Residual tactile sensitivity with self-directed stimulation in hemianaesthesia

Sense of ownership influence on tactile perception: Is the predictive coding account valid for the somatic rubber hand Illusion?

According to the predictive coding account, the attenuation of tactile perception on the hand exposed to the visuo-tactile Rubber Hand Illusion (vtRHI) relies on a weight increase of visual information deriving from the fake hand and a weight decrease of tactile information deriving from the individual's hand. To explore if this diametrical modulation persists in the absence of vision when adopting the somatic RHI (sRHI), we recorded tactile acuity measures before and after both RHI paradigms in 31 healthy individuals, hypothesizing a weight decrease for somatosensory information deriving from the hand undergoing the illusion and a weight increase for those deriving from the contralateral hand in the sRHI. Our results showed a significant overall decrease in tactile acuity on the hand undergoing the illusion whilst no changes emerged on the contralateral hand during sRHI. Since the sRHI was not accompanied by the hand spatial remapping, despite the generation of the feeling of ownership toward the fake hand, we hypothesized spatial remapping might play a pivotal role in determining sensory information weight attribution.

Active self-touch restores bodily proprioceptive spatial awareness following disruption by 'rubber hand illusion'

Bodily self-awareness relies on a constant integration of visual, tactile, proprioceptive, and motor signals. In the 'rubber hand illusion' (RHI), conflicting visuo-tactile stimuli lead to changes in self-awareness. It remains unclear whether other, somatic signals could compensate for the alterations in self-awareness caused by visual information about the body. Here, we used the RHI in combination with robot-mediated self-touch to systematically investigate the role of tactile, proprioceptive and motor signals in maintaining and restoring bodily self-awareness. Participants moved the handle of a leader robot with their right hand and simultaneously received corresponding tactile feedback on their left hand from a follower robot. This self-touch stimulation was performed either before or after the induction of a classical RHI. Across three experiments, active self-touch delivered after-but not before-the RHI, significantly reduced the proprioceptive drift caused by RHI, supporting a restorative role of active self-touch on bodily self-awareness. The effect was not present during involuntary self-touch. Unimodal control conditions confirmed that both tactile and motor components of self-touch were necessary to restore bodily self-awareness. We hypothesize that active self-touch transiently boosts the precision of proprioceptive representation of the touched body part, thus counteracting the visual capture effects that underlie the RHI.

Self-touch facilitates the recognition of the dis-owned left hand in somatoparaphrenia: a single case study

We investigated whether self-administered tactile stimulation could act as a temporary restorative mechanism for body ownership disorders, both implicitly and explicitly. We tested this hypothesis in a patient with somatoparaphrenia, who displayed increased accuracy in explicitly recognizing their left hand during self-touch. Furthermore, the patient implicitly perceived their hand and the experimenter's hand as more belonging to their own body compared to conditions where vision was the sole sensory input. These findings highlight the importance of self-touch in maintaining a coherent body representation, while also demonstrating the potential dissociation between the recovery of explicit and implicit perceptions of body ownership.

An integrative perspective on the role of touch in the development of intersubjectivity

Touch concerns a fundamental component of sociality. In this review, we examine the hypothesis that somatomotor development constitutes a crucial psychophysiological element in the ontogeny of intersubjectivity. An interdisciplinary perspective is provided on how the communication channel of touch contributes to the sense of self and extends to the social self. During gestation, the transformation of random movements into organized sequences of actions with sensory consequences parallels the development of the brain's functional architecture. Brain subsystems shaped by the coordinated activity of somatomotor circuits to support these first body-environment interactions are the first brain functional arrangements to develop. We propose that tactile self-referring behaviour during gestation constitutes a prototypic mode of interpersonal exchange that supports the subsequent development of intersubjective exchange. The reviewed research suggests that touch constitutes a pivotal bodily experience that in early stages builds and later filters self-other interactions. This view is corroborated by the fact that aberrant social-affective touch experiences appear fundamentally associated with attachment anomalies, interpersonal trauma, and personality disorders. Given the centrality of touch for the development of intersubjectivity and for psychopathological conditions in the social domain, dedicated research is urged to elucidate the role of touch in the evolution of subjective self-other coding.

