Hand size underestimation grows during childhood

Alterations of tactile and anatomical spatial representations of the hand after stroke

Stroke often causes long-term motor and somatosensory impairments. Motor planning and tactile perception rely on spatial body representations. However, the link between altered spatial body representations, motor deficit and tactile spatial coding remains unclear. This study investigates the relationship between motor deficits and alterations of anatomical (body) and tactile spatial representations of the hand in 20 post-stroke patients with upper limb hemiparesis. Anatomical and tactile spatial representations were assessed from 10 targets (nails and knuckles) respectively cued verbally by their anatomical name or using tactile stimulations. Two distance metrics (hand width and finger length) and two structural measures (relative organization of targets positions and angular deviation of fingers from their physical posture) were computed and compared to clinical assessments, normative data and lesions sites. Over half of the patients had altered anatomical and/or tactile spatial representations. Metrics of tactile and anatomical representations showed common variations, where a wider hand representation was linked to more severe motor deficits. In contrast, alterations in structural measures were not concomitantly observed in tactile and anatomical representations and did not correlate with clinical assessments. Finally, a preliminary analysis showed that specific alterations in tactile structural measures were associated with dorsolateral prefrontal stroke lesions. This study reveals shared and distinct characteristics of anatomical and tactile hand spatial representations, reflecting different mechanisms that can be affected differently after stroke: metrics and location of tactile and anatomical representations were partially shared while the structural measures of tactile and anatomical representations had distinct characteristics.

Misreporting of height and weight by primary school children in Japan: a cross-sectional study on individual and environmental determinants

BACKGROUND

Appropriate body constitution during childhood is important for future health. However, it has been suggested that thinness is increasing among adolescent girls and boys in Japan. Since misreporting of height/weight may be a possible reflection of the child's ideal body image, we investigated the magnitude and direction of height/weight misreporting and its determinants among Japanese young adolescents.

METHODS

A total of 1019 children in public primary schools were included in the analysis. Both measured and self-reported values of height/weight were obtained. Misreporting of height/weight was calculated by subtracting the measured value from the self-reported value. The association between misreporting and several variables such as the BMI z-score of individuals and body constitution of surrounding children was explored by multivariate linear mixed models.

RESULTS

As BMI z-score increased, 'overreporting' of height by boys and 'underreporting' of height by girls became larger (p = 0.06 in boys, p = 0.02 in girls). Both boys and girls with a larger body size tended to underreport their weight (p < 0.01 in boys, p < 0.01 in girls). Boys who belonged to a school with a larger average BMI z-score were more likely to overreport their weight. This tendency was not observed for girls.

CONCLUSIONS

Self-reported height/weight was generally accurate in Japanese primary school children. However, even primary school children misreported their height/weight intentionally like adults, possibly due to social pressure to lose weight or that not to stand out. Thus, health education about appropriate body constitution should be provided from the beginning of adolescence, particularly for girls.

The role of hand size in body representation: a developmental investigation

Knowledge of one's own body size is a crucial facet of body representation, both for acting on the environment and perhaps also for constraining body ownership. However, representations of body size may be somewhat plastic, particularly to allow for physical growth in childhood. Here we report a developmental investigation into the role of hand size in body representation (the sense of body ownership, perception of hand position, and perception of own-hand size). Using the rubber hand illusion paradigm, this study used different fake hand sizes (60%, 80%, 100%, 120% or 140% of typical size) in three age groups (6- to 7-year-olds, 12- to 13-year-olds, and adults; N = 229). We found no evidence that hand size constrains ownership or position: participants embodied hands which were both larger and smaller than their own, and indeed judged their own hands to have changed size following the illusion. Children and adolescents embodied the fake hands more than adults, with a greater tendency to feel their own hand had changed size. Adolescents were particularly sensitive to multisensory information. In sum, we found substantial plasticity in the representation of own-body size, with partial support for the hypothesis that children have looser representations than adults.

