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

Predicting the bodily self in space and time

To understand how the human brain distinguishes itself from external stimulation, it was examined if motor predictions enable healthy adult volunteers to infer self-location and to distinguish their body from the environment (and other agents). By uniquely combining a VR-setup with full-body motion capture, a full-body illusion paradigm (FBI) was developed with different levels of motion control: (A) a standard, passive FBI in which they had no motion control; (B) an active FBI in which they made simple, voluntary movements; and (C) an immersive game in which they real-time controlled a human-sized avatar in third person. Systematic comparisons between measures revealed a causal relationship between (i) motion control (prospective agency), (ii) self-other identification, and (iii) the ability to locate oneself. Healthy adults could recognise their movements in a third-person avatar and psychologically align with it (action observation); but did not lose a sense of place (self-location), time (temporal binding), nor who they are (self/other). Instead, motor predictions enabled them to localise their body and to distinguish self from other. In the future, embodied games could target and strengthen the brain's control networks in psychosis and neurodegeneration; real-time motion simulations could help advance neurorehabilitation techniques by fine-tuning and personalising therapeutic settings.

Out-of-body experiences in relation to lucid dreaming and sleep paralysis: A theoretical review and conceptual model

Out-of-body experiences (OBEs) are characterized by the subjective experience of being located outside the physical body. Little is known about the neurophysiology of spontaneous OBEs, which are often reported by healthy individuals as occurring during states of reduced vigilance, particularly in proximity to or during sleep (sleep-related OBEs). In this paper, we review the current state of research on sleep-related OBEs and hypothesize that maintaining consciousness during transitions from wakefulness to REM sleep (sleep-onset REM periods) may facilitate sleep-related OBEs. Based on this hypothesis, we propose a new conceptual model that potentially describes the relationship between OBEs and sleep states. The model sheds light on the phenomenological differences between sleep-related OBEs and similar states of consciousness, such as lucid dreaming (the realization of being in a dream state) and sleep paralysis (feeling paralyzed while falling asleep or waking up), and explores the potential polysomnographic features underlying sleep-related OBEs. Additionally, we apply the predictive coding framework and suggest a connecting link between sleep-related OBEs and OBEs reported during wakefulness.

Localization of Vestibular Cortex Using Electrical Cortical Stimulation: A Systematic Literature Review

The vestibular system plays a fundamental role in body orientation, posture control, and spatial and body motion perception, as well as in gaze and eye movements. We aimed to review the current knowledge regarding the location of the cortical and subcortical areas, implicated in the processing of vestibular stimuli. The search was performed in PubMed and Scopus. We focused on studies reporting on vestibular manifestations after electrical cortical stimulation. A total of 16 studies were finally included. Two main types of vestibular responses were elicited, including vertigo and perception of body movement. The latter could be either rotatory or translational. Electrical stimulation of the temporal structures elicited mainly vertigo, while stimulation of the parietal lobe was associated with perceptions of body movement. Stimulation of the occipital lobe produced vertigo with visual manifestations. There was evidence that the vestibular responses became more robust with increasing current intensity. Low-frequency stimulation proved to be more effective than high-frequency in eliciting vestibular responses. Numerous non-vestibular responses were recorded after stimulation of the vestibular cortex, including somatosensory, viscero-sensory, and emotional manifestations. Newer imaging modalities such as functional MRI (fMRI), Positron Emission Tomography (PET), SPECT, and near infra-red spectroscopy (NIRS) can provide useful information regarding localization of the vestibular cortex.

Relating different Dimensions of Bodily Experiences: Review and proposition of an integrative model relying on phenomenology, predictive brain and neuroscience of the self

How we mentally experience our body has been studied in a variety research domains. Each of these domains focuses in its own ways on different aspects of the body, namely the neurophysiological, perceptual, affective or social components, and proposes different conceptual taxonomies. It is therefore difficult to find one's way through this vast literature and to grasp the relationships between the different dimensions of bodily experiences. In this narrative review, we summarize the existing research directions and present their limits. We propose an integrative framework, grounded in studies on phenomenal consciousness, self-consciousness and bodily self-consciousness, that can provide a common basis for evaluating findings on different dimensions of bodily experiences. We review the putative mechanisms, relying on predictive processes, and neural substrates that support this model. We discuss how this model enables a conceptual assessment of the interrelationships between multiple dimensions of bodily experiences and potentiate interdisciplinary approaches.

