Multisensory integration and the body schema: close to hand and within reach

Peripersonal space: why so last-second?

A vast range of neurophysiological, neuropsychological and behavioural results in monkeys and humans have shown that the immediate surroundings of the body, also known as peripersonal space (PPS), are processed in a unique way. Three roles have been ascribed to PPS mechanisms: to react to threats, to avoid obstacles and to act on objects. However, in many circumstances, one does not wait for objects or agents to enter PPS to plan these behaviours. Typically, one has more chances to survive if one starts running away from the lion when one sees it in the distance than if it is a few steps away. PPS makes sense in shortsighted creatures but we are not such creatures. The crucial question is thus twofold: (i) why are these adaptive processes triggered only at the last second or even milliseconds? And (ii) what is their exact contribution, especially for defensive and navigational behaviours? Here, we propose that PPS mechanisms correspond to a plan B, useful in unpredictable situations or when other anticipatory mechanisms have failed. Furthermore, we argue that there are energetic, cognitive and behavioural costs to PPS mechanisms, which explain why this plan B is triggered only at the last second. This article is part of the theme issue 'Minds in movement: embodied cognition in the age of artificial intelligence'.

Robotic task specific training for upper limb neurorehabilitation: a mixed methods feasibility trial reporting achievable dose

PURPOSE

Robotic devices for upper-limb neurorehabilitation allow an increase in intensity of practice, often relying on video game-based training strategies with limited capacity to individualise training and integrate functional training. This study shows the development of a robotic Task Specific Training (TST) protocol and evaluate the achieved dose.

MATERIALS AND METHODS

Mixed-method study. A 3D robotic device for the upper limb, was made available to therapists for use during neurorehabilitation sessions. A first phase allowed clinicians to define a dedicated session protocol for TST. In a second phase the protocol was applied and the achieved dose was measured.

RESULTS

First phase (N = 5): a specific protocol, using deweighting for assessment, followed by customised passive movements and then active movement practice was developed. Second phase: the protocol was successfully applied with all participants (N = 10). Intervention duration: 4.5 ± 0.8 weeks, session frequency: 1.4 ± 0.2sessions/week, session length: 42 ± 9mins, session density: 39 ± 13%, intensity: 214 ± 84 movements/session, difficulty: dn = 0.77 ± 0.1 (normalised reaching distance) and Ɵ = 6.3 ± 23° (transverse reaching angle). Sessions' density and intensity were consistent across participants but clear differences of difficulty were observed. No changes in metrics were observed over the intervention.

CONCLUSIONS

Robotic systems can support TST with high therapy intensity by modulating the practice difficulty to participants' needs and capabilities.

Comparison of head posture and neck proprioceptive sense of individuals with chronic neck pain and healthy controls: A cross-sectional study

BACKGROUND

Chronic pain can affect body perception at the central level by causing the somatosensory cortex to rearrange. Additionally, cervical afferent abnormalities in individuals with neck pain can impair proprioceptive sensitivity, potentially leading to alterations in body alignment and biomechanics. Nevertheless, there are insufficient studies exploring these notions.

OBJECTIVE

The main objective of this study was to compare the head posture and neck proprioceptive sense of individuals with chronic neck pain and healthy controls.

METHODS

Utilizing a cross-sectional study, a total of 76 volunteers comprising 38 individuals with neck pain and 38 matched healthy controls participated in the study. Head posture and cervical joint position sense were measured using a Cervical Range of Motion Deluxe (CROM) device. Firstly, the deviation angles of the head in three planes were evaluated, then the Head Repositioning Accuracy (HRA) test was performed to determine the joint position error. Visual Analogue Scale (VAS) was used to determine the severity of pain in individuals with neck pain.

RESULTS

The deviation angles of the head in all three planes were significantly lower in the healthy control group (p< 0.05). Joint position error values were significantly higher in all directions (flexion-extension, right-left lateral flexion, and rotation) in the neck pain group (p< 0.001).

CONCLUSION

The findings show that the proprioceptive sensation of the cervical region in individuals with neck pain was adversely affected, with changes were observed in the head posture.

NOTE

The abstract of this study was presented as a verbal declaration at the International Congress of Health Sciences-ICHES-IDU 2020 that was held in İzmir on 20-21 June 2020.

Influence of Impaired Upper Extremity Motor Function on Static Balance in People with Chronic Stroke

BACKGROUND

Stroke is a leading cause of disability, especially due to an increased fall risk and postural instability. The objective of this study was to analyze the impact of motor impairment in the hemiparetic UE on static balance in standing, in subject with chronic stroke.

METHODS

Seventy adults with chronic stroke, capable of independent standing and walking, participated in this cross-sectional study. The exclusion criteria included vestibular, cerebellar, or posterior cord lesions. The participants were classified based on their UE impairment using the Fugl-Meyer Assessment of Motor Recovery after Stroke (FMA-UE). A posturographic evaluation (mCTSIB) was performed in the standing position to analyze the center of pressure (COP) displacement in the mediolateral (ML) and anteroposterior (AP) axes and its mean speed with eyes open (OE) and closed (EC) on stable and unstable surfaces.

RESULTS

A strong and significant correlation (r = -0.53; p < 0.001) was observed between the mediolateral (ML) center of pressure (COP) oscillation and the FMA-UE, which was particularly strong with eyes closed [r(EO) = 0.5; r(EC) = 0.54]. The results of the multiple linear regression analysis indicated that the ML oscillation is influenced significantly by the FMA-Motor, and specifically by the sections on UE, wrist, coordination/speed, and sensation.

CONCLUSIONS

The hemiparetic UE motor capacity is strongly related to the ML COP oscillation during standing in individuals with chronic stroke, with a lower motor capacity associated with a greater instability. Understanding these relationships underpins the interventions to improve balance and reduce falls in people who have had a stroke.

Rewiring the evolution of the human hand: How the embodiment of a virtual bionic tool improves behavior

Humans are the most versatile tool users among animals. Accordingly, our manual skills evolved alongside the shape of the hand. In the future, further evolution may take place: humans may merge with their tools, and technology may integrate into our biology in a way that blurs the line between the two. So, the question is whether humans can embody a bionic tool (i.e., experience it as part of their body) and thus if this would affect behavior. We investigated in virtual reality how the substitution of the hand with a virtual grafting of an end-effector, either non-naturalistic (a bionic tool) or naturalistic (a hand), impacts embodiment and behavior. Across four experiments, we show that the virtual grafting of a bionic tool elicits a sense of embodiment similar to or even stronger than its natural counterpart. In conclusion, the natural usage of bionic tools can rewire the evolution of human behavior.

Bound by Experience: Updating the Body Representation When Using Virtual Objects

OBJECTIVE

Four web-based experiments investigated flexibility of disembodiment of a virtual object that is no longer actively controlled. Emphasis was on possibilities to modify the timescale of this process.

BACKGROUND

Interactions with virtual objects are commonplace in settings like teleoperation, rehabilitation, and computer-aided design. These objects are quickly integrated into the operator's body schema (embodiment). Less is known about how long such embodiment lasts. Understanding the dynamics of this process is crucial because different applied settings either profit from fast or slow disembodiment.

METHOD

To induce embodiment, participants moved a 2D virtual hand through operating a computer mouse or touchpad. After initial embodiment, participants either stopped or continued moving for a fixed period of time. Embodiment ratings were collected continuously during each trial.

RESULTS

Results across all experiments indicated that embodiment for the virtual hand gradually increased during active use and gradually decreased after stopping to use it. Disembodiment unfolded nearly twice as fast as embodiment and showed a curved decay pattern. These dynamics remained unaffected by anticipation of active control that would be required in an upcoming task.

CONCLUSION

The results highlight the importance of continuously experiencing active control in virtual interactions if aiming at inducing stable embodiment of a virtual object.

