Predicting the bodily self in space and time

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

Abnormal Spatial and Temporal Overlap of Time-Varying Brain Functional Networks in Patients with Schizophrenia

Schizophrenia (SZ) is a complex psychiatric disorder with unclear etiology and pathological features. Neuroscientists are increasingly proposing that schizophrenia is an abnormality in the dynamic organization of brain networks. Previous studies have found that the dynamic brain networks of people with SZ are abnormal in both space and time. However, little is known about the interactions and overlaps between hubs of the brain underlying spatiotemporal dynamics. In this study, we aimed to investigate different patterns of spatial and temporal overlap of hubs between SZ patients and healthy individuals. Specifically, we obtained resting-state functional magnetic resonance imaging data from the public dataset for 43 SZ patients and 49 healthy individuals. We derived a representation of time-varying functional connectivity using the Jackknife Correlation (JC) method. We employed the Betweenness Centrality (BC) method to identify the hubs of the brain's functional connectivity network. We then applied measures of temporal overlap, spatial overlap, and hierarchical clustering to investigate differences in the organization of brain hubs between SZ patients and healthy controls. Our findings suggest significant differences between SZ patients and healthy controls at the whole-brain and subnetwork levels. Furthermore, spatial overlap and hierarchical clustering analysis showed that quasi-periodic patterns were disrupted in SZ patients. Analyses of temporal overlap revealed abnormal pairwise engagement preferences in the hubs of SZ patients. These results provide new insights into the dynamic characteristics of the network organization of the SZ brain.

Theories of consciousness and psychiatric disorders - A comparative analysis

Disorders of consciousness represent an efficient way to test theories of consciousness' (ToCs) predictions. So far, ToCs have mostly focused on disorders of quantitative awareness such as coma, vegetative state, spatial neglect and hemianopia. Psychiatric disorders, by contrast, have received little attention, leaving their contribution to consciousness research almost unexplored. Therefore, this paper aims to assess the relation between ToCs and psychiatric disorders - that is, the extent to which current ToCs can account for psychiatric symptomatology. First, I review direct and indirect evidence linking each ToC to psychiatry disorders. Next, I differentiate ToCs based on their theoretical and methodological ground, highlighting how they distinctively address neural, cognitive, and phenomenological aspects of conscious experience and, in turn, psychiatric symptoms. Finally, I refer to one specific symptom to directly compare ToCs' explanatory power. Overall, Temporospatial Theory of Consciousness (TTC) appears to provide a more comprehensive account of psychiatric disorders, suggesting that a novel dimension of consciousness (i.e., form of consciousness) may be needed to address more qualitative alterations in conscious experience.

Relating movement markers of schizophrenia to self-experience-a mixed-methods study

Introduction

Basic self-disorders on the one hand and motor symptoms on the other hand are discussed as endophenotypes of schizophrenia psychopathology. However, the systematic interaction between motor symptoms and the self-experience of patients is rarely studied.

Methods

In a previous study we defined motor markers of schizophrenia via a data-driven analysis of patients' gait patterns. In this study, we related the movement markers to measures of basic self-disorder obtained with EASE interviews. We substantiated the correlations with a qualitative content analysis of the interviews of a subset of four patients. We related qualitative and quantitative data on an intra- and interpersonal level.

Results

Our results suggest an association between the previously defined, theory-independent movement markers and basic self-disorders, specifically in the domain of cognition, self-experience and bodily experiences. While movement marker manifestation was not precisely reflected in the individuals' descriptions of anomalous self- and body experience, we found clear trends of more and more intense descriptions with increasing movement marker scores, when looking at specific experiences, such as hyper reflexivity.

Discussion

These results foster an integrated view of the patient and could stimulate therapeutic approaches aiming at an improvement of self- and body-experience of patients with schizophrenia.

The Role of the Angular Gyrus in Goal-directed Behavior-Two Transcranial Magnetic Stimulation Studies Examining Response Outcome Learning and Outcome Anticipation

Learning the contingencies between a situational context (S), one's own responses (R), and their outcomes (O) and selecting responses according to their anticipated outcomes is the basis of a goal-directed behavior. Previous imaging studies found the angular gyrus (AG) to be correlated to both the representation of R-O associations and outcome-based response selection. Based on this correlational relationship, we investigated the causal link between AG function and goal-directed behavior in offline and online TMS experiments. To this end, we employed an experimental R-O compatibility paradigm testing outcome anticipation during response selection and S-R-O knowledge to probe S-R-O learning. In Experiment 1, we applied 1-Hz rTMS offline to the AG or the vertex before participants performed the experimental tasks. In Experiment 2, we applied online 10-Hz pulse trains to the AG or used sham stimulation during an early action selection stage in half of the trials. In both experiments, the R-O compatibility effect was unaltered when response selection was outcome-based, suggesting no causal role of the AG in outcome anticipation during response selection. However, in both experiments, groups with AG stimulation showed significantly modulated knowledge of S-R-O associations in a posttest. Additionally, in an explorative analysis, we found an induced R-O compatibility effect later in the experiment when response selection was guided by stimulus-response rules, suggesting reduced selectivity of outcome anticipation. We discuss possible compensatory behavioral and brain mechanism as well as specific TMS-related methodical considerations demonstrating important implications for further studies investigating cognitive function by means of TMS.

