lost in space: multisensory conflict yields adaptation in spatial representations across frames of reference

According to embodied cognition, bodily interactions with our environment shape the perception and representation of our body and the surrounding space, that is, peripersonal space. To investigate the adaptive nature of these spatial representations, we introduced a multisensory conflict between vision and proprioception in an immersive virtual reality. During individual bimanual interaction trials, we gradually shifted the visual hand representation. As a result, participants unknowingly shifted their actual hands to compensate for the visual shift. We then measured the adaptation to the invoked multisensory conflict by means of a self-localization and an external localization task. While effects of the conflict were observed in both tasks, the effects systematically interacted with the type of localization task and the available visual information while performing the localization task (i.e., the visibility of the virtual hands). The results imply that the localization of one's own hands is based on a multisensory integration process, which is modulated by the saliency of the currently most relevant sensory modality and the involved frame of reference. Moreover, the results suggest that our brain strives for consistency between its body and spatial estimates, thereby adapting multiple, related frames of reference, and the spatial estimates within, due to a sensory conflict in one of them.

Changing the size of a mirror-reflected hand moderates the experience of embodiment but not proprioceptive drift: a repeated measures study on healthy human participants

Mirror visual feedback is used for reducing pain and visually distorting the size of the reflection may improve efficacy. The findings of studies investigating size distortion are inconsistent. The influence of the size of the reflected hand on embodiment of the mirror reflection is not known. The aim of this study was to compare the effect of magnifying and minifying mirror reflections of the hand on embodiment measured using an eight-item questionnaire and on proprioceptive drift. During the experiment, participants (n = 45) placed their right hand behind a mirror and their left hand in front of a mirror. Participants watched a normal-sized, a magnified and a minified reflection of the left hand while performing synchronised finger movements for 3 min (adaptive phase). Measurements of embodiment were taken before (pre) and after (post) synchronous movements of the fingers of both hands (embodiment adaptive phase). Results revealed larger proprioceptive drift post-adaptive phase (p = 0.001). Participants agreed more strongly with questionnaire items associated with location, ownership and agency of the reflection of the hand post-adaptive phase (p < 0.001) and when looking at the normal-sized reflection (p < 0.001). In conclusion, irrespective of size, watching a reflection of the hand while performing synchronised movements enhances the embodiment of the reflection of the hand. Magnifying and minifying the reflection of the hand has little effect on proprioceptive drift, but it weakens the subjective embodiment experience. Such factors need to be taken into account in future studies using this technique, particularly when assessing mirror visual feedback for pain management.

Visual illusion of tool use recalibrates tactile perception

Brief use of a tool recalibrates multisensory representations of the user's body, a phenomenon called tool embodiment. Despite two decades of research, little is known about its boundary conditions. It has been widely argued that embodiment requires active tool use, suggesting a critical role for somatosensory and motor feedback. The present study used a visual illusion to cast doubt on this view. We used a mirror-based setup to induce a visual experience of tool use with an arm that was in fact stationary. Following illusory tool use, tactile perception was recalibrated on this stationary arm, and with equal magnitude as physical use. Recalibration was not found following illusory passive tool holding, and could not be accounted for by sensory conflict or general interhemispheric plasticity. These results suggest visual tool-use signals play a critical role in driving tool embodiment.

Integration of Visual and Proprioceptive Limb Position Information in Human Posterior Parietal, Premotor, and Extrastriate Cortex

The brain constructs a flexible representation of the body from multisensory information. Previous work on monkeys suggests that the posterior parietal cortex (PPC) and ventral premotor cortex (PMv) represent the position of the upper limbs based on visual and proprioceptive information. Human experiments on the rubber hand illusion implicate similar regions, but since such experiments rely on additional visuo-tactile interactions, they cannot isolate visuo-proprioceptive integration. Here, we independently manipulated the position (palm or back facing) of passive human participants' unseen arm and of a photorealistic virtual 3D arm. Functional magnetic resonance imaging (fMRI) revealed that matching visual and proprioceptive information about arm position engaged the PPC, PMv, and the body-selective extrastriate body area (EBA); activity in the PMv moreover reflected interindividual differences in congruent arm ownership. Further, the PPC, PMv, and EBA increased their coupling with the primary visual cortex during congruent visuo-proprioceptive position information. These results suggest that human PPC, PMv, and EBA evaluate visual and proprioceptive position information and, under sufficient cross-modal congruence, integrate it into a multisensory representation of the upper limb in space.

