Dissociations between the horizontal and dorsoventral axes in body-size perception

Lesions Causing Alice in Wonderland Syndrome Map to a Common Brain Network Linking Body and Size Perception

OBJECTIVE

Alice in Wonderland syndrome (AIWS) profoundly affects human perception of size and scale, particularly regarding one's own body and the environment. Its neuroanatomical basis has remained elusive, partly because brain lesions causing AIWS can occur in different brain regions. Here, we aimed to determine if brain lesions causing AIWS map to a distributed brain network.

METHODS

A retrospective case-control study analyzing 37 cases of lesion-induced AIWS identified through systematic literature review was conducted. Using resting-state functional connectome data from 1,000 healthy individuals, the whole-brain connections of each lesion were estimated and contrasted with those from a control dataset comprising 1,073 lesions associated with 25 other neuropsychiatric syndromes. Additionally, connectivity findings from lesion-induced AIWS cases were compared with functional neuroimaging results from 5 non-lesional AIWS cases.

RESULTS

AIWS-associated lesions were located in various brain regions with minimal overlap (≤33%). However, the majority of lesions (≥85%) demonstrated shared connectivity to the right extrastriate body area, known to be selectively activated by viewing body part images, and the inferior parietal cortex, involved in size and scale judgements. This pattern was uniquely characteristic of AIWS when compared with other neuropsychiatric disorders (family-wise error-corrected p < 0.05) and consistent with functional neuroimaging observations in AIWS due to nonlesional causes (median correlation r = 0.56, interquartile range 0.24).

INTERPRETATION

AIWS-related perceptual distortions map to one common brain network, encompassing regions critical for body representation and size-scale processing. These findings lend insight into the neuroanatomical localization of higher-order perceptual functions, and may inform future therapeutic strategies for perceptual disorders. ANN NEUROL 2024.

Reduced body-image disturbance by body-image interventions is associated with neural-response changes in visual and social processing regions: a preliminary study

Introduction

Body-image disturbance is a major factor in the development of eating disorders, especially among young women. There are two main components: perceptual disturbance, characterized by a discrepancy between perceived and actual body size, and affective disturbance, characterized by a discrepancy between perceived and ideal body size. Interventions targeting body-image disturbance ask individuals to describe their own body without using negative expressions when either viewing it in a mirror or imagining it. Despite the importance of reducing body-image disturbance, its neural mechanisms remain unclear. Here we investigated the changes in neural responses before and after an intervention. We hypothesized that neural responses correlated with the degree of body-image disturbance would also be related to its reduction, i.e., a reduction in perceptual and affective disturbances would be related to changes in attentional and socio-cognitive processing, respectively.

Methods

Twenty-eight young adult women without known psychiatric disorders underwent a single 40-min intervention. Participants completed tasks before and after the intervention, in which they estimated their perceived and ideal body sizes using distorted silhouette images to measure body-image disturbance. We analyzed the behavioral and neural responses of participants during the tasks.

Results

The intervention did not significantly reduce body-image disturbance. Analysis of individual differences showed distinct changes in neural responses for each type of disturbance. A decrease in perceptual disturbance was associated with bodily visuospatial processing: increased activation in the left superior parietal lobule, bilateral occipital gyri, and right cuneus. Reduced affective disturbance was associated with socio-cognitive processing; decreased activation in the right temporoparietal junction, and increased functional connectivity between the left extrastriate body area and the right precuneus.

Discussion

We identified distinct neural mechanisms (bodily visuospatial and socio-cognitive processing) associated with the reduction in each component of body-image disturbance. Our results imply that different neural mechanisms are related to reduced perceptual disturbance and the expression thereof, whereas similar neural mechanisms are related to the reduction and expression of affective disturbance. Considering the small sample size of this study, our results should be regarded as preliminary.

Neural mechanisms of perceptual and affective body-image disturbance during own-body and ideal-body estimation

Body-image disturbance is a core feature of eating disorders and can predict their development in healthy individuals. There are two components of body-image disturbance: perceptual disturbance (associated with overestimation of body size) and affective disturbance (associated with body dissatisfaction). Previous behavioral studies have hypothesized that attention to particular body parts and negative body-related emotions resulting from social pressure are associated with the respective degrees of perceptual and affective disturbance; however, the neural representations that underlie this hypothesis have not been elucidated. Thus, this study investigated the brain regions and connectivity associated with the degree of body-image disturbance. Specifically, we examined the brain activations associated with participants' estimation of the width of their actual and ideal bodies; we sought to determine which brain regions and functional connectivity from body-related visual processing regions were correlated with the degree of each component of body-image disturbance. The degree of perceptual disturbance was positively correlated with excessive width-dependent brain activations in the left anterior cingulate cortex when estimating one's body size; it was positively correlated with the functional connectivity between the left extrastriate body area and left anterior insula. The degree of affective disturbance was positively correlated with excessive width-dependent brain activation in the right temporoparietal junction and negatively correlated with functional connectivity between the left extrastriate body area and right precuneus when estimating one's ideal body size. These results support the hypothesis that perceptual disturbance is associated with attentional processing, whereas affective disturbance is associated with social processing.