Controllability boosts neural and cognitive signatures of changes-of-mind in uncertain environments

In uncertain environments, seeking information about alternative choice options is essential for adaptive learning and decision-making. However, information seeking is usually confounded with changes-of-mind about the reliability of the preferred option. Here, we exploited the fact that information seeking requires control over which option to sample to isolate its behavioral and neurophysiological signatures. We found that changes-of-mind occurring with control require more evidence against the current option, are associated with reduced confidence, but are nevertheless more likely to be confirmed on the next decision. Multimodal neurophysiological recordings showed that these changes-of-mind are preceded by stronger activation of the dorsal attention network in magnetoencephalography, and followed by increased pupil-linked arousal during the presentation of decision outcomes. Together, these findings indicate that information seeking increases the saliency of evidence perceived as the direct consequence of one's own actions.

A new model for freedom of movement using connectomic analysis

The problem of whether we can execute free acts or not is central in philosophical thought, and it has been studied by numerous scholars throughout the centuries. Recently, neurosciences have entered this topic contributing new data and insights into the neuroanatomical basis of cognitive processes. With the advent of connectomics, a more refined landscape of brain connectivity can be analysed at an unprecedented level of detail. Here, we identify the connectivity network involved in the movement process from a connectomics point of view, from its motivation through its execution until the sense of agency develops. We constructed a "volitional network" using data derived from the Brainnetome Atlas database considering areas involved in volitional processes as known in the literature. We divided this process into eight processes and used Graph Theory to measure several structural properties of the network. Our results show that the volitional network is small-world and that it contains four communities. Nodes of the right hemisphere are contained in three of these communities whereas nodes of the left hemisphere only in two. Centrality measures indicate the nucleus accumbens is one of the most connected nodes in the network. Extensive connectivity is observed in all processes except in Decision (to move) and modulation of Agency, which might correlate with a mismatch mechanism for perception of Agency.

The sense of agency for brain disorders: A comprehensive review and proposed framework

Sense of Agency (SoA) refers to the feeling of control over voluntary actions and the outcomes of those actions. Several brain disorders are characterized by an abnormal SoA. To date, there is no robust treatment for aberrant agency across disorders; this is, in large part, due to gaps in our understanding of the cognitive mechanisms and neural correlates of the SoA. This apparent gap stems from a lack of synthesis in established findings. As such, the current review reconciles previously established findings into a novel neurocognitive framework for future investigations of the SoA in brain disorders, which we term the Agency in Brain Disorders Framework (ABDF). In doing so, we highlight key top-down and bottom-up cues that contribute to agency prospectively (i.e., prior to action execution) and retrospectively (i.e., after action execution). We then examine brain disorders, including schizophrenia, autism spectrum disorders (ASD), obsessive-compulsive disorders (OCD), and cortico-basal syndrome (CBS), within the ABDF, to demonstrate its potential utility in investigating neurocognitive mechanisms underlying phenotypically variable presentations of the SoA in brain disorders.

I Hear My Voice; Therefore I Spoke: The Sense of Agency Over Speech Is Enhanced by Hearing One's Own Voice

The subjective experience of causing an action is known as the sense of agency. Dysfunctional sense of agency over speech has been suggested as a cause of auditory hallucinations. However, agency over speech has not been extensively characterized in previous empirical studies. Here, we manipulated self-voice identity, an indicator of self, embedded in the acoustic quality of voice and examined implicit and explicit measures of the sense of agency. Experiment 1 (N = 29 adults) demonstrated more compression of a perceived interval between action and outcome when participants heard their undistorted voices than their pitch-distorted voices. Experiment 2 (N = 28 adults) revealed a strong top-down effect of self-voice identity: Specifically, the judgment of agency over speech was more resistant than the judgment of agency over hand/limb movement to low-level sensorimotor inconsistency. Our findings provide new insight into the sense of agency over speech and an informative perspective for understanding aberrant experience in auditory hallucinations.

Understanding source monitoring subtypes and their relation to psychosis: a systematic review and meta-analysis

AIMS

Source monitoring (SM) is the metacognitive ability to determine the origin of one's experiences. SM is altered in primary psychiatric psychosis, although relationships between SM subtypes, other cognitive domains and symptoms are unclear. Our aims were to synthesize evidence comparing psychosis -with and without hallucinations- and healthy controls classifying SM subtypes by source discrimination (internal/external/reality monitoring) and stimulus modality (visual/auditory/imagined/performed).

METHODS

This systematic review adopted Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Meta-analyses Of Observational Studies in Epidemiology and Population, Intervention, Comparison and Outcomes guidelines. Core demographical and clinical parameters were extracted. Newcastle-Ottawa Scale was used as quality check. SM differences between (i) psychosis patients versus healthy controls and (ii) patients with versus without hallucinations were investigated via random-effect model meta-analysis. The primary effect size measure was standardized mean difference (SMD) in each SM subtype performance (error or accuracy). Heterogeneity, publication biases and meta-regressions were assessed.