SD-CNN: A static-dynamic convolutional neural network for functional brain networks

Static functional connections (sFCs) and dynamic functional connections (dFCs) have been widely used in the resting-state functional MRI (rs-fMRI) analysis. sFCs, calculated based on entire rs-fMRI scans, can accurately describe the static topology of the brain network. dFCs, estimated by dividing rs-fMRI scans into a series of short sliding windows, are used to reveal time-varying changes in FC patterns. Currently, how to jointly use sFCs and dFCs to identify brain diseases under the framework of deep learning is still a hot issue. To this end, we propose a static-dynamic convolutional neural network for functional brain networks, which involves a static pathway and a dynamic pathway for taking full advantages of sFCs and dFCs. Specifically, the static pathway, using high-resolution convolution filters (i.e., convolution filters with a high number of channels) at a single adjacency matrix of sFCs, is performed to capture static FC patterns. The dynamic pathway, using low-resolution convolution filters at each adjacency matrix of dFCs, is performed to capture time-varying FC patterns. Two types of diffusion connections are used in this model for encouraging the transfer of information between the static pathway and the dynamic pathway, which can make the learned features more discriminative. Furthermore, a static and dynamic combination classifier is introduced to combine features from two pathways for identifying brain diseases. Experiments on two real datasets demonstrate the effectiveness and advantages of our proposed method.

The Development of a Flexible Bodily Representation: Behavioral Outcomes and Brain Oscillatory Activity During the Rubber Hand Illusion in Preterm and Full-Term School-Age Children

During childhood, the body undergoes rapid changes suggesting the need to constantly update body representation based on the integration of multisensory signals. Sensory experiences in critical periods of early development may have a significant impact on the neurobiological mechanisms underpinning the development of the sense of one’s own body. Specifically, preterm children are at risk for sensory processing difficulties, which may lead to specific vulnerability in binding together sensory information in order to modulate the representation of the bodily self. The present study aims to investigate the malleability of body ownership in preterm (N = 21) and full-term (N = 19) school-age children, as reflected by sensitivity to the Rubber Hand Illusion. The results revealed that multisensory processes underlying the ability to identify a rubber hand as being part of one’s own body are already established in childhood, as indicated by a higher subjective feeling of embodiment over the rubber hand during synchronous visual-tactile stimulation. Notably, the effect of visual-tactile synchrony was related to the suppression of the alpha band oscillations over frontal, central, and parietal scalp regions, possibly indicating a greater activation of somatosensory and associative areas underpinning the illusory body ownership. Moreover, an interaction effect between visual-tactile condition and group emerged, suggesting that preterm children showed a greater suppression of alpha oscillatory activity during the illusion. This result together with lower scores of subjective embodiment over the rubber hand reported by preterm children indicate that preterm birth may affect the development of the flexible representation of the body. These findings provide an essential contribution to better understand the processes of identification and differentiation of the bodily self from the external environment, in both full-term and preterm children, paving the way for a multisensory and embodied approach to the investigation of social and cognitive development.

Autoscopic phenomena as an atypical psychiatric presentation of Huntington's disease: A case report including longitudinal clinical and neuroimaging data

Huntington's disease (HD) is a monogenetic neurodegenerative disease prototypically characterized by the progressive presentation of motor abnormalities, cognitive deterioration and neuropsychiatric symptoms. Even when the disorder is diagnosed based on the presence of unequivocal motor symptoms, subtle cognitive and behavioral changes emerge decades before the first motor manifestations. Here we present the atypical case of a young premanifest gene-mutation carrier who developed progressive complex autoscopic phenomena (feelings of presence, out of body experience, and heautoscopic hallucinations). To our knowledge, this is the first report of these symptoms in the context of HD. Considering the availability of serial neurologic, neuropsychological and neuroimaging data collected before and after the presentation of these symptoms, this case provides new insights into the brain mechanisms leading to autoscopic phenomena and atypical phenotypes that may occur in HD.

Vestibular Function in Adults With Epilepsy of Unknown Etiology

OBJECTIVE

This study aimed to evaluate vestibular function in adults with chronic epilepsy of unknown etiology in the inter-ictal period.

BACKGROUND

Epilepsy is a chronic medical disorder. Life-long therapy may be required in one-third of patients. Epilepsy is associated with comorbid somatic conditions which impairs patients' quality of life.

METHODS

This cross-sectional study included 28 with generalized tonic clonic (GTC) convulsions and 14 and 3 with temporal (TLE) and frontal lobe (FLE) epilepsies with secondary generalization (all were on regular carbamazepine therapy) and 40 healthy control subjects. The patients' mean age was 34.97 ± 7.35 years and the duration of illness was 18.75 ± 7.99 years. All underwent videonystagmography (VNG).