Increased Effective Connectivity of the Left Parietal Lobe During Walking Tasks in Parkinson's Disease

BACKGROUND

In Parkinson's disease (PD), walking may depend on the activation of the cerebral cortex. Understanding the patterns of interaction between cortical regions during walking tasks is of great importance.

OBJECTIVE

This study investigated differences in the effective connectivity (EC) of the cerebral cortex during walking tasks in individuals with PD and healthy controls.

METHODS

We evaluated 30 individuals with PD (62.4±7.2 years) and 22 age-matched healthy controls (61.0±6.4 years). A mobile functional near-infrared spectroscopy (fNIRS) was used to record cerebral oxygenation signals in the left prefrontal cortex (LPFC), right prefrontal cortex (RPFC), left parietal lobe (LPL), and right parietal lobe (RPL) and analyze the EC of the cerebral cortex. A wireless movement monitor was used to measure the gait parameters.

RESULTS

Individuals with PD demonstrated a primary coupling direction from LPL to LPFC during walking tasks, whereas healthy controls did not demonstrate any main coupling direction. Compared with healthy controls, individuals with PD showed statistically significantly increased EC coupling strength from LPL to LPFC, from LPL to RPFC, and from LPL to RPL. Individuals with PD showed decreased gait speed and stride length and increased variability in speed and stride length. The EC coupling strength from LPL to RPFC negatively correlated with speed and positively correlated with speed variability in individuals with PD.

CONCLUSION

In individuals with PD, the left prefrontal cortex may be regulated by the left parietal lobe during walking. This may be the result of functional compensation in the left parietal lobe.

Selective effects of a brain tumor on the metric representation of the hand: a pre- versus post-surgery comparison

Body representation disorders are complex, varied, striking, and very disabling in most cases. Deficits of body representation have been described after lesions to multimodal and sensorimotor cortical areas. A few studies have reported the effects of tumors on the representation of the body, but little is known about the changes after tumor resection. Moreover, the impact of brain lesions on the hand size representation has been investigated in few clinical cases. Hands are of special importance, as no other body part has the ability for movement and interaction with the environment that the hands have, and we use them for a multitude of daily activities. Studies with clinical population can add further knowledge into the way hands are represented. Here, we report a single case study of a patient (AM) who was an expert bodybuilder and underwent a surgery to remove a glioblastoma in the left posterior prefrontal and precentral cortex at the level of the hand's motor region. Pre- (20 days) and post- (4 months) surgery assessment did not show any motor or cognitive impairments. A hand localization task was used, before and after surgery (12 months), to measure possible changes of the metric representation of his right hand. Results showed a post-surgery modulation of the typically distorted hand representation, with an overall accuracy improvement, especially on width dimension. These findings support the direct involvement of sensorimotor areas in the implicit representation of the body size and its relevance on defining specific size representation dimensions.

The Perceived Match Between Observed and Own Bodies, but Not Its Accuracy, Is Influenced by Movement Dynamics and Clothing Cues

Own-perceived body matching - the ability to match one's own body with an observed body - is a difficult task for both general and clinical populations. Thus far, however, own-perceived body matching has been investigated in situations that are incongruent with how we are used to experience and perceive our body in daily life. In the current study, we aimed to examine own-perceived body matching in a context that more closely resembles real life. More specifically, we investigated the effects of body movement dynamics and clothing cues on own-perceived body matching. We asked participants to match their own body with an externally perceived body that was a 3D-generated avatar based on participants' real bodies, fitted with a computer-generated dress. This perceived body was (1) either static (non-walking avatar) or dynamic (walking avatar), (2) either bigger, smaller, or the same size as participants' own body size, and (3) fitted with a dress with a size either bigger, smaller, or the same as participants' own dress size. Our results suggest that movement dynamics cues did not improve the accuracy of own-perceived body matching, but that confidence about dress fit was higher for dynamic avatars, and that the difference between dynamic and static avatars was dependent on participants' self-esteem. Furthermore, when participants were asked to rate the observed body in reference to how they wanted to represent themselves to others, dynamic avatars were rated lower than static avatars for the biggest-sized bodies only, possibly reflecting the influence of movement cues on amplifying socio-cultural stereotypes. Finally, while smaller body/dress sizes were systematically rated higher than bigger body/dress sizes for several self-report items, the interplay between body and dress size played an important role in participants' self-report as well. Thus, while our research suggests that movement and garment dynamics, allowing for realistic, concrete situations that are reminiscent of daily life, influence own-body perception, these cues did not lead to an improvement in accuracy. These findings provide important insights for research exploring (own-) body perception and bodily self-awareness, with practical (e.g., development of online avatars) and clinical (e.g., anorexia nervosa and body dysmorphic disorder) implications.