RESULTS

Five thousand two hundred and fifty-six records were screened to finally include 44 studies (1566 patients, 1175 controls). Mean Newcastle-Ottawa score was 7.41 out of 9. Few studies measured SM associations with cognition (n = 9) and symptoms (n = 19), with heterogeneous findings. SM performance across all measures was reduced in psychosis versus healthy controls (SMD = 0.458). Internal SM (SMD: errors = 0.513; accuracy = 0.733) and imagined stimuli (SMD: errors = 0.688; accuracy = 0.978) were specifically impaired. Patients with versus without hallucinations showed SM deficits only for externalizing (SMD = 0.410) and imagined/auditory (SMD = 0.498/0.277) errors.

CONCLUSION

The proposed classifications highlight specific SM deficits for internal/imagined stimuli in psychosis, providing evidence-based indications to design and interpret future studies.

Stress-sensitive inference of task controllability

Estimating the controllability of the environment enables agents to better predict upcoming events and decide when to engage controlled action selection. How does the human brain estimate controllability? Trial-by-trial analysis of choices, decision times and neural activity in an explore-and-predict task demonstrate that humans solve this problem by comparing the predictions of an 'actor' model with those of a reduced 'spectator' model of their environment. Neural blood oxygen level-dependent responses within striatal and medial prefrontal areas tracked the instantaneous difference in the prediction errors generated by these two statistical learning models. Blood oxygen level-dependent activity in the posterior cingulate, temporoparietal and prefrontal cortices covaried with changes in estimated controllability. Exposure to inescapable stressors biased controllability estimates downward and increased reliance on the spectator model in an anxiety-dependent fashion. Taken together, these findings provide a mechanistic account of controllability inference and its distortion by stress exposure.

Judgments of agency are affected by sensory noise without recruiting metacognitive processing

Acting in the world is accompanied by a sense of agency, or experience of control over our actions and their outcomes. As humans, we can report on this experience through judgments of agency. These judgments often occur under noisy conditions. We examined the computations underlying judgments of agency, in particular under the influence of sensory noise. Building on previous literature, we studied whether judgments of agency incorporate uncertainty in the same way that confidence judgments do, which would imply that the former share computational mechanisms with metacognitive judgments. In two tasks, participants rated agency, or confidence in a decision about their agency, over a virtual hand that tracked their movements, either synchronously or with a delay and either under high or low noise. We compared the predictions of two computational models to participants’ ratings and found that agency ratings, unlike confidence, were best explained by a model involving no estimates of sensory noise. We propose that agency judgments reflect first-order measures of the internal signal, without involving metacognitive computations, challenging the assumed link between the two cognitive processes.

The Role of the Medial Prefontal Cortex in Self-Agency in Schizophrenia

Schizophrenia is a disorder of the self. In particular, patients show cardinal deficits in self-agency (i.e., the experience and awareness of being the agent of one’s own thoughts and actions) that directly contribute to positive psychotic symptoms of hallucinations and delusions and distort reality monitoring (defined as distinguishing self-generated information from externally-derived information). Predictive coding models suggest that the experience of self-agency results from a minimal prediction error between the predicted sensory consequence of a self-generated action and the actual outcome. In other words, the experience of self-agency is thought to be driven by making reliable predictions about the expected outcomes of one’s own actions. Most of the agency literature has focused on the motor system; here we present a novel viewpoint that examines agency from a different lens using distinct tasks of reality monitoring and speech monitoring. The self-prediction mechanism that leads to self-agency is necessary for reality monitoring in that self-predictions represent a critical precursor for the successful encoding and memory retrieval of one’s own thoughts and actions during reality monitoring to enable accurate self-agency judgments (i.e., accurate identification of self-generated information). This self-prediction mechanism is also critical for speech monitoring where we continually compare auditory feedback (i.e., what we hear ourselves say) with what we expect to hear. Prior research has shown that the medial prefrontal cortex (mPFC) may represent one potential neural substrate of this self-prediction mechanism. Unfortunately, patients with schizophrenia (SZ) show mPFC hypoactivity associated with self-agency impairments on reality and speech monitoring tasks, as well as aberrant mPFC functional connectivity during intrinsic measures of agency during resting states that predicted worsening psychotic symptoms. Causal neurostimulation and neurofeedback techniques can move the frontiers of schizophrenia research into a new era where we implement techniques to manipulate excitability in key neural regions, such as the mPFC, to modulate patients’ reliance on self-prediction mechanisms on distinct tasks of reality and speech monitoring. We hypothesize these findings will show that mPFC provides a unitary basis for self-agency, driven by reliance on self-prediction mechanisms, which will facilitate the development of new targeted treatments in patients with schizophrenia.