RESULTS

Compared with controls, patients had frequent vestibular symptoms including dizziness (62.22%) (p = 0.0001) and sense of imbalance (44.44%) (p = 0.0001). Eleven patients (24.44%) had central vestibular dysfunction (p = 0.0001); 9 (20%) had mixed vestibular dysfunction and one (2.22%) had peripheral vestibular dysfunction (p = 0.0001). Abnormalities were observed in saccadic (44.4%) and pursuit (42.2%) eye movements, optokinetic nystagmus (42.2%) and positioning/positional (11.11%) and caloric (13.33%) testing. TLE and FLE were associated with more VNG abnormalities than GTC. No significant differences were observed in the demographic and clinical characteristics between patients with and without VNG abnormalities.

CONCLUSION

Vestibular manifestations are frequent in patients with epilepsy. This may be a result of the permanent damaging effect of chronic epilepsy on the vestibular cortical areas and/or a toxic effect from prolonged carbamazepine therapy on the peripheral and central vestibular systems.

Incidence and localizing value of vertigo and dizziness in patients with epilepsy: Video-EEG monitoring study

Vertigo and dizziness are common neurological complaints that have long been associated with epilepsy. However, studies of patients with epileptic vertigo or dizziness with concurrent EEG monitoring are scarce. We performed the present study to investigate the incidence and localizing value of vertigo and dizziness in patients with epilepsy who had confirmation of EEG changes via video-EEG monitoring. Data of aura and clinical seizure episodes of 831 consecutive patients who underwent video-EEG monitoring were analyzed retrospectively. Out of 831 patients, 40 patients (4.8%) experienced vertigo or dizziness as aura (mean age, 32.8±11.8years), all of whom had partial seizures. Eight had mesial temporal, 20 had lateral temporal, four had frontal, one had parietal, and seven had occipital lobe onset seizures. An intracranial EEG with cortical stimulation study was performed in seven patients, and the area of stimulation-induced vertigo or dizziness coincided with the ictal onset area in only one patient. Our study showed that vertigo or dizziness is a common aura in patients with epilepsy, and that the temporal lobe is the most frequent ictal onset area in these patients. However, it can be suggested that the symptomatogenic area in patients with epileptic vertigo and dizziness may not coincide with the ictal onset area.

The Moving History of Vestibular Stimulation as a Therapeutic Intervention

Although the discovery and understanding of the function of the vestibular system date back only to the 19th century, strategies that involve vestibular stimulation were used long before to calm, soothe and even cure people. While such stimulation was classically achieved with various motion devices, like Cox's chair or Hallaran's swing, the development of caloric and galvanic vestibular stimulation has opened up new possibilities in the 20th century. With the increasing knowledge and recognition of vestibular contributions to various perceptual, motor, cognitive, and emotional processes, vestibular stimulation has been suggested as a powerful and non-invasive treatment for a range of psychiatric, neurological and neurodevelopmental conditions. Yet, the therapeutic interventions were, and still are, often not hypothesis-driven as broader theories remain scarce and underlying neurophysiological mechanisms are often vague. We aim to critically review the literature on vestibular stimulation as a form of therapy in various selected disorders and present its successes, expectations, and drawbacks from a historical perspective.

Third International Congress on Epilepsy, Brain, and Mind: Part 2

Epilepsy is both a disease of the brain and the mind. Here, we present the second of two papers with extended summaries of selected presentations of the Third International Congress on Epilepsy, Brain and Mind (April 3-5, 2014; Brno, Czech Republic). Humanistic, biologic, and therapeutic aspects of epilepsy, particularly those related to the mind, were discussed. The extended summaries provide current overviews of epilepsy, cognitive impairment, and treatment, including brain functional connectivity and functional organization; juvenile myoclonic epilepsy; cognitive problems in newly diagnosed epilepsy; SUDEP including studies on prevention and involvement of the serotoninergic system; aggression and antiepileptic drugs; body, mind, and brain, including pain, orientation, the "self-location", Gourmand syndrome, and obesity; euphoria, obsessions, and compulsions; and circumstantiality and psychiatric comorbidities.