Staying in touch with our bodies: Stronger sense of ownership during self- compared to other touch despite temporal mismatches

Self-touch is considered important for bodily self-consciousness and self-other distinction and has been reported to improve clinical symptoms of disembodiment. To investigate the link between self-touch and disembodiment in healthy participants, we studied the effect of self-touch versus touch produced by another person (other-touch) on experimentally induced disembodiment. In a mixed reality paradigm, across two experiments, participants could see their own body and surroundings with a controllable visual delay and either stroked their own hand with a paintbrush or were stroked with it by the experimenter. Experiment 1 first assessed the sensitivity to temporal multimodal mismatches and delay-induced changes in the sense of body ownership in three conditions, namely self-touch, other-touch and hidden-self-touch (visually occluding the touching hand). In a second block, we compared phenomenological and physiological (threat response) measures of disembodiment between the self-touch and other-touch conditions. Experiment 2 roughly replicated the first block of Experiment 1 but included a condition in which participants performed the self-touch gesture without touching their hand. Such experiment attempted to control for the potential role of efferent signals. Our results show that increasing visual delay generally enhances the feeling of disembodiment, yet the decrease of body ownership is less pronounced during self-touch. For sensitivity to delay between conditions, however, diverging findings are discussed. This study provides evidence for the importance of self-touch in sustaining a healthy sense of body in the context of disembodiment.

Effect of prism adaptation on neglect hemianesthesia

Prism adaptation (PA) has proven to be effective in alleviating many signs of unilateral spatial neglect (USN). Generally, the principal improvement after PA treatment was found to be in the high-level cognitive function. Nevertheless, some evidence has also been found for it in somatosensory function. We have aimed to test the influence of PA on neglect hemianesthesia, a condition in which the high-level neglect-related deficit mimics hemianesthesia. Twenty-one USN patients were enrolled in the study. Each patient performed two sessions of PA, one with neutral glasses and one with prism glasses using a cross-over design. Sensitivity on the upper limb was tested using two methods. The first task was the sensibility subtest which was derived from the standard clinical examination. The second was the perceptual and motor electro-cutaneous threshold on the forearms using an electro-cutaneous stimulator. Four neuropsychological tests were used to diagnose USN and to check improvement: Star cancellation, Line bisection, Sentence reading and the Comb & Razor test. Comparing prism with sham conditions, our results show significant improvements in double extinction and in the electro-cutaneous perceptual threshold only for the contralesional hand. No improvement was found for the ipsilesional hand, for the motor threshold, and for neutral glasses. Significant improvement was found in personal neglect. Replication of the task in a subgroup of patients confirmed the primary results. The improvements in somatosensory perception together with the amelioration of personal neglect suggest that PA also has a specific effect on the neglect hemianesthesia.

Computerized Exposure Therapy for Spider Phobia: Effects of Cardiac Timing and Interoceptive Ability on Subjective and Behavioral Outcomes

OBJECTIVE

Spider phobia is a common form of anxiety disorder for which exposure therapy is an effective first-line treatment. Motivated by the observed modulation of threat processing by afferent cardiac signals, we tested the hypothesis that interoceptive information concerning cardiovascular arousal can influence the outcomes of computerized exposure therapy for spider phobia.

METHOD

Fifty-three normal healthy participants with high spider phobia scores underwent one of the following three modified computerized exposure protocols, defined by the timing of exposure to brief spider stimuli within the cardiac cycle: systole (during afferent baroreceptor firing); diastole (during baroreceptor-quiescent interbeat interval); random (noncontingent on cardiac cycle). Outcomes were judged on phobic and anxiety measures and physiological data (skin conductance). Individuals were also rated on interoceptive accuracy.

RESULTS

MANCOVA analysis showed that timing group affected the outcome measures (F(10,80) = 2.405, p = .015) and there was a group interaction with interoception ability (F(15,110) = 1.808, p = .045). Subjective symptom reduction was greatest in the systolic group relative to the other two groups (diastolic (t = 3.115, ptukey = .009); random (t = 2.438, ptukey = .048)), with greatest reductions in those participants with lower interoceptive accuracy. Behavioral aversion reduced more in cardiac-contingent groups than the noncontingent (random) group (diastolic (t = 3.295, ptukey = .005); systolic (t = 2.602, ptukey = .032)). Physiological (skin conductance response) responses remained strongest for spider stimuli presented at cardiac systole.

