Over my fake body: body ownership illusions for studying the multisensory basis of own-body perception

Threatening an Illusory Limb: An Event-related Potential Study of the Rubber Hand Illusion

BACKGROUND

The rubber hand illusion (RHI) is a well-established method for studying body ownership: Given adequate concordance of visual, sensory, and proprioceptive stimuli, the individual experiences a rubber hand as his or her own.

OBJECTIVE

To study the effects of a threat to the rubber hand.

METHODS

We created a typical RHI paradigm but added threatening pain: Both the real hand of an individual and the rubber hand were stroked with a brush, either synchronously (RHI-inducing condition) or asynchronously (control condition), but only the rubber hand was then pricked with a needle to create a threatening pain condition. Event-related potentials (ERPs) were recorded in a group of 23 typically developed individuals. ERP effects were source-localized using low-resolution electromagnetic tomography.

RESULTS

The individuals consistently reported experience of the RHI during the experiment when the brush strokes were applied synchronously to both the real hand and the rubber hand. ERP analysis revealed that synchronous brush stroking gave rise to higher amplitude of frontal ERPs in the 100-200 ms range than asynchronous brush stroking, which was interpreted as reflecting the RHI. In the threatening pain condition, ERPs showed a greater positivity at frontocentral electrodes, source localized in the supplementary motor area (SMA).

CONCLUSION

SMA activation could reflect a control mechanism over reflexive motor activity, facilitating a possible threat-related response. Further studies should address ERP effects and the extent of the RHI to standard and threat stimuli in a correlative fashion to further elucidate the functional significance of the neurophysiological findings.

Bound by Experience: Updating the Body Representation When Using Virtual Objects

OBJECTIVE

Four web-based experiments investigated flexibility of disembodiment of a virtual object that is no longer actively controlled. Emphasis was on possibilities to modify the timescale of this process.

BACKGROUND

Interactions with virtual objects are commonplace in settings like teleoperation, rehabilitation, and computer-aided design. These objects are quickly integrated into the operator's body schema (embodiment). Less is known about how long such embodiment lasts. Understanding the dynamics of this process is crucial because different applied settings either profit from fast or slow disembodiment.

METHOD

To induce embodiment, participants moved a 2D virtual hand through operating a computer mouse or touchpad. After initial embodiment, participants either stopped or continued moving for a fixed period of time. Embodiment ratings were collected continuously during each trial.

RESULTS

Results across all experiments indicated that embodiment for the virtual hand gradually increased during active use and gradually decreased after stopping to use it. Disembodiment unfolded nearly twice as fast as embodiment and showed a curved decay pattern. These dynamics remained unaffected by anticipation of active control that would be required in an upcoming task.

CONCLUSION

The results highlight the importance of continuously experiencing active control in virtual interactions if aiming at inducing stable embodiment of a virtual object.

APPLICATION

Our findings suggest that applications of virtual disembodiment such as virtual tools or interventions to affect a person's body representation critically depend on continuous updating of sensorimotor experience. However, if switching between virtual objects, for example, during teleoperation or video gaming, after-effects are unlikely to affect performance.

Eliciting the rubber hand illusion by the activation of nociceptive C and Aδ fibers

ABSTRACT

The coherent perceptual experience of one's own body depends on the processing and integration of signals from multiple sensory modalities, including vision, touch, and proprioception. Although nociception provides critical information about damage to the tissues of one's body, little is known about how nociception contributes to own-body perception. A classic experimental approach to investigate the perceptual and neural mechanisms involved in the multisensory experience of one's own body is the rubber hand illusion (RHI). During the RHI, people experience a rubber hand as part of their own body (sense of body ownership) caused by synchronized stroking of the rubber hand in the participant's view and the hidden participant's real hand. We examined whether the RHI can be elicited by visual and "pure" nociceptive stimulation, ie, without tactile costimulation, and if so, whether it follows the basic perceptual rules of the illusion. In 6 separate experiments involving a total of 180 healthy participants, we used a Nd:YAP laser stimulator to specifically target C and Aδ fibers in the skin and compared the illusion condition (congruent visuonociceptive stimulation) to control conditions of incongruent visuonociceptive, incongruent visuoproprioceptive, and no nociceptive stimulation. The illusion was quantified through direct (questionnaire) and indirect (proprioceptive drift) behavioral measures. We found that a nociceptive rubber hand illusion (N-RHI) could be elicited and that depended on the spatiotemporal congruence of visuonociceptive signals, consistent with basic principles of multisensory integration. Our results suggest that nociceptive information shapes multisensory bodily awareness and contributes to the sense of body ownership.

Hierarchical and dynamic relationships between body part ownership and full-body ownership

What is the relationship between experiencing individual body parts and the whole body as one's own? We theorised that body part ownership is driven primarily by the perceptual binding of visual and somatosensory signals from specific body parts, whereas full-body ownership depends on a more global binding process based on multisensory information from several body segments. To examine this hypothesis, we used a bodily illusion and asked participants to rate illusory changes in ownership over five different parts of a mannequin's body and the mannequin as a whole, while we manipulated the synchrony or asynchrony of visual and tactile stimuli delivered to three different body parts. We found that body part ownership was driven primarily by local visuotactile synchrony and could be experienced relatively independently of full-body ownership. Full-body ownership depended on the number of synchronously stimulated parts in a nonlinear manner, with the strongest full-body ownership illusion occurring when all parts received synchronous stimulation. Additionally, full-body ownership influenced body part ownership for nonstimulated body parts, and skin conductance responses provided physiological evidence supporting an interaction between body part and full-body ownership. We conclude that body part and full-body ownership correspond to different processes and propose a hierarchical probabilistic model to explain the relationship between part and whole in the context of multisensory awareness of one's own body.

Is the rubber hand illusion associated with somatic symptom reporting?

Current approaches to somatic symptom perception conceptualize somatic symptoms partly as somato-visceral or body illusions evoked by an interaction between bottom-up (sensory) and top-down (expectations, attention) processes. Similar processes of multisensory integration are assumed to contribute to the rubber hand illusion (RHI). Findings concerning the strength and direction of associations between these two phenomena, symptom perception and the RHI, are equivocal. Individuals of a non-clinical sample (N = 63; 56% females; Mage = 20.4; SD = 1.6) completed the Patient Health Questionnaire Somatic Symptom Scale (PHQ-15) and participated in an experiment that evoked the RHI. In repeated measures analyses of variance with the PHQ-15 score as covariate, no significant interaction effects between the PHQ-15 score and indicators of the RHI, i.e., proprioceptive drift (F(1,61) < 0.001 p = 0.993, partial η2 < 0.001; BF10 = 0.307), felt body ownership(F(1,59) = 0.043, p = 0.836, partial η2 = 0,001; BF10 = 0.501), and felt body disownership (F(1,59) = 0.148, p = 0.702, partial η2 = 0.002; BF10 = 1.972) were found. Overall, frequentist and Bayesian analysis indicated that the support for a possible association between the PHQ-15 and indicators of the RHI remains inconclusive, i.e., neither the null nor the alternative hypotheses were sufficiently supported. At least in this non-clinical sample, the association between somatic symptom distress and the strength of the RHI appears so weak (perhaps non-existing), that both phenomena (somatic symptom distress and the RHI) appear distinct and largely unrelated.