APPLICATION

Our findings suggest that applications of virtual disembodiment such as virtual tools or interventions to affect a person's body representation critically depend on continuous updating of sensorimotor experience. However, if switching between virtual objects, for example, during teleoperation or video gaming, after-effects are unlikely to affect performance.

Virtual social grooming in macaques and its psychophysiological effects

Allogrooming is a widespread, pervasive activity among non-human primates. Besides its hygienic function, it is thought to be instrumental in maintaining social bonds and establishing hierarchical structures within groups. However, the question arises as to whether the physiological and social benefits derived from social touch stem directly from body stimulation, or whether other mechanisms come into play. We address this question by analyzing an elaborate social behavior that we observed in two adult male macaques. This behavior demonstrates the existence of a persistent motivation to interact through a form of simulated grooming, as the animals were housed in adjacent enclosures separated by a glass panel preventing direct tactile contact. We find that such virtual grooming produces similar physiological sensations and social effects as allogrooming. We suggest that this behavior engages affective and reward brain circuits to the same extent as real social touch, and that this is probably achieved through high level processes similar to those involved in bodily illusions or synaesthetic phenomena previously described in humans. This observation reveals the unsuspected capacity of non-human primates to invent alternative, quasi-symbolic strategies to obtain effects similar to those provided by direct bodily interaction, which are so important for maintaining social bonds.

The different impact of attention, movement, and sensory information on body metric representation

A growing body of research investigating the relationship between body representation and tool-use has shown that body representation is highly malleable. The nature of the body representation does not consist only of sensory attributes but also of motor action-oriented qualities, which may modulate the subjective experience of our own body. However, how these multisensory factors and integrations may specifically guide and constrain body reorientation's plasticity has been under-investigated. In this study, we used a forearm bisection task to selectively investigate the contribution of motor, sensory, and attentional aspects in guiding body representation malleability. Results show that the perceived forearm midpoint deviates from the real one. This shift is further modulated by a motor task but not by a sensory task, whereas the attentional task generates more uncertain results. Our findings provide novel insight into the individual role of movement, somatosensation, and attention in modulating body metric representation.

Mindfulness Affects the Boundaries of Bodily Self-Representation: The Effect of Focused-Attention Meditation in Fading the Boundary of Peripersonal Space

Peripersonal space (PPS) is a dynamic multisensory representation of the space around the body, influenced by internal and external sensory information. The malleability of PPS boundaries, as evidenced by their expansion after tool use or modulation through social interactions, positions PPS as a crucial element in understanding the subjective experiences of self and otherness. Building on the existing literature highlighting both the cognitive and bodily effects of mindfulness meditation, this study proposes a novel approach by employing focused-attention meditation (FAM) and a multisensory audio-tactile task to assess PPS in both the extension and sharpness of its boundaries. The research hypothesis posits that FAM, which emphasizes heightened attention to bodily sensations and interoception, may reduce the extension of PPS and make its boundaries less sharp. We enrolled 26 non-meditators who underwent a repeated measure design in which they completed the PPS task before and after a 15-min FAM induction. We found a significant reduction in the sharpness of PPS boundaries but no significant reduction in PPS extension. These results provide novel insights into the immediate effects of FAM on PPS, potentially shedding light on the modulation of self-other representations in both cognitive and bodily domains. Indeed, our findings could have implications for understanding the intricate relationship between mindfulness practices and the subjective experience of self within spatial contexts.

Cortical activations associated with spatial remapping of finger touch using EEG

The spatial coding of tactile information is functionally essential for touch-based shape perception and motor control. However, the spatiotemporal dynamics of how tactile information is remapped from the somatotopic reference frame in the primary somatosensory cortex to the spatiotopic reference frame remains unclear. This study investigated how hand position in space or posture influences cortical somatosensory processing. Twenty-two healthy subjects received electrical stimulation to the right thumb (D1) or little finger (D5) in three position conditions: palm down on right side of the body (baseline), hand crossing the body midline (effect of position), and palm up (effect of posture). Somatosensory-evoked potentials (SEPs) were recorded using electroencephalography. One early-, two mid-, and two late-latency neurophysiological components were identified for both fingers: P50, P1, N125, P200, and N250. D1 and D5 showed different cortical activation patterns: compared with baseline, the crossing condition showed significant clustering at P1 for D1, and at P50 and N125 for D5; the change in posture showed a significant cluster at N125 for D5. Clusters predominated at centro-parietal electrodes. These results suggest that tactile remapping of fingers after electrical stimulation occurs around 100-125 ms in the parietal cortex.

Beyond peripersonal boundaries: insights from crossmodal interactions

We experience our self as a body located in space. However, how information about self-location is integrated into multisensory processes underlying the representation of the peripersonal space (PPS), is still unclear. Prior studies showed that the presence of visual information related to oneself modulates the multisensory processes underlying PPS. Here, we used the crossmodal congruency effect (CCE) to test whether this top-down modulation depends on the spatial location of the body-related visual information. Participants responded to tactile events on their bodies while trying to ignore a visual distractor presented on the mirror reflection of their body (Self) either in the peripersonal space (Near) or in the extrapersonal space (Far). We found larger CCE when visual events were presented on the mirror reflection in the peripersonal space, as compared to the extrapersonal space. These results suggest that top-down modulation of the multisensory bodily self is only possible within the PPS.

Subcortical contributions to the sense of body ownership

The sense of body ownership (i.e. the feeling that our body or its parts belong to us) plays a key role in bodily self-consciousness and is believed to stem from multisensory integration. Experimental paradigms such as the rubber hand illusion have been developed to allow the controlled manipulation of body ownership in laboratory settings, providing effective tools for investigating malleability in the sense of body ownership and the boundaries that distinguish self from other. Neuroimaging studies of body ownership converge on the involvement of several cortical regions, including the premotor cortex and posterior parietal cortex. However, relatively less attention has been paid to subcortical structures that may also contribute to body ownership perception, such as the cerebellum and putamen. Here, on the basis of neuroimaging and neuropsychological observations, we provide an overview of relevant subcortical regions and consider their potential role in generating and maintaining a sense of ownership over the body. We also suggest novel avenues for future research targeting the role of subcortical regions in making sense of the body as our own.

The role of bodily self-consciousness in episodic memory of naturalistic events: an immersive virtual reality study

Recent studies suggest that the human body plays a critical role in episodic memory. Still, the precise relationship between bodily self-consciousness (BSC) and memory formation of specific events, especially in real-life contexts, remains a topic of ongoing research. The present study investigated the relationship between BSC and episodic memory (EM) using immersive virtual reality (VR) technology. Participants were immersed in an urban environment with naturalistic events, while their visuomotor feedback was manipulated in three within-subjects conditions: Synchronous, Asynchronous, and No-body. Our results show that asynchronous visuomotor feedback and not seeing one's body, compared to synchronous feedback, decrease the sense of self-identification, self-location and agency, and sense of presence. Moreover, navigating in the Asynchronous condition had a detrimental impact on incidental event memory, perceptual details, contextual association, subjective sense of remembering, and memory consolidation. In contrast, participants in the No-Body condition were only impaired in egocentric spatial memory and the sense of remembering at ten-day delay. We discuss these findings in relation to the role of bodily self-representation in space during event memory encoding. This study sheds light on the complex interplay between BSC, sense of presence, and episodic memory processes, and strengthens the potential of embodiment and VR technology in studying and enhancing human cognition.

Disturbed body schema, perceptual body image, and attitudinal body image in patients with borderline personality disorder

Background

Borderline personality disorder (BPD) is a severe mental disorder that affects attitudes toward the body. However, whether this condition also affects body schema and perceptual body image remains unclear. Previous questionnaire-based studies found dissatisfaction with one's body in patients with BPD. In addition to attitudinal body image, our study investigates whether body schema and perceptual body image are disturbed in patients with BPD.