Changing perspective: The role of vestibular signals

Social interactions depend on mechanisms such as the ability to take another person's viewpoint, i.e. visuo-spatial perspective taking. However, little is known about the sensorimotor mechanisms underpinning perspective taking. Because vestibular signals play roles in mental rotation and spatial cognition tasks and because damage to the vestibular cortex can disturb egocentric perspective, vestibular signals stand as important candidates for the sensorimotor foundations of perspective taking. Yet, no study merged natural full-body vestibular stimulations and explicit visuo-spatial perspective taking tasks in virtual environments. In Experiment 1, we combined natural vestibular stimulation on a rotatory chair with virtual reality to test how vestibular signals are processed to simulate the viewpoint of a distant avatar. While they were rotated, participants tossed a ball to a virtual character from the viewpoint of a distant avatar. Our results showed that vestibular signals influence perspective taking in a direction-specific way: participants were faster when their physical body rotated in the same direction as the mental rotation needed to take the avatar's viewpoint. In Experiment 2, participants realized 3D object mental rotations, which did not involve perspective taking, during the same whole-body vestibular stimulation. Our results demonstrated that vestibular stimulation did not affect 3D object mental rotations. Altogether, these data indicate that vestibular signals have a direction-specific influence on visuo-spatial perspective taking (self-centered mental imagery), but not a general effect on mental imagery. Findings from this study suggest that vestibular signals contribute to one of the most crucial mechanisms of social cognition: understanding others' actions.

Out-of-Body Experiences and Other Complex Dissociation Experiences in a Patient with Unilateral Peripheral Vestibular Damage and Deficient Multisensory Integration

Out-of-body experiences (OBEs) are illusory perceptions of one’s body from an elevated disembodied perspective. Recent theories postulate a double disintegration process in the personal (visual, proprioceptive and tactile disintegration) and extrapersonal (visual and vestibular disintegration) space as the basis of OBEs. Here we describe a case which corroborates and extends this hypothesis. The patient suffered from peripheral vestibular damage and presented with OBEs and lucid dreams. Analysis of the patient’s behaviour revealed a failure of visuo-vestibular integration and abnormal sensitivity to visuo-tactile conflicts that have previously been shown to experimentally induce out-of-body illusions (in healthy subjects). In light of these experimental findings and the patient’s symptomatology we extend an earlier model of the role of vestibular signals in OBEs. Our results advocate the involvement of subcortical bodily mechanisms in the occurrence of OBEs.

The brain network reflecting bodily self-consciousness: a functional connectivity study

Several brain regions are important for processing self-location and first-person perspective, two important aspects of bodily self-consciousness. However, the interplay between these regions has not been clarified. In addition, while self-location and first-person perspective in healthy subjects are associated with bilateral activity in temporoparietal junction (TPJ), disturbed self-location and first-person perspective result from damage of only the right TPJ. Identifying the involved brain network and understanding the role of hemispheric specializations in encoding self-location and first-person perspective, will provide important information on system-level interactions neurally mediating bodily self-consciousness. Here, we used functional connectivity and showed that right and left TPJ are bilaterally connected to supplementary motor area, ventral premotor cortex, insula, intraparietal sulcus and occipitotemporal cortex. Furthermore, the functional connectivity between right TPJ and right insula had the highest selectivity for changes in self-location and first-person perspective. Finally, functional connectivity revealed hemispheric differences showing that self-location and first-person perspective modulated the connectivity between right TPJ, right posterior insula, and right supplementary motor area, and between left TPJ and right anterior insula. The present data extend previous evidence on healthy populations and clinical observations in neurological deficits, supporting a bilateral, but right-hemispheric dominant, network for bodily self-consciousness.

A neuroscientific account of how vestibular disorders impair bodily self-consciousness

The consequences of vestibular disorders on balance, oculomotor control, and self-motion perception have been extensively described in humans and animals. More recently, vestibular disorders have been related to cognitive deficits in spatial navigation and memory tasks. Less frequently, abnormal bodily perceptions have been described in patients with vestibular disorders. Altered forms of bodily self-consciousness include distorted body image and body schema, disembodied self-location (out-of-body experience), altered sense of agency, as well as more complex experiences of dissociation and detachment from the self (depersonalization). In this article, I suggest that vestibular disorders create sensory conflict or mismatch in multisensory brain regions, producing perceptual incoherence and abnormal body and self perceptions. This hypothesis is based on recent functional mapping of the human vestibular cortex, showing vestibular projections to the primary and secondary somatosensory cortex and in several multisensory areas found to be crucial for bodily self-consciousness.

