Seeing the body produces limb-specific modulation of skin temperature

How the inner repetition of a desired perception changes actual tactile perception

Autosuggestion is a cognitive process where the inner repetition of a thought actively influences one's own perceptual state. In spite of its potential benefits for medical interventions, this technique has gained little scientific attention so far. Here, we took advantage of the known link between intensity and frequency perception in touch ('Békésy effect'). In three separate experiments, participants were asked to modulate the perceived intensity of vibrotactile stimuli at the fingertip through the inner reiteration of the thought that this perception feels very strong (Experiment 1, n = 19) or very weak (Experiments 2, n = 38, and 3, n = 20), while they were asked to report the perceived frequency. We show that the task to change the perceived intensity of a tactile stimulus via the inner reiteration of a thought modulates tactile frequency perception. This constitutes the first experimental demonstration that an experimental design that triggers autosuggestion alters participants' tactile perception using a response orthogonal to the suggested variable. We discuss whether this cognitive process could be used to influence the perception of pain in a clinical context.

Autosuggestion: a cognitive process that empowers your brain?

Autosuggestion is a cognitive process that is believed to enable control over one's own cognitive and physiological states. Despite its potential importance for basic science and clinical applications, such as in rehabilitation, stress reduction, or pain therapy, the neurocognitive mechanisms and psychological concepts that underlie autosuggestion are poorly defined. Here, by reviewing empirical data on autosuggestion and related phenomena such as mental imagery, mental simulation, and suggestion, we offer a neurocognitive concept of autosuggestion. We argue that autosuggestion is characterized by three major factors: reinstantiation, reiteration, and volitional, active control over one's own physiological states. We also propose that autosuggestion might involve the 'overwriting' of existing predictions or brain states that expect the most common (but not desired) outcome. We discuss potential experimental paradigms that could be used to study autosuggestion in the future, and discuss the strengths and weaknesses of current evidence. This review provides a first overview on how to define, experimentally induce, and study autosuggestion, which may facilitate its use in basic science and clinical practice.

Attention to body parts prompts thermoregulatory reactions in Body Integrity Dysphoria

In healthy subjects, the transient perturbation of body part ownership is accompanied by regional skin temperature decrease. This observation leaves an open question about a possible body part-specific thermoregulatory response in pathological conditions, in which the sense of ownership over that body part is altered. For instance, Body Integrity Dysphoria (BID), a poorly understood neuropsychiatric disorder, is characterised by the non-acceptance of one or more of one's extremities. This unsettling feeling pervasively captures the individuals' attention towards the unwanted limb. Previous studies characterised BID in terms of absent ownership feeling with preserved ownership judgment. We explored for the first time whether this altered feeling is also associated with a specific thermoregulatory response. We recorded thermal image sequences of circumscribed regions of the limbs' skin in seven individuals with BID desiring to remove one leg while they were invited to focus their attention toward one particular limb (arm or leg). Their event-related thermoregulatory pattern was compared to a group of healthy matched controls. In individuals with BID but not in control persons, we found a bilateral decrease in leg temperature when focusing their attention on either the unwanted or accepted leg. The event-related thermoregulatory response for both upper limbs was similar between individuals with BID and healthy controls. Our results suggest that the alteration of the sense of body ownership in neuropsychiatric conditions such as BID may critically rest on specific event-related thermoregulatory patterns in response to modulation of attention to body parts.

Effects of Symmetry and Apparent Distance in a Parasagittal-Mirror Variant of the Rubber Hand Illusion Paradigm

When I see my face in a mirror, its apparent position (behind the glass) is not one that my own face could be in. I accept the face I see as my own because I have an implicit understanding of how mirrors work. The situation is different if I look at the reflection of my right hand in a parasagittal mirror (parallel to body midline) when my left hand is hidden behind the mirror. It is as if I were looking through a window at my own left hand. The experience of body ownership has been investigated using rubber hand illusion (RHI) paradigms, and several studies have demonstrated ownership of a rubber hand viewed in a frontal mirror. Our “proof of concept” study was the first to combine use of a parasagittal mirror and synchronous stroking of both a prosthetic hand (viewed in the mirror) and the participant’s hand, with a manipulation of distance between the hands. The strength of the RHI elicited by our parasagittal-mirror paradigm depended not on physical distance between the hands (30, 45, or 60 cm) but on apparent distance between the prosthetic hand (viewed in the mirror) and the participant’s hand. This apparent distance was reduced to zero when the prosthetic hand and participant’s hand were arranged symmetrically (e.g., 30 cm in front of and behind the mirror). Thus, the parasagittal-mirror paradigm may provide a distinctive way to assess whether competition for ownership depends on spatial separation between the prosthetic hand and the participant’s hand.