Method

Our study included 31 patients diagnosed with BPD (25 women) and 30 healthy individuals (19 women) (Mage = 29 for both groups). The SCID-5-PD interview was used to determine personality disorder. Attitudinal body image was measured using the Body Attitude Test (BAT) factors. Body schema and perceptual body image were measured by two conditions of a body representation task, the body portraying method (BPM).

Results

BPD patients achieved higher scores in all three BAT factors and were more susceptible to misinformation in both conditions of BPM. Based on the results, BPD patients appear to have more negative attitudes toward their bodies and worse perceptual body image and body schema.

Conclusion

The novel finding of our study is that, besides the previously found attitudinal dissatisfaction with the body, individuals with BPD also show disturbances at the levels of body schema and perceptual body image. Our findings concerning disturbances in body schema and perceptual body need further research into their etiological factors and provide new therapeutic targets for the treatment of BPD.

Fast updating feedback from piriform cortex to the olfactory bulb relays multimodal reward contingency signals during rule-reversal

While animals readily adjust their behavior to adapt to relevant changes in the environment, the neural pathways enabling these changes remain largely unknown. Here, using multiphoton imaging, we investigated whether feedback from the piriform cortex to the olfactory bulb supports such behavioral flexibility. To this end, we engaged head-fixed mice in a multimodal rule-reversal task guided by olfactory and auditory cues. Both odor and, surprisingly, the sound cues triggered cortical bulbar feedback responses which preceded the behavioral report. Responses to the same sensory cue were strongly modulated upon changes in stimulus-reward contingency (rule reversals). The re-shaping of individual bouton responses occurred within seconds of the rule-reversal events and was correlated with changes in the behavior. Optogenetic perturbation of cortical feedback within the bulb disrupted the behavioral performance. Our results indicate that the piriform-to-olfactory bulb feedback carries reward contingency signals and is rapidly re-formatted according to changes in the behavioral context.

Tool-use training in augmented reality: plasticity of forearm body schema does not predict sense of ownership or agency in older adults

In young adults (YA) who practised controlling a virtual tool in augmented reality (AR), the emergence of a sense of body ownership over the tool was associated with the integration of the virtual tool into the body schema (BS). Agency emerged independent of BS plasticity. Here we aimed to replicate these findings in older adults (OA). Although they are still able to learn new motor tasks, brain plasticity and learning capacity are reduced in OA. We predicted that OA would be able to gain control over the virtual tool indicated by the emergence of agency but would show less BS plasticity as compared to YA. Still, an association between BS plasticity and body ownership was expected. OA were trained in AR to control a virtual gripper to enclose and touch a virtual object. In the visuo-tactile (VT) but not the vision-only (V) condition, vibro-tactile feedback was applied through a CyberTouch II glove when the tool touched the object. BS plasticity was assessed with a tactile distance judgement task where participants judged distances between two tactile stimuli applied to their right forearm. Participants further rated their perceived ownership and agency after training. As expected, agency emerged during the use of the tool. However, results did not indicate any changes in the BS of the forearm after virtual tool-use training. Also, an association between BS plasticity and the emergence of body ownership could not be confirmed for OA. Similar to YA, the practice effect was stronger in the visuo-tactile feedback condition compared with the vision-only condition. We conclude that a sense of agency may strongly relate to improvement in tool-use in OA independent of alterations in the BS, while ownership did not emerge due to a lack of BS plasticity.

Seeing our hand or a tool during visually-guided actions: Different effects on the somatosensory and visual cortices

The processing of proprioceptive information in the context of a conflict between visual and somatosensory feedbacks deteriorates motor performance. Previous studies have shown that seeing one's hand increases the weighting assigned to arm somatosensory inputs. In this light, we hypothesized that the sensory conflict, when tracing the contour of a shape with mirror-reversed vision, will be greater for participants who trace with a stylus seen in their hand (Hand group, n = 17) than for participants who trace with the tip of rod without seen their hand (Tool group, n = 15). Based on this hypothesis, we predicted that the tracing performance with mirror vision will be more deteriorated for the Hand group than for the Tool group, and we predicted a greater gating of somatosensory information for the Hand group to reduce the sensory conflict. The participants of both groups followed the outline of a shape in two visual conditions. Direct vision: the participants saw the hand or portion of a light 40 cm rod directly. Mirror Vision: the hand or the rod was seen through a mirror. We measured tracing performance using a digitizing tablet and the cortical activity with electroencephalography. Behavioral analyses revealed that the tracing performance of both groups was similarly impaired by mirror vision. However, contrasting the spectral content of the cortical oscillatory activity between the Mirror and Direct conditions, we observed that tracing with mirror vision resulted in significantly larger alpha (8-12 Hz) and beta (15-25 Hz) powers in the somatosensory cortex for participants of the Hand group. The somatosensory alpha and beta powers did not significantly differ between Mirror and Direct vision conditions for the Tool group. For both groups, tracing with mirror vision altered the activity of the visual cortex: decreased alpha power for the Hand group, decreased alpha and beta power for the Tool group. Overall, these results suggest that seeing the hand enhanced the sensory conflict when tracing with mirror vision and that the increase of alpha and beta powers in the somatosensory cortex served to reduce the weight assigned to somatosensory information. The increased activity of the visual cortex observed for both groups in the mirror vision condition suggests greater visual processing with increased task difficulty. Finally, the fact that the participants of the Tool group did not show better tracing performance than those of the Hand group suggests that tracing deterioration resulted from a sensorimotor conflict (as opposed to a visuo-proprioceptive conflict).

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.

Breast Cancer: How Hippotherapy Bridges the Gap between Healing and Recovery-A Randomized Controlled Clinical Trial

BACKGROUND

Breast cancer is the most diagnosed women's cancer, and has a high survival rate. Despite great progress in detection and treatment, life reconstruction requires comprehensive cross-sectoral approaches between different disciplines and deeper consideration of the patient's challenges. Hippotherapy is an emerging specialized rehabilitation approach, performed by accredited health professionals and equine specialists, on specially trained horses via their movement, activating major paths for physical, mental, psychic and social reinforcement, and is synergistic to rehabilitative and supportive care.

METHODS

We conducted a randomized open, prospective, two-armed, controlled trial on the effectiveness of hippotherapy versus conventional supportive care on adult women with a diagnosis of breast cancer, after the period of primary treatment (surgery, chemotherapy, radiotherapy). The 6-month program included, in the treated group, an initial 1-week daily hippotherapy session, followed by three short 2-day sessions with an interval of 2 months between each, where the patients received conventional supportive care. The control group received 6 months of conventional supportive care. The primary end point was quality of life. Cognitive performances, fatigue, anxiety, depression, and body image were the secondary end points. Measurements were done through self-reported questionnaires.

RESULTS

We observed statistical differences in the evolution of the measured parameters over time between the two groups. The hippotherapy group showed a much faster, favorable and continuous improvement until the end of the program for each function assessed. The most striking improvements were observed in global quality of life, and fatigue, while breast cancer-specific quality of life, cognitive performance, anxiety and depression and body image showed a less marked but still statistically significant difference at the final post-treatment evaluation.

CONCLUSIONS

We demonstrate the therapeutic relevance of hippotherapy, a one-health approach, as a key initial stage after cancer diagnosis and treatment to foster recovery. Furthermore, hippotherapy has a strong impact on cancer treatments' efficiency and reconstruction of patient's life and ecosystem. This work reveals a layer of complexity that needs to be broadly considered.

TRIAL REGISTRATION

ClincalTrials.gov NCT04350398 accessed on 1 January 2022. Registered 17 April 2020, retrospectively registered; French Clinical Trials in Cancer Register RECF3818. Registered 18 March 2019, retrospectively registered.