CONCLUSIONS

Interoceptive information influences exposure benefit. The reduction in the subjective expression of fear/phobia is facilitated by "bottom-up" afferent signals, whereas improvement in the behavioral expression is further dependent on "top-down" representation of self-related physiology (heart rhythm). Individual interoceptive differences moderate these effects, suggesting means to personalize therapy.

Suppression of the auditory N1-component for heartbeat-related sounds reflects interoceptive predictive coding

Although many studies have elucidated the neurocognitive mechanisms supporting the processing of externally generated sensory signals, less is known about the processing of interoceptive signals related to the viscera. Drawing a parallel with research on agency and the perception of self-generated action effects, in the present EEG study we report a reduced auditory N1 component when participants listened to heartbeat-related sounds compared to externally generated sounds. The auditory suppression for heartbeat sounds was robust and persisted after controlling for ECG-related artifacts, the number of trials involved and the phase of the cardiac cycle. In addition, the auditory N1 suppression for heartbeat-related sounds had a comparable scalp distribution as the N1 suppression observed for actively generated sounds. This finding indicates that the brain automatically differentiates between heartbeat-related and externally generated sounds through a process of sensory suppression, suggesting that a comparable predictive mechanism may underlie the processing of heartbeat and action-related information. Extending recent behavioral data about cardio-visual integration, the present cardio-auditory EEG data reveal that the processing of sounds in auditory cortex is systematically modulated by an interoceptive cardiac signal. The findings are discussed with respect to theories of interoceptive awareness, emotion, predictive coding, and their relevance to bodily self-consciousness.

A new method for assessing self-touch enhancement of the foot in stroke patients with mobility problems

Patient NG is the first reported case of lower-limb 'self-touch enhancement' following stroke. Mobility problems prevented NG from reaching to touch her foot, thus we used a self-touch rubber-hand paradigm to mimic the conditions of self-administered touch. With vision precluded, NG administered stimulation to a prosthetic limb while the Examiner administered synchronous stimulation to NG's affected left foot. NG detected all stimulation administered with our self-touch paradigm, whereas in the control condition (with NG not involved in administering stimulation), NG had failed to detect one-third of Examiner-administered stimulation. When mobility problems are a barrier to investigating self-touch enhancement, the self-touch paradigm can be used to demonstrate residual tactile sensation following stroke.

The role of self-touch in somatosensory and body representation disorders after stroke

Somatosensory impairments occur in about half of the cases of stroke. These impairments range from primary deficits in tactile detection and the perception of features, to higher order impairments in haptic object recognition and bodily experience. In this paper, we review the influence of active- and self-touch on somatosensory impairments after stroke. Studies have shown that self-touch improves tactile detection in patients with primary tactile deficits. A small number of studies concerned with the effect of self-touch on bodily experience in healthy individuals have demonstrated that self-touch influences the structural representation of one's own body. In order to better understand the effect of self-touch on body representations, we present an informal study of a stroke patient with somatoparaphrenia and misoplegia. The role of self-touch on body ownership was investigated by asking the patient to stroke the impaired left hand and foreign hands. The patient reported ownership and a change in affect over all presented hands through self-touch. The time it took to accomplish ownership varied, based on the resemblance of the foreign hand to the patient's own hand. Our findings suggest that self-touch can modulate impairments in body ownership and affect, perhaps by helping to reinstate the representation of the body.

Errors of somatosensory localisation in a patient with right-hemisphere stroke

Following a right-hemisphere stroke, Patient NG could detect somatosensory stimulation that she was unable to localise. With vision precluded, NG systematically mislocalized touch on the little and ring finger of her affected left hand, and reported feeling this touch on the neighbouring rightward finger. This pattern of mislocalization occurred not only when the Examiner administered touch but also when touch was self-administered. We manipulated the relative position of NG's two hands during sensory assessment of the affected hand. When NG's right hand was positioned to the left of her affected hand, NG exhibited improved localisation. Theoretical and clinical implications are discussed.