Understanding and treating body image disturbances in eating disorders through body illusion interventions: a scoping review protocol

BACKGROUND

We plan a scoping review aimed to synthesize what is known about the use of sensory-driven body illusion (BI) interventions for understanding and treating body image disturbance (BID) in people diagnosed with clinical eating disorders (EDs) and people with subclinical ED symptomatology. Our study will provide an outline of the current literature, identify gaps within the literature, and suggest novel directions for future research.

METHODS/DESIGN

The scoping review process will be guided by the methodological framework of Arksey and O'Malley, subsequent recommendations by Levac et al., and the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols Extension for Scoping Reviews guidelines. The following electronic databases will be systematically searched: MEDLINE (via PubMed), Web of Science, PsycINFO, and Scopus. Furthermore, to identify additional studies, we will use a search engine such as Google Scholar, and for grey literature, we will include Proquest for Dissertations and Theses. A search strategy has been identified and agreed upon by the research team in conjunction with a research librarian. Two researchers will screen the titles and abstracts independently and then assess the full text of the selected citations for the inclusion criteria. A third reviewer will be involved in cases of disagreement. Data will be extracted, collated, and charted to summarize all the relevant methods, outcomes, and key findings in the articles.

DISCUSSION

A better understanding of this topic will aid in the development and refinement of current treatments aimed at treating BID in people with EDs. Implications and recommendations for research, policy, and practice in the context of the ED community will be discussed.

SYSTEMATIC REVIEW REGISTRATION

https://osf.io/3bcm6/?view_only=83b2e8a2445d4266909992e3dfb51929.

With hand on heart: A cardiac Rubber Hand Illusion

Body illusions such as the Rubber Hand Illusion (RHI) have highlighted how multisensory integration underpins the sense of one's own body. Much of this research has focused on senses arising from outside the body (e.g. vision and touch), but sensations from within the body may also play a role. In a pre-registered study, participants completed a cardiac variation of the RHI, where taps to the finger occurred in or out of time with the heartbeat. We replicated the RHI effect, showing that synchronous but not asynchronous taps to the real and rubber hand increased sensations of embodiment over the rubber hand and caused a shift in the perceived hand location. However, there were no significant influences of cardiac timing on embodiment, nor did it interact with visuo-tactile synchrony. An exploratory analysis found a three-way interaction between synchrony, cardiac timing and interoceptive accuracy as measured by a heartbeat counting task, such that greater interoceptive accuracy was associated with lower embodiment ratings in the systole condition compared to diastole, but only during synchronous stimulation. Although our novel methodology successfully replicated the RHI, our findings suggest that the cooccurence of vision and touch with cardiac signals may make little contribution to the sense of one's body.

Texture congruence modulates perceptual bias but not sensitivity to visuotactile stimulation during the rubber hand illusion

The sense of body ownership is the feeling that one's body belongs to oneself. To study body ownership, researchers use bodily illusions, such as the rubber hand illusion (RHI), which involves experiencing a visible rubber hand as part of one's body when the rubber hand is stroked simultaneously with the hidden real hand. The RHI is based on a combination of vision, touch, and proprioceptive information following the principles of multisensory integration. It has been posited that texture incongruence between rubber hand and real hand weakens the RHI, but the underlying mechanisms remain poorly understood. To investigate this, we recently developed a novel psychophysical RHI paradigm. Based on fitting psychometric functions, we discovered the RHI resulted in shifts in the point of subjective equality when the rubber hand and the real hand were stroked with matching materials. We analysed these datasets further by using signal detection theory analysis, which distinguishes between the participants' sensitivity to visuotactile stimulation and the associated perceptual bias. We found that texture incongruence influences the RHI's perceptual bias but not its sensitivity to visuotactile stimulation. We observed that the texture congruence bias effect was the strongest in shorter visuotactile asynchronies (50-100 ms) and weaker in longer asynchronies (200 ms). These results suggest texture-related perceptual bias is most prominent when the illusion's sensitivity is at its lowest. Our findings shed light on the intricate interactions between top-down and bottom-up processes in body ownership, the links between body ownership and multisensory integration, and the impact of texture congruence on the RHI.

Subcortical contributions to the sense of body ownership

The sense of body ownership (i.e. the feeling that our body or its parts belong to us) plays a key role in bodily self-consciousness and is believed to stem from multisensory integration. Experimental paradigms such as the rubber hand illusion have been developed to allow the controlled manipulation of body ownership in laboratory settings, providing effective tools for investigating malleability in the sense of body ownership and the boundaries that distinguish self from other. Neuroimaging studies of body ownership converge on the involvement of several cortical regions, including the premotor cortex and posterior parietal cortex. However, relatively less attention has been paid to subcortical structures that may also contribute to body ownership perception, such as the cerebellum and putamen. Here, on the basis of neuroimaging and neuropsychological observations, we provide an overview of relevant subcortical regions and consider their potential role in generating and maintaining a sense of ownership over the body. We also suggest novel avenues for future research targeting the role of subcortical regions in making sense of the body as our own.

Multisensory processing and proprioceptive plasticity during resizing illusions

Bodily resizing illusions typically use visual and/or tactile inputs to produce a vivid experience of one's body changing size. Naturalistic auditory input (an input that reflects the natural sounds of a stimulus) has been used to increase illusory experience during the rubber hand illusion, whilst non-naturalistic auditory input can influence estimations of finger length. We aimed to use a non-naturalistic auditory input during a hand-based resizing illusion using augmented reality, to assess whether the addition of an auditory input would increase both subjective illusion strength and measures of performance-based tasks. Forty-four participants completed the following three conditions: no finger stretching, finger stretching without tactile feedback and finger stretching with tactile feedback. Half of the participants had an auditory input throughout all the conditions, whilst the other half did not. After each condition, the participants were given one of the following three performance tasks: stimulated (right) hand dot touch task, non-stimulated (left) hand dot touch task, and a ruler judgement task. Dot tasks involved participants reaching for the location of a virtual dot, whereas the ruler task concerned estimates of the participant's own finger on a ruler whilst the hand was hidden from view. After all trials, the participants completed a questionnaire capturing subjective illusion strength. The addition of auditory input increased subjective illusion strength for manipulations without tactile feedback but not those with tactile feedback. No facilitatory effects of audio were found for any performance task. We conclude that adding auditory input to illusory finger stretching increased subjective illusory experience in the absence of tactile feedback but did not affect performance-based measures.

The emergence of the multisensory brain: From the womb to the first steps

The becoming of the human being is a multisensory process that starts in the womb. By integrating spontaneous neuronal activity with inputs from the external world, the developing brain learns to make sense of itself through multiple sensory experiences. Over the past ten years, advances in neuroimaging and electrophysiological techniques have allowed the exploration of the neural correlates of multisensory processing in the newborn and infant brain, thus adding an important piece of information to behavioral evidence of early sensitivity to multisensory events. Here, we review recent behavioral and neuroimaging findings to document the origins and early development of multisensory processing, particularly showing that the human brain appears naturally tuned to multisensory events at birth, which requires multisensory experience to fully mature. We conclude the review by highlighting the potential uses and benefits of multisensory interventions in promoting healthy development by discussing emerging studies in preterm infants.