Computational models of the "active self" and its disturbances in schizophrenia

The notion that self-disorders are at the root of the emergence of schizophrenia rather than a symptom of the disease, is getting more traction in the cognitive sciences. This is in line with philosophical approaches that consider an enactive self, constituted through action and interaction with the environment. We thereby analyze different definitions of the self and evaluate various computational theories lending to these ideas. Bayesian and predictive processing are promising approaches for computational modeling of the "active self". We evaluate their implementation and challenges in computational psychiatry and cognitive developmental robotics. We describe how and why embodied robotic systems provide a valuable tool in psychiatry to assess, validate, and simulate mechanisms of self-disorders. Specifically, mechanisms involving sensorimotor learning, prediction, and self-other distinction, can be assessed with artificial agents. This link can provide essential insights to the formation of the self and new avenues in the treatment of psychiatric disorders.

Neural correlates of implicit agency during the transition from adolescence to adulthood: An ERP study

Sense of agency (SoA), the experience of being in control of our voluntary actions and their outcomes, is a key feature of normal human experience. Frontoparietal brain circuits associated with SoA undergo a major maturational process during adolescence. To examine whether this translates to neurodevelopmental changes in agency experience, we investigated two key neural processes associated with SoA, the activity that is leading to voluntary action (Readiness Potential) and the activity that is associated with the action outcome processing (attenuation of auditory N1 and P2 event related potentials, ERPs) in mid-adolescents (13-14), late-adolescents (18-20) and adults (25-28) while they perform an intentional binding task. In this task, participants pressed a button (action) that delivered a tone (outcome) after a small delay and reported the time of the tone using the Libet clock. This action-outcome condition alternated with a no-action condition where an identical tone was triggered by a computer. Mid-adolescents showed greater outcome binding, such that they perceived self-triggered tones as being temporally closer to their actions compared to adults. Suggesting greater agency experience over the outcomes of their voluntary actions during mid-adolescence. Consistent with this, greater levels of attenuated neural response to self-triggered auditory tones (specifically P2 attenuation) were found during mid-adolescence compared to older age groups. This enhanced attenuation decreased with age as observed in outcome binding. However, there were no age-related differences in the readiness potential leading to the voluntary action (button press) as well as in the N1 attenuation to the self-triggered tones. Notably, in mid-adolescents greater outcome binding scores were positively associated with greater P2 attenuation, and smaller negativity in the late readiness potential. These findings suggest that the greater experience of implicit agency observed during mid-adolescence may be mediated by a neural over-suppression of action outcomes (auditory P2 attenuation), and over-reliance on motor preparation (late readiness potential), which we found to become adult-like during late-adolescence. Implications for adolescent development and SoA related neurodevelopmental disorders are discussed.

Neural Correlates of Self-other Distinction in Patients with Schizophrenia Spectrum Disorders: The Roles of Agency and Hand Identity

Schizophrenia spectrum disorders (SSD) are characterized by disturbed self-other distinction. While previous studies associate abnormalities in the sense of agency (ie, the feeling that an action and the resulting sensory consequences are produced by oneself) with disturbed processing in the angular gyrus, passive movement conditions to isolate contributions of motor predictions are lacking. Furthermore, the role of body identity (ie, visual features determining whether a seen body part belongs to oneself) in self-other distinction is unclear. In the current study, fMRI was used to assess the roles of agency and hand identity in self-other distinction. Patients with SSD and healthy controls (HC) performed active and passive hand movements (agency manipulation) while seeing their own or someone else's hand moving in accordance with their action (hand identity manipulation). Variable delays (0-417 ms) between movement and feedback had to be detected. Our results showed overall lower delay detection performances during active than passive conditions; however, these differences were reduced in patients when the own hand was displayed. On a neural level, we found that in HC, activation in the right angular gyrus was modulated by agency and hand identity. In contrast, agency and hand identity revealed no overlapping activation in patients, due to reduced effects of agency. Importantly, HC and SSD patients shared similar effects of hand identity in the angular gyrus. Our results suggest that disturbances of self-other distinction in SSD are particularly driven by agency, while self-other distinction based on hand identity might be spared.

Bodily Self-Disturbances in Schizophrenia: A Comparative Study of South Korea and the USA

BACKGROUND

Bodily self-disturbances are highly salient to the phenomenology of schizophrenia (SZ) but difficult to quantify owing to the subjective nature of these experiences that challenge verbal descriptions. The Benson et al. [PsyCh J. 2019 Mar;8(1):110-21] Body Disturbances Inventory (B-BODI) provides visual aids to help participants access the frequency, distressfulness, and vividness of subjective self-experiences with good reliability and validity in North American samples. However, the concept of the self and, accordingly, the conceptualization of self-disorders are influenced by culture. Therefore, we examined self-disturbances in individuals with SZ and control (CO) participants in 2 distinct cultures.

METHODS

B-BODI was administered to South Korean and North American participants, with and without SZ. Severity of symptoms in diagnosed individuals with SZ and schizotypy in CO was assessed. We also assessed perceived social isolation and mood in all participants.

RESULTS

Endorsement and frequency of bodily self-disturbances in SZ were similar in both cultures. In contrast, there were significant cultural differences in the degree of distress and vividness of self-disturbances. Bodily self-disturbances were experienced as more vivid and distressing to Americans than Koreans, regardless of diagnosis. For both cultures, B-BODI scores were associated with positive, but not negative, symptoms in SZ. For CO, elevated schizotypy was associated with B-BODI scores. Mood and loneliness were not associated with B-BODI scores.