Perceptual Biases as the Side Effect of a Multisensory Adaptive System: Insights from Verticality and Self-Motion Perception

Perceptual biases can be interpreted as adverse consequences of optimal processes which otherwise improve system performance. The review presented here focuses on the investigation of inaccuracies in multisensory perception by focusing on the perception of verticality and self-motion, where the vestibular sensory modality has a prominent role. Perception of verticality indicates how the system processes gravity. Thus, it represents an indirect measurement of vestibular perception. Head tilts can lead to biases in perceived verticality, interpreted as the influence of a vestibular prior set at the most common orientation relative to gravity (i.e., upright), useful for improving precision when upright (e.g., fall avoidance). Studies on the perception of verticality across development and in the presence of blindness show that prior acquisition is mediated by visual experience, thus unveiling the fundamental role of visuo-vestibular interconnections across development. Such multisensory interactions can be behaviorally tested with cross-modal aftereffect paradigms which test whether adaptation in one sensory modality induces biases in another, eventually revealing an interconnection between the tested sensory modalities. Such phenomena indicate the presence of multisensory neural mechanisms that constantly function to calibrate self-motion dedicated sensory modalities with each other as well as with the environment. Thus, biases in vestibular perception reveal how the brain optimally adapts to environmental requests, such as spatial navigation and steady changes in the surroundings.

Exploring the development of high-level contributions to body representation using the rubber hand illusion and the monkey hand illusion

During development our body undergoes significant changes, yet we are able to maintain a coherent experience of our body and sense of self. Bodily experience is thought to comprise integration of multisensory signals (vision, touch, and proprioception) constrained by top-down knowledge of body appearance. Evidence from developmental studies suggests that low-level multisensory integration develops throughout childhood, reaching adult levels by 10 years of age. However, how high-level cognitive knowledge changes during childhood to constrain our multisensory body experience is unknown. This study describes four experiments examining high-level contributions to the bodily experience in children compared with adults using the rubber hand illusion and a monkey hand illusion. We found that children (5-17 years of age) exhibited more flexible body representations, showing stronger illusions for small and fantastical (monkey) fake hands compared with adults. Conversely, using a task indirectly capturing changes in hand size, we found that children and adults demonstrated statistically equivalent increases and decreases in hand size following illusions over large and small hands, respectively. Interestingly, at baseline children showed a bias in reporting larger hand size judgments that decreased with age. Finally, we did not find a relationship between individual differences in fantasy proneness and illusion strength for a fantastical (monkey) hand for children or adults, suggesting that developmental changes of top-down constraints are not purely driven by more diffuse boundaries between imagination and reality. These data suggest that high-level constraints acting on our multisensory body experience change during development, allowing children a more flexible bodily experience compared with adults.

Neonatal brachial plexus palsy and hand representation in children and young adults

AIM

To assess the impact of neonatal brachial plexus palsy (NBPP) on higher-order hand representation.

METHOD

Eighty-two left-handed children and adolescents with and without right-sided NBPP were recruited. Thirty-one participants with NBPP (mean age [SD] 11y 4mo [4y 4mo]; age range 6y 2mo-21y 0mo; 15 females; C5-6, n=4, C5-7, n=12, C5-T1, n=11, C5-T1 with Horner sign, n=4) were assessed along with 30 controls (mean age 11y 5mo [4y 4mo]; age range 6y 7mo-21y 7mo; 14 females). Participants' estimated hand size and shape on measure of implicit and explicit hand representation was assessed. A linear mixed model (LMM) was used to investigate the effect of condition, sensorimotor impairment, and age.

RESULTS

Individuals with NBPP showed a significant difference in implicit hand representation between affected and non-affected hands. LMM confirmed a significant influence of the severity of sensorimotor injury. Only the estimated implicit hand representation was associated with age, with a significant difference between 6- to 8-year-olds and 9- to 10-year-olds.

INTERPRETATION

The effect of sensorimotor impairment on central hand representation in individuals with NBPP is specific due to its implicit component and is characterized by finger length underestimation in the affected hand compared to the characteristic underestimation in the unaffected hand. Neither NBPP nor age impacted the explicit hand estimate. This study confirms the importance of sensorimotor contribution to the development of implicit hand representation.

Shrinking of spatial hand representation but not of objects across the lifespan

Perception and action are based on cerebral spatial representations of the body and the external world. However, spatial representations differ from the physical characteristics of body and external space (e.g., objects). It remains unclear whether these discrepancies are related to functional requirements of action and are shared between different spatial representations, indicating common brain processes. We hypothesized that distortions of spatial hand representation would be affected by age, sensorimotor practice and external space representation. We assessed hand representations using tactile and verbal localization tasks and quantified object representation in three age groups (20-79 yrs, total n = 60). Our results show significant shrinking of spatial hand representations (hand width) with age, unrelated to sensorimotor functions. No such shrinking occurred in spatial object representations despite some common characteristics with hand representations. Therefore, spatial properties of body representation partially share characteristics of object representation but also evolve independently across the lifespan.