Neck Muscle Vibration Alters Upper Limb Proprioception as Demonstrated by Changes in Accuracy and Precision during an Elbow Repositioning Task

Upper limb control depends on accurate internal models of limb position relative to the head and neck, accurate sensory inputs, and accurate cortical processing. Transient alterations in neck afferent feedback induced by muscle vibration may impact upper limb proprioception. This research aimed to determine the effects of neck muscle vibration on upper limb proprioception using a novel elbow repositioning task (ERT). 26 right-handed participants aged 22.21 ± 2.64 performed the ERT consisting of three target angles between 80−90° (T1), 90−100° (T2) and 100−110° (T3). Controls (CONT) (n = 13, 6F) received 10 min of rest and the vibration group (VIB) (n = 13, 6F) received 10 min of 60 Hz vibration over the right sternocleidomastoid and left cervical extensor muscles. Task performance was reassessed following experimental manipulation. Significant time by group interactions occurred for T1: (F1,24 = 25.330, p < 0.001, ηp2 = 0.513) where CONT improved by 26.08% and VIB worsened by 134.27%, T2: (F1,24 = 16.157, p < 0.001, ηp2 = 0.402) where CONT improved by 20.39% and VIB worsened by 109.54%, and T3: (F1,24 = 21.923, p < 0.001, ηp2 = 0.447) where CONT improved by 37.11% and VIB worsened by 54.39%. Improvements in repositioning accuracy indicates improved proprioceptive ability with practice in controls. Decreased accuracy following vibration suggests that vibration altered proprioceptive inputs used to construct body schema, leading to inaccurate joint position sense and the observed changes in elbow repositioning accuracy.

A systematic review of chiropractic care for fall prevention: rationale, state of the evidence, and recommendations for future research

BACKGROUND

Falls in older adults are a significant and growing public health concern. There are multiple risk factors associated with falls that may be addressed within the scope of chiropractic training and licensure. Few attempts have been made to summarize existing evidence on multimodal chiropractic care and fall risk mitigation. Therefore, the broad purpose of this review was to summarize this research to date. BODY: Systematic review was conducted following PRISMA guidelines. Databases searched included PubMed, Embase, Cochrane Library, PEDro, and Index of Chiropractic Literature. Eligible study designs included randomized controlled trials (RCT), prospective non-randomized controlled, observational, and cross-over studies in which multimodal chiropractic care was the primary intervention and changes in gait, balance and/or falls were outcomes. Risk of bias was also assessed using the 8-item Cochrane Collaboration Tool. The original search yielded 889 articles; 21 met final eligibility including 10 RCTs. One study directly measured the frequency of falls (underpowered secondary outcome) while most studies assessed short-term measurements of gait and balance. The overall methodological quality of identified studies and findings were mixed, limiting interpretation regarding the potential impact of chiropractic care on fall risk to qualitative synthesis.

CONCLUSION

Little high-quality research has been published to inform how multimodal chiropractic care can best address and positively influence fall prevention. We propose strategies for building an evidence base to inform the role of multimodal chiropractic care in fall prevention and outline recommendations for future research to fill current evidence gaps.

Instant disembodiment of virtual body parts

Evidence from multisensory body illusions suggests that body representations may be malleable, for instance, by embodying external objects. However, adjusting body representations to current task demands also implies that external objects become disembodied from the body representation if they are no longer required. In the current web-based study, we induced the embodiment of a two-dimensional (2D) virtual hand that could be controlled by active movements of a computer mouse or on a touchpad. Following initial embodiment, we probed for disembodiment by comparing two conditions: Participants either continued moving the virtual hand or they stopped moving and kept the hand still. Based on theoretical accounts that conceptualize body representations as a set of multisensory bindings, we expected gradual disembodiment of the virtual hand if the body representations are no longer updated through correlated visuomotor signals. In contrast to our prediction, the virtual hand was instantly disembodied as soon as participants stopped moving it. This result was replicated in two follow-up experiments. The observed instantaneous disembodiment might suggest that humans are sensitive to the rapid changes that characterize action and body in virtual environments, and hence adjust corresponding body representations particularly swiftly.

Effects of Chinese Martial Arts on Motor Skills in Children between 5 and 6 Years of Age: A Randomized Controlled Trial

Children’s motor skills can be fully developed only by the appropriate stimulation of physical activities and the environment, and the poor development of motor skills greatly increases the risk of cognitive impairment, obesity, and movement coordination disorder. This study aimed to examine the effects of Chinese martial arts on the motor skills of preschool children aged 5−6 years through a randomized controlled trial. A total of 87 children aged 5−6 years served as participants in a martial arts sensory teaching group (MAST, n = 29), a martial arts traditional teaching group (MATT, n = 29), and a free activity group (FA, n = 29). The interventions were conducted twice weekly for a total of 10 weeks, with each session lasting 30 min. Children’s motor skills were assessed before and after the intervention using the Movement Assessment Battery for Children (MABC-2). The results indicated that the balance index scores in the MAST (p < 0.001) and MATT (p = 0.014) groups were significantly higher than those in the FA and that the MAST score was significantly higher than the MATT (p = 0.004). Meanwhile, the MAST was significantly higher in total scores on motor skills when compared to the FA (p = 0.039), and the MAST showed significantly higher scores on manual dexterity when compared to both the MATT (p = 0.021) and FA (p = 0.011). Chinese martial arts can significantly improve the balance ability of preschool children, and the MAST method was found to be better than that of the MATT. Meanwhile, the MAST had good potential for the development of preschool children’s manual dexterity and their overall level of motor skills.

Embodiment of a virtual prosthesis through training using an EMG-based human-machine interface: Case series

Therapeutic strategies capable of inducing and enhancing prosthesis embodiment are a key point for better adaptation to and acceptance of prosthetic limbs. In this study, we developed a training protocol using an EMG-based human-machine interface (HMI) that was applied in the preprosthetic rehabilitation phase of people with amputation. This is a case series with the objective of evaluating the induction and enhancement of the embodiment of a virtual prosthesis. Six men and a woman with unilateral transfemoral traumatic amputation without previous use of prostheses participated in the study. Participants performed a training protocol with the EMG-based HMI, composed of six sessions held twice a week, each lasting 30 mins. This system consisted of myoelectric control of the movements of a virtual prosthesis immersed in a 3D virtual environment. Additionally, vibrotactile stimuli were provided on the participant’s back corresponding to the movements performed. Embodiment was investigated from the following set of measurements: skin conductance response (affective measurement), crossmodal congruency effect (spatial perception measurement), ability to control the virtual prosthesis (motor measurement), and reports before and after the training. The increase in the skin conductance response in conditions where the virtual prosthesis was threatened, recalibration of the peripersonal space perception identified by the crossmodal congruency effect, ability to control the virtual prosthesis, and participant reports consistently showed the induction and enhancement of virtual prosthesis embodiment. Therefore, this protocol using EMG-based HMI was shown to be a viable option to achieve and enhance the embodiment of a virtual prosthetic limb.

Variations of Sensorimotor Representation (Structure): The Functional Interplay between Object Features and Goal-Directed Grasping Actions

This study investigated the structure of sensorimotor representations during goal-directed grasping actions and explored their relationship with object features. Sixteen 3D-printed spheres that varied in size (i.e., a diameter of 20 mm, 40 mm, 60 mm, 80 mm) and weight (i.e., 40 g, 52 g, 76 g, 91 g) were used as experimental stimuli. The Structural Dimensional Analysis of Mental Representation (SDA-M) method was used to assess the sensorimotor representation structure during grasping. Participants were instructed in each trial to weigh, lift, or transport sets of two different spheres and to judge the similarity of the objects’ features, taking into account the executed grasping movement. Each participant performed a total of 240 trials, and object presentation was randomized. The results suggest that the functional interplay between object features and goal-directed actions accounts for the significant variations in the structure of sensorimotor representations after grasping. Specifically, the relevance of the perceived objects’ size and weight is closely interrelated to the grasping task demands and movement dynamics of the executed action. Our results suggest that distinct sensorimotor representations support individual grasping actions according to top-down influences modulated by motor intentions, functional task demands, and task-relevant object features.