Bilateral skin temperature drop and warm sensibility decrease following modulation of body part ownership through mirror-box illusion

The implicit and explicit awareness of owning a body and its parts is a constant accompaniment in our everyday life and our interaction with the outside world. The way in which we build and maintain a coherent sense of body ownership is not fully understood. It has been postulated that the integration between exteroceptive, interoceptive, and proprioceptive signals may play a fundamental role in the sense of body ownership. For instance, studies on healthy subjects and brain-damaged patients have suggested that alterations in the sense of body ownership are coupled with autonomic signal changes, such as thermoregulatory reactions. However, the available evidence is conflicting, possibly due to shortcomings in the experimental paradigm that previous studies have adopted. In this study, we explore the relationship between body ownership, thermoregulation, and thermal sensitivity through a novel application of the mirror-box illusion paradigm, overcoming some of the limitations of previous studies. We find a bilateral decrease in hand skin temperature, together with reduced thermal sensitivity for warm thermal stimuli following the induction of the illusion of ownership towards the participant's reflected hand. These findings demonstrate the importance of the orchestration of exteroceptive (e.g., visual), autonomic (e.g., body temperature) and proprioceptive (e.g., position and movement of the body) signals in maintaining a coherent sense of body ownership.

A Continuous Illusion of Having a Sixth Finger

Our body is central to our sense of self and personal identity, yet it can be manipulated in the laboratory in surprisingly easy ways. Several multisensory illusions have shown the flexibility of the mental representation of our bodies by inducing the illusion of owning an artificial body part or having a body part with altered features. Recently, new studies showed we can embody additional body parts such as a supernumerary finger. Newport et al. recently reported a novel six-finger illusion using conflicting visual and tactile signals induced with the mirror box to create the illusory perception of having a sixth finger for a brief moment. In this study, we aimed to replicate this result and to investigate whether the experience of embodiment of a sixth finger could be prolonged for an extended duration by applying continuous visual-tactile stimulation. Results showed that a continuous illusion of having a sixth finger can be clearly induced. This shows that the six-finger illusion does not reflect merely a momentary confusion due to conflicting multisensory signals but can reflect an enduring representation of a supernumerary finger.

An investigation of contextual factors in the application of multisensory illusions for analgesia in hand osteoarthritis

Objective

Emerging evidence suggests that multisensory illusions can modulate pain and can lead to changes in body perception. The aim of this study was to investigate whether contextual factors could explain the analgesic effects of multisensory body illusions on pain and body perception in people with hand OA (HOA).

Methods

In a crossover study, 28 individuals with painful HOA viewed their most affected hand in and outside of a real-time mediated reality system, with illusory stretching of the hand and changes in sensory input. The outcome measures were pain ratings, pressure pain thresholds, hand function and the subjective experience of the illusion.

Results

Stretching the hand both inside and outside the virtual environment led to a reduction in subjective pain ratings (all P < 0.05). Virtual stretching led to changes in body perception (P < 0.05) with no changes in pressure pain threshold (all P > 0.05). Higher pain at baseline predicted susceptibility to the stretch illusion and mean susceptibility ratings were greatest after the stretch illusion.

Conclusion

The current study highlights the importance of the context in which pain occurs and in which potential treatments may be applied. In this case, virtual and physical stretching modulated pain, but not viewing the hand alone. The research opens important implications for future research, including the use of contextual control conditions and the development of visual feedback interventions for a range of similarly visible chronic conditions for which pain, body image disturbances and body dissatisfaction may be apparent.

The depersonalized brain: New evidence supporting a distinction between depersonalization and derealization from discrete patterns of autonomic suppression observed in a non-clinical sample

Depersonalization and Derealization are characterised by feelings of detachment from one's bodily self/surroundings and a general emotional numbness. We explored predisposition to trait-based experiences of depersonalization/derealization-type experiences and autonomic arousal toward simulated body-threats, which were delivered to the participant's own body (i.e. Self) and when observed being delivered to another individual (i.e. Other). Ninety participants took part in an "Implied Body-Threat Illusion" task (Dewe, Watson, & Braithwaite, 2016) and autonomic arousal was recorded via standardised skin conductance responses and finger temperature. Autonomic suppression in response to threats delivered to the Self correlated with increases in trait-based depersonalization-type experiences. In contrast, autonomic suppression for threats delivered to Others correlated with trait-based derealization-like experiences. Body-temperature and anticipatory arousal did not correlate reliably with predisposition to depersonalization- or derealization-type experiences. The theoretical implications of these findings are discussed in terms of a fronto-limbic autonomic suppression mechanism.