Use of a real-life practical context changes the relationship between implicit body representations and real body measurements

A mismatch exists between people's mental representations of their own body and their real body measurements, which may impact general well-being and health. We investigated whether this mismatch is reduced when contextualizing body size estimation in a real-life scenario. Using a reverse correlation paradigm, we constructed unbiased, data-driven visual depictions of participants' implicit body representations. Across three conditions-own abstract, ideal, and own concrete body-participants selected the body that looked most like their own, like the body they would like to have, or like the body they would use for online shopping. In the own concrete condition only, we found a significant correlation between perceived and real hip width, suggesting that the perceived/real body match only exists when body size estimation takes place in a practical context, although the negative correlation indicated inaccurate estimation. Further, participants who underestimated their body size or who had more negative attitudes towards their body weight showed a positive correlation between perceived and real body size in the own abstract condition. Finally, our results indicated that different body areas were implicated in the different conditions. These findings suggest that implicit body representations depend on situational and individual differences, which has clinical and practical implications.

The signing body: extensive sign language practice shapes the size of hands and face

The representation of the metrics of the hands is distorted, but is susceptible to malleability due to expert dexterity (magicians) and long-term tool use (baseball players). However, it remains unclear whether modulation leads to a stable representation of the hand that is adopted in every circumstance, or whether the modulation is closely linked to the spatial context where the expertise occurs. To this aim, a group of 10 experienced Sign Language (SL) interpreters were recruited to study the selective influence of expertise and space localisation in the metric representation of hands. Experiment 1 explored differences in hands’ size representation between the SL interpreters and 10 age-matched controls in near-reaching (Condition 1) and far-reaching space (Condition 2), using the localisation task. SL interpreters presented reduced hand size in near-reaching condition, with characteristic underestimation of finger lengths, and reduced overestimation of hands and wrists widths in comparison with controls. This difference was lost in far-reaching space, confirming the effect of expertise on hand representations is closely linked to the spatial context where an action is performed. As SL interpreters are also experts in the use of their face with communication purposes, the effects of expertise in the metrics of the face were also studied (Experiment 2). SL interpreters were more accurate than controls, with overall reduction of width overestimation. Overall, expertise modifies the representation of relevant body parts in a specific and context-dependent manner. Hence, different representations of the same body part can coexist simultaneously.

Topological and hodological aspects of body representation in right brain damaged patients

The triadic taxonomy posits that three distinct types of body representations do exist, namely the body schema (BS), which corresponds to the representation derived from multiple sensory and motor inputs, the body structural representation (BSR), which corresponds to the structural description of spatial relations among the body parts, and the body semantics (SEM), which corresponds to the lexical-semantic representation of the body. Although several studies have assessed neural correlates of these representations, no study has compared them in brain-damaged patients, controlling for deficits in other cognitive domains. Also, little is known about the contribution of the right hemisphere to different body representations. Here we used a computerized battery to test these three body representations in twenty-six right brain damaged patients, controlling for other cognitive deficits by means of tests tapping similar spatial and lexical processes on non-body related stimuli. Residual scores corresponding to the BS, the BSR and the SEM were used to test neural correlates, which were assessed by integrating topological and hodological approaches to lesion-deficit analyses. We found that the BSR was associated with lesion of the superior temporal gyrus, the insula, the supramarginal gyrus and the temporo-parietal junction, extending also to the Rolandic operculum and the inferior frontal gyrus. Also, it was associated with the disconnection probability of the posterior arcuate segment. The BS was associated with a small cluster of voxels in the precentral and postcentral gyri, whereas the SEM was associated with white matter lesion at the boundary between the parietal and temporal lobes. Overall, these results provide strong support to the regional and connectional contribution of the right hemisphere to body representation, and more specifically to the BSR.

