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Raimo S, Ferrazzano G, Di Vita A, Gaita M, Satriano F, Veneziano M, Torchia V, Zerella MP, Malimpensa L, Signoriello E, Lus G, Palermo L, Conte A. The multidimensional assessment of body representation and interoception in multiple sclerosis. Mult Scler Relat Disord 2024; 87:105692. [PMID: 38810419 DOI: 10.1016/j.msard.2024.105692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 11/29/2023] [Accepted: 05/20/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND The mental representation of the body (or body representation, BR) derives from the processing of multiple sensory and motor inputs and plays a crucial role in guiding our actions and in how we perceive our body. Fundamental inputs for BR construction come also from the interoceptive systems which refer to the whole bidirectional processes between the brain and the body. People with Multiple sclerosis (MS) show an abnormal multisensory integration which may compromise BR and interoception integrity. However, no study has evaluated possible deficits on distinct and dissociable dimensions of body representation (i.e., action-oriented, aBR; and a nonaction-oriented body representation, NaBR) and interoception (i.e., interoceptive accuracy, interoceptive sensibility, and interoceptive awareness) in MS. OBJECTIVE In the present study, we aimed to determine whether participants with MS present changes in BR and interoceptive dimensions. METHODS We performed comparison analyses on tasks and questionnaires tapping all BR and interoceptive dimensions between 36 people with relapsing-remitting MS (RRMS) and 42 healthy controls, and between 23 people with progressive MS (PMS) and 33 healthy controls. RESULTS Overall, patients with MS exhibited lower interoceptive accuracy than matched controls. The RRMS group also showed higher visceral interoceptive sensibility levels. No differences were found in BR accuracy measures, but the PMS reported longer response times when performing the aBR task. CONCLUSION These findings open a new issue on the role of inner-signal monitoring in the body symptomatology of MS and highlight the need for an accurate BR and interoceptive assessment in a clinical setting.
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Affiliation(s)
- Simona Raimo
- Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy.
| | - Gina Ferrazzano
- Department of Human Neuroscience, 'Sapienza' University of Rome, Roma, Italy
| | - Antonella Di Vita
- Department of Human Neuroscience, 'Sapienza' University of Rome, Roma, Italy
| | - Mariachiara Gaita
- Department of Psychology, University of Campania 'Luigi Vanvitelli', Caserta, Italy
| | - Federica Satriano
- Department of Human Neuroscience, 'Sapienza' University of Rome, Roma, Italy
| | - Miriam Veneziano
- Department of Psychology, University of Campania 'Luigi Vanvitelli', Caserta, Italy
| | - Valentina Torchia
- Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
| | - Maria Paola Zerella
- Department of Human Neuroscience, 'Sapienza' University of Rome, Roma, Italy
| | | | - Elisabetta Signoriello
- Multiple Sclerosis Center, II Neurological Clinic, University of Campania 'Luigi Vanvitelli', Napoli, Italy; Department of Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Napoli, Italy
| | - Giacomo Lus
- Multiple Sclerosis Center, II Neurological Clinic, University of Campania 'Luigi Vanvitelli', Napoli, Italy; Department of Medical and Surgical Sciences, University of Campania 'Luigi Vanvitelli', Napoli, Italy
| | - Liana Palermo
- Department of Medical and Surgical Sciences, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
| | - Antonella Conte
- Department of Human Neuroscience, 'Sapienza' University of Rome, Roma, Italy; IRCCS Neuromed, Pozzilli (IS), Italy
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Donegan T, Ryan BE, Sanchez-Vives MV, Świdrak J. Altered bodily perceptions in chronic neuropathic pain conditions and implications for treatment using immersive virtual reality. Front Hum Neurosci 2022; 16:1024910. [PMID: 36466621 PMCID: PMC9714822 DOI: 10.3389/fnhum.2022.1024910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/18/2022] [Indexed: 08/12/2023] Open
Abstract
Chronic neuropathic pain is highly disabling and difficult to treat and manage. Patients with such conditions often report altered bodily perceptions that are thought to be associated with maladaptive structural and functional alterations in the somatosensory cortex. Manipulating these altered perceptions using body illusions in virtual reality is being investigated and may have positive clinical implications for the treatment of these conditions. Here, we have conducted a narrative review of the evidence for the types of bodily distortions associated with a variety of peripheral and central neuropathic pain conditions. In addition, we summarize the experimental and clinical studies that have explored embodiment and body transformation illusions in immersive virtual reality for neuropathic pain relief, which are thought to target these maladaptive changes, as well as suggesting directions for future research.