Tactile localization biases are modulated by gaze direction

Identifying the spatial location of touch on the skin surface is a fundamental function of our somatosensory system. Despite the fact that stimulation of even single mechanoreceptive afferent fibres is sufficient to produce clearly localised percepts, tactile localisation can be modulated also by higher level processes such as body posture. This suggests that tactile events are coded using multiple representations using different coordinate systems. Recent reports provide evidence for systematic biases on tactile localisation task, which are thought to result from a supramodal representation of the skin surface. While the influence of non-informative vision of the body and gaze direction on tactile discrimination tasks has been extensively studied, their effects on tactile localisation tasks remain largely unexplored. To address this question, participants performed a tactile localization task on their left hand under different visual conditions by means of a mirror box; in the mirror condition, a single stimulus was delivered on participants' hand, while the reflexion of the right hand was seen through the mirror; in the object condition, participants looked at a box through the mirror, and in the right hand condition, participants looked directly at their right hand. Participants reported the location of the tactile stimuli using a silhouette of a hand. Results showed a shift in the localization of the touches towards the tip of the fingers (distal bias) and the thumb (radial biases) across conditions. Critically, distal biases were reduced when participants looked towards the mirror compared to when they looked at their right hand suggesting that gaze direction reduces the typical proximo-distal biases in tactile localization. Moreover, vision of the hand modulates the internal configuration of points' locations, by elongating it, in the radio-ulnar axis.

Vision of the body improves inter-hemispheric integration of tactile-motor responses

Sensory input from and motor output to the two sides of the body needs to be continuously integrated between the two cerebral hemispheres. This integration can be measured through its cost in terms of processing speed. In simple detection tasks, reaction times (RTs) are faster when stimuli are presented to the side of the body ipsilateral to the body part used to respond. This advantage - the contralateral-ipsilateral difference (also known as the crossed-uncrossed difference: CUD) - is thought to reflect inter-hemispheric interactions needed for sensorimotor information to be integrated between the two hemispheres. Several studies have shown that non-informative vision of the body enhances performance in tactile tasks. However, it is unknown whether the CUD can be similarly affected by vision. Here, we investigated whether the CUD is modulated by vision of the body (i.e., the stimulated hand) by presenting tactile stimuli unpredictably on the middle fingers when one hand was visible (i.e., either the right or left hand). Participants detected the stimulus and responded as fast as possible using either their left or right foot. Consistent with previous results, a clear CUD (5.8ms) was apparent on the unseen hand. Critically, however, no such effect was found on the hand that was visible (-2.2ms). Thus, when touch is delivered to a seen hand, the usual cost in processing speed of responding with a contralateral effector is eliminated. This result suggests that vision of the body improves the interhemispheric integration of tactile-motor responses.

The multisensory basis of the self: From body to identity to others [Formula: see text]

By grounding the self in the body, experimental psychology has taken the body as the starting point for a science of the self. One fundamental dimension of the bodily self is the sense of body ownership that refers to the special perceptual status of one's own body, the feeling that "my body" belongs to me. The primary aim of this review article is to highlight recent advances in the study of body ownership and our understanding of the underlying neurocognitive processes in three ways. I first consider how the sense of body ownership has been investigated and elucidated in the context of multisensory integration. Beyond exteroception, recent studies have considered how this exteroceptively driven sense of body ownership can be linked to the other side of embodiment, that of the unobservable, yet felt, interoceptive body, suggesting that these two sides of embodiment interact to provide a unifying bodily self. Lastly, the multisensorial understanding of the self has been shown to have implications for our understanding of social relationships, especially in the context of self-other boundaries. Taken together, these three research strands motivate a unified model of the self inspired by current predictive coding models.

Distorted body representations in healthy cognition

Delusions and misperceptions about the body are a conspicuous feature of numerous neurological and psychiatric conditions. In stark contrast to such pathological cases, the immediacy and familiarity of our ordinary experience of our body can make it seem as if our representation of our body is highly accurate, even infallible. Recent research has begun to demonstrate, however, that large and systematic distortions of body representation are a normal part of healthy cognition. Here, I describe this research, focusing on distortions of body representations underlying tactile distance perception and position sense. I also discuss evidence for distortions of higher-order body representations, such as the conscious body image. Finally, I will end with a discussion of the potential relations among different body representations and their distortions.

Uncomfortably numb: new evidence for suppressed emotional reactivity in response to body-threats in those predisposed to sub-clinical dissociative experiences

INTRODUCTION

Depersonalisation and derealisation disorders refer to feelings of detachment and dissociation from one's "self" or surroundings. A reduced sense of self (or "presence") and emotional "numbness" is thought to be mediated by aberrant emotional processing due to biases in self-referent multi-sensory integration. This emotional "numbing" is often accompanied by suppressed autonomic arousal to emotionally salient stimuli.

METHODS

118 participants completed the Cambridge Depersonalisation scale [Sierra, & Berrios, 2000. The Cambridge Depersonalisation Scale: A new instrument for the measurement of depersonalisation. Psychiatry Research, 93, 153-164)] as an index of dissociative anomalous experience. Participants took part in a novel "Implied Body-Threat Illusion" task; a pantomimed injection procedure conducted directly onto their real body (hand). Objective psychophysiological data were recorded via standardised threat-related skin conductance responses and finger temperature measures.

