Visual appearance of a virtual upper limb modulates the temperature of the real hand: a thermal imaging study in Immersive Virtual Reality

Does Embodying a Divine Avatar Influence Moral Decisions? An Immersive Virtual Reality Study

The term Proteus effect refers to the changes in attitudes and behavior induced by the characteristics of an embodied virtual agent. Whether the effect can extend to the moral sphere is currently unknown. To deal with this issue, we investigated if embodying virtual agents (i.e., avatars) with different characteristics modulate people's moral standards differentially. Participants were requested to embody an avatar resembling the Christian God in His anthropomorphic appearance or a control human avatar and to perform a text-based version of incidental and instrumental dilemmas in a virtual environment. For each participant, we recorded (1) chosen options (deontological vs. utilitarian), (2) decision times, (3) postdecision feelings, and (4) physiological reactions (skin conductance response and heart rate). We found that embodying God vs. a control avatar did not change the performance in the moral dilemma task, indicating that no strong Proteus effect was at play in our experimental conditions. We interpreted this result by examining the constraints and limitations of our task, reasoning about the necessary conditions for eliciting the Proteus effect, and discussing future developments and advances in the field. Moreover, we presented compelling effects concerning dilemma type, chosen option, personality traits, and religion affiliation, thus supporting and extending literature on decision making in moral dilemmas.

Early threat perception is independent of later cognitive and behavioral control. A virtual reality-EEG-ECG study

Research on social threat has shown influences of various factors, such as agent characteristics, proximity, and social interaction on social threat perception. An important, yet understudied aspect of threat exposure concerns the ability to exert control over the threat and its implications for threat perception. In this study, we used a virtual reality (VR) environment showing an approaching avatar that was either angry (threatening body expression) or neutral (neutral body expression) and informed participants to stop avatars from coming closer under five levels of control success (0, 25, 50, 75, or 100%) when they felt uncomfortable. Behavioral results revealed that social threat triggered faster reactions at a greater virtual distance from the participant than the neutral avatar. Event-related potentials (ERPs) revealed that the angry avatar elicited a larger N170/vertex positive potential (VPP) and a smaller N3 than the neutral avatar. The 100% control condition elicited a larger late positive potential (LPP) than the 75% control condition. In addition, we observed enhanced theta power and accelerated heart rate for the angry avatar vs. neutral avatar, suggesting that these measures index threat perception. Our results indicate that perception of social threat takes place in early to middle cortical processing stages, and control ability is associated with cognitive evaluation in middle to late stages.

Embodying the avatar of an omnipotent agent modulates the perception of one's own abilities and enhances feelings of invulnerability

Immersive virtual reality can give people the illusion of owning artificial bodies (i.e., avatars) and controlling their actions. Tellingly, people appear to adhere to the newly embodied entities not just on the basis of physical traits but also behaving accordingly with the hallmarks of the represented characters. In two studies we pushed the limits of this process by testing if one's own sense of power could be affected by embodying the anthropomorphic representation of the Christian God, that is considered an omnipotent entity. A human Muscled and a Normotype avatar were used as controls. Results showed that participants embodying the God-avatar: (i) reacted to a threatening event compromising their physical safety by exhibiting a lower skin conductance response and heart rate deceleration compared to the Normotype-control avatar (Study 1); (ii) estimated they had more physical abilities compared to both the Normotype-control and the Muscled-control avatars (Study 2). Taken together, our findings suggest that embodying an omnipotent agent may exert an influence on people's perception of their own limits and capabilities, nourishing feelings of physical invulnerability and strength. Our study indicates that effectively embodying virtual role models may boost achievements and have translational implications in the field of empowerment.

Gut markers of bodily self-consciousness in men

Bodily self-consciousness, the state of mind that allows humans to be aware of their own body, forms the backdrop for almost every human experience, yet its underpinnings remain elusive. Here we combine an ingestible, minimally invasive capsule with surface electrogastrography to probe if gut physiology correlates with bodily self-consciousness in a sample of healthy men during a virtual bodily illusion. We discover that specific patterns of stomach and bowel activity (temperature, pressure, and pH) covary with specific facets of bodily self-consciousness (feelings of body location, agency, and disembodiment). These results uncover the hitherto untapped potential of minimally invasive probes to study the link between mental and gut states and show the significance of deep visceral organs in the self-conscious perception of ourselves as embodied beings.