Resourceful Event-Predictive Inference: The Nature of Cognitive Effort

Pursuing a precise, focused train of thought requires cognitive effort. Even more effort is necessary when more alternatives need to be considered or when the imagined situation becomes more complex. Cognitive resources available to us limit the cognitive effort we can spend. In line with previous work, an information-theoretic, Bayesian brain approach to cognitive effort is pursued: to solve tasks in our environment, our brain needs to invest information, that is, negative entropy, to impose structure, or focus, away from a uniform structure or other task-incompatible, latent structures. To get a more complete formalization of cognitive effort, a resourceful event-predictive inference model (REPI) is introduced, which offers computational and algorithmic explanations about the latent structure of our generative models, the active inference dynamics that unfold within, and the cognitive effort required to steer the dynamics-to, for example, purposefully process sensory signals, decide on responses, and invoke their execution. REPI suggests that we invest cognitive resources to infer preparatory priors, activate responses, and anticipate action consequences. Due to our limited resources, though, the inference dynamics are prone to task-irrelevant distractions. For example, the task-irrelevant side of the imperative stimulus causes the Simon effect and, due to similar reasons, we fail to optimally switch between tasks. An actual model implementation simulates such task interactions and offers first estimates of the involved cognitive effort. The approach may be further studied and promises to offer deeper explanations about why we get quickly exhausted from multitasking, how we are influenced by irrelevant stimulus modalities, why we exhibit magnitude interference, and, during social interactions, why we often fail to take the perspective of others into account.

A Study on the Correlation between Intelligence and Body Schema in Children Who Practice Chess at School

The role of intelligence in chess is crucial because the game involves a situation of adversity between two players whose goal is to checkmate the opponent’s king. Due to the complex nature of the game and the huge amount of information needed to become a professional chess player, the ability to receive, analyze, sort and use abstract notions is essential. A total of 67 children from the third grade were selected and tested twice, initially and finally, to establish the level of body schema and intelligence. The Raven test was used to numerically quantify their intelligence and the Goodenough test was conducted for the body schema. We used the paired samples T-test to highlight the statistical difference between the results and performed a simple linear regression to see if the level of intelligence is a predictor of the body schema. There is a linear relationship between intelligence and body schema, and we can use the first one to predict the evolution of the second. In conclusion, body schema can be educated through chess lessons, and this will lead to better psychomotor development.

Seeing through the cat's eyes: evidence of a spontaneous perspective taking process using a non-human avatar

In many daily face-to-face interactions, people are able to take the perspective of others, for example, coding right and left based on point-of-view of others. In the present study, we investigated whether observers are able to take the perspective of a non-human figure such as a cat, observing the same effects obtained with human or robot avatars. In both experiments, we used a centrally presented stimulus (i.e. a cat), with its tail lateralized to the left or to the right. Participants had to respond to the side of the tail with a lateralized keypress. In Experiment 1 (spatial perspective taking task), participants were required to explicitly adopt the cat's perspective to respond, whereas in Experiment 2 (SR compatibility task), this was not explicitly required. In both experiments, faster RTs are obtained when the cat is presented back, with a greater difference between front and back views when the tail is on the right; furthermore, there is no temporal modulation of the back-front effect. These common results between the two experiments are interpreted on the basis of the spatial perspective taking processes, elicited voluntarily (Experiment 1) or spontaneously (Experiment 2).

"Tricking the Brain" Using Immersive Virtual Reality: Modifying the Self-Perception Over Embodied Avatar Influences Motor Cortical Excitability and Action Initiation

To offer engaging neurorehabilitation training to neurologic patients, motor tasks are often visualized in virtual reality (VR). Recently introduced head-mounted displays (HMDs) allow to realistically mimic the body of the user from a first-person perspective (i.e., avatar) in a highly immersive VR environment. In this immersive environment, users may embody avatars with different body characteristics. Importantly, body characteristics impact how people perform actions. Therefore, alternating body perceptions using immersive VR may be a powerful tool to promote motor activity in neurologic patients. However, the ability of the brain to adapt motor commands based on a perceived modified reality has not yet been fully explored. To fill this gap, we "tricked the brain" using immersive VR and investigated if multisensory feedback modulating the physical properties of an embodied avatar influences motor brain networks and control. Ten healthy participants were immersed in a virtual environment using an HMD, where they saw an avatar from first-person perspective. We slowly transformed the surface of the avatar (i.e., the "skin material") from human to stone. We enforced this visual change by repetitively touching the real arm of the participant and the arm of the avatar with a (virtual) hammer, while progressively replacing the sound of the hammer against skin with stone hitting sound via loudspeaker. We applied single-pulse transcranial magnetic simulation (TMS) to evaluate changes in motor cortical excitability associated with the illusion. Further, to investigate if the "stone illusion" affected motor control, participants performed a reaching task with the human and stone avatar. Questionnaires assessed the subjectively reported strength of embodiment and illusion. Our results show that participants experienced the "stone arm illusion." Particularly, they rated their arm as heavier, colder, stiffer, and more insensitive when immersed with the stone than human avatar, without the illusion affecting their experienced feeling of body ownership. Further, the reported illusion strength was associated with enhanced motor cortical excitability and faster movement initiations, indicating that participants may have physically mirrored and compensated for the embodied body characteristics of the stone avatar. Together, immersive VR has the potential to influence motor brain networks by subtly modifying the perception of reality, opening new perspectives for the motor recovery of patients.

Multiple representations of the body schema for the same body part

Accurate motor control depends on maps of the body in the brain, called the body schema. Disorders of the body schema cause motor deficits. Although we often execute actions with different motor systems such as the eye and hand, how the body schema operates during such actions is unknown. In this study, participants simultaneously directed eye and hand movements to the same body part. These two movements were found to be guided by different body maps. This finding demonstrates multiple motor system–specific representations of the body schema, suggesting that the choice of motor system toward one’s body can determine which of the brain’s body maps is observed. This may offer a new way to visualize patients’ body schema.

Purposeful motor actions depend on the brain’s representation of the body, called the body schema, and disorders of the body schema have been reported to show motor deficits. The body schema has been assumed for almost a century to be a common body representation supporting all types of motor actions, and previous studies have considered only a single motor action. Although we often execute multiple motor actions, how the body schema operates during such actions is unknown. To address this issue, I developed a technique to measure the body schema during multiple motor actions. Participants made simultaneous eye and reach movements to the same location of 10 landmarks on their hand. By analyzing the internal configuration of the locations of these points for each of the eye and reach movements, I produced maps of the mental representation of hand shape. Despite these two movements being simultaneously directed to the same bodily location, the resulting hand map (i.e., a part of the body schema) was much more distorted for reach movements than for eye movements. Furthermore, the weighting of visual and proprioceptive bodily cues to build up this part of the body schema differed for each effector. These results demonstrate that the body schema is organized as multiple effector-specific body representations. I propose that the choice of effector toward one’s body can determine which body representation in the brain is observed and that this visualization approach may offer a new way to understand patients’ body schema.

Bodily Illusions and Motor Imagery in Fibromyalgia

Fibromyalgia (FM) is characterised by chronic, continuous, widespread pain, often associated with a sense of fatigue, non-restorative sleep and physical exhaustion. Due to the nature of this condition and the absence of other neurological issues potentially able to induce disorders in body representations per se, it represents a perfect model since it provides an opportunity to study the relationship between pain and the bodily self. Corporeal illusions were investigated in 60 participants with or without a diagnosis of FM by means of an ad hoc devised interview. In addition, motor imagery was investigated and illusions relating to body part movements and changes in body size, feelings of alienness, and sensations of body parts not belonging to one's own body (disownership and somatoparaphrenic-like sensations) were found. Crucially, these symptoms do not correlate with any of the clinical measures of pain or functional deficits. The results showed that motor imagery was also impaired, and the severity of the deficits found correlated with the functional impairment of the participant. This indicates that disorders in body representations and motor imagery are part of the clinical expression of FM. However, while motor imagery seems to be linked to reduced autonomy and functional deficits, bodily illusions are independent and potentially represent a concurrent symptom.