Virtually simulated interpersonal touch negatively affects perceived closeness and social affiliation to an avatar partner

Interpersonal touch is an essential component of human non-verbal communication, facilitating social affiliation and bonding. With the widespread use of digital interfaces and online platforms in all realms of human interactions, there are fewer opportunities for communicating through touch. Popular online platforms that virtually simulate human interactions rely primarily on visual and auditory modalities, providing limited or no capacity for the exchange of tactile cues. Previous studies of virtual interactions have explored the simulation of social touch using haptic devices, but little is known about how the visual representation of interpersonal touch is perceived and integrated into a virtual social experience. In two studies we examined how the exchange of virtual touch mediated by simulated 3-dimensional human characters, or avatars, within an online virtual environment influenced affiliation towards an unfamiliar interaction partner. Surprisingly, the exchange of virtual touch negatively affected the perceived closeness and affiliation to the partner and the social evaluation of the interaction but did not affect the level of physiological arousal during the interaction. These results indicate that the visual representation of social touch is sufficient to virtually communicate touch-related cues that impact social affiliation, but the influence of touch may be dependent on the interaction context.

Brain-inspired bodily self-perception model for robot rubber hand illusion

The core of bodily self-consciousness involves perceiving ownership of one's body. A central question is how body illusions like the rubber hand illusion (RHI) occur. Existing theoretical models still lack satisfying computational explanations from connectionist perspectives, especially for how the brain encodes body perception and generates illusions from neuronal interactions. Moreover, the integration of disability experiments is also neglected. Here, we integrate biological findings of bodily self-consciousness to propose a brain-inspired bodily self-perception model by which perceptions of bodily self are autonomously constructed without any supervision signals. We successfully validated the model with six RHI experiments and a disability experiment on an iCub humanoid robot and simulated environments. The results show that our model can not only well-replicate the behavioral and neural data of monkeys in biological experiments but also reasonably explain the causes and results of RHI at the neuronal level, thus contributing to the revelation of mechanisms underlying RHI.

Embodied perspective-taking enhances interpersonal synchronization: A body-swap study

Humans exhibit a strong tendency to synchronize movements with each other, with visual perspective potentially influencing interpersonal synchronization. By manipulating the visual scenes of participants engaged in a joint finger-tapping task, we examined the effects of 1st person and 2nd person visual perspectives on their coordination dynamics. We hypothesized that perceiving the partner's movements from their 1st person perspective would enhance spontaneous interpersonal synchronization, potentially mediated by the embodiment of the partner's hand. We observed significant differences in attractor dynamics across visual perspectives. Specifically, participants in 1st person coupling were unable to maintain de-coupled trajectories as effectively as in 2nd person coupling. Our findings suggest that visual perspective influences coordination dynamics in dyadic interactions, engaging error-correction mechanisms in individual brains as they integrate the partner's hand into their body representation. Our results have the potential to inform the development of applications for motor training and rehabilitation.

Imperceptible body transformation in virtual reality: Saliency of self representation

Change blindness (CB) is the perceptual phenomenon whereby people are blind to dramatic changes in their visual environment. In virtual reality (VR) a person's body can be substituted by a life-sized virtual one that moves synchronously with their real body movements as their self-representation. We consider whether CB occurs in VR, and whether there are differences in the case of changes to their own virtual body compared with the body of another. Forty people took part in a Qi Gong lesson in VR led by a virtual instructor. During the lesson both their own and the instructor's face dramatically changed in appearance. Overall, 73% and 85% did not notice the changes to their own and instructor's face respectively. People make iconic inferences about their visual surroundings without sampling detail, and reduced CB in the case of their own body may be a marker for self-representation.

The role of bodily self-consciousness in episodic memory of naturalistic events: an immersive virtual reality study

Recent studies suggest that the human body plays a critical role in episodic memory. Still, the precise relationship between bodily self-consciousness (BSC) and memory formation of specific events, especially in real-life contexts, remains a topic of ongoing research. The present study investigated the relationship between BSC and episodic memory (EM) using immersive virtual reality (VR) technology. Participants were immersed in an urban environment with naturalistic events, while their visuomotor feedback was manipulated in three within-subjects conditions: Synchronous, Asynchronous, and No-body. Our results show that asynchronous visuomotor feedback and not seeing one's body, compared to synchronous feedback, decrease the sense of self-identification, self-location and agency, and sense of presence. Moreover, navigating in the Asynchronous condition had a detrimental impact on incidental event memory, perceptual details, contextual association, subjective sense of remembering, and memory consolidation. In contrast, participants in the No-Body condition were only impaired in egocentric spatial memory and the sense of remembering at ten-day delay. We discuss these findings in relation to the role of bodily self-representation in space during event memory encoding. This study sheds light on the complex interplay between BSC, sense of presence, and episodic memory processes, and strengthens the potential of embodiment and VR technology in studying and enhancing human cognition.

The correlation between proprioceptive drift and subjective embodiment during the rubber hand illusion: A meta-analytic approach

In the rubber hand illusion (RHI), participants see a fake hand touched synchronously with their real hand, which is hidden from view. The three-way interaction between vision, touch, and proprioception induces the sensation that the dummy hand belongs to oneself (i.e., subjective embodiment) and the illusory displacement of the real hand towards the fake one (i.e., proprioceptive drift). In the literature, there are mixed results (some positive and some null) regarding the existence of a relationship between subjective embodiment and proprioceptive drift. We conducted a Bayesian meta-analysis to tackle this issue quantitatively. Evidence strongly favours the presence of a correlation between subjective embodiment and proprioceptive drift, supporting the model proposed by Botvinick and Cohen in 1998. However, the correlation is around .35, a value suggesting that the two indices capture different facets of the RHI. This result clarifies the association between the illusory effects produced by the RHI and may be helpful for designing studies having appropriate statistical power.

From rubber hands to neuroprosthetics: Neural correlates of embodiment

Our interaction with the world rests on the knowledge that we are a body in space and time, which can interact with the environment. This awareness is usually referred to as sense of embodiment. For the good part of the past 30 years, the rubber hand illusion (RHI) has been a prime tool to study embodiment in healthy and people with a variety of clinical conditions. In this paper, we provide a critical overview of this research with a focus on the RHI paradigm as a tool to study prothesis embodiment in individuals with amputation. The RHI relies on well-documented multisensory integration mechanisms based on sensory precision, where parietal areas are involved in resolving the visuo-tactile conflict, and premotor areas in updating the conscious bodily representation. This mechanism may be transferable to prosthesis ownership in amputees. We discuss how these results might transfer to technological development of sensorised prostheses, which in turn might progress the acceptability by users.

The self and the Bayesian brain: Testing probabilistic models of body ownership through a self-localization task

Simple multisensory manipulations can induce the illusory misattribution of external objects to one's own body, allowing to experimentally investigate body ownership. In this context, body ownership has been conceptualized as the result of the online Bayesian optimal estimation of the probability that one object belongs to the body from the congruence of multisensory inputs. This idea has been highly influential, as it provided a quantitative basis to bottom-up accounts of self-consciousness. However, empirical evidence fully supporting this view is scarce, as the optimality of the putative inference process has not been assessed rigorously. This pre-registered study aimed at filling this gap by testing a Bayesian model of hand ownership based on spatial and temporal visuo-proprioceptive congruences. Model predictions were compared to data from a virtual-reality reaching task, whereby reaching errors induced by a spatio-temporally mismatching virtual hand have been used as an implicit proxy of hand ownership. To rigorously test optimality, we compared the Bayesian model versus alternative non-Bayesian models of multisensory integration, and independently assess unisensory components and compare them to model estimates. We found that individually measured values of proprioceptive precision correlated with those fitted from our reaching task, providing compelling evidence that the underlying visuo-proprioceptive integration process approximates Bayesian optimality. Furthermore, reaching errors correlated with explicit ownership ratings at the single individual and trial level. Taken together, these results provide novel evidence that body ownership, a key component of self-consciousness, can be truly described as the bottom-up, behaviourally optimal processing of multisensory inputs.