Epilepsy and the cortical vestibular system: tales of dizziness and recent concepts

Cortical representations of the vestibular system are now well recognized. In contrast, the fact that epilepsy can affect these systems, provoking transient vestibular symptoms, is less known. Focal seizures may nonetheless manifest by prominent vestibular changes ranging from mild unsteadiness to true rotational vertigo. Most often these symptoms are associated with other subjective manifestations. In pure vestibular forms, the diagnosis may be more difficult and is often delayed. The cortical origin of these symptoms will be discussed and compared with the known "vestibular" cortical representations. In addition, the existence of a specific "vestibular epilepsy" has been suggested in some publications. This condition affects young subjects with a frequent family history and most often a benign evolution, raising the possibility of a form of idiopathic epilepsy (Hewett etal., 2011).

Abnormal brain activation of adolescent internet addict in a ball-throwing animation task: possible neural correlates of disembodiment revealed by fMRI

While adolescent internet addicts are immersed in cyberspace, they are easily able to experience 'disembodied state'. The purposes of this study were to investigate the difference of brain activity between adolescent internet addicts and normal adolescents in a state of disembodiment, and to find the correlation between the activities of disembodiment-related areas and the behavioral characteristics related to internet addiction. The fMRI images were taken while the addiction group (N=17) and the control group (N=17) were asked to perform the task composed with ball-throwing animations. The task reflected on either self-agency about ball-throwing or location of a ball. And each block was shown with either different (Changing View) or same animations (Fixed View). The disembodiment-related condition was the interaction between Agency Task and Changing View. Within-group analyses revealed that the addiction group exhibited higher activation in the thalamus, bilateral precentral area, bilateral middle frontal area, and the area around the right temporo-parietal junction. And between-group analyses showed that the addiction group exhibited higher activation in the area near the left temporo-parieto-occipital junction, right parahippocampal area, and other areas than the control group. Finally, the duration of internet use was significantly correlated with the activity of posterior area of left middle temporal gyrus in the addiction group. These results show that the disembodiment-related activation of the brain is easily manifested in adolescent internet addicts. Internet addiction of adolescents could be significantly unfavorable for their brain development related with identity formation.

Unilateral autoscopic phenomena as a lateralizing sign in focal epilepsy

Positive autoscopic phenomena - autoscopy, heautoscopy and out-of-body experience - may occur in a variety of diseases and also in physiological conditions. They are a rare but probably underreported phenomenon in focal epilepsies. Here, we investigate whether ictal lateralized autoscopic phenomena give lateralizing information about the underlying epileptic focus. We present the cases of seven patients from our center who experienced ictal lateralized autoscopic phenomena and analyzed their focus lateralization and localization of the underlying brain lesion. In addition, we reviewed seven cases published in German and English language literature. In the total group of 14 patients with ictal lateralized autoscopic phenomena, 12 (85.7%) of them had a well-defined epileptic focus contralateral to the side of the autoscopic appearance. Therefore, the data point to an association between ictal lateralized autoscopy and contralateral epileptic focus.

Multi-sensory and sensorimotor foundation of bodily self-consciousness - an interdisciplinary approach

Scientific investigations on the nature of the self have so far focused on high-level mechanisms. Recent evidence, however, suggests that low-level bottom-up mechanisms of multi-sensory integration play a fundamental role in encoding specific components of bodily self-consciousness, such as self-location and first-person perspective (Blanke and Metzinger, 2009). Self-location and first-person perspective are abnormal in neurological patients suffering from out-of-body experiences (Blanke et al., 2004), and can be manipulated experimentally in healthy subjects by imposing multi-sensory conflicts (Lenggenhager et al., 2009). Activity of the temporo-parietal junction (TPJ) reflects experimentally induced changes in self-location and first-person perspective (Ionta et al., 2011), and dysfunctions in TPJ are causally associated with out-of-body experiences (Blanke et al., 2002). We argue that TPJ is one of the key areas for multi-sensory integration of bodily self-consciousness, that its levels of activity reflect the experience of the conscious "I" as embodied and localized within bodily space, and that these mechanisms can be systematically investigated using state of the art technologies such as robotics, virtual reality, and non-invasive neuroimaging.

Benign temporo-parieto-occipital junction epilepsy with vestibular disturbance: an underrecognized form of epilepsy?