Perceived match between own and observed models' bodies: influence of face, viewpoints, and body size

People are generally unable to accurately determine their own body measurements and to translate this knowledge to identifying a model/avatar that best represents their own body. This inability has not only been related to health problems (e.g. anorexia nervosa), but has important practical implications as well (e.g. online retail). Here we aimed to investigate the influence of three basic visual features—face presence, amount of viewpoints, and observed model size—on the perceived match between own and observed models’ bodies and on attitudes towards these models. Models were real-life models (Experiment 1) or avatar models based on participants’ own bodies (Experiment 2). Results in both experiments showed a strong effect of model size, irrespective of participants’ own body measurements. When models were randomly presented one by one, participants gave significantly higher ratings to smaller- compared to bigger-sized models. The reverse was true, however, when participants observed and compared models freely, suggesting that the mode of presentation affected participants’ judgments. Limited evidence was found for an effect of facial presence or amount of viewpoints. These results add evidence to research on visual features affecting the ability to match observed bodies with own body image, which has biological, clinical, and practical implications.

Secondary somatosensory cortex of primates: beyond body maps, toward conscious self-in-the-world maps

Recent human imaging studies have revealed the involvement of the secondary somatosensory cortex (SII) in processes that require high-level information integration, such as self-consciousness, social relations, whole body representation, and metaphorical extrapolations. These functions are far beyond its known role in the formation of body maps (even in their most complex forms), requiring the integration of different information modalities in addition to somatosensory information. However, no evidence of such complex processing seems to have been detected at the neuronal level in animal experiments, which would constitute a major discrepancy between human and non-human animals. This article scrutinizes this gap, introducing experimental evidence of human and non-human primates’ SII functions set in context with their evolutionary significance and mechanisms, functionally situating the human SII as a primate brain. Based on the presented data, a new concept of a somatocentric holistic self is proposed, represented as a more comprehensive body-in-the-world map in the primate SII, taking into account evolutionary aspects that characterize the human SII and its implication in the emergence of self-consciousness. Finally, the idea of projection is introduced from the viewpoint of cognitive science, providing a logical explanation to bridge this gap between observed behavior and neurophysiological data.

The Representation of Body Size: Variations With Viewpoint and Sex

Perceived body size is a fundamental construct that reflects our knowledge of self and is important for all aspects of perception, yet how we perceive our bodies and how the body is represented in the brain is not yet fully understood. In order to understand how the brain perceives and represents the body, we need an objective method that is not vulnerable to affective or cognitive influences. Here, we achieve this by assessing the accuracy of full-body size perception using a novel psychophysical method that taps into the implicit body representation for determining perceived size. Participants were tested with life-size images of their body as seen from different viewpoints with the expectation that greater distortions would occur for unfamiliar views. The Body Shape Questionnaire was also administered. Using a two-alternative forced choice design, participants were sequentially shown two life-size images of their whole body dressed in a standardized tight-fitting outfit seen from the front, side, or back. In one image, the aspect ratio (with the horizontal or vertical dimension fixed) was varied using an adaptive staircase, while the other was undistorted. Participants reported which image most closely matched their own body size. The staircase honed in on the distorted image that was equally likely as the undistorted photo to be judged as matching their perception of themselves. From this, the perceived size of their internal body representation could be calculated. Underestimation of body width was found when the body was viewed from the front or back in both sexes. However, females, but not males, overestimated their width when the body was viewed from the side. Height was perceived accurately in all views. These findings reveal distortions in perceived size for healthy populations and show that both viewpoint and sex matter for the implicit body representation. Though the back view of one’s body is rarely–if ever–seen, perceptual distortions were the same as for the front view. This provides insight into how the brain might construct its representation of three-dimensional body shape.

Perceptual Distortions of 3-D Finger Size

Our body is a volumetric, three-dimensional (3-D) object in the world, and we experience it as such. Existing methods for measuring the perceptual body image, however, have been based on judgments of one-dimensional (1-D) length or two-dimensional images. We developed a new approach to the 3-D perceptual body image of the fingers by asking people to judge whether each finger would fit through rings of varying diameter. This task requires participants to conceptualize their finger as a volumetric object entering the ring. In two experiments, we used an adaptive staircase procedure to estimate the perceived size of each finger. There were systematic distortions of perceived 3-D finger size, with the size of index finger and (to a lesser extent) the middle finger underestimated. These distortions were unaffected by changes in hand posture. Notably, the pattern of distortions is qualitatively different from that found in previous research investigating 1-D finger length, suggesting that 3-D judgments of the body may differ in fundamental ways from 1-D judgments of individual body dimensions.