CONCLUSION

SZ reported overall increased levels of bodily self-disturbances compared with CO, regardless of culture. However, there were cultural differences in one's emotional reaction to these experiences. Americans were more distressed by self-disturbances and experienced them more vividly than Koreans. These findings suggest that Americans may be less accepting of anomalous bodily self-experiences relative to Koreans. Last, B-BODI appears to be a useful tool for future cross-cultural studies of SZ phenomenology.

A causal role for the right angular gyrus in self-location mediated perspective taking

Recent theories suggest that self-consciousness, in its most elementary form, is functionally disconnected from the phenomenal body. Patients with psychosis frequently misattribute their thoughts and actions to external sources; and in certain out-of-body experiences, lucid states, and dreams body-ownership is absent but self-identification is preserved. To explain these unusual experiences, we hypothesized that self-identification depends on inferring self-location at the right angular gyrus (i.e., perspective-taking). This process relates to the discrimination of self-produced signals (endogenous attention) from environmental stimulation (exogenous attention). Therefore, when this mechanism fails, this causes altered sensations and perceptions. We combined a Full-body Illusion paradigm with brain stimulation (HD-tDCS) and found a clear causal association between right angular gyrus activation and alterations in self-location (perspective-taking). Anodal versus sham HD-tDCS resulted in: a more profound out-of-body shift (with reduced sense of agency); and a weakened ability to discriminate self from other perspectives. We conclude that self-identification is mediated in the brain by inferring self-location (i.e., perspective-taking). Self-identification can be decoupled from the bodily self, explaining phenomena associated with disembodiment. These findings present novel insights into the relationship between mind and body, and may offer important future directions for treating psychosis symptoms and rehabilitation programs to aid in the recovery from a nervous system injury. The brain's ability to locate itself might be the key mechanism for self-identification and distinguishing self from other signals (i.e., perspective-taking).

Modulation of Reaction Times and Sense of Agency via Subliminal Priming in Functional Movement Disorders

Background: In functional movement disorders, explicit movements are impaired, while implicit movements are preserved. Furthermore, there is evidence that the sense of agency is abnormal. Aim: We aimed to investigate how motor responses and sense of agency were affected by subliminal or supraliminal cues in people with functional movement disorders. Methods: Twenty-three people with a functional movement disorder and 26 healthy controls took part in a subliminal and supraliminal priming experiment which investigated reaction times, choice and sense of agency. Participants pressed a left or right arrow key in response to an imperative left or right pointing arrow. Either key could be pressed in response to bidirectional arrows. The imperative arrow was preceded by a small left or right pointing prime arrow, that was non-predictive (50% correct) and was presented in either subliminal or supraliminal conditions. The participant's response caused the appearance of a colored circle and they rated the degree of control they felt over its appearance (sense of agency). The circle's color depended on whether their response was congruent or incongruent with the prime arrow direction. After exclusion, 19 participants remained in each group. Results: Prime-compatible responses led to faster reaction times in both the subliminal and supraliminal condition. Subliminal prime-compatible responses were chosen more frequently in the free choice condition. The sense of agency did not depend on prime-response congruency. There were no significant differences in any of these measures between the two groups. Conclusion: With non-predictive cues, reaction times, choices, and the sense of agency remain normal in people with functional movement disorders, for both subliminal and supraliminal primes. The findings suggest that it is not so much conscious awareness of the movement, but rather conscious motor preparation that is detrimental to motor function in functional movement disorders.

Cerebral responses to self-initiated action during social interactions

Social interaction involves self-initiated actions that engage subjective awareness of one's own volition. Individuals with social communication needs or social anxiety find it particularly difficult to initiate social interactions. However, extant studies have not specifically addressed how perceived exclusion may influence self-initiated actions during social interaction. As a first step to address this question, we scanned 24 healthy adults participating in a Cyberball game with two fictive players. By contrasting events of observing, receiving, and initiating ball toss during a scenario of fair game (FG) and of exclusion (EX), we examined the neural correlates of self-initiated action during social interactions. Behaviorally, participants were faster in catching but slower in tossing the ball in EX compared with FG, suggesting a burden during self-initiated actions during social exclusion. Tossing versus receiving (or observing) engaged higher activity during EX than FG in the precuneus and angular gyrus, regions that have been widely implicated in theory of mind processing and social emotions. Across subjects these cortical activities correlated positively with the difference between EX and FG in the percentage of trials where participants tossed the ball back to the same player (r = 0.69, p < 0.001). Together, the results suggested that, in healthy adults, social exclusion encumbered and engaged higher posterior cortical activations during self-initiated actions. The findings may facilitate future research of neural markers of social behavioral disorders.