Empathy as a predictor of peripersonal space: Evidence from the crossmodal congruency task

To investigate whether individual differences in Empathy predict the characteristics of Peripersonal Space (PPS) representations, we asked participants to complete the IRI questionnaire and a visuo-tactile crossmodal congruency task (CCT) as an index of PPS. In the CCT, they responded to the elevation of a tactile target while ignoring a visual distractor presented at the same (i.e. congruent) or different (i.e. incongruent) elevation. The target-distractor distance was also manipulated in depth, with visual distractors randomly presented at near, middle or far locations (0 cm, 25 cm or 50 cm). The near and middle crossmodal congruency effects (CCE) were inversely related to participants' scores on the Empathic Concern sub-scale (EC). Furthermore, the slope of participants' CCE across locations was related to EC scores, with flatter slopes for higher EC individuals. Thus, higher EC individuals showed reduced visuo-tactile integration responses within PPS and a reduced differentiation between PPS and extra-personal space (EPS).

Effects of spatial attention and limb position on the cortical interaction of bilateral noxious inputs

Bilateral noxious inputs interact in the brain to provide a better representation of physical threat. In the present study, we investigated the effects of spatial attention and limb position on this interaction. Painful laser stimuli were applied randomly on the right hand or on both hands, while varying spatial attention (focal or overall) and limb position (hands near or far from each other). Pain perception and laser-evoked potentials (N1, N2, P2) were compared between conditions in 27 healthy volunteers. Compared with unilateral stimulation, bilateral stimulation increased pain (p = .004), the N2 (p = .0015) and P2 (p < .001) amplitude. The effects on pain and the P2 were greater when hands were in the near compared with the far position (p < .05). The effect on pain was also greater for overall compared with focal pain rating (p = .003). In addition, the N1 amplitude was greater for bilateral stimulation when hands were in the far compared with the near position (p = .01). These results show that increased brain responses and pain for bilateral compared with unilateral noxious stimulation are modulated differentially by spatial attention and limb position. This suggests that the integration of noxious inputs occurs through partially independent pain-related processes, that it is modulated by limb position, and that it is partially independent of pain perception. We propose that this is necessary to produce coordinated, flexible and adapted defensive responses.

Smartphone and the Self: Experimental Investigation of Self-Incorporation of and Attachment to Smartphones

Smartphones are a constant companion in everyday life. Interacting with a smartphone calls for a multimodal input and often leads to a multisensory output. Combining research in human-computer interaction (HCI) and psychology, the present research explored the idea that a smartphone is more than a smart object but represents an object to which people feel emotionally attached to and which is even perceived as a part or an extension of a person’s self. To this end, we used an established rubber hand illusion paradigm to experimentally induce body ownership experiences in young adults (n = 76) in a 4-level mixed-design study. Our results revealed that in contrast to a neutral control object participants indeed felt attached to a smartphone, perceived it as a part of themselves and felt the need to interact with the device. This was specifically pronounced when hedonic characteristics were evaluated as high and when its usage for social communication was highlighted during the experiment. Psychological mechanisms of the incorporation of technologies are discussed and connected to positive and negative effects of smartphone usage on human behavior, its implications for technology design and marketing.

Seeming confines: Electrophysiological evidence of peripersonal space remapping following tool-use in humans

The peripersonal space (PPS) is a special portion of space immediately surrounding the body, where the integration between tactile stimuli delivered on the body and auditory or visual events emanating from the environment occurs. Interestingly, PPS can widen if a tool is employed to interact with objects in the far space. However, electrophysiological evidence of such tool-use dependent plasticity in the human brain is scarce. Here, in a series of three experiments, participants were asked to respond to tactile stimuli, delivered to their right hand, either in isolation (unimodal condition) or combined with auditory stimulation, which could occur near (bimodal-near) or far from the stimulated hand (bimodal-far). According to multisensory integration spatial rule, when bimodal stimuli are presented at the same location, we expected a response enhancement (response time - RT - facilitation and event-related potential - ERP - super-additivity). In Experiment 1, we verified that RT facilitation was driven by bimodal input spatial congruency, independently from auditory stimulus intensity. In Experiment 2, we showed that our bimodal task was effective in eliciting the magnification of ERPs in bimodal conditions, with significantly larger responses in the near as compared to far condition. In Experiment 3 (main experiment), we explored tool-use driven PPS plasticity. Our audio-tactile task was performed either following tool-use (a 20-min reaching task, performed using a 145 cm-long rake) or after a control cognitive training (a 20-min visual discrimination task) performed in the far space. Following the control training, faster RTs and greater super-additive ERPs were found in bimodal-near as compared to bimodal-far condition (replicating Experiment 2 results). Crucially, this far-near differential response was significantly reduced after tool-use. Altogether our results indicate a selective effect of tool-use remapping in extending the boundaries of PPS. The present finding might be considered as an electrophysiological evidence of tool-use dependent plasticity in the human brain.

Frontal and parietal background connectivity and their dynamic changes account for individual differences in the multisensory representation of peripersonal space

Functional connectivity (FC) of brain networks dynamically fluctuates during both rest and task execution. Individual differences in dynamic FC have been associated with several cognitive and behavioral traits. However, whether dynamic FC also contributes to sensorimotor representations guiding body-environment interactions, such as the representation of peripersonal space (PPS), is currently unknown. PPS is the space immediately surrounding the body and acts as a multisensory interface between the individual and the environment. We used an audio-tactile task with approaching sounds to map the individual PPS extension, and fMRI to estimate the background FC. Specifically, we analyzed FC values for each stimulus type (near and far space) and its across-trial variability. FC was evaluated between task-relevant nodes of two fronto-parietal networks (the Dorsal Attention Network, DAN, and the Fronto-Parietal Network, FPN) and a key PPS region in the premotor cortex (PM). PM was significantly connected to specific task-relevant nodes of the DAN and the FPN during the audio-tactile task, and FC was stronger while processing near space, as compared to far space. At the individual level, less PPS extension was associated with stronger premotor-parietal FC during processing of near space, while the across-trial variability of premotor-parietal and premotor-frontal FC was higher during the processing of far space. Notably, only across-trial FC variability captured the near-far modulation of space processing. Our findings indicate that PM connectivity with task-relevant frontal and parietal regions and its dynamic changes participate in the mechanisms that enable PPS representation, in agreement with the idea that neural variability plays a crucial role in plastic and dynamic sensorimotor representations.

Maladaptive reorganization following SCI: The role of body representation and multisensory integration

In this review we focus on maladaptive brain reorganization after spinal cord injury (SCI), including the development of neuropathic pain, and its relationship with impairments in body representation and multisensory integration. We will discuss the implications of altered sensorimotor interactions after SCI with and without neuropathic pain and possible deficits in multisensory integration and body representation. Within this framework we will examine published research findings focused on the use of bodily illusions to manipulate multisensory body representation to induce analgesic effects in heterogeneous chronic pain populations and in SCI-related neuropathic pain. We propose that the development and intensification of neuropathic pain after SCI is partly dependent on brain reorganization associated with dysfunctional multisensory integration processes and distorted body representation. We conclude this review by suggesting future research avenues that may lead to a better understanding of the complex mechanisms underlying the sense of the body after SCI, with a focus on cortical changes.