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Affiliation(s)
- Tony Donegan
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Brenda E. Ryan
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Maria V. Sanchez-Vives
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Justyna Świdrak
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
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3
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Giurgola S, Casati C, Stampatori C, Perucca L, Mattioli F, Vallar G, Bolognini N. Abnormal multisensory integration in relapsing–remitting multiple sclerosis. Exp Brain Res 2022; 240:953-968. [PMID: 35094114 PMCID: PMC8918188 DOI: 10.1007/s00221-022-06310-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 01/15/2022] [Indexed: 12/22/2022]
Abstract
Temporal Binding Window (TBW) represents a reliable index of efficient multisensory integration process, which allows individuals to infer which sensory inputs from different modalities pertain to the same event. TBW alterations have been reported in some neurological and neuropsychiatric disorders and seem to negatively affects cognition and behavior. So far, it is still unknown whether deficits of multisensory integration, as indexed by an abnormal TBW, are present even in Multiple Sclerosis. We addressed this issue by testing 25 participants affected by relapsing–remitting Multiple Sclerosis (RRMS) and 30 age-matched healthy controls. Participants completed a simultaneity judgment task (SJ2) to assess the audio-visual TBW; two unimodal SJ2 versions were used as control tasks. Individuals with RRMS showed an enlarged audio-visual TBW (width range = from − 166 ms to + 198 ms), as compared to healthy controls (width range = − 177/ + 66 ms), thus showing an increased tendency to integrate temporally asynchronous visual and auditory stimuli. Instead, simultaneity perception of unimodal (visual or auditory) events overall did not differ from that of controls. These results provide first evidence of a selective deficit of multisensory integration in individuals affected by RRMS, besides the well-known motor and cognitive impairments. The reduced multisensory temporal acuity is likely caused by a disruption of the neural interplay between different sensory systems caused by multiple sclerosis.
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Affiliation(s)
- Serena Giurgola
- Department of Psychology and NeuroMI, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milan, Italy
| | - Carlotta Casati
- Neuropsychology Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | | | - Laura Perucca
- Neurorehabilitation Sciences, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Flavia Mattioli
- Neuropsychology Unit, Spedali Civili of Brescia, Brescia, Italy
| | - Giuseppe Vallar
- Department of Psychology and NeuroMI, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milan, Italy
- Neuropsychology Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Nadia Bolognini
- Department of Psychology and NeuroMI, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, 20126 Milan, Italy
- Neuropsychology Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Tagini S, Scarpina F, Bruni F, Scacchi M, Mauro A, Zampini M. The Virtual Hand Illusion in Obesity: Dissociation Between Multisensory Interactions Supporting Illusory Experience and Self-Location Recalibration. Multisens Res 2020; 33:337-361. [PMID: 31722290 DOI: 10.1163/22134808-20191425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 10/16/2019] [Indexed: 11/19/2022]
Abstract
The Rubber Hand Illusion (RHI) is used widely to investigate the multisensory integration mechanisms that support bodily self-consciousness and, more specifically, body ownership and self-location. It has been reported that individuals affected by obesity show anomalous multisensory integration processes. We propose that these obesity-induced changes could lead to an unusual susceptibility to the RHI and anomalous bodily self-experience. To test this hypothesis, we administered a modified version of the RHI (using a picture of the participant's hand) to individuals affected by obesity and participants with a healthy weight. During synchronous and asynchronous stimulation, we compared the subjective experience of the illusion (using a questionnaire) and the effect of the illusion on self-location (i.e., proprioceptive drift). In accordance with the illusion phenomenology, both groups had a comparable subjective illusory experience after the synchronous stimulation. Nevertheless, individuals affected by obesity showed less recalibration of self-location than healthy weight participants. In light of a recent interpretation of the multisensory integration mechanisms that underpin the RHI, our findings suggest that in obesity visuo-tactile integration supporting the subjective experience of the illusion is preserved, whereas visuo-proprioceptive integration for self-location is reduced.
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Affiliation(s)
- Sofia Tagini
- 1Center for Mind/Brain Sciences, CIMeC, University of Trento, Rovereto,Italy
| | - Federica Scarpina
- 2Istituto Auxologico Italiano, IRCCS, Ospedale S. Giuseppe, Piancavallo,Italy
| | - Francesca Bruni
- 2Istituto Auxologico Italiano, IRCCS, Ospedale S. Giuseppe, Piancavallo,Italy
| | - Massimo Scacchi
- 2Istituto Auxologico Italiano, IRCCS, Ospedale S. Giuseppe, Piancavallo,Italy.,3Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Alessandro Mauro
- 2Istituto Auxologico Italiano, IRCCS, Ospedale S. Giuseppe, Piancavallo,Italy.,4Rita Levi Montalcini Department of Neuroscience, University of Turin, Turin, Italy
| | - Massimiliano Zampini
- 1Center for Mind/Brain Sciences, CIMeC, University of Trento, Rovereto,Italy.,5Department of Psychology and Cognitive Science, University of Trento, Rovereto,Italy
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Body image in multiple sclerosis patients: a descriptive review. Neurol Sci 2019; 40:923-928. [DOI: 10.1007/s10072-019-3722-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 01/12/2019] [Indexed: 12/18/2022]
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Nava E, Gamberini C, Berardis A, Bolognini N. Action Shapes the Sense of Body Ownership Across Human Development. Front Psychol 2018; 9:2507. [PMID: 30618937 PMCID: PMC6304390 DOI: 10.3389/fpsyg.2018.02507] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 11/26/2018] [Indexed: 12/30/2022] Open
Abstract
In this study we investigated, both in childhood and adulthood, the role of action in promoting and shaping the sense of body ownership, which is traditionally viewed as dependent on multisensory integration. By means of a novel action-based version of the rubber hand illusion (RHI), in which participants could actively self-stroke the rubber hand, with (Version 1) or without visual feedback (Version 2) of their own actions, we showed that self-generated actions promote the emergence of a sense of ownership over the rubber hand in children, while it interferes with the embodiment of the rubber hand in adults. When the movement is missing (Version 3, i.e., mere view of the rubber hand being stroked concurrently with one's own hand), the pattern of results is reversed, with adults showing embodiment of the rubber hand, but children lacking to do so. Our novel findings reveal a dynamic and plastic contribution of the motor system to the emergence of a coherent bodily self, suggesting that the development of the sense of body ownership is shaped by motor experience, rather than being purely sensory.