Transcranial direct current stimulation improves action-outcome monitoring in schizophrenia spectrum disorder

Patients with schizophrenia spectrum disorder often demonstrate impairments in action-outcome monitoring. Passivity phenomena and hallucinations, in particular, have been related to impairments of efference copy-based predictions which are relevant for the monitoring of outcomes produced by voluntary action. Frontal transcranial direct current stimulation has been shown to improve action-outcome monitoring in healthy subjects. However, whether transcranial direct current stimulation can improve action monitoring in patients with schizophrenia spectrum disorder remains unknown. We investigated whether transcranial direct current stimulation can improve the detection of temporal action-outcome discrepancies in patients with schizophrenia spectrum disorder. On 4 separate days, we applied sham or left cathodal/right anodal transcranial direct current stimulation in a randomized order to frontal (F3/F4), parietal (CP3/CP4) and frontoparietal (F3/CP4) areas of 19 patients with schizophrenia spectrum disorder and 26 healthy control subjects. Action-outcome monitoring was assessed subsequent to 10 min of sham/transcranial direct current stimulation (1.5 mA). After a self-generated (active) or externally generated (passive) key press, subjects were presented with a visual outcome (a dot on the screen), which was presented after various delays (0-417 ms). Participants had to detect delays between the key press and the visual consequence. Symptom subgroups were explored based on the presence or absence of symptoms related to a paranoid-hallucinatory syndrome. In general, delay-detection performance was impaired in the schizophrenia spectrum disorder compared to the healthy control group. Interaction analyses showed group-specific (schizophrenia spectrum disorder versus healthy control group) and symptom-specific (with/without relevant paranoid-hallucinatory symptoms) transcranial direct current stimulation effects. Post hoc tests revealed that frontal transcranial direct current stimulation improved the detection of long delays in active conditions and reduced the proportion of false alarms in undelayed trials of the passive condition in patients. The patients with no or few paranoid-hallucinatory symptoms benefited especially from frontal transcranial direct current stimulation in active conditions, while improvement in the patients with paranoid-hallucinatory symptoms was predominantly reflected in reduced false alarm rates in passive conditions. These data provide some first evidence for the potential utility of transcranial direct current stimulation in improving efference copy mechanisms and action-outcome monitoring in schizophrenia spectrum disorder. Current data indicate that improving efference copy-related processes can be especially effective in patients with no or few positive symptoms, while intersensory matching (i.e. task-relevant in passive conditions) could be more susceptible to improvement in patients with paranoid-hallucinatory symptoms.

Embodied Predictions, Agency, and Psychosis

Psychotic symptoms, i.e., hallucinations and delusions, involve gross departures from conscious apprehension of consensual reality; respectively, perceiving and believing things that, according to same culture peers, do not obtain. In schizophrenia, those experiences are often related to abnormal sense of control over one's own actions, often expressed as a distorted sense of agency (i.e., passivity symptoms). Cognitive and computational neuroscience have furnished an account of these experiences and beliefs in terms of the brain's generative model of the world, which underwrites inferences to the best explanation of current and future states, in order to behave adaptively. Inference then involves a reliability-based trade off of predictions and prediction errors, and psychotic symptoms may arise as departures from this inference process, either an over- or under-weighting of priors relative to prediction errors. Surprisingly, there is empirical evidence in favor of both positions. Relatedly, there is evidence for both an enhanced and a diminished sense of agency in schizophrenia. How can this be? We argue that there is more than one generative model in the brain, and that ego- and allo-centric models operate in tandem. In brief, ego-centric models implement corollary discharge signals that cancel out the effects of self-generated actions while allo-centric models compare several hypothesis regarding the causes of sensory inputs (including the self among the potential causes). The two parallel hierarchies give rise to different levels of agency, with ego-centric models subserving "feelings of agency" and allo-centric predictions giving rise to "judgements of agency." Those two components are weighted according to their reliability and combined, generating a higher-level "sense of agency." We suggest that in schizophrenia a failure of corollary discharges to suppress self-generated inputs results in the absence of a "feeling of agency" and in a compensatory enhancement of allo-centric priors, which might underlie hallucinations, delusions of control but also, under certain circumstances, the enhancement of "judgments of agency." We discuss the consequences of such a model, and potential courses of action that could lead to its falsification.

Transcranial magnetic stimulation over the right temporoparietal junction influences the sense of agency in healthy humans

Background

The sense of agency is an important aspect of motor control. Impaired sense of agency has been linked to several medical conditions, including schizophrenia and functional neurological disorders. A complex brain network subserves the sense of agency, and the right temporoparietal junction is one of its main nodes. In this paper, we tested whether transcranial magnetic stimulation over the right temporoparietal junction elicited behavioural changes in the sense of agency.

Methods

In experiment 1, 15 healthy participants performed a behavioural task during functional MRI, with the goal of localizing the area relevant for the sense of agency in the right temporoparietal junction. In the task, the movement of a cursor (controlled by the participants) was artificially manipulated, and the sense of agency was either diminished (turbulence) or enhanced (magic). In experiment 2, we applied transcranial magnetic stimulation in 20 healthy participants in a sham-controlled, crossover trial with excitatory, inhibitory or sham (vertex) stimulation. We measured the summary agency score, an indicator of the sense of agency (lower values correspond to diminished sense of agency).

Results

Experiment 1 revealed a peak of activation during agency manipulation in the right temporoparietal junction (Montreal Neurological Institute coordinates x, y, z: 68, -26, 34). Experiment 2 showed that inhibition of the right temporoparietal junction significantly reduced the summary agency score in both turbulence (from -14.4 ± 11.4% to -22.5 ± 8.9%), and magic (from -0.7 ± 5.8% to -4.4 ± 4.4%).