SIGNIFICANCE STATEMENT

The position of our limbs in space constantly changes, yet the brain manages to represent limb position accurately by combining information from vision and proprioception. Electrophysiological recordings in monkeys have revealed neurons in the posterior parietal and premotor cortices that seem to implement and update such a multisensory limb representation, but this has been difficult to demonstrate in humans. Our fMRI experiment shows that human posterior parietal, premotor, and body-selective visual brain areas respond preferentially to a virtual arm seen in a position corresponding to one's unseen hidden arm, while increasing their communication with regions conveying visual information. These brain areas thus likely integrate visual and proprioceptive information into a flexible multisensory body representation.

The mirror illusion's effects on body state estimation

The mirror illusion uses a standard mirror to create a compelling illusion in which movements of one limb seem to be made by the other hidden limb. In this paper we adapt a motor control framework to examine which estimates of the body's configuration are affected by the illusion. We propose that the illusion primarily alters estimates related to upcoming states of the body (the desired state and the predicted state), with smaller effects on the estimate of the body state prior to movement initiation. Support for this proposal is provided both by behavioural effects of the illusion and by neuroimaging evidence from one neural region, V6A, that is critically involved in the mirror illusion and limb state estimation more generally.

A Simple Method to Stand outside Oneself

Here we outline a simple method of using two mirrors which allows one to stand out-side oneself. This method demonstrates that registration of vision with touch and proprioception is crucial for the perception of the corporeal self. Our method may also allow the disassociation of taste from touch, proprioception, and movement.

Rubber Hands Feel the Touch of Light

Two experiments involving a total of 220 subjects are reported. The experiments document that “stroking” a false hand with the bright beam of light from a laser pointer can produce tactile and thermal sensations when the hand can be seen as one's own. Overall, 66% of subjects reported somatic sensations from the light. Felt hand location was recalibrated toward the location of the false hand for those subjects who felt the light. Moreover, the proprioceptive recalibration from the laser experience was comparable to that produced by actual coordinated brushing of the false hand and of the unseen real hand after 2 min of stimulation. The illusion may be experienced on one's real hand as well. The results are discussed in terms of multisensory integration.

Effects of Reliability and Global Context on Explicit and Implicit Measures of Sensed Hand Position in Cursor-Control Tasks

In a cursor-control task in which the motion of the cursor is rotated randomly relative to the movement of the hand, the sensed directions of hand and cursor are mutually biased. In our previous study, we used implicit and explicit measures of the bias of sensed hand direction toward the direction of the cursor and found different characteristics. The present study serves to explore further differences and commonalities of these measures. In Experiment 1, we examined the effects of different relative reliabilities of visual and proprioceptive information on the explicitly and implicitly assessed bias of sensed hand direction. In two conditions, participants made an aiming movement and returned to the start position immediately or after a delay of 6 s during which the cursor was no longer visible. The unimodal proprioceptive information on final hand position in the delayed condition served to increase its relative reliability. As a result, the bias of sensed hand direction toward the direction of the cursor was reduced for the explicit measure, with a complementary increase of the bias of sensed cursor direction, but unchanged for the implicit measure. In Experiment 2, we examined the influence of global context, specifically of the across-trial sequence of judgments of hand and cursor direction. Both explicitly and implicitly assessed biases of sensed hand direction did not significantly differ between the alternated condition (trial-to-trial alternations of judgments of hand and cursor direction) and the blocked condition (judgments of hand or cursor directions in all trials). They both substantially decreased from the alternated to the randomized condition (random sequence of judgments of hand and cursor direction), without a complementary increase of the bias of sensed cursor direction. We conclude that our explicit and implicit measures are equally sensitive to variations of coupling strength as induced by the variation of global context in Experiment 2, but are differently sensitive to variations of the relative reliabilities as induced by our additional unimodal proprioceptive information in Experiment 1.