No reduction in motor-evoked potential amplitude during the rubber hand illusion

INTRODUCTION

In the rubber hand illusion (RHI), touches are applied to a fake hand at the same time as touches are applied to a participant's real hand that is hidden in a congruent position. Synchronous (but not asynchronous) tactile stimulation of the two hands may induce the sensation that the fake hand is the participant's own. As such, the illusion is commonly used to examine the sense of body ownership. Some studies indicate that in addition to the subjective experience of limb ownership reported by participants, the RHI can also reduce corticospinal excitability (e.g., as reflected in motor-evoked potential [MEP] amplitude) and alter parietal-motor cortical connectivity in passive participants. These findings have been taken to support a link between motor cortical processing and the subjective experience of body ownership.

METHODS

In this study, we tried to replicate the reduction in MEP amplitude associated with the RHI and uncover the components of the illusion that might explain these changes. As such, we used single-pulse transcranial magnetic stimulation to probe the excitability of the corticospinal motor system as participants experienced the RHI.

RESULTS

Despite participants reporting the presence of the illusion and showing shifts in perceived real hand position towards the fake limb supporting its elicitation, we did not observe any associated reduction in MEP amplitude.

CONCLUSION

We conclude that a reduction in MEP amplitude is not a reliable outcome of the RHI and argue that if such effects do occur, they are unlikely to be large or functionally relevant.

Facilitation of imitative movement in patients with chronic hemiplegia triggered by illusory ownership

The sense of body ownership, the feeling that one's body belongs to oneself, is a crucial subjective conscious experience of one's body. Recent methodological advances regarding crossmodal illusions have provided novel insights into how multisensory interactions shape human perception and cognition, underpinning conscious experience, particularly alteration of body ownership. Moreover, in post-stroke rehabilitation, encouraging the use of the paretic limb in daily life is considered vital, as a settled sense of ownership and attentional engagement toward the paralyzed body part may promote increased frequency of its use and prevent learned nonuse. Therefore, in addition to traditional methods, novel interventions using neurorehabilitation techniques that induce self-body recognition are needed. This study investigated whether the illusory experience of a patient's ownership alterations of their paretic hand facilitates the enhancement in the range of motion of succeeding imitation movements. An experiment combining a modified version of the rubber hand illusion with imitation training was conducted with chronic hemiplegia. A larger imitation movement of the paretic hand was observed in the illusion-induced condition, indicating that the feeling of ownership toward the observed limb promotes the induction of intrinsic potential for motor performance. This training, using subjective experience, may help develop new post-stroke rehabilitation interventions.

Metacognitive awareness in the sound-induced flash illusion

Hundreds (if not thousands) of multisensory studies provide evidence that the human brain can integrate temporally and spatially discrepant stimuli from distinct modalities into a singular event. This process of multisensory integration is usually portrayed in the scientific literature as contributing to our integrated, coherent perceptual reality. However, missing from this account is an answer to a simple question: how do confidence judgements compare between multisensory information that is integrated across multiple sources, and multisensory information that comes from a single, congruent source in the environment? In this paper, we use the sound-induced flash illusion to investigate if confidence judgements are similar across multisensory conditions when the numbers of auditory and visual events are the same, and the numbers of auditory and visual events are different. Results showed that congruent audiovisual stimuli produced higher confidence than incongruent audiovisual stimuli, even when the perceptual report was matched across the two conditions. Integrating these behavioural findings with recent neuroimaging and theoretical work, we discuss the role that prefrontal cortex may play in metacognition, multisensory causal inference and sensory source monitoring in general. This article is part of the theme issue 'Decision and control processes in multisensory perception'.

Effect of visuo-proprioceptive mismatch rate on recalibration in hand perception

We estimate our hand's position by combining relevant visual and proprioceptive cues. A cross-sensory spatial mismatch can be created by viewing the hand through a prism or, more recently, rotating a visual cursor that represents hand position. This is often done in the context of target-directed reaching to study motor adaptation, the systematic updating of motor commands in response to a systematic movement error. However, a visuo-proprioceptive mismatch also elicits recalibration in the relationship between the hand's seen and felt position. The principles governing visuo-proprioceptive recalibration are poorly understood, compared to motor adaptation. For example, motor adaptation occurs robustly whether the cursor is rotated quickly or slowly, although the former may involve more explicit processes. Here, we asked whether visuo-proprioceptive recalibration, in the absence of motor adaptation, works the same way. Three groups experienced a 70 mm visuo-proprioceptive mismatch about their hand at a Slow, Medium, or Fast rate (0.84, 1.67, or 3.34 mm every two trials, respectively), with no error feedback. Once attained, the 70 mm mismatch was maintained for the remaining trials. Total recalibration differed significantly across groups, with the Fast, Medium, and Slow groups recalibrating 63.7, 56.3, and 42.8 mm on average, respectively. This suggests a slower mismatch rate may be less effective at eliciting recalibration. In contrast to motor adaptation studies, no further recalibration was observed in the maintenance phase. This may be related to the distinct mechanisms thought to contribute to perceptual recalibration via cross-sensory cue conflict versus sensory prediction errors.

Quantifying body ownership information processing and perceptual bias in the rubber hand illusion

Bodily illusions have fascinated humankind for centuries, and researchers have studied them to learn about the perceptual and neural processes that underpin multisensory channels of bodily awareness. The influential rubber hand illusion (RHI) has been used to study changes in the sense of body ownership - that is, how a limb is perceived to belong to one's body, which is a fundamental building block in many theories of bodily awareness, self-consciousness, embodiment, and self-representation. However, the methods used to quantify perceptual changes in bodily illusions, including the RHI, have mainly relied on subjective questionnaires and rating scales, and the degree to which such illusory sensations depend on sensory information processing has been difficult to test directly. Here, we introduce a signal detection theory (SDT) framework to study the sense of body ownership in the RHI. We provide evidence that the illusion is associated with changes in body ownership sensitivity that depend on the information carried in the degree of asynchrony of correlated visual and tactile signals, as well as with perceptual bias and sensitivity that reflect the distance between the rubber hand and the participant's body. We found that the illusion's sensitivity to asynchrony is remarkably precise; even a 50 ms visuotactile delay significantly affected body ownership information processing. Our findings conclusively link changes in a complex bodily experience such as body ownership to basic sensory information processing and provide a proof of concept that SDT can be used to study bodily illusions.