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We studied the gastrointestinal (GI) underpinnings of bodily self-consciousness

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An ingestible pill tracked how GI parameters change during a bodily illusion

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GI activity was generally correlated with higher embodiment and lower disembodiment

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Gut plays a significant role in how our self embodies entities such as avatars

Embodying an artificial hand increases blood flow to the investigated limb [version 3; peer review: 2 approved]

Background

The autonomic nervous system is the main determinant of the blood flow directed towards a body part, and it is tightly connected to the representation of the body in the brain; would the experimental modulation of the sense of limb ownership affect its blood perfusion?

Methods

In healthy participants, we employed the rubber hand illusion paradigm to modulate limb ownership while we monitored the brachial artery blood flow and resistance index within the investigated limb.

Results

In all conditions with brush-stroking, we found an initial drop in the blood flow due to tactile stimulation. Subsequently, in the illusion condition (where both the rubber and real hand synchronous brush-stroking were present), the blood flow rose significantly faster and reached significantly higher values. Moreover, the increase in blood flow correlated with the extent of embodiment as measured by questionnaires and correlated negatively with the change of peripherical vascular resistance.

Conclusions

These findings suggest that modulating the representation of a body part impacts its blood perfusion.

Breathing control, brain, and bodily self-consciousness: Toward immersive digiceuticals to alleviate respiratory suffering

Breathing is peculiar among autonomic functions through several characteristics. It generates a very rich afferent traffic from an array of structures belonging to the respiratory system to various areas of the brain. It is intimately associated with bodily movements. It bears particular relationships with consciousness as its efferent motor control can be automatic or voluntary. In this review within the scope of "respiratory neurophysiology" or "respiratory neuroscience", we describe the physiological organisation of breathing control. We then review findings linking breathing and bodily self-consciousness through respiratory manipulations using virtual reality (VR). After discussing the currently admitted neurophysiological model for dyspnea, as well as a new Bayesian model applied to breathing control, we propose that visuo-respiratory paradigms -as developed in cognitive neuroscience- will foster insights into some of the basic mechanisms of the human respiratory system and will also lead to the development of immersive VR-based digital health tools (i.e. digiceuticals).

Midfrontal Theta tACS Facilitates Motor Coordination in Dyadic Human-Avatar Interactions

Synchronous interpersonal motor interactions require moment-to-moment prediction and proactive monitoring of the partner's actions. Neurophysiologically, this is highlighted by an enhancement of midfrontal theta (4-7 Hz) oscillations. In this study, we explored the causal role of midfrontal theta for interpersonal motor interactions using transcranial alternating current stimulation (tACS). We implemented a realistic human-avatar interaction task in immersive virtual reality where participants controlled a virtual arm and hand to press a button synchronously with a virtual partner. Participants completed the task while receiving EEG-informed theta (Experiment 1) or beta (control frequency, Experiment 2) tACS over the frontal midline, as well as sham stimulation as a control. Results showed that midfrontal theta tACS significantly improved behavioral performance (i.e., reduced interpersonal asynchrony) and participants' motor strategies (i.e., increased movement times and reduced RTs), whereas beta tACS had no effect on these measures. These results suggest that theta tACS over frontal areas facilitates action monitoring and motor abilities supporting interpersonal interactions.

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.

Embodying an artificial hand increases blood flow to the investigated limb

Background: The autonomic nervous system is the main determinant of the blood flow directed towards a body part, and it is tightly connected to the representation of the body in the brain; would the experimental modulation of the sense of ownership of the limb affect its blood perfusion? Methods: In healthy participants, we employed the rubber hand illusion paradigm to modulate limb ownership while we monitored the brachial artery blood flow and resistance of the investigated limb. Results: In all conditions with brush-stroking, we found an initial drop in the blood flow due to tactile stimulation. Subsequently, in the illusion condition where both the rubber and real hand experience synchronous brush-stroking, the blood flow rose significantly faster and reached significantly higher values. Moreover, the increase in blood flow correlated to the embodiment level measured by questionnaires and, negatively, to the change of peripherical vascular resistance. Conclusions: These findings demonstrate that modulating the representation of a body part impacts its blood perfusion.