The influence of embodiment on multisensory integration using the mirror box illusion

We examined the relationship between subcomponents of embodiment and multisensory integration using a mirror box illusion. The participants' left hand was positioned against the mirror, while their right hidden hand was positioned 12″, 6″, or 0″ from the mirror - creating a conflict between visual and proprioceptive estimates of limb position in some conditions. After synchronous tapping, asynchronous tapping, or no movement of both hands, participants gave position estimates for the hidden limb and filled out a brief embodiment questionnaire. We found a relationship between different subcomponents of embodiment and illusory displacement towards the visual estimate. Illusory visual displacement was positively correlated with feelings of deafference in the asynchronous and no movement conditions, whereas it was positive correlated with ratings of visual capture and limb ownership in the synchronous and no movement conditions. These results provide evidence for dissociable contributions of different aspects of embodiment to multisensory integration.

Upper Limb Motor Impairment After Stroke

Understanding poststroke upper limb impairment is essential to planning therapeutic efforts to restore function. However, determining which upper limb impairment to treat and how is complex because the impairments are not static and multiple impairments may be present simultaneously. How impairments contribute to upper limb dysfunction may be understood by examining them from the perspective of their functional consequences. There are 3 main functional consequences of impairments on upper limb function: (1) learned nonuse, (2) learned bad use, and (3) forgetting as determined by behavioral analysis of tasks. The impairments that contribute to each of these functional limitations are described.

Enhancing the mirror illusion with transcranial direct current stimulation

Visual feedback has a strong impact on upper-extremity movement production. One compelling example of this phenomena is the mirror illusion (MI), which has been used as a treatment for post-stroke movement deficits (mirror therapy). Previous research indicates that the MI increases primary motor cortex excitability, and this change in excitability is strongly correlated with the mirror's effects on behavioral performance of neurologically-intact controls. Based on evidence that primary motor cortex excitability can also be increased using transcranial direct current stimulation (tDCS), we tested whether bilateral tDCS to the primary motor cortices (anode right-cathode left and anode left-cathode right) would modify the MI. We measured the MI using a previously-developed task in which participants make reaching movements with the unseen arm behind a mirror while viewing the reflection of the other arm. When an offset in the positions of the two limbs relative to the mirror is introduced, reaching errors of the unseen arm are biased by the reflected arm's position. We found that active tDCS in the anode right-cathode left montage increased the magnitude of the MI relative to sham tDCS and anode left-cathode right tDCS. We take these data as a promising indication that tDCS could improve the effect of mirror therapy in patients with hemiparesis.

Kinaesthetic mirror illusion and spatial congruence

Position sense and kinaesthesia are mainly derived from the integration of somaesthetic and visual afferents to form a single, coherent percept. However, visual information related to the body can play a dominant role in these perceptual processes in some circumstances, and notably in the mirror paradigm. The objective of the present study was to determine whether or not the kinaesthetic illusions experienced in the mirror paradigm obey one of the key rules of multisensory integration: spatial congruence. In the experiment, the participant's left arm (the image of which was reflected in a mirror) was either passively flexed/extended with a motorized manipulandum (to induce a kinaesthetic illusion in the right arm) or remained static. The right (unseen) arm remained static but was positioned parallel to the left arm's starting position or placed in extension (from 15° to 90°, in steps of 15°), relative to the left arm's flexed starting position. The results revealed that the frequency of the illusion decreased only slightly as the incongruence prior to movement onset between the reflected left arm and the hidden right arm grew and remained quite high even in the most incongruent settings. However, the greater the incongruence between the visually and somaesthetically specified positions of the right forearm (from 15° to 90°), the later the onset and the lower the perceived speed of the kinaesthetic illusion. Although vision dominates perception in a context of visuoproprioceptive conflict (as in the mirror paradigm), our results show that the relative weightings allocated to proprioceptive and visual signals vary according to the degree of spatial incongruence prior to movement onset.

The moving rubber hand illusion revisited: comparing movements and visuotactile stimulation to induce illusory ownership

The rubber hand illusion is a perceptual illusion in which a model hand is experienced as part of one's own body. In the present study we directly compared the classical illusion, based on visuotactile stimulation, with a rubber hand illusion based on active and passive movements. We examined the question of which combinations of sensory and motor cues are the most potent in inducing the illusion by subjective ratings and an objective measure (proprioceptive drift). In particular, we were interested in whether the combination of afferent and efferent signals in active movements results in the same illusion as in the purely passive modes. Our results show that the illusion is equally strong in all three cases. This demonstrates that different combinations of sensory input can lead to a very similar phenomenological experience and indicates that the illusion can be induced by any combination of multisensory information.