Proprioceptive uncertainty promotes the rubber hand illusion

Body ownership is the multisensory perception of a body as one's own. Recently, the emergence of body ownership illusions like the visuotactile rubber hand illusion has been described by Bayesian causal inference models in which the observer computes the probability that visual and tactile signals come from a common source. Given the importance of proprioception for the perception of one's body, proprioceptive information and its relative reliability should impact this inferential process. We used a detection task based on the rubber hand illusion where participants had to report whether the rubber hand felt like their own or not. We manipulated the degree of asynchrony of visual and tactile stimuli delivered to the rubber hand and the real hand under two levels of proprioceptive noise using tendon vibration applied to the lower arm's antagonist extensor and flexor muscles. As hypothesized, the probability of the emergence of the rubber hand illusion increased with proprioceptive noise. Moreover, this result, well fitted by a Bayesian causal inference model, was best described by a change in the a priori probability of a common cause for vision and touch. These results offer new insights into how proprioceptive uncertainty shapes the multisensory perception of one's own body.

Feeling without localizing: exploring tactile misperception in a patient with uncommon parietal left brain damage

Introduction

We report a very unique clinical presentation of a patient who complained, after a left parietal brain damage, about feeling tactile stimulations on his right upper limb without being able to localize them.

Methods

Using a single case study approach, we report three experiments relying on several custom-made tasks to explore the different levels of somatosensory information processing, ranging from somato-sensation to somato-representation.

Results

Our results showed a preserved ability to localize tactile stimuli applied on the right upper limb when using pointing responses while the ability to localize was less efficient when having to name the stimulated part (akin Numbsense). When the stimuli were applied on more distal locations (i.e., on the hand and on fingers), the number of correct responses decreased significantly independently of the modality of response. Finally, when visually presented with a stimulus delivered on the hand of an examiner in synchrony with the stimulation on the hidden hand of the patient, responses were largely influenced by the visual information available. Altogether, the convergence of these different customized tasks revealed an absence of autotopagnosia for motor responses for the right upper limb, associated with altered abilities to discriminate stimulus applied on distal and restricted/closer zones in the hand.

Discussion

The somato-representation of our patient seemed to significantly rely on visual information, leading to striking deficits to localize tactile stimuli when vision and somesthesic afferences are discordant. This case report offers a clinical illustration of pathological imbalance between vision and somesthesia. Implications of these troubles in somato-representation on higher cognitive level processes are discussed.

Changes in body perception following virtual object manipulation are accompanied by changes of the internal reference scale

Changes in body perception often arise when observers are confronted with related yet discrepant multisensory signals. Some of these effects are interpreted as outcomes of sensory integration of various signals, whereas related biases are ascribed to learning-dependent recalibration of coding individual signals. The present study explored whether the same sensorimotor experience entails changes in body perception that are indicative of multisensory integration and those that indicate recalibration. Participants enclosed visual objects by a pair of visual cursors controlled by finger movements. Then either they judged their perceived finger posture (indicating multisensory integration) or they produced a certain finger posture (indicating recalibration). An experimental variation of the size of the visual object resulted in systematic and opposite biases of the perceived and produced finger distances. This pattern of results is consistent with the assumption that multisensory integration and recalibration had a common origin in the task we used.

Synchronous motor imagery and visual feedback of finger movement elicit the moving rubber hand illusion, at least in illusion-susceptible individuals

Recent evidence suggests that imagined auditory and visual sensory stimuli can be integrated with real sensory information from a different sensory modality to change the perception of external events via cross-modal multisensory integration mechanisms. Here, we explored whether imagined voluntary movements can integrate visual and proprioceptive cues to change how we perceive our own limbs in space. Participants viewed a robotic hand wearing a glove repetitively moving its right index finger up and down at a frequency of 1 Hz, while they imagined executing the corresponding movements synchronously or asynchronously (kinesthetic-motor imagery); electromyography (EMG) from the participants' right index flexor muscle confirmed that the participants kept their hand relaxed while imagining the movements. The questionnaire results revealed that the synchronously imagined movements elicited illusory ownership and a sense of agency over the moving robotic hand-the moving rubber hand illusion-compared with asynchronously imagined movements; individuals who affirmed experiencing the illusion with real synchronous movement also did so with synchronous imagined movements. The results from a proprioceptive drift task further demonstrated a shift in the perceived location of the participants' real hand toward the robotic hand in the synchronous versus the asynchronous motor imagery condition. These results suggest that kinesthetic motor imagery can be used to replace veridical congruent somatosensory feedback from a moving finger in the moving rubber hand illusion to trigger illusory body ownership and agency, but only if the temporal congruence rule of the illusion is obeyed. This observation extends previous studies on the integration of mental imagery and sensory perception to the case of multisensory bodily awareness, which has potentially important implications for research into embodiment of brain-computer interface controlled robotic prostheses and computer-generated limbs in virtual reality.

Facial feedback effect on the sense of body ownership during the rubber hand illusion

The sense of body ownership, a feeling that one’s body belongs to the self, is an essential aspect of self-consciousness. Studies have focused on emotions and bodily states that could influence multisensory integration for the sense of body ownership. Based on the Facial Feedback Hypothesis, the purpose of this study was to examine whether displaying specific facial expressions affects the rubber hand illusion. We hypothesized that the expression of a smiling face changes the emotional experience and facilitates the formation of a sense of body ownership. In the experiment, participants (n = 30) were asked to hold a wooden chopstick in their mouths to simulate smile, neutral, and disgusted facial expressions during the induction of the rubber hand illusion. The results did not support the hypothesis, showing that proprioceptive drift (an index of illusory experience) was enhanced when the subjects displayed a disgusted facial expression, while the subjective reports of the illusion were not affected. These results, together with the previous studies regarding the effect of positive emotions, suggest that bodily affective information, regardless of its valence, facilitates multisensory integration and could influence the conscious representation of the bodily self.

Look at me now! Enfacement illusion over computer-generated faces

According to embodied cognition research, one’s bodily self-perception can be illusory and temporarily shifted toward an external body. Similarly, the so-called “enfacement illusion” induced with a synchronous multisensory stimulation over the self-face and an external face can result in implicit and explicit changes in the bodily self. The present study aimed to verify (i) the possibility of eliciting an enfacement illusion over computer-generated faces and (ii) which multisensory stimulation condition was more effective. A total of 23 participants were asked to look at a gender-matched avatar in three synchronous experimental conditions and three asynchronous control conditions (one for each stimulation: visuotactile, visuomotor, and simple exposure). After each condition, participants were asked to complete a questionnaire assessing both the embodiment and the enfacement sensations to address different facets of the illusion. Results suggest a stronger effect of synchronous vs. asynchronous stimulation, and the difference was more pronounced for the embodiment items of the questionnaire. We also found a greater effect of visuotactile and visuomotor stimulations as compared to the simple exposure condition. These findings support the enfacement illusion as a new paradigm to investigate the ownership of different face identities and the specific role of visuotactile and visuomotor stimulations with virtual reality stimuli.

On the Role of Interoception in Body and Object Perception: A Multisensory-Integration Account

Various "embodied perception" phenomena suggest that what people sense of their body shapes what they perceive of the environment and that what they perceive of the environment shapes what they perceive of their bodies. For example, an observer's own hand can be felt where a fake hand is seen, events produced by own body movements seem to occur earlier than they did, and feeling a heavy weight at an observer's back may prompt hills to look steeper. Here we argue that such and various other phenomena are instances of multisensory integration of interoceptive signals from the body and exteroceptive signals from the environment. This overarching view provides a mechanistic description of what embodiment in perception means and how it works. It suggests new research questions while questioning a special role of the body itself and various phenomenon-specific explanations in terms of ownership, agency, or action-related scaling of visual information.