Exploring the Embodiment of a Virtual Hand in a Spatially Augmented Respiratory Biofeedback Setting

Enhancing the embodiment of artificial limbs—the individuals' feeling that a virtual or robotic limb is integrated in their own body scheme—is an impactful strategy for improving prosthetic technology acceptance and human-machine interaction. Most studies so far focused on visuo-tactile strategies to empower the embodiment processes. However, novel approaches could emerge from self-regulation techniques able to change the psychophysiological conditions of an individual. Accordingly, this pilot study investigates the effects of a self-regulated breathing exercise on the processes of body ownership underlying the embodiment of a virtual right hand within a Spatially Augmented Respiratory Biofeedback (SARB) setting. This investigation also aims at evaluating the feasibility of the breathing exercise enabled by a low-cost SARB implementation designed for upcoming remote studies (a need emerged during the COVID-19 pandemic). Twenty-two subjects without impairments, and two transradial prosthesis users for a preparatory test, were asked (in each condition of a within-group design) to maintain a normal (about 14 breaths/min) or slow (about 6 breaths/min) respiratory rate to keep a static virtual right hand “visible” on a screen. Meanwhile, a computer-generated sphere moved from left to right toward the virtual hand during each trial (1 min) of 16. If the participant's breathing rate was within the target (slow or normal) range, a visuo-tactile event was triggered by the sphere passing under the virtual hand (the subjects observed it shaking while they perceived a vibratory feedback generated by a smartphone). Our results—mainly based on questionnaire scores and proprioceptive drift—highlight that the slow breathing condition induced higher embodiment than the normal one. This preliminary study reveals the feasibility and potential of a novel psychophysiological training strategy to enhance the embodiment of artificial limbs. Future studies are needed to further investigate mechanisms, efficacy and generalizability of the SARB techniques in training a bionic limb embodiment.

Impact of Outdoor Temperature Variations on Thermal State in Experiments Using Immersive Virtual Environment

Recent studies have established immersive virtual environments (IVEs) as promising tools for studying human thermal states and human–building interactions. One advantage of using immersive virtual environments is that experiments or data collection can be conducted at any time of the year. However, previous studies have confirmed the potential impact of outdoor temperature variations, such as seasonal variations on human thermal sensation. To the best of our knowledge, no study has looked into the potential impact of variations in outdoor temperatures on experiments using IVE. Thus, this study aimed to determine if different outdoor temperature conditions affected the thermal states in experiments using IVEs. Experiments were conducted using a head mounted display (HMD) in a climate chamber, and the data was analyzed under three temperature ranges. A total of seventy-two people participated in the experiments conducted in two contrasting outdoor temperature conditions, i.e., cold and warm outdoor conditions. The in situ experiments conducted in two cases, i.e., cooling in warm outdoor conditions and heating in cold outdoor conditions, were used as a baseline. The baseline in-situ experiments were then compared with the IVE experiments conducted in four cases, i.e., cooling in warm and cold outdoor conditions and heating in warm and cold outdoor conditions. The selection of cooling in cold outdoor conditions and heating in warm outdoor conditions for IVE experiments is particularly for studying the impact of outdoor temperature variations. Results showed that under the experimental and outdoor temperature conditions, outdoor temperature variations in most cases did not impact the results of IVE experiments, i.e., IVE experiments can replicate a temperature environment for participants compared to the ones in the in situ experiments. In addition, the participant’s thermal sensation vote was found to be a reliable indicator between IVE and in situ settings in all studied conditions. A few significantly different cases were related to thermal comfort, thermal acceptability, and overall skin temperature.

The perspectives of mapping and monitoring of the sense of self in neurosurgical patients

Surgical treatment of tumors, epileptic foci or of vascular origin, requires a detailed individual pre-surgical workup and intra-operative surveillance of brain functions to minimize the risk of post-surgical neurological deficits and decline of quality of life. Most attention is attributed to language, motor functions, and perception. However, higher cognitive functions such as social cognition, personality, and the sense of self may be affected by brain surgery. To date, the precise localization and the network patterns of brain regions involved in such functions are not yet fully understood, making the assessment of risks of related post-surgical deficits difficult. It is in the interest of neurosurgeons to understand with which neural systems related to selfhood and personality they are interfering during surgery. Recent neuroscience research using virtual reality and clinical observations suggest that the insular cortex, medial prefrontal cortex, and temporo-parietal junction are important components of a neural system dedicated to self-consciousness based on multisensory bodily processing, including exteroceptive and interoceptive cues (bodily self-consciousness (BSC)). Here, we argue that combined extra- and intra-operative approaches using targeted cognitive testing, functional imaging and EEG, virtual reality, combined with multisensory stimulations, may contribute to the assessment of the BSC and related cognitive aspects. Although the usefulness of particular biomarkers, such as cardiac and respiratory signals linked to virtual reality, and of heartbeat evoked potentials as a surrogate marker for intactness of multisensory integration for intra-operative monitoring has to be proved, systemic and automatized testing of BSC in neurosurgical patients will improve future surgical outcome.