Availability of synchronous information in an additional sensory modality does not enhance the full body illusion

The Full body illusion (FBI) is an illusion in which participants experience a change in self-location to a body that is perceived from a third-person perspective. The FBI is usually induced through experimenter generated stroking but can also be induced through self-generated stroking. In four experiments (three preregistered) we compared a self-generated stroking induction condition to a self-generated movement condition, where the only difference between conditions was the presence or absence of touch. We investigated whether the illusion reflects an all-or-nothing phenomenon or whether the illusion is influenced by the availability of synchronous information in an additional sensory modality. As a prerequisite, we investigated whether the FBI can also be induced using just self-generated movement in the absence of synchronous touch. Illusion strength was measured through illusion statements. Participants reported an equally strong illusion for both induction methods in Experiments 1, 2 and 3. In the third experiment, we additionally measured the time of illusion onset. Like the illusion strength measures, the illusion onset times did not differ between the two induction methods. In the fourth experiment participants only completed the self-generated movement condition. Again, they reported the FBI, demonstrating that the findings of Experiments 1, 2 and 3 were not dependent on the presence of a condition that used synchronous touch. Together, these findings confirm the hypothesis that the FBI is an all-or-nothing phenomenon and that adding additional multisensory synchronicity does not help to enhance the strength, onset time or onset probability of the illusion.

Asymmetrical influence of bi-thermal caloric vestibular stimulation on a temporal order judgment task

Recent evidences suggest that binaural vestibular stimulation affects tactile temporal processing. However, it remains difficult to determine the physiological mechanisms supporting the vestibular-somatosensory interactions observed during a TOJ task. Controlling the activation of the right or left vestibular system separately could allow to better understand the physiological bases of these findings and reconcile previous studies. The objective of the present study was to examine tactile temporal processing using a temporal order judgment task following selective stimulation of the right and left vestibular system with bi-thermal caloric vestibular stimulation (CVS). A total of 24 right-handed participants received bi-thermal CVS either in the right ear (n = 12) or the left ear (n = 12). Participants held vibrators in both hands which delivered a signal temporally separated by a variable asynchrony. Participants had to report the hand where the vibration was perceived first. The task was performed in three different CVS conditions: (1) baseline, (2) warm CVS, and (3) cold CVS. Analysis of the logistics curve parameters-just noticeable difference (JND) and point of subjective simultaneity (PSS)-for each participant in each CVS conditions revealed an increase in JND greater following warm CVS. A significant increase in JND following warm CVS was measured bilaterally. However, cold CVS increased JND only when CVS was applied in the left ear, but not in the right ear. Finally, no influence of CVS on PSS was observed.

Does response facilitation to visuo-tactile stimuli around a remote-controlled hand avatar reflect peripersonal space or attentional bias?

People react faster to visuo-tactile stimuli presented near the body (i.e., in peripersonal space) than to tactile stimuli presented alone. This multi-sensory facilitation effect has been used as a measurement of peripersonal space. Previous research has reported that peripersonal space representations can be modulated by actively using hand-held tools or disconnected hand avatars. However, previous research has ignored the possibility that the attentional effect of active tool use could affect multi-sensory facilitation. In the present study, we delivered tactile stimuli to participants' left or right hand concurrently with visual stimuli presented near a virtual hand avatar operated by the movements of participants' left or right hand, which was shown far in a virtual environment and disconnected from the body. Participants reacted to tactile stimuli while ignoring the visual stimuli. The results indicated a multi-sensory facilitation effect when tactile stimuli were delivered to the hand used to operate the hand avatar. In contrast, the facilitation was not observed when the tactile stimuli were delivered to the hand that is not operating the hand avatar. These results suggest that the strength of the multi-sensory facilitation effect differed across conditions, even though the visual attention captured around the hand avatar was controlled across conditions. We concluded that the modulation of peripersonal space resulting from using tools or avatars is nearly independent of visual attention captured around tools or avatars.

Tool Use Affects Spatial Perception

Tools do not just expand our capabilities. They change what we can do, and in doing so, they change who we are. Serena is Serena because of what she can do with a tennis racket. Tiger is Tiger because of what he can do with a golf club. In changing what we can do, tools also change the very way we perceive the spatial layout of the world. Objects beyond arm's reach appear closer when we wield a tool that can expand out to the object. Catchable objects seem to move faster when we wield a tool that is less effective for catching the object. These examples illustrate how the basic processes of spatial vision are impacted by tool use.

Musical Interaction Reveals Music as Embodied Language

Life and social sciences often focus on the social nature of music (and language alike). In biology, for example, the three main evolutionary hypotheses about music (i.e., sexual selection, parent-infant bond, and group cohesion) stress its intrinsically social character (Honing et al., 2015). Neurobiology thereby has investigated the neuronal and hormonal underpinnings of musicality for more than two decades (Chanda and Levitin, 2013; Salimpoor et al., 2015; Mehr et al., 2019). In line with these approaches, the present paper aims to suggest that the proper way to capture the social interactive nature of music (and, before it, musicality), is to conceive of it as an embodied language, rooted in culturally adapted brain structures (Clarke et al., 2015; D'Ausilio et al., 2015). This proposal heeds Ian Cross' call for an investigation of music as an "interactive communicative process" rather than "a manifestation of patterns in sound" (Cross, 2014), with an emphasis on its embodied and predictive (coding) aspects (Clark, 2016; Leman, 2016; Koelsch et al., 2019). In the present paper our goal is: (i) to propose a framework of music as embodied language based on a review of the major concepts that define joint musical action, with a particular emphasis on embodied music cognition and predictive processing, along with some relevant neural underpinnings; (ii) to summarize three experiments conducted in our laboratories (and recently published), which provide evidence for, and can be interpreted according to, the new conceptual framework. In doing so, we draw on both cognitive musicology and neuroscience to outline a comprehensive framework of musical interaction, exploring several aspects of making music in dyads, from a very basic proto-musical action, like tapping, to more sophisticated contexts, like playing a jazz standard and singing a hocket melody. Our framework combines embodied and predictive features, revolving around the concept of joint agency (Pacherie, 2012; Keller et al., 2016; Bolt and Loehr, 2017). If social interaction is the "default mode" by which human brains communicate with their environment (Hari et al., 2015), music and musicality conceived of as an embodied language may arguably provide a route toward its navigation.

Congruency of Information Rather Than Body Ownership Enhances Motor Performance in Highly Embodied Virtual Reality

In immersive virtual reality, the own body is often visually represented by an avatar. This may induce a feeling of body ownership over the virtual limbs. Importantly, body ownership and the motor system share neural correlates. Yet, evidence on the functionality of this neuroanatomical coupling is still inconclusive. Findings from previous studies may be confounded by the congruent vs. incongruent multisensory stimulation used to modulate body ownership. This study aimed to investigate the effect of body ownership and congruency of information on motor performance in immersive virtual reality. We aimed to modulate body ownership by providing congruent vs. incongruent visuo-tactile stimulation (i.e., participants felt a brush stroking their real fingers while seeing a virtual brush stroking the same vs. different virtual fingers). To control for congruency effects, unimodal stimulation conditions (i.e., only visual or tactile) with hypothesized low body ownership were included. Fifty healthy participants performed a decision-making (pressing a button as fast as possible) and a motor task (following a defined path). Body ownership was assessed subjectively with established questionnaires and objectively with galvanic skin response (GSR) when exposed to a virtual threat. Our results suggest that congruency of information may decrease reaction times and completion time of motor tasks in immersive virtual reality. Moreover, subjective body ownership is associated with faster reaction times, whereas its benefit on motor task performance needs further investigation. Therefore, it might be beneficial to provide congruent information in immersive virtual environments, especially during the training of motor tasks, e.g., in neurorehabilitation interventions.