Data-Driven Assessment of Adolescents' Mental Health During the COVID-19 Pandemic

OBJECTIVE

Adolescents' mental health was severely compromised during the COVID-19 pandemic. Longitudinal real-world studies on changes in the mental health of adolescents during the later phase of the pandemic are limited. We aimed to quantify the effect of COVID-19 pandemic on adolescents' mental health outcomes based on electronic health records.

METHOD

This was a retrospective cohort study using the computerized database of a 2.5 million members, state-mandated health organization in Israel. Rates of mental health diagnoses and psychiatric drug dispensations were measured among adolescents 12 to 17 years of age with and without pre-existing mental history, for the years 2017 to 2021. Relative risks were computed between the years, and interrupted time series (ITS) analyses evaluated changes in monthly incidence rates of psychiatric outcomes.

RESULTS

The average population size was 218,146 in 2021. During the COVID-19 period, a 36% increase was observed in the incidence of depression (95% CI = 25-47), 31% in anxiety (95% CI = 23-39), 20% in stress (95% CI = 13-27), 50% in eating disorders (95% CI = 35-67), 25% in antidepressant use (95% CI = 25-33), and 28% in antipsychotic use (95% CI = 18-40). A decreased rate of 26% (95% CI = 0.80-0.88) was observed in ADHD diagnoses. The increase of the examined outcomes was most prominent among youth without psychiatric history, female youth, general secular Jewish population, youth with medium-high socioeconomic status, and those 14 to 15 years of age. ITS analysis confirmed a significantly higher growth in the incidence of psychiatric outcomes during the COVID-19 period, compared to those in previous years.

CONCLUSION

This real-world study highlights the deterioration of adolescents' mental health during the COVID-19 pandemic and suggests that youth mental health should be considered during health policy decision making.

DIVERSITY & INCLUSION STATEMENT

We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We actively worked to promote sex and gender balance in our author group. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.

Self/other distinction in adolescents with autism spectrum disorder (ASD) assessed with a double mirror paradigm

BACKGROUND

Self/other distinction (SOD), which refers to the ability to distinguish one's own body, actions, and mental representations from those of others, is an essential skill for effective social interaction. A large body of clinical evidence suggests that disruptions in SOD may be key to social communication deficits in individuals with autism spectrum disorders (ASD). In particular, egocentric biases have been found in cognitive, affective, behavioural, and motor domains. However, research in this area is scarce and consists of recognition paradigms that have used only static images; these methods may be insufficient for assessing SOD, given the increasing role of embodiment in our understanding of the pathophysiology of ASD.

METHOD

A single-centre, prospective pilot study was carried out to investigate, for the first time, self-recognition and SOD in seven adolescents with ASD compared with matched, typically developing controls (TDCs) using the "Alter Ego"TM double mirror paradigm. The participants viewed a double mirror in which their own face was gradually morphed into the face of an unfamiliar other (self-to-other sequence) or vice versa (other-to-self sequence); participants were instructed to indicate at which point the morph looked more like their own face than the other's face. Two judgement criteria were used: 1) M1: the threshold at which subjects started to recognize their own face during the other-to-self morphing sequence; 2) M2: the threshold at which subjects started to recognize the other's face during the self-to-other morphing sequence.

RESULTS

Consistent with the predictions, the results showed that the participants with ASD exhibited earlier self-recognition in the other-to-self sequence and delayed other-recognition in the self-to-other sequence, suggesting an egocentric bias. SOD impairments were also marginally correlated with ASD severity, indicating earlier face recognition in more severely affected individuals. Furthermore, in contrast with that of TDCs, the critical threshold for switching between self and other varied with the direction of morphing in ASD participants. Finally, these differences in face recognition and SOD using mirrors, unlike previous research using static images, support the central place of bodily self-consciousness in SOD impairments.

CONCLUSIONS

Although additional research is needed to replicate the results of this preliminary study, it revealed the first behavioural evidence of altered SOD in ASD individuals on an embodied, semiecological face-recognition paradigm. Implications for understanding ASD are discussed from a developmental perspective, and new research and therapeutic perspectives are presented.

The neuroscience of body memory: Recent findings and conceptual advances

The body is a very special object, as it corresponds to the physical component of the self and it is the medium through which we interact with the world. Our body awareness includes the mental representation of the body that happens to be our own, and traditionally has been defined in terms of body schema and body image. Starting from the distinction between these two types of representations, the present paper tries to reconcile the literature around body representations under the common framework of body memory. The body memory develops ontogenetically from birth and across all the life span and is directly linked to the development of the self. Therefore, our sense of self and identity is fundamentally based on multisensory knowledge accumulated in body memory, so that the sensations collected by our body, stored as implicit memory, can unfold in the future, under suitable circumstances. Indeed, these sets of bodily information had been proposed as possible key factors underpinning several mental health illnesses. Following this perspective, the Embodied Medicine approach put forward the use of advanced technologies to alter the dysfunctional body memory to enhance people's well-being. In the last sections, recent experimental pieces of evidence will be illustrated that targeted specifically bodily information for increasing health and wellbeing, by means of two strategies: interoceptive feedback and bodily illusions. See also Figure 1(Fig. 1).

Combining virtual reality and tactile stimulation to investigate embodied finger-based numerical representations

Finger-based representation of numbers is a high-level cognitive strategy to assist numerical and arithmetic processing in children and adults. It is unclear whether this paradigm builds on simple perceptual features or comprises several attributes through embodiment. Here we describe the development and initial testing of an experimental setup to study embodiment during a finger-based numerical task using Virtual Reality (VR) and a low-cost tactile stimulator that is easy to build. Using VR allows us to create new ways to study finger-based numerical representation using a virtual hand that can be manipulated in ways our hand cannot, such as decoupling tactile and visual stimuli. The goal is to present a new methodology that can allow researchers to study embodiment through this new approach, maybe shedding new light on the cognitive strategy behind the finger-based representation of numbers. In this case, a critical methodological requirement is delivering precisely targeted sensory stimuli to specific effectors while simultaneously recording their behavior and engaging the participant in a simulated experience. We tested the device's capability by stimulating users in different experimental configurations. Results indicate that our device delivers reliable tactile stimulation to all fingers of a participant's hand without losing motion tracking quality during an ongoing task. This is reflected by an accuracy of over 95% in participants detecting stimulation of a single finger or multiple fingers in sequential stimulation as indicated by experiments with sixteen participants. We discuss possible application scenarios, explain how to apply our methodology to study the embodiment of finger-based numerical representations and other high-level cognitive functions, and discuss potential further developments of the device based on the data obtained in our testing.

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.