The Untapped Potential of Virtual Reality in Rehabilitation of Balance and Gait in Neurological Disorders

Dynamic systems theory transformed our understanding of motor control by recognizing the continual interaction between the organism and the environment. Movement could no longer be visualized simply as a response to a pattern of stimuli or as a demonstration of prior intent; movement is context dependent and is continuously reshaped by the ongoing dynamics of the world around us. Virtual reality is one methodological variable that allows us to control and manipulate that environmental context. A large body of literature exists to support the impact of visual flow, visual conditions, and visual perception on the planning and execution of movement. In rehabilitative practice, however, this technology has been employed mostly as a tool for motivation and enjoyment of physical exercise. The opportunity to modulate motor behavior through the parameters of the virtual world is often ignored in practice. In this article we present the results of experiments from our laboratories and from others demonstrating that presenting particular characteristics of the virtual world through different sensory modalities will modify balance and locomotor behavior. We will discuss how movement in the virtual world opens a window into the motor planning processes and informs us about the relative weighting of visual and somatosensory signals. Finally, we discuss how these findings should influence future treatment design.

Virtual Body Ownership Illusions for Mental Health: A Narrative Review

Over the last 20 years, virtual reality (VR) has been widely used to promote mental health in populations presenting different clinical conditions. Mental health does not refer only to the absence of psychiatric disorders but to the absence of a wide range of clinical conditions that influence people’s general and social well-being such as chronic pain, neurological disorders that lead to motor o perceptual impairments, psychological disorders that alter behaviour and social cognition, or physical conditions like eating disorders or present in amputees. It is known that an accurate perception of oneself and of the surrounding environment are both key elements to enjoy mental health and well-being, and that both can be distorted in patients suffering from the clinical conditions mentioned above. In the past few years, multiple studies have shown the effectiveness of VR to modulate such perceptual distortions of oneself and of the surrounding environment through virtual body ownership illusions. This narrative review aims to review clinical studies that have explored the manipulation of embodied virtual bodies in VR for improving mental health, and to discuss the current state of the art and the challenges for future research in the context of clinical care.

How to lose a hand: Sensory updating drives disembodiment

Body representations are readily expanded based on sensorimotor experience. A dynamic view of body representations, however, holds that these representations cannot only be expanded but that they can also be narrowed down by disembodying elements of the body representation that are no longer warranted. Here we induced illusory ownership in terms of a moving rubber hand illusion and studied the maintenance of this illusion across different conditions. We observed ownership experience to decrease gradually unless participants continued to receive confirmatory multisensory input. Moreover, a single instance of multisensory mismatch – a hammer striking the rubber hand but not the real hand – triggered substantial and immediate disembodiment. Together, these findings support and extend previous theoretical efforts to model body representations through basic mechanisms of multisensory integration. They further support an updating model suggesting that embodied entities fade from the body representation if they are not refreshed continuously.

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.

Visual appearance of the virtual hand affects embodiment in the virtual hand illusion

Body ownership (the feeling that one’s body belongs to oneself) is commonly studied with Rubber hand illusion (RHI) paradigm that allows inducing a temporary illusory feeling of ownership of a life-sized rubber hand. However, it remains unclear whether illusory ownership of the fake hand relies on the same mechanisms as ownership of one’s own real hand. Here, we directly compared ownership of the own hand (OH) and fake hand (FH) in the same set of conditions within immersive virtual reality. We obtained behavioral (proprioceptive drift) and subjective (questionnaire) measures of ownership and disownership for virtual OH, FH and object (Obj) that were located congruently or incongruently with the participant’s real hand and were stimulated synchronously or asynchronously with the real hand. Both OH and FH (but not Obj) were embodied after synchronous stimulation in both locations. Crucially, subjective ownership of the OH was stronger than of the FH in congruent location after synchronous stimulation. It was also present after asynchronous stimulation, being stronger when the virtual OH was subjectively more similar to the real hand. The results suggest that the detailed appearance of the body might act as an additional component in the construction of body ownership.