Growing into your hand: the developmental trajectory of the body model

We rely on accurate body representations to successfully interact with the environment. As adults, we rely on many years of experience with a body that has stayed relatively the same size. Children, however, go through periods of rapid growth and whether or not their body representation matches this physical growth is unknown. To address this question, we examined the developmental trajectory of the body model of the hand. The body model is the representation of our bodies that underlies position sense. We recruited a group of children (8-16 years) and a control group of young adults (18-26 years) and asked them to complete the body model task. In this task, participants estimated the location of ten different landmarks (the tips and metacarpophalangeal joints of each of their five fingers). The position (XY location) of each estimate was tracked using an Optotrak camera. From the XY locations we derived hand width and finger length. Not surprisingly, children's physical hand width and finger length were smaller than adults but remarkably, the body model, was similar for both groups. This result indicates that children overestimate hand size and suggests that the body model is ahead of physical growth. This result contradicts the notion that body representation lags physical growth during puberty, accounting for the clumsy motor behaviour characteristic of teens. We discuss the results in relation to the different taxonomies of body representation and how an enlarged representation of the hand during childhood may influence action.

The Body across the Lifespan: On the Relation between Interoceptive Sensibility and High-Order Body Representations

Background: Interoceptive information plays a pivotal role in building higher-order cognitive body representations (BR) that neuropsychological and neuroimaging evidence classifies as action-oriented (i.e., body schema) or non-action-oriented (i.e., visuo-spatial body map). This study aimed to explore the development of BR, considering the association with the interoceptive sensibility throughout the lifespan. Methods: Two hundred thirty-nine healthy participants divided into five age groups (7 to 8 years; 9 to 10 years; 18 to 40 years; 41 to 60 years; over 60 years) completed a self-report measure of interoceptive sensibility (the Self-Awareness Questionnaire; SAQ) and were given tasks assessing the two BR (action-oriented: hand laterality task; non-action-oriented: frontal body evocation task). Results: Both children (7–8 and 9–10 years) and older adults (over 60 years) performed worse than young (18–40 years) and middle-aged adults (41–60 years) in action- and non-action-oriented BR tasks. Moderation analyses showed that the SAQ score significantly moderated the relationship between age and action-oriented BR. Conclusions: The current results are consistent with inverted U-shaped developmental curves for action- and non-action-oriented BR. As an innovative aspect, the ability to mentally represent one’s own body parts in diverse states could be negatively affected by higher interoceptive sensibility levels in childhood and late adulthood.

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

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

Whole-hand perceptual maps of joint location

Hands play a fundamental role in everyday behaviour. Nevertheless, healthy adults show striking misrepresentations of their hands which have been documented by a wide range of studies addressing various aspects of body representation. For example, when asked to indicate the location within the hand of the knuckles, people place them substantially farther forward than they actually are. Previous research, however, has focused exclusively on the knuckles at the base of each finger, not considering the other knuckles in the fingers. This study, therefore, aimed to investigate conceptual knowledge of the structure of the whole hand, by investigating judgements of the location of all 14 knuckle joints in the hand. Participants localised each of the 14 knuckles of their own hand (Experiment 1) or of the experimenter's hand (Experiment 2) on a hand silhouette. We measured whether there are systematic localisation biases. The results showed highly similar pattern of mislocalisation for the knuckles of one's own hand and those of another person's hand, suggesting that people share an abstract conceptual knowledge about the hand structure. In line with previous reports, we showed that the metacarpophalangeal joints at the base of the fingers are judged as substantially father forward in the hand than they actually are. Moreover, for the first time we showed a gradient of this bias, with progressive reduction of distal bias from more proximal to more distal joints. In sum, people think their finger segments are roughly the same, and that their fingers are shorter than they are.