We describe a series of adolescents and adults who share the electroclinical characteristics of a nonlesional, pharmacoresponsive epilepsy manifesting as prominent vestibular disturbances, suggesting a temporo-parieto-occipital (TPO) junction origin. We retrospectively reviewed a database of consecutive patients referred to the epilepsy clinic over a 10-year period with respect to the following criteria: recurrent episodes of paroxysmal vestibular symptoms, normal MRI, and interictal EEG changes over the posterior regions. Fourteen patients were finally selected (10 males, 4 females). Mean age at onset was 26.5 (range: 12-59). The diagnosis of epilepsy was usually delayed until after cardiology and/or otorhinolaryngology workup. The predominant features on interictal scalp EEGs were abnormalities over the posterior areas. All patients responded well to antiepileptic medication. We propose that although further characterization is needed to label it a syndrome, this underdiagnosed form of epilepsy merits recognition.

Partial and full own-body illusions of epileptic origin in a child with right temporoparietal epilepsy

Partial and full own-body illusions of neurological origin have been claimed crucial to understand the contribution of bodily experience and perception to self-consciousness. Whereas partial body illusions are relatively common and well defined, much less is known about full own-body illusions, and even less is known about these illusions in children. Here we describe a 10-year-old patient with the association of partial and full own-body illusions (somatoparaphrenia and out-of-body experience) that occurred sequentially during an epileptic seizure caused by right temporoparietal epilepsy. This report shows that partial and full own-body illusions share functional and neuroanatomical properties and highlights the importance of the right temporoparietal junction for bodily self-consciousness. This is the first report of out-of-body experiences in a child with focal epilepsy.

The thalamocortical vestibular system in animals and humans

The vestibular system provides the brain with sensory signals about three-dimensional head rotations and translations. These signals are important for postural and oculomotor control, as well as for spatial and bodily perception and cognition, and they are subtended by pathways running from the vestibular nuclei to the thalamus, cerebellum and the "vestibular cortex." The present review summarizes current knowledge on the anatomy of the thalamocortical vestibular system and discusses data from electrophysiology and neuroanatomy in animals by comparing them with data from neuroimagery and neurology in humans. Multiple thalamic nuclei are involved in vestibular processing, including the ventroposterior complex, the ventroanterior-ventrolateral complex, the intralaminar nuclei and the posterior nuclear group (medial and lateral geniculate nuclei, pulvinar). These nuclei contain multisensory neurons that process and relay vestibular, proprioceptive and visual signals to the vestibular cortex. In non-human primates, the parieto-insular vestibular cortex (PIVC) has been proposed as the core vestibular region. Yet, vestibular responses have also been recorded in the somatosensory cortex (area 2v, 3av), intraparietal sulcus, posterior parietal cortex (area 7), area MST, frontal cortex, cingulum and hippocampus. We analyze the location of the corresponding regions in humans, and especially the human PIVC, by reviewing neuroimaging and clinical work. The widespread vestibular projections to the multimodal human PIVC, somatosensory cortex, area MST, intraparietal sulcus and hippocampus explain the large influence of vestibular signals on self-motion perception, spatial navigation, internal models of gravity, one's body perception and bodily self-consciousness.

Exploring the impact of ketamine on the experience of illusory body ownership

BACKGROUND

Our sense of body ownership is profound and familiar, yet it may be misleading. In the rubber-hand illusion, synchronous tactile and visual stimulation lead to the experience that a rubber hand is actually one's own. This illusion is stronger in schizophrenia. Given the evidence that ketamine, a noncompetitive N-methyl-D-aspartate antagonist reproduces symptoms of schizophrenia, we sought to determine whether the rubber-hand illusion is augmented by ketamine.

METHODS

We studied 15 healthy volunteers in a within-subjects placebo-controlled study. All volunteers carried out two versions of the rubber-hand task, each under both placebo and ketamine infusions. In one task, they saw a rubber hand being stroked in synchrony with tactile stimulation of their real, hidden hand. In the other, stroking of the real and rubber hands was asynchronous. We recorded subjective changes in sense of ownership, as well as participants' ability to localize their hidden hand.

RESULTS

Ketamine was associated with significant increases in subjective measures of the illusion and in hand mislocalization. Although asynchronous visuotactile stimulation attenuates the strength of the illusion during both placebo and ketamine, there remained a significant illusory effect during asynchronous visuotactile stimulation under ketamine compared with placebo. The strength of the illusion during asynchronous visuotactile stimulation correlated with other subjective effects of the drug.

CONCLUSIONS

Ketamine mimics the perturbed sense of body ownership seen in schizophrenia, suggesting that it produces a comparable alteration in integration of information across sensory domains and in the subjective and behavioral consequences of such integration.