Phantom limbs: pain, embodiment, and scientific advances in integrative therapies

Research over the past two decades has begun to identify some of the key mechanisms underlying phantom limb pain and sensations; however, this continues to be a clinically challenging condition to manage. Treatment of phantom pain, like all chronic pain conditions, demands a holistic approach that takes into consideration peripheral, spinal, and central neuroplastic mechanisms. In this review, we focus on nonpharmacological treatments tailored to reverse the maladaptive neuroplasticity associated with phantom pain. Recent scientific advances emerging from interdisciplinary research between neuroscience, virtual reality, robotics, and prosthetics show the greatest promise for alternative embodiment and maintaining the integrity of the multifaceted representation of the body in the brain. Importantly, these advances have been found to prevent and reduce phantom limb pain. In particular, therapies that involve sensory and/or motor retraining, most naturally through the use of integrative prosthetic devices, as well as peripheral (e.g., transcutaneous electrical nerve stimulation) or central (e.g., transcranial magnetic stimulation or deep brain stimulation) stimulation techniques, have been found to both restore the neural representation of the missing limb and to reduce the intensity of phantom pain. While the evidence for the efficacy of these therapies is mounting, but well-controlled and large-scale studies are still needed. WIREs Cogn Sci 2014, 5:221-231. doi: 10.1002/wcs.1277 CONFLICT OF INTEREST: The authors have no financial or other relationship that might lead to a conflict of interest. For further resources related to this article, please visit the WIREs website.

Implicit and explicit representations of hand position in tool use

Understanding the interactions of visual and proprioceptive information in tool use is important as it is the basis for learning of the tool's kinematic transformation and thus skilled performance. This study investigated how the CNS combines seen cursor positions and felt hand positions under a visuo-motor rotation paradigm. Young and older adult participants performed aiming movements on a digitizer while looking at rotated visual feedback on a monitor. After each movement, they judged either the proprioceptively sensed hand direction or the visually sensed cursor direction. We identified asymmetric mutual biases with a strong visual dominance. Furthermore, we found a number of differences between explicit and implicit judgments of hand directions. The explicit judgments had considerably larger variability than the implicit judgments. The bias toward the cursor direction for the explicit judgments was about twice as strong as for the implicit judgments. The individual biases of explicit and implicit judgments were uncorrelated. Biases of these judgments exhibited opposite sequential effects. Moreover, age-related changes were also different between these judgments. The judgment variability was decreased and the bias toward the cursor direction was increased with increasing age only for the explicit judgments. These results indicate distinct explicit and implicit neural representations of hand direction, similar to the notion of distinct visual systems.

A self-organizing model of the visual development of hand-centred representations

We show how hand-centred visual representations could develop in the primate posterior parietal and premotor cortices during visually guided learning in a self-organizing neural network model. The model incorporates trace learning in the feed-forward synaptic connections between successive neuronal layers. Trace learning encourages neurons to learn to respond to input images that tend to occur close together in time. We assume that sequences of eye movements are performed around individual scenes containing a fixed hand-object configuration. Trace learning will then encourage individual cells to learn to respond to particular hand-object configurations across different retinal locations. The plausibility of this hypothesis is demonstrated in computer simulations.

Effect of a mirror-like illusion on activation in the precuneus assessed with functional near-infrared spectroscopy

Mirror therapy is a therapy to treat patients with pain syndromes or hemiparesis after stroke. However, the underlying neurophysiologic mechanisms are not clearly understood. In order to determine the effect of a mirror-like illusion (MIR) on brain activity using functional near-infrared spectroscopy, 20 healthy right-handed subjects were examined. A MIR was induced by a digital horizontal inversion of the subjects' filmed hand. Optodes were placed on the primary motor cortex (M1) and the occipito-parietal cortex (precuneus, PC). Regions of interest (ROI) were defined a priori based on previous results of similar studies and confirmed by the analysis of effect sizes. Analysis of variance of the ROI signal revealed a dissociated pattern: at the PC, the MIR caused a significant inversion of a hemispheric lateralization opposite to the perceived hand, independent of the moving hand. In contrast, activity in M1 showed lateralization opposite to the moving hand, but revealed no mirror effect. These findings extend our understanding on interhemispheric rivalry and indicate that a MIR is integrated into visuomotor coordination similar to normal view, irrespective of the hand that is actually performing the task.