The long developmental trajectory of body representation plasticity following tool use

Humans evolution is distinctly characterized by their exquisite mastery of tools, allowing them to shape their environment in more elaborate ways compared to other species. This ability is present ever since infancy and most theories indicate that children become proficient with tool use very early. In adults, tool use has been shown to plastically modify metric aspects of the arm representation, as indexed by changes in movement kinematics. To date, whether and when the plastic capability of updating the body representation develops during childhood remains unknown. This question is particularly important since body representation plasticity could be impacted by the fact that the human body takes years to achieve a stable metric configuration. Here we assessed the kinematics of 90 young participants (8-21 years old) required to reach for an object before and after tool use, as a function of their pubertal development. Results revealed that tool incorporation, as indexed by the adult typical kinematic pattern, develops very slowly and displays a u-shaped developmental trajectory. From early to mid puberty, the changes in kinematics following tool use seem to reflect a shortened arm representation, opposite to what was previously reported in adults. This pattern starts reversing after mid puberty, which is characterized by the lack of any kinematics change following tool use. The typical adult-like pattern emerges only at late puberty, when body size is stable. These findings reveal the complex dynamics of tool incorporation across development, possibly indexing the transition from a vision-based to a proprioception-based body representation plasticity.

Hand size representation in healthy children and young adults

Whereas we experience our body as a coherent volumetric object, the brain appears to maintain highly fragmented representations of individual body parts. Little is known about how body representations of hand size and shape are built and evolve during infancy and young adulthood. This study aimed to investigate the effect of hand side, handedness, and age on the development of central hand size representation. The observational study with comparison groups was conducted with 90 typically developing Belgian school children and young adults (48 male and 42 female; age range = 5.0-23.0 years; 49 left-handed and 41 right-handed). Participants estimated their hand size and shape using two different tasks. In the localization task, participants were verbally cued to judge the locations of 10 anatomical landmarks of an occluded hand. An implicit hand size map was constructed and compared with actual hand dimensions. In the template selection task, the explicit hand shape was measured with a depictive method. Hand shape indexes were calculated and compared for the actual, implicit, and explicit conditions. Participants were divided into four age groups (5-8 years, 9-10 years, 11-16 years, and 17-23 years). Implicit hand maps featured underestimation of finger length and overestimation of hand width, which is already present in the youngest children. Linear mixed modeling revealed no influence of hand side on finger length underestimation; nonetheless, a significant main effect of age (p = .001) was exposed. Sinistrals aged 11 to 16 years showed significantly less underestimation (p = .03) than dextrals of the same age. As for the hand shape, the implicit condition differed significantly with the actual and explicit conditions (p < .001). Again, the implicit shape index was subjected to handedness and age effects, with significant differences being found between sinistrals and dextrals in the age groups of 9 and 10 years (p = .029) and 11 to 16 years (p < .001). In conclusion, the implicit metric component of the hand representation in children and young adults is misperceived, featuring shortened fingers and broadened hands since a very young age. Crucially, the finger length underestimation increases with age and shows a different developmental trajectory for sinistrals and dextrals. In contrast, the explicit hand shape is approximately veridical and seems immune from age and handedness effects. This study confirms the dual character of somatoperception and establishes a point of reference for children and young adults.

The Developing Bodily Self: How Posture Constrains Body Representation in Childhood

Adults' body representation is constrained by multisensory information and knowledge of the body such as its possible postures. This study (N = 180) tested for similar constraints in children. Using the rubber hand illusion with adults and 6- to 7-year olds, we measured proprioceptive drift (an index of hand localization) and ratings of felt hand ownership. The fake hand was either congruent or incongruent with the participant's own. Across ages, congruency of posture and visual-tactile congruency yielded greater drift toward the fake hand. Ownership ratings were higher with congruent visual-tactile information, but unaffected by posture. Posture constrains body representation similarly in children and adults, suggesting that children have sensitive, robust mechanisms for maintaining a sense of bodily self.

Perceptual Representation of Own Hand Size in Early Childhood and Adulthood

Hand size perceptual distortions characterize adult human cognition. Notwithstanding the importance of uncovering how hand size representation develops in humans, studies in this field are still at a preliminary stage. Indeed, it is yet to be understood whether hand size distortions are present and reliable in early childhood and whether they differ from adults’ distortions, offering a more in-depth insight into the emergence and development of such representations. We addressed this issue by comparing 4- to 6- year-old children and adults’ representation of their own hand size, as assessed with a 2-forced choice visual perceptual task. To test participants’ ability to estimate their own hand size, children and adults judged whether pictures of their own hand, resized to appear smaller or bigger than their own hand, matched or not its actual dimension. Results show that children aged 4 to 6 years tend to underestimate their own hand size, while adults underestimate their own hand more weakly. This evidence suggests that body-parts perceptual distortions are already in place in early childhood, and thus represent a characteristic of the human body representation.