Being an Avatar "for Real": A Survey on Virtual Embodiment in Augmented Reality

Virtual self-avatars have been increasingly used in Augmented Reality (AR) where one can see virtual content embedded into physical space. However, little is known about the perception of self-avatars in such a context. The possibility that their embodiment could be achieved in a similar way as in Virtual Reality opens the door to numerous applications in education, communication, entertainment, or the medical field. This article aims to review the literature covering the embodiment of virtual self-avatars in AR. Our goal is (i) to guide readers through the different options and challenges linked to the implementation of AR embodiment systems, (ii) to provide a better understanding of AR embodiment perception by classifying the existing knowledge, and (iii) to offer insight on future research topics and trends for AR and avatar research. To do so, we introduce a taxonomy of virtual embodiment experiences by defining a "body avatarization" continuum. The presented knowledge suggests that the sense of embodiment evolves in the same way in AR as in other settings, but this possibility has yet to be fully investigated. We suggest that, whilst it is yet to be well understood, the embodiment of avatars has a promising future in AR and conclude by discussing possible directions for research.

Body transfer illusions in the schizophrenia spectrum: a systematic review

Schizophrenia has been viewed as a disorder of the self. Accordingly, the question arises if and how senses of ownership and agency are impaired in schizophrenia. To address this question, several body transfer illusions (BTIs) have been investigated in schizophrenia patients and other schizophrenia spectrum (SCZ-S) populations. The objective of the study was to systematically review the current evidence from BTIs in the SCZ-S. A systematic literature search in PubMed and CENTRAL (search date: February 12, 2022) was conducted on BTI studies carried out in SCZ-S populations. Studies were included if they were published in English after peer review, reported original research data, related to the SCZ-S, and used a BTI as its study method. Conference papers, study protocols, and reviews were excluded. For each included BTI study, various study characteristics and outcomes were retrieved, and a risk-of-bias score was calculated based on six study quality criteria. K = 40 studies were identified, of which k = 20 studies met the eligibility criteria. For BTI paradigms using visuotactile stimulation, most studies found elevated sense of ownership ratings in SCZ-S populations compared to healthy controls (HC). Implicit illusion measures (e.g., proprioceptive drift), in turn, did not generally indicate elevated embodiment levels in SCZ-S populations. Likewise, no consistent group differences emerged between SCZ-S populations and HC with respect to BTI paradigms using visuomotor stimulation. Furthermore, BTI vividness was found to correlate significantly with core symptoms of schizophrenia and various subclinical characteristics related to the SCZ-S. In line with the self-disturbance hypothesis, SCZ-S populations appear to be affected by aberrations in bodily self-awareness. Review registration: PROSPERO (identifier: CRD42022287960).

The Virtual "Enfacement Illusion" on Pain Perception in Patients Suffering from Chronic Migraine: A Study Protocol for a Randomized Controlled Trial

BACKGROUND

given the limited efficacy, tolerability, and accessibility of pharmacological treatments for chronic migraine (CM), new complementary strategies have gained increasing attention. Body ownership illusions have been proposed as a non-pharmacological strategy for pain relief. Here, we illustrate the protocol for evaluating the efficacy in decreasing pain perception of the enfacement illusion of a happy face observed through an immersive virtual reality (VR) system in CM.

METHOD

the study is a double-blind randomized controlled trial with two arms, involving 100 female CM patients assigned to the experimental group or the control group. The experimental group will be exposed to the enfacement illusion, whereas the control group will be exposed to a pleasant immersive virtual environment. Both arms of the trial will consist in three VR sessions (20 min each). At the baseline and at the end of the intervention, the patients will fill in questionnaires based on behavioral measures related to their emotional and psychological state and their body satisfaction. Before and after each VR session, the level of pain, the body image perception, and the affective state will be assessed.

DISCUSSION

this study will provide knowledge regarding the relationship between internal body representation and pain perception, supporting the effectiveness of the enfacement illusion as a cognitive behavioral intervention in CM.

Sense of body ownership and body agency in schizophrenia

Recent research suggests that embodiment sensations (sense of body ownership and sense of body agency) are altered in schizophrenia. Using a mirror box illusion setup, we tested if the anomalous embodiment experience depends on deficient processing of visuomotor synchrony, disrupted processing of movement mode, or both. The task required participants to press a lever with their index while looking at the image of the experimenter's hand moving on a similar lever. The illusion of embodiment could arise because looking toward the direction of their own hand the participant saw the reflection of the experimenter's hand visually superimposed to his own one through a mirror. During the illusion induction, we systematically varied visuomotor asynchrony (4 delays were imposed on the movement of the experimenter's hand) and the mode of movement (the participant could perform active vs. passive movements). The strength of the illusion of embodiment of the external hand was assessed with explicit judgments of ownership and agency. Patients' data showed an anomalous modulation of ownership with respect to visuomotor synchrony manipulation and an altered modulation of agency with respect to both visuomotor synchrony and movement mode manipulations. Results from the present study suggest that impairments affecting both the processing of temporal aspects of visuomotor signals and the processing of type of movement underlie anomalous embodiment sensations in schizophrenia. Hypotheses about potential deficits accounting for our results are proposed.

Is this my foot? Experimentally induced disownership in individuals with body integrity dysphoria

In body integrity dysphoria (BID), otherwise healthy individuals feel like a part of their physical body does not belong to them despite normal sensorimotor functioning. Theoretical and empirical evidence suggested aweakened integration of the affected body part into higher-order multisensory cortical body networks. Here, we used a multisensory stimulation paradigm in mixed reality to modulate and investigate multisensory processing underlying body (dis)ownership in individuals with BID of the lower limb. In 20 participants with BID, delay perception and body ownership were measured after introducing delays between the visual and tactile information of viewed stroking applied to affected and unaffected body parts. Unlike predicted, delay perception did not differ between the two body parts. However, specifically for the affected limb, ownership was lower and more strongly modulated by delay. These findings might be following the idea of a stronger dependency on online bottom up sensory signals in BID.

Effects of Frequent Changes in Extended Self-Avatar Movements on Adaptation Performance

Among several perceptive traits of virtual reality, the relationship between the physical body and a self-avatar is unclear. In this study, we investigate a case of hyper-adaptability, i.e., the capability of users to adjust to the movements of an altered self-avatar when such movements abruptly and frequently change. Focusing on movements of the upper limbs, we show experimentally the effect of the frequency of variations in virtual body alterations on adaptability. Moreover, we report a positive evaluation of the sense of embodiment and the overall user experience with virtual reality, and finally underline how these studies can be considered a basis for the design and development of virtual rehabilitation systems.

Effects of virtual hands and feet on the onset time and duration of illusory body ownership

In the illusory body ownership, humans feel as if a rubber hand or an avatar in a virtual environment is their own body through visual-tactile synchronization or visual-motor synchronization. Despite the onset time and duration of illusory body ownership has been investigated, it is not clear how the onset time and duration change when a part of the body is missing from the full-body. In this study, we investigated the completeness of the full-body for the illusion onset and duration by comparing the following conditions: complete avatar, avatar missing hands and feet, and avatar with hands and feet only. Our results suggest that avatar hands and feet only shorten the duration of the illusion, and missing body parts, such as only hands and feet or no hands and feet, reduce the sense of body ownership and of agency. However, the effects of avatar completeness on the onset time are unclear, and no conclusions can be made in either direction based on the current findings.