RESULTS

Individuals predisposed to depersonalisation/derealisation revealed suppressed skin conductance responses towards the pantomimed body-threat. Although the task revealed a reliable reduction in finger temperature as a fear response, this reduction was not reliably associated with measures of dissociative experience.

CONCLUSIONS

The present findings significantly extend previous research by revealing emotional suppression via a more direct body-threat task, even for sub-clinical groups. The findings are discussed within probabilistic and predictive coding frameworks of multi-sensory integration underlying a coherent sense of self.

Left caloric vestibular stimulation as a tool to reveal implicit and explicit parameters of body representation

Homeostatic parameters, such as temperature, are related to body representation. In this study, we measured whether caloric vestibular stimulation (CVS) alters body temperature and tactile processing, and if in the direction predicted by a holistic body matrix representation. Skin temperature and tactile two-point discrimination (TPD) acuity were measured for both arms before, immediately after and with a delay from CVS. Participants were also administered a personality questionnaire and an anxiety inventory to rule out confounding factors. Two control experiments were planned to exclude casual variations. Our results show that temperature drops significantly in both arms after CVS. CVS also induces a bilateral improvement in tactile acuity (even though not immediately after but in the delayed condition). Finally, these effects are not due to learning, as demonstrated by the control experiment. In summary, our results suggest that vestibular stimulation updates body representation, supporting the evidence in favor of a body matrix.

Multimodal Contributions to Body Representation

Our body is a unique entity by which we interact with the external world. Consequently, the way we represent our body has profound implications in the way we process and locate sensations and in turn perform appropriate actions. The body can be the subject, but also the object of our experience, providing information from sensations on the body surface and viscera, but also knowledge of the body as a physical object. However, the extent to which different senses contribute to constructing the rich and unified body representations we all experience remains unclear. In this review, we aim to bring together recent research showing important roles for several different sensory modalities in constructing body representations. At the same time, we hope to generate new ideas of how and at which level the senses contribute to generate the different levels of body representations and how they interact. We will present an overview of some of the most recent neuropsychological evidence about multisensory control of pain, and the way that visual, auditory, vestibular and tactile systems contribute to the creation of coherent representations of the body. We will focus particularly on some of the topics discussed in the symposium on Multimodal Contributions to Body Representation held on the 15th International Multisensory Research Forum (2015, Pisa, Italy).

Altered visual feedback modulates cortical excitability in a mirror-box-like paradigm

Watching self-generated unilateral hand movements reflected in a mirror-oriented along the midsagittal plane-enhances the excitability of the primary motor cortex (M1) ipsilateral to the moving hand of the observer. Mechanisms detecting sensory-motor conflicts generated by the mirror reflection of such movements might mediate this effect; if so, cortical excitability should be modulated by the magnitude of sensory-motor conflict. To this end, we explored the modulatory effects of an altered visual feedback on M1 excitability in a mirror-box-like paradigm, by increasing or decreasing the speed of the observed movement. Healthy subjects performed movements with their left index finger while watching a video of a hand superimposed to their right static hand, which was hidden from view. The hand observed in the video executed the same movement as the observer's left hand, but at slower, same, or faster paces. Motor evoked potentials (MEPs) induced by transcranial magnetic stimulation were measured from the first dorsal interosseous and the abductor digiti minimi of the participant's hidden resting hand. The excitability of the M1 ipsilateral to the moving hand was systematically modulated by the speed of the observed hand movement: the slower the observed movement, the greater the MEP amplitude from both muscles. This evidence shows that the magnitude of the visual-motor conflicts can be used to adjust the activity of the observer's motor system. Hence, an appropriate alteration of the visual feedback, here the reduction in the movement speed, may be useful to increase its modulatory effect on motor cortical excitability.

Binding body and self in visuo-vestibular conflicts

Maintenance of the bodily self relies on the accurate integration of multisensory inputs in which visuo-vestibular cue integration is thought to play an essential role. Here, we tested in healthy volunteers how conflicting visuo-vestibular bodily input might impact on body self-coherence in a full body illusion set-up. Natural passive vestibular stimulation was provided on a motion platform, while visual input was manipulated using virtual reality equipment. Explicit (questionnaire) and implicit (skin temperature) measures were employed to assess illusory self-identification with either a mannequin or a control object. Questionnaire results pointed to a relatively small illusion, but hand skin temperature, plausibly an index of illusory body ownership, showed the predicted drop specifically in the condition when participants saw the mannequin moving in congruence with them. We argue that this implicit measure was accessible to visuo-vestibular modulation of the sense of self, possibly mediated by shared neural processes in the insula involved in vestibular and interoceptive signalling, thermoregulation and multisensory integration.