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Affiliation(s)
- Elena Nava
- Department of Psychology and NeuroMi - Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy
| | - Chiara Gamberini
- Department of Psychology and NeuroMi - Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy
| | - Agnese Berardis
- Department of Psychology and NeuroMi - Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy
| | - Nadia Bolognini
- Department of Psychology and NeuroMi - Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy.,Laboratory of Neuropsychology, IRCSS Istituto Auxologico Italiano, Milan, Italy
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Fossataro C, Bruno V, Giurgola S, Bolognini N, Garbarini F. Losing my hand. Body ownership attenuation after virtual lesion of the primary motor cortex. Eur J Neurosci 2018; 48:2272-2287. [PMID: 30117217 DOI: 10.1111/ejn.14116] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/12/2018] [Accepted: 07/31/2018] [Indexed: 12/22/2022]
Abstract
A fundamental component of the self-awareness is the sensation that we are acting with our own body. Thus, a coherent sense of self implies the existence of a tight link between the sense of body ownership and the motor system. Here, we investigated this issue by taking advantage of a well-known experimental manipulation of body ownership, i.e., the rubber hand illusion (RHI), during which the subjects perceive a fake hand as part of their own body. To test the effect of the motor system down-regulation on the RHI susceptibility, we designed a sham-controlled study, where the primary motor cortex (M1) excitability was modulated by off-line low-frequency repetitive transcranial magnetic stimulation (rTMS). After rTMS (real or sham), subjects underwent the RHI either on the right hand, contralateral to the inhibited hemisphere (Experiment 1), or on the left hand, ipsilateral to the inhibited hemisphere (Experiment 2). Only in Experiment 1, the procedure strengthened the illusory experience, as proved by a significant increase, in rTMS compared to Sham, of both subjective (Embodiment/Disembodiment Questionnaires) and objective (Proprioceptive Drift) RHI measures. This evidence demonstrates that, when the M1 activity is down-regulated, the sense of body ownership is attenuated and the subjects become more prone to incorporate an alien body part. This, in turn, supports the existence of a mutual interaction between the sense of body ownership and the motor system, shedding new light on the construction of a coherent sense of self as an acting body.
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Affiliation(s)
- Carlotta Fossataro
- Department of Psychology, SAMBA - SpAtial, Motor & Bodily Awareness - Research Group, University of Turin, Turin, Italy
| | - Valentina Bruno
- Department of Psychology, SAMBA - SpAtial, Motor & Bodily Awareness - Research Group, University of Turin, Turin, Italy
| | - Serena Giurgola
- Department of Psychology & PhD School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Nadia Bolognini
- Department of Psychology & NeuroMI - Milan Center for Neuroscience, University of Milano-Bicocca, Milano, Italy.,Neuropsychological Laboratory, IRCCS, Istituto Auxologico Italiano, Milano, Italy
| | - Francesca Garbarini
- Department of Psychology, SAMBA - SpAtial, Motor & Bodily Awareness - Research Group, University of Turin, Turin, Italy
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Convento S, Romano D, Maravita A, Bolognini N. Roles of the right temporo‐parietal and premotor cortices in self‐location and body ownership. Eur J Neurosci 2018; 47:1289-1302. [DOI: 10.1111/ejn.13937] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 03/16/2018] [Accepted: 03/25/2018] [Indexed: 01/01/2023]
Affiliation(s)
- Silvia Convento
- Psychology Department and NeuroMiMilan Center for NeuroscienceUniversity of Milano‐Bicocca Milan Italy
- Neuroscience DepartmentBaylor College of Medicine Houston Texas
| | - Daniele Romano
- Psychology Department and NeuroMiMilan Center for NeuroscienceUniversity of Milano‐Bicocca Milan Italy
| | - Angelo Maravita
- Psychology Department and NeuroMiMilan Center for NeuroscienceUniversity of Milano‐Bicocca Milan Italy
| | - Nadia Bolognini
- Psychology Department and NeuroMiMilan Center for NeuroscienceUniversity of Milano‐Bicocca Milan Italy
- Laboratory of NeuropsychologyIRCSS Italian Auxological Institute Milan Italy
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