Toward Enhanced Teleoperation Through Embodiment

Telerobotics aims to transfer human manipulation skills and dexterity over an arbitrary distance and at an arbitrary scale to a remote workplace. A telerobotic system that is transparent enables a natural and intuitive interaction. We postulate that embodiment (with three sub-components: sense of ownership, agency, and self-location) of the robotic system leads to optimal perceptual transparency and increases task performance. However, this has not yet been investigated directly. We reason along four premises and present findings from the literature that substantiate each of them: (1) the brain can embody non-bodily objects (e.g., robotic hands), (2) embodiment can be elicited with mediated sensorimotor interaction, (3) embodiment is robust against inconsistencies between the robotic system and the operator's body, and (4) embodiment positively correlates to dexterous task performance. We use the predictive encoding theory as a framework to interpret and discuss the results reported in the literature. Numerous previous studies have shown that it is possible to induce embodiment over a wide range of virtual and real extracorporeal objects (including artificial limbs, avatars, and android robots) through mediated sensorimotor interaction. Also, embodiment can occur for non-human morphologies including for elongated arms and a tail. In accordance with the predictive encoding theory, none of the sensory modalities is critical in establishing ownership, and discrepancies in multisensory signals do not necessarily lead to loss of embodiment. However, large discrepancies in terms of multisensory synchrony or visual likeness can prohibit embodiment from occurring. The literature provides less extensive support for the link between embodiment and (dexterous) task performance. However, data gathered with prosthetic hands do indicate a positive correlation. We conclude that all four premises are supported by direct or indirect evidence in the literature, suggesting that embodiment of a remote manipulator may improve dexterous performance in telerobotics. This warrants further implementation testing of embodiment in telerobotics. We formulate a first set of guidelines to apply embodiment in telerobotics and identify some important research topics.

Building the bodily self-awareness: Evidence for the convergence between interoceptive and exteroceptive information in a multilevel kernel density analysis study

Exteroceptive and interoceptive signals shape and sustain the bodily self-awareness. The existence of a set of brain areas, supporting the integration of information coming from the inside and the outside of the body in building the sense of bodily self-awareness has been postulated, yet the evidence remains limited, a matter of discussion never assessed quantitatively. With the aim of unrevealing where in the brain interoceptive and exteroceptive signals may converge, we performed a meta-analysis on imaging studies of the sense of body ownership, modulated by external visuotactile stimulation, and studies on interoception, which involves the self-awareness for internal bodily sensations. Using a multilevel kernel density analysis, we found that processing of stimuli of the two domains converges primarily in the supramarginal gyrus bilaterally. Furthermore, we found a right-lateralized set of areas, including the precentral and postcentral, and superior temporal gyri. We discuss these results and propose this set of areas as ideal candidates to match multiple body-related signals contributing to the creation of a multidimensional representation of the bodily self.

Modulation of Body Representation Impacts on Efferent Autonomic Activity

The afferent branch of the autonomic nervous system contributes with interoception to the multimodal sensory correlation continuously needed to update our representation of the body. To test whether the modulation of body representation would have an impact on the efferent branch of the autonomic nervous system, nonspecific skin conductance has been measured in three rubber hand illusion (RHI) experiments, controlled with asynchronous brush-stroking and incongruent fake hand position. Nonspecific skin conductance standard deviation (SCSD) computed along the whole 90 sec of stroking was found to be increased by the illusion and to correlate with all the typical measures of embodiment. Computing SCSD in shorter time windows strongly enhanced the difference between illusion and controls. The highest difference was found in the 10-55 sec window, being the 14-34 sec window as the most informative one. The higher correlations with the validated measures of embodiment (all but the proprioceptive drift) were found for time windows ranging between 35 and 65 sec. The SCSD was no longer significantly higher when the RHI was repeated twice (two trials each iteration), but it was still significantly higher in synchronous stroking even when considering only the second trial. However, after the first iteration of the RHI paradigm, the effect of the embodiment on nonspecific skin conductance response results to be attenuated, suggesting that novelty in presentation of the RHI can contribute to the effect on nonspecific skin conductance response. Results candidate SCSD as a noninvasive, cheap, easy, and objective measure of embodiment, especially sensible to onset and strength of the illusion. Alike the already known enhanced autonomic reaction to a threatening, SCSD does not interfere with the collection of other behavioral measures. Correlations and their dynamics, presence of the effect in the second presentation of the setup but relative low robustness against multiple repetition, suggest that the increased fluctuations of skin conductance caught by SCSD are not just the effect of different presented sensory stimuli but more likely a stronger arousal response to the novelty of the updated perceptual status.