Exploring the development of high-level contributions to body representation using the rubber hand illusion and the monkey hand illusion

During development our body undergoes significant changes, yet we are able to maintain a coherent experience of our body and sense of self. Bodily experience is thought to comprise integration of multisensory signals (vision, touch, and proprioception) constrained by top-down knowledge of body appearance. Evidence from developmental studies suggests that low-level multisensory integration develops throughout childhood, reaching adult levels by 10 years of age. However, how high-level cognitive knowledge changes during childhood to constrain our multisensory body experience is unknown. This study describes four experiments examining high-level contributions to the bodily experience in children compared with adults using the rubber hand illusion and a monkey hand illusion. We found that children (5-17 years of age) exhibited more flexible body representations, showing stronger illusions for small and fantastical (monkey) fake hands compared with adults. Conversely, using a task indirectly capturing changes in hand size, we found that children and adults demonstrated statistically equivalent increases and decreases in hand size following illusions over large and small hands, respectively. Interestingly, at baseline children showed a bias in reporting larger hand size judgments that decreased with age. Finally, we did not find a relationship between individual differences in fantasy proneness and illusion strength for a fantastical (monkey) hand for children or adults, suggesting that developmental changes of top-down constraints are not purely driven by more diffuse boundaries between imagination and reality. These data suggest that high-level constraints acting on our multisensory body experience change during development, allowing children a more flexible bodily experience compared with adults.

Multisensory Integration Dominates Hypnotisability and Expectations in the Rubber Hand Illusion

Some recent papers by P. Lush and colleagues have argued that the rubber hand illusion (RHI), where participants can feel a rubber hand as their own under appropriate multisensory stimulation, may be caused mainly by hypnotic suggestibility and expectations (demand characteristics). These papers rely primarily on a study with 353 participants who took part in a RHI experiment carried out in a classical way with brush stroking. Participants experienced a synchronous condition where the rubber hand was seen to be touched in synchrony with touch felt on their corresponding hidden real hand, or the touches were applied asynchronously as a control. Each participant had a related measure of their hypnotisability on a scale known as the Sussex-Waterloo Scale of Hypnotisability (SWASH). The authors found a correlation between the questionnaire ratings of the RHI in the synchronous condition and the SWASH score. From this, they concluded that the RHI is largely driven by suggestibility and further proposed that suggestibility and expectations may even entirely explain the RHI. Here we examine their claims in a series of extensive new analyses of their data. We find that at every level of SWASH, the synchronous stimulation results in greater levels of the illusion than the asynchronous condition; moreover, proprioceptive drift is greater in the synchronous case at every level of SWASH. Thus, while the level of hypnotisability does modestly influence the subjective reports (higher SWASH is associated with somewhat higher illusion ratings), the major difference between the synchronous and asynchronous stimulation is always present. Furthermore, by including in the model the participants' expectancy ratings of how strongly they initially believed they would experience the RHI in the two conditions, we show that expectations had a very small effect on the illusion ratings; model comparisons further demonstrate that the multisensory condition is two-to-three-times as dominant as the other factors, with hypnotisability contributing modestly and expectations negligibly. Thus, although the results indicate that trait suggestibility may modulate the RHI, presumably through intersubject variations in top-down factors, the findings also suggest that the primary explanation for the RHI is as a multisensory bodily illusion.

Enhance VR: A Multisensory Approach to Cognitive Training and Monitoring

Cognitive training systems aim to improve specific domains or global cognition by engaging users in cognitively demanding tasks. While screen-based applications can improve performance in the trained cognitive abilities, they are often criticized for their poor transferability to activities of daily living. These systems, however, exclude the user's body and motor skills, which invariably serves to restrict the user experience. Immersive Virtual Reality (IVR) systems, in contrast, present the user with body-related information, such as proprioceptive and visuomotor information, allowing for an immersive and embodied experience of the environment. This feature renders VR a very appealing tool for cognitive training and neurorehabilitation applications. We present Enhance VR, an IVR-based cognitive training and monitoring application that offers short daily cognitive workouts. The games are designed to train and monitor specific cognitive domains such as memory, task flexibility, information processing, orientation, attention, problem-solving, and motor control. The aim is to test whether cognitively demanding tasks, presented in an IVR setting, provide a naturalistic system to train and monitor cognitive capabilities.

The rubber hand illusion in microgravity and water immersion

Our body has evolved in terrestrial gravity and altered gravitational conditions may affect the sense of body ownership (SBO). By means of the rubber hand illusion (RHI), we investigated the SBO during water immersion and parabolic flights, where unconventional gravity is experienced. Our results show that unconventional gravity conditions remodulate the relative weights of visual, proprioceptive, and vestibular inputs favoring vision, thus inducing an increased RHI susceptibility.

Younger and Older Adults’ Cognitive and Physical Functioning in a Virtual Reality Age Manipulation

Objectives: Age group stereotypes (AGS), especially those targeting old age, affect an individual’s behavior and long-term cognitive and physiological functioning. Conventional paradigms investigating the related mechanisms lack validity and stability. Our novel approach for the activation of self-relevant AGS uses a virtual reality (VR) ageing experience, measuring relevant effects on performance parameters.

Methods: In a between-subjects experimental design, young participants embodied either a younger or older avatar in a 3D virtual environment to capture the effects on physical (Study 1; N = 68) and cognitive performance (Study 2; N = 45). In Study 3 (N = 117), the paradigm was applied to older participants.

Results: For the younger participants, embodying older avatars was associated with declines in memory and physical performance when compared to the younger avatar age group. Furthermore, the manipulations’ main effects were moderated by negative explicit AGS that matched the respective performance domains. For the older participants, we found no significant performance differences in the two domains investigated.

Discussion: The experimental manipulation demonstrated an impact on relevant performance parameters on a motivational and strategic level, especially for strong performance-related AS, but for young participants only. Possible reasons and mechanisms for the differences in younger and older samples’ results are discussed.

Verbal Suggestion Modulates the Sense of Ownership and Heat Pain Threshold During the "Injured" Rubber Hand Illusion

The appearance of the self-body influences the feeling that one's body belongs to oneself, that is, a sense of ownership (SoO) and pain perception. This can be identified by measuring the SoO and pain thresholds after performing the rubber hand illusion (RHI) with an injured rubber hand. The generation of SoO is thought to be caused by multisensory integration of bottom-up factors (vision, proprioceptive, and touch), and by top-down factors, such as the context effect. The appearance is one of the context effects which may become more effective when used simultaneously with other context effects (e.g., verbal suggestion). However, in the RHI, when appearance and other context effects are used simultaneously, the effect is unclear. In this study, we attempted to identify the influence of verbal suggestion on the SoO and heat pain threshold (HPT). As a preliminary step, in Experiment 1, the "normal" rubber hand and "penetrated nail" as injured rubber hand were used to clarify the context effect with appearance alone during RHI (synchronous/asynchronous), which was conducted within-subjects. In Experiment 2, we only used the "penetrated nail" rubber hand to clarify the context effect with verbal suggestion and appearance during RHI. We randomly classified participants into two suggestion groups ("fear" and "no-fear"). The RHI (synchronous/asynchronous) was conducted for each group. In each experiment, the effect of each condition was assessed by subjective measures of SoO, such as questionnaire, and objective measures of SoO, such as proprioceptive drift and electrodermal activity. Following RHI in each condition, HPT was measured. The main finding was that, in the synchronous condition, the "penetrated nail" appearance with "fear" verbal suggestion modulated questionnaire and HPT, but not electrodermal activity. We conclude that the context-included multisensory integration affected the subjective factors because it contains a higher cognitive process by verbal suggestion.