Body size estimation of self and others in females varying in BMI

Previous literature suggests that a disturbed ability to accurately identify own body size may contribute to overweight. Here, we investigated the influence of personal body size, indexed by body mass index (BMI), on body size estimation in a non-clinical population of females varying in BMI. We attempted to disentangle general biases in body size estimates and attitudinal influences by manipulating whether participants believed the body stimuli (personalized avatars with realistic weight variations) represented their own body or that of another person. Our results show that the accuracy of own body size estimation is predicted by personal BMI, such that participants with lower BMI underestimated their body size and participants with higher BMI overestimated their body size. Further, participants with higher BMI were less likely to notice the same percentage of weight gain than participants with lower BMI. Importantly, these results were only apparent when participants were judging a virtual body that was their own identity (Experiment 1), but not when they estimated the size of a body with another identity and the same underlying body shape (Experiment 2a). The different influences of BMI on accuracy of body size estimation and sensitivity to weight change for self and other identity suggests that effects of BMI on visual body size estimation are self-specific and not generalizable to other bodies.

Neural correlates of evoked phantom limb sensations

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We present a neural network related to evoked phantom sensations in amputees.

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Such networks were not related to the stimulation from the residual limb.

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Difference in intra- and inter-hemispheric interactions between amputees and yoked controls.

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This finding yields novel insights into the neural basis of phantom sensation.

Previous work showed the existence of changes in the topographic organization within the somatosensory cortex (SI) in amputees with phantom limb pain, however, the link between nonpainful phantom sensations such as cramping or tingling or the percept of the limb and cortical changes is less clear.

We used functional magnetic resonance imaging (fMRI) in a highly selective group of limb amputees who experienced inducible and reproducible nonpainful phantom sensations. A standardized procedure was used to locate body sites eliciting phantom sensations in each amputee. Selected body sites that could systematically evoke phantom sensations were stimulated using electrical pulses in order to induce phasic phantom sensations. Homologous body parts were also stimulated in a group of matched controls.

Activations related to evoked phantom sensations were found bilaterally in SI and the intraparietal sulci (IPS), which significantly correlated with the intensity of evoked phantom sensations. In addition, we found differences in intra- and interhemispheric interaction between amputees and controls during evoked phantom sensations. We assume that phantom sensations might be associated with a functional decoupling between bilateral SI and IPS, possibly resulting from transcallosal reorganization mechanisms following amputation.

To move or not to move, that is the question! Body schema and non-action oriented body representations: An fMRI meta-analytic study

Many studies have attempted to identify the different cognitive components of body representation (BR). Due to methodological issues, the data reported in these studies are often confusing. Here we summarize the fMRI data from previous studies and explore the possibility of a neural segregation between BR supporting actions (body-schema, BS) or not (non-oriented-to-action-body-representation, NA). We performed a general activation likelihood estimation meta-analysis of 59 fMRI experiments and two individual meta-analyses to identify the neural substrates of different BR. Body processing involves a wide network of areas in occipital, parietal, frontal and temporal lobes. NA selectively activates the somatosensory primary cortex and the supramarginal gyrus. BS involves the primary motor area and the right extrastriate body area. Our data suggest that motor information and recognition of body parts are fundamental to build BS. Instead, sensory information and processing of the egocentric perspective are more important for NA. In conclusion, our results strongly support the idea that different and segregated neural substrates are involved in body representations orient or not to actions.

Owning an overweight or underweight body: distinguishing the physical, experienced and virtual body

Our bodies are the most intimately familiar objects we encounter in our perceptual environment. Virtual reality provides a unique method to allow us to experience having a very different body from our own, thereby providing a valuable method to explore the plasticity of body representation. In this paper, we show that women can experience ownership over a whole virtual body that is considerably smaller or larger than their physical body. In order to gain a better understanding of the mechanisms underlying body ownership, we use an embodiment questionnaire, and introduce two new behavioral response measures: an affordance estimation task (indirect measure of body size) and a body size estimation task (direct measure of body size). Interestingly, after viewing the virtual body from first person perspective, both the affordance and the body size estimation tasks indicate a change in the perception of the size of the participant's experienced body. The change is biased by the size of the virtual body (overweight or underweight). Another novel aspect of our study is that we distinguish between the physical, experienced and virtual bodies, by asking participants to provide affordance and body size estimations for each of the three bodies separately. This methodological point is important for virtual reality experiments investigating body ownership of a virtual body, because it offers a better understanding of which cues (e.g. visual, proprioceptive, memory, or a combination thereof) influence body perception, and whether the impact of these cues can vary between different setups.

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

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