Characterizing Body Image Distortion and Bodily Self-Plasticity in Anorexia Nervosa via Visuo-Tactile Stimulation in Virtual Reality

We combined virtual reality and multisensory bodily illusion with the aim to characterize and reduce the perceptual (body overestimation) and the cognitive-emotional (body dissatisfaction) components of body image distortion (BID) in anorexia nervosa (AN). For each participant (20 anorexics, 20 healthy controls) we built personalized avatars that reproduced their own body size, shape, and verisimilar increases and losses of their original weight. Body overestimation and dissatisfaction were measured by asking participants to choose the avatar that best resembled their real and ideal body. Results show higher body dissatisfaction in AN, caused by the desire of a thinner body, and no body-size overestimation. Interpersonal multisensory stimulation (IMS) was then applied on the avatar reproducing participant’s perceived body, and on the two avatars which reproduced increases and losses of 15% of it, all presented with a first-person perspective (1PP). Embodiment was stronger after synchronous IMS in both groups, but did not reduce BID in participants with AN. Interestingly, anorexics reported more negative emotions after embodying the fattest avatar, which scaled with symptoms severity. Overall, our findings suggest that the cognitive-emotional, more than the perceptual component of BID is severely altered in AN and that perspective (1PP vs. 3PP) from which a body is evaluated may play a crucial role. Future research and clinical trials might take advantage of virtual reality to reduce the emotional distress related to body dissatisfaction.

The Embodiment of Objects: Review, Analysis, and Future Directions

Here we offer a thorough review of the empirical literature on the conditions under which an object, such as a tool or a prosthetic (whether real or virtual), can be experienced as being in some sense a part or extension of one's body. We discuss this literature both from the standpoint of the apparent malleability of our body representations, and also from within the framework of radical embodied cognition, which understands the phenomenon to result not from an alteration to a representation, but rather from the achievement of a certain kind of sensory/motor coupling. We highlight both the tensions between these frameworks, and also areas where they can productively complement one another for future research.

The "embreathment" illusion highlights the role of breathing in corporeal awareness

Recent theories posit that physiological signals contribute to corporeal awareness, the basic feeling that one has a body (body ownership) that acts according to one's will (body agency) and occupies a specific position (body location). Combining physiological recordings with immersive virtual reality, we found that an ecological mapping of real respiratory patterns onto a virtual body illusorily changes corporeal awareness. This new way of inducing a respiratory bodily illusion, called "embreathment," revealed that breathing is almost as important as visual appearance for inducing body ownership and more important than any other cue for body agency. These effects were moderated by individual levels of interoception, as assessed through a standard heartbeat-counting task and a new "pneumoception" task. By showing that respiratory, visual, and spatial signals exert a specific and weighted influence on the fundamental feeling that one is an embodied agent, we pave the way for a comprehensive hierarchical model of corporeal awareness.NEW & NOTEWORTHY Our body is the only object we sense from the inside; however, it is unclear how much inner physiology contributes to the global sensation of having a body and controlling it. We combine respiration recordings with immersive virtual reality and find that making a virtual body breathe like the real body gives an illusory sense of ownership and agency over the avatar, elucidating the role of a key physiological process like breathing in corporeal awareness.