The science of interpersonal touch: an overview

Surprisingly little scientific research has been conducted on the topic of interpersonal touch over the years, despite the importance of touch in our everyday social interactions from birth through to adulthood and old age. In this review, we critically evaluate the results of the research on this topic that have emerged from disciplines, such as cognitive and social psychology, neuroscience, and cultural anthropology. We highlight some of the most important advances to have been made in our understanding of this topic: For example, research has shown that interpersonal tactile stimulation provides an effective means of influencing people's social behaviors (such as modulating their tendency to comply with requests, in affecting people's attitudes toward specific services, in creating bonds between couples or groups, and in strengthening romantic relationships), regardless of whether or not the tactile contact itself can be remembered explicitly. What is more, interpersonal touch can be used to communicate emotion in a manner similar to that demonstrated previously in vision and audition. The recent growth of studies investigating the potential introduction of tactile sensations to long-distance communication technologies (by means of mediated or 'virtual' touch) are also reviewed briefly. Finally, we highlight the synergistic effort that will be needed by researchers in different disciplines if we are to develop a more complete understanding of interpersonal touch in the years to come.

Touchant-touché: the role of self-touch in the representation of body structure

The "body image" is a putative mental representation of one's own body, including structural and geometric details, as well as the more familiar visual and affective aspects. Very little research has investigated how we learn the structure of our own body, with most researchers emphasising the canonical visual representation of the body when we look at ourselves in a mirror. Here, we used non-visual self-touch in healthy participants to investigate the possibility that primary sensorimotor experience may influence cognitive representations of one's own body structure. Participants used the fingers of one hand (the 'active' hand), to touch the fingers of the other (the 'passive' hand). A conflict between the experience of the active and passive hand was introduced by experimenter interleaving their fingers with the fingers of the participant's passive hand. This led to the active hand experiencing that it touched more fingers than the passive hand felt it was being touched by. The effects on representation of body structure were assessed using an implicit measure based on Kinsbourne and Warrington's 'in-between task'. We found an underestimation of the number of fingers in the central part of the hand specifically linked to the experience of self-touch. This pattern of results corresponds to the experience of the passive hand, but not the active hand. Nevertheless, comparable reorganisation of fingers within the hand representation was found for both active and passive hands. We show that primary sensorimotor experience can modify the representation of body structure. This modification is driven by the passive experience of being touched, rather than by the active experience of touching. We believe this is the first experimental study of effects of self-touch on the mental representation of the body.

Implicit short-lived motor representations of space in brain damaged and healthy subjects

This article reviews experimental evidence for a specific sensorimotor function which can be dissociated from higher level representations of space. It attempts to delineate this function on the basis of results obtained by psychophysical experiments performed with brain damaged and healthy subjects. Eye and hand movement control exhibit automatic features, such that they are incompatible with conscious control. In addition, they rely on a reference frame different from the one used by conscious perception. Neuropsychological cases provide a strong support for this specific motor representation of space, which can be spared in patients with lesions of primary sensory systems who have lost conscious perception of visual, tactile or proprioceptive stimuli. Observation of these patients also showed that their motor behavior can be "attracted" by a goal only under specific conditions, that is, when the response is immediate and when no cognitive representation of this goal is elaborated at the same time. Beyond the issue of the dissociation between an implicit motor representation and more cognitive processing of spatial information, the issue of the interaction between these two systems is thus a matter of interest. It is suggested that the conscious, cognitive representation of a stimulus can contaminate or override the short-lived motor representation, but no reciprocal influence seem to occur. The interaction observed in patients can also be investigated in normals. The literature provides examples of interaction between sensorimotor and cognitive framing of space, which confirm that immediate action is not mediated by the same system as delayed action, and that elaborating a categorial representation of the action goal prevents the expression of the short-lived sensorimotor representation. It is concluded that action can be controlled by a sensory system which is specialized for on-line processing of relevant goal characteristics. The temporal constraints of this system are such that it can affect the action before a full sensory analysis of this goal has been completed. The performance obtained on the basis of this spatial sensory processing suggests that short-lived motor representations may rather be considered as real "presentation" of the action world, which share its metric properties.

Temporary remission of left hemianesthesia after vestibular stimulation. A sensory neglect phenomenon

In three right-brain damaged patients with contralesional neglect vestibular stimulation induced a temporary remission of left hemianesthesia, in addition to the well-known transient recovery of extrapersonal and personal neglect. These findings indicate that in neglect patients attentional factors may play an important role in producing apparently "primary" sensory deficits, which may be interpreted in terms of defective access to conscious processing.