Limitations

We found no excitatory effects, possibly because of a ceiling effect (because healthy participants have a normal sense of agency) or noneffectiveness of the excitatory protocol.

Conclusion

Our experiments showed that the network subserving the sense of agency was amenable to neuromodulation in healthy participants. This sets the ground for further research in patients with impaired sense of agency. Clinical trial identification: DRKS00012992 (German clinical trials registry).

Establishing a Causal Role for Medial Prefrontal Cortex in Reality Monitoring

Reality monitoring is defined as the ability to distinguish internally self-generated information from externally-derived information. Functional imaging studies have consistently found that the medial prefrontal cortex (mPFC) is a key brain region subserving reality monitoring. This study aimed to determine a causal role for mPFC in reality monitoring using navigated repetitive transcranial magnetic stimulation (nrTMS). In a subject-blinded sham-controlled crossover design, healthy individuals received either active or sham nrTMS targeting mPFC. Active modulation of mPFC using nrTMS at a frequency of 10 Hz, significantly improved identification of both self-generated and externally-derived information during reality monitoring, when compared to sham or baseline. Targeted excitatory modulation of mPFC also improved positive mood, reduced negative mood, and increased overall alertness/arousal. These results establish optimal nrTMS dosing parameters that maximized tolerability/comfort and induced significant neuromodulatory effects in the mPFC target. Importantly, this is a proof-of-concept study that establishes the mPFC as a novel brain target that can be stimulated with nrTMS to causally impact both higher-order reality monitoring and mood.

Investigating the Components of Body Image Disturbance Within Eating Disorders

Body image disturbance has been highlighted as a common characteristic within the development and maintenance of clinical eating disorders (EDs), represented by alterations in an individual's bodily experience. However, whilst the perceptual stability of the sense of body ownership has been investigated in ED patients, the stability of the sense of body agency in those with ED is yet to be examined. Therefore, body ownership and body agency were investigated using the moving rubber hand illusion, alongside measures of explicit and implicit body satisfaction. Furthermore, with evidence demonstrating a direct link between perceptual and cognitive-affective components of body image in the healthy population, the relationship between measures of body perception and body satisfaction was investigated. Results showed that both ED and healthy individuals displayed a similar subjective experience of illusory ownership and agency towards the fake hand, following voluntary movement. However, whilst both groups initially overestimated their own hand width prior to the illusion, the ED group displayed a significant reduction in hand size estimation following the illusion, which was not matched to the same degree in healthy individuals. In addition, ED individuals displayed a significantly lower body satisfaction compared with healthy females, on both an explicit and implicit level. Such implicit outcomes were shown to be driven specifically by a weaker association between the self and attractiveness. Finally, a significant relationship was observed between specific perceptual measures and implicit body satisfaction, which highlights the important link between perceptual and cognitive-affective components of one's body image. Together, such findings provide a useful foundation for further research to study the conditions in which these two components relate with regard to body image and its disturbance, particularly in relation to the prognosis and treatment of EDs.

Cost-benefit trade-offs in decision-making and learning

Value-based decision-making involves trading off the cost associated with an action against its expected reward. Research has shown that both physical and mental effort constitute such subjective costs, biasing choices away from effortful actions, and discounting the value of obtained rewards. Facing conflicts between competing action alternatives is considered aversive, as recruiting cognitive control to overcome conflict is effortful. Moreover, engaging control to proactively suppress irrelevant information that could conflict with task-relevant information would presumably also be cognitively costly. Yet, it remains unclear whether the cognitive control demands involved in preventing and resolving conflict also constitute costs in value-based decisions. The present study investigated this question by embedding irrelevant distractors (flanker arrows) within a reversal-learning task, with intermixed free and instructed trials. Results showed that participants learned to adapt their free choices to maximize rewards, but were nevertheless biased to follow the suggestions of irrelevant distractors. Thus, the perceived cost of investing cognitive control to suppress an external suggestion could sometimes trump internal value representations. By adapting computational models of reinforcement learning, we assessed the influence of conflict at both the decision and learning stages. Modelling the decision showed that free choices were more biased when participants were less sure about which action was more rewarding. This supports the hypothesis that the costs linked to conflict management were traded off against expected rewards. During the learning phase, we found that learning rates were reduced in instructed, relative to free, choices. Learning rates were further reduced by conflict between an instruction and subjective action values, whereas learning was not robustly influenced by conflict between one’s actions and external distractors. Our results show that the subjective cognitive control costs linked to conflict factor into value-based decision-making, and highlight that different types of conflict may have different effects on learning about action outcomes.