Multisensory Integration as per Technological Advances: A Review

Multisensory integration research has allowed us to better understand how humans integrate sensory information to produce a unitary experience of the external world. However, this field is often challenged by the limited ability to deliver and control sensory stimuli, especially when going beyond audio-visual events and outside laboratory settings. In this review, we examine the scope and challenges of new technology in the study of multisensory integration in a world that is increasingly characterized as a fusion of physical and digital/virtual events. We discuss multisensory integration research through the lens of novel multisensory technologies and, thus, bring research in human-computer interaction, experimental psychology, and neuroscience closer together. Today, for instance, displays have become volumetric so that visual content is no longer limited to 2D screens, new haptic devices enable tactile stimulation without physical contact, olfactory interfaces provide users with smells precisely synchronized with events in virtual environments, and novel gustatory interfaces enable taste perception through levitating stimuli. These technological advances offer new ways to control and deliver sensory stimulation for multisensory integration research beyond traditional laboratory settings and open up new experimentations in naturally occurring events in everyday life experiences. Our review then summarizes these multisensory technologies and discusses initial insights to introduce a bridge between the disciplines in order to advance the study of multisensory integration.

Whatever Next and Close to My Self-The Transparent Senses and the "Second Skin": Implications for the Case of Depersonalization

In his paper “Whatever next? Predictive brains, situated agents, and the future of cognitive science,” Andy Clark seminally proposed that the brain's job is to predict whatever information is coming “next” on the basis of prior inputs and experiences. Perception fundamentally subserves survival and self-preservation in biological agents, such as humans. Survival however crucially depends on rapid and accurate information processing of what is happening in the here and now. Hence, the term “next” in Clark's seminal formulation must include not only the temporal dimension (i.e., what is perceived now) but also the spatial dimension (i.e., what is perceived here or next-to-my-body). In this paper, we propose to focus on perceptual experiences that happen “next,” i.e., close-to-my-body. This is because perceptual processing of proximal sensory inputs has a key impact on the organism's survival. Specifically, we focus on tactile experiences mediated by the skin and what we will call the “extended skin” or “second skin,” that is, immediate objects/materials that envelop closely to our skin, namely, clothes. We propose that the skin and tactile experiences are not a mere border separating the self and world. Rather, they simultaneously and inherently distinguish and connect the bodily self to its environment. Hence, these proximal and pervasive tactile experiences can be viewed as a “transparent bridge” intrinsically relating and facilitating exchanges between the self and the physical and social world. We conclude with potential implications of this observation for the case of Depersonalization Disorder, a condition that makes people feel estranged and detached from their self, body, and the world.

Cognitive and Behavioral Disorders in Patients with Precuneal Infarcts

OBJECTIVE

Ischemic stroke of the precuneal cortex (PC) alone is extremely rare. This study aimed to evaluate the clinical, neurocognitive, and behavioral characteristics of isolated PC infarcts.

METHODS

We assessed neuropsychological and behavioral findings in 12 patients with isolated PC infarct among 3,800 patients with ischemic stroke. To determine the most frequently affected brain locus in patients, we first overlapped the ischemic area of patients with specific cognitive disorders and patients without specific cognitive disorders. Second, we compared both overlap maps using the "subtraction plot" function of MRIcroGL.

RESULTS

Patients showed various types of cognitive disorders. All patients experienced more than 1 category of cognitive disorder, except for 2 patients with only 1 cognitive disorder. Lesion topographical analysis showed that damage within the anterior precuneal region might lead to consciousness disorders (25%), self-processing impairment (42%), visuospatial disorders (58%), and lesions in the posterior precuneal region caused episodic and semantic memory impairment (33%). The whole precuneus is involved in at least one body awareness disorder. The cause of stroke was cardioembolism in 5 patients (42%), large artery disease in 3 (25%), and unknown in 4 (33%).

CONCLUSIONS

This study showed a wide variety of neuropsychological and behavioral disorders in patients with precuneal infarct. Future studies are needed to achieve a proper definition of the function of the precuneus in relation to the extended cortical areas. PC region infarcts have been found to predict a source of embolism from the large arteries or heart.

Perception of body shape and size without touch or proprioception: evidence from individuals with congenital and acquired neuropathy

The degree to which mental representations of the body can be established and maintained without somatosensory input remains unclear. We contrast two "deafferented" adults, one who acquired large fibre sensory loss as an adult (IW) and another who was born without somatosensation (KS). We compared their responses to those of matched controls in three perceptual tasks: first accuracy of their mental image of their hands (assessed by testing recognition of correct hand length/width ratio in distorted photographs and by locating landmarks on the unseen hand); then accuracy of arm length judgements (assessed by judgement of reaching distance), and finally, we tested for an attentional bias towards peri-personal space (assessed by reaction times to visual target presentation). We hypothesised that IW would demonstrate responses consistent with him accessing conscious knowledge, whereas KS might show evidence of responses dependent on non-conscious mechanisms. In the first two experiments, both participants were able to give consistent responses about hand shape and arm length, but IW displayed a better awareness of hand shape than KS (and controls). KS demonstrated poorer spatial accuracy in reporting hand landmarks than both IW and controls, and appears to have less awareness of her hands. Reach distance was overestimated by both IW and KS, as it was for controls; the precision of their judgements was slightly lower than that of the controls. In the attentional task, IW showed no reaction time differences across conditions in the visual detection task, unlike controls, suggesting that he has no peri-personal bias of attention. In contrast, KS did show target location-dependent modulation of reaction times, when her hands were visible. We suggest that both IW and KS can access a conscious body image, although its accuracy may reflect their different experience of hand action. Acquired sensory loss has deprived IW of any subconscious body awareness, but the congenital absence of somatosensation may have led to its partial replacement by a form of visual proprioception in KS.

When two worlds collide: the influence of an obstacle in peripersonal space on multisensory encoding

Multisensory coding of the space surrounding our body, the peripersonal space, is crucial for motor control. Recently, it has been proposed that an important function of multisensory coding is that it allows anticipation of the tactile consequences of contact with a nearby object. Indeed, performing goal-directed actions (i.e. pointing and grasping) induces a continuous visuotactile remapping as a function of on-line sensorimotor requirements. Here, we investigated whether visuotactile remapping can be induced by obstacles, e.g. objects that are not the target of the grasping movement. In the current experiment, we used a cross-modal obstacle avoidance paradigm, in which participants reached past an obstacle to grasp a second object. Participants indicated the location of tactile targets delivered to the hand during the grasping movement, while a visual cue was sometimes presented simultaneously on the to-be-avoided object. The tactile and visual stimulation was triggered when the reaching hand passed a position that was drawn randomly from a continuous set of predetermined locations (between 0 and 200 mm depth at 5 mm intervals). We observed differences in visuotactile interaction during obstacle avoidance dependent on the location of the stimulation trigger: visual interference was enhanced for tactile stimulation that occurred when the hand was near the to-be-avoided object. We show that to-be-avoided obstacles, which are relevant for action but are not to-be-interacted with (as the terminus of an action), automatically evoke the tactile consequences of interaction. This shows that visuotactile remapping extends to obstacle avoidance and that this process is flexible.

Interpersonal Motor Interactions Shape Multisensory Representations of the Peripersonal Space

This perspective review focuses on the proposal that predictive multisensory integration occurring in one's peripersonal space (PPS) supports individuals' ability to efficiently interact with others, and that integrating sensorimotor signals from the interacting partners leads to the emergence of a shared representation of the PPS. To support this proposal, we first introduce the features of body and PPS representations that are relevant for interpersonal motor interactions. Then, we highlight the role of action planning and execution on the dynamic expansion of the PPS. We continue by presenting evidence of PPS modulations after tool use and review studies suggesting that PPS expansions may be accounted for by Bayesian sensory filtering through predictive coding. In the central section, we describe how this conceptual framework can be used to explain the mechanisms through which the PPS may be modulated by the actions of our interaction partner, in order to facilitate interpersonal coordination. Last, we discuss how this proposal may support recent evidence concerning PPS rigidity in Autism Spectrum Disorder (ASD) and its possible relationship with ASD individuals' difficulties during interpersonal coordination. Future studies will need to clarify the mechanisms and neural underpinning of these dynamic, interpersonal modulations of the PPS.