Hand blink reflex in virtual reality: The role of vision and proprioception in modulating defensive responses

Our research focused on the role of vision and proprioception in modulating a defensive reflex (hand blink reflex, HBR) whose magnitude is enhanced when the threatened hand is inside the peripersonal space of the face. We capitalized on virtual reality, which allows dissociating vision and proprioception by presenting a virtual limb in congruent/incongruent positions with respect to the participants' limb. In experiment 1, participants placed their own stimulated hand in far/near positions with respect to their face (postural manipulation task), while observing a virtual empty scenario. Vision was not informative, but the HBR was significantly enhanced in near compared with far position, suggesting that proprioception is sufficient for the HBR modulation to occur. In experiment 2, participants did not perform the postural manipulation but they (passively) observed the avatar's virtual limb performing it. Proprioceptive signals were not informative, but the HBR was significantly enhanced when the observed virtual limb was near to the face, suggesting that visual information plays a role in modulating the HBR. In experiment 3, both participants and avatar performed the postural manipulation, either congruently (both of them far/near) or incongruently (one of them far, the other near). The HBR modulation was present only in congruent conditions. In incongruent conditions, the conflict between vision and proprioception confounded the system, abolishing the difference between far and near positions. Taken together, these findings promote the view that observing a virtual limb modulates the HBR, providing also new evidence on the role of vision and proprioception in modulating this subcortical reflex.

Active control as evidence in favor of sense of ownership in the moving Virtual Hand Illusion

The sense of ownership, the feeling that our body belongs to ourselves, relies on multiple sources of sensory information. Among these sources, the contribution of visuomotor information is still debated. We tested the effect of active control in the sense of ownership in the moving Virtual Hand Illusion. Participants reported sense of ownership and sense of agency over a virtual arm in which we manipulated the morphological congruence of the hand and the visuomotor information. We found that congruent active control enhanced and maintained the reported sense of ownership over a hand that appeared detached from the body, but not in a morphological congruent limb. Also, incongruent active control, achieved by adding noise to the trajectory of the movement, decreased both reported sense of agency and ownership. Overall, our results are consistent with a framework in which active control acts as evidence for eliciting a sense of ownership.

Body ownership increases the interference between observed and executed movements

When we successfully achieve willed actions, the feeling that our moving body parts belong to the self (i.e., body ownership) is barely required. However, how and to what extent the awareness of our own body contributes to the neurocognitive processes subserving actions is still debated. Here we capitalized on immersive virtual reality in order to examine whether and how body ownership influences motor performance (and, secondly, if it modulates the feeling of voluntariness). Healthy participants saw a virtual body either from a first or a third person perspective. In both conditions, they had to draw continuously straight vertical lines while seeing the virtual arm doing the same action (i.e., drawing lines) or deviating from them (i.e., drawing ellipses). Results showed that when there was a mismatch between the intended and the seen movements (i.e., participants had to draw lines but the avatar drew ellipses), motor performance was strongly "attracted" towards the seen (rather than the performed) movement when the avatar's body part was perceived as own (i.e., first person perspective). In support of previous studies, here we provide direct behavioral evidence that the feeling of body ownership modulates the interference of seen movements to the performed movements.

The neuroscience of body memory: From the self through the space to the others

Our experience of the body is not direct; rather, it is mediated by perceptual information, influenced by internal information, and recalibrated through stored implicit and explicit body representation (body memory). This paper presents an overview of the current investigations related to body memory by bringing together recent studies from neuropsychology, neuroscience, and evolutionary and cognitive psychology. To do so, in the paper, I explore the origin of representations of human body to elucidate their developmental process and, in particular, their relationship with more explicit concepts of self. First, it is suggested that our bodily experience is constructed from early development through the continuous integration of sensory and cultural data from six different representations of the body, i.e., the Sentient Body (Minimal Selfhood), the Spatial Body (Self Location), the Active Body (Agency), the Personal Body (Whole Body Ownership - Me); the Objectified Body (Objectified Self - Mine), and the Social Body (Body Satisfaction - Ideal Me). Then, it is suggested that these six representations can be combined in a coherent supramodal representation, i.e. the "body matrix", through a predictive, multisensory processing activated by central, top-down, attentional processes. From an evolutionary perspective, the main goal of the body matrix is to allow the self to protect and extend its boundaries at both the homeostatic and psychological levels. From one perspective, the self extends its boundaries (peripersonal space) through the enactment and recognition of motor schemas. From another perspective, the body matrix, by defining the boundaries of the body, also defines where the self is present, i.e., in the body that is processed by the body matrix as the most likely to be its one, and in the space surrounding it. In the paper I also introduce and discuss the concept of "embodied medicine": the use of advanced technology for altering the body matrix with the goal of improving our health and well-being.