Value-based decision-making involves trading off the cost associated with an action–such as physical or mental effort–against its expected reward. Although facing conflicts between competing action alternatives is considered aversive and effortful, it remains unclear whether conflict also constitutes a cost in value-based decisions. We tested this hypothesis by combining a classic conflict (flanker) task with a reinforcement-learning task. Results showed that participants learned to maximise their earnings, but were nevertheless biased to follow irrelevant suggestions. Computational model-based analyses showed a greater choice bias with more uncertainty about the best action to make, supporting the hypothesis that the costs linked to conflict management were traded off against expected rewards. We additionally found that learning rates were reduced when following instructions, relative to when choosing freely what to do. Learning was further reduced by conflict between instructions and subjective action values. In short, we found that the subjective cognitive control costs linked to conflict factor into value-based decision-making, and that different types of conflict may have different effects on learning about action outcomes.

Reduced transfer of visuomotor adaptation is associated with aberrant sense of agency in schizophrenia

One deficit associated with schizophrenia (SZ) is the reduced ability to distinguish self-caused sensations from those due to external sources. This reduced sense of agency (SoA, subjective awareness of control over one's actions) is hypothesized to result from a diminished utilization of internal monitoring signals of self-movement (i.e., efference copy) which subsequently impairs forming and utilizing sensory prediction errors (differences between the predicted and actual sensory consequences resulting from movement). Another important function of these internal monitoring signals is the facilitation of higher-order mechanisms related to motor learning and control. Current predictive-coding models of adaptation postulate that the sensory consequences of motor commands are predicted based on internal action-related information, and that ownership and control of motor behavior is modified in various contexts based on predictive processing. Here, we investigated the connections between SoA and motor adaptation. Schizophrenia patients (SZP, N=30) and non-psychiatric control subjects (HC, N=31) adapted to altered movement visual feedback and applied the motor recalibration to untested contexts (i.e., the spatial generalization). Although adaptation was similar for SZP and controls, the extent of generalization was significantly less for SZP; movement trajectories made by patients to the furthest untrained target (135^o) before and after adaptation were largely indistinguishable. Interestingly, deficits in generalization were correlated with positive symptoms of psychosis in SZP (e.g., hallucinations). Generalization was also associated with measures of SoA across both SZP and HC, emphasizing the role action awareness plays in motor behavior, and suggesting that misattributing agency, even in HC, manifests in abnormal motor performance.

Neural Correlates of Interval Timing Deficits in Schizophrenia

Previous research has shown that schizophrenia (SZ) patients exhibit impairments in interval timing. The cause of timing impairments in SZ remains unknown but may be explained by a dysfunction in the fronto-striatal circuits. Although the current literature includes extensive behavioral data on timing impairments, there is limited focus on the neural correlates of timing in SZ. The neuroimaging literature included in the current review reports hypoactivation in the dorsal-lateral prefrontal cortex (DLPFC), supplementary motor area (SMA) and the basal ganglia (BG). Timing deficits and deficits in attention and working memory (WM) in SZ are likely due to a dysfunction of dopamine (DA) and gamma-aminobutyric acid (GABA) neurotransmission in the cortico-striatal-thalamo-cortical circuits, which are highly implicated in executive functioning and motor preparation.

A Delusion of Control - What happens to a sense of Agency in Schizophrenic patients?

The sense of agency is known to be disrupted in Schizophrenia. This article explores the transition from the comparator model to the two-step model of agency, in order to review the paper ‘In and out of control: brain mechanisms linking fluency of action selection to self-agency in patients with Schizophrenia’1. A sense of agency involves using retrospective cues to make causal inferences, but this paper also introduces a new, prospective aspect. This paper shows that subliminal priming, a prospective cue, increases the reported sense of agency over a subsequent action outcome. It also shows that in schizophrenic patients, retrospective cues had more of an influence on their reported sense of agency, while conversely, prospective cues had less influence. This may reflect a greater reliance on retrospective cues in schizophrenia, which could be one of the underlying factors for some of the delusions seen in schizophrenia. Using fMRI measurements during the task, results suggest that angular gyrus activation reflects the experience of non-agency. In healthy controls, they saw altered connectivity between frontal areas and the angular gyrus associated with priming. In schizophrenic patients, there was no effect of priming on activation of the angular gyrus, or frontoparietal connectivity. In our review, we have introduced a putative schema that suggests that the action selection signals from the frontal lobes into the angular gyrus represent the prospective aspect of agency. This connection is disrupted In schizophrenia, and that may be why prospective agency is impaired.

Integrating prospective and retrospective cues to the sense of agency: a multi-study investigation

Sense of agency (SoA) refers to the experience of voluntary control over one’s own actions, and, through them, over events in the outside world. Recent accounts suggest that SoA involves an integration of various cues. These include prospective cues, for example, related to the fluency of action selection, and retrospective cues, linked to outcome monitoring. It remains unclear whether these cues may have independent effects on SoA, and, in particular, how their relative contributions may change during instrumental learning. In the present study, we explored these issues by conducting a multi-study analysis of seven published and unpublished studies on the role of prospective cues to the SoA. Our main question was how the effects of selection fluency on SoA might change as information about action–outcome contingencies is gathered. Results show that selection fluency can have a general and consistent influence on the SoA, independent of outcome monitoring. This suggests selection fluency is used as a heuristic cue, to prospectively inform our SoA. In addition, our results show that the influence of selection fluency on SoA may change systematically as action–outcome contingencies are gradually learned. We speculate that dysfluent selection may impair formation of mental associations between action and outcome.