Those are Your Legs: The Effect of Visuo-Spatial Viewpoint on Visuo-Tactile Integration and Body Ownership

Peripersonal space around the upper and the lower limbs

Peripersonal space (PPS), the space closely surrounding the body, is typically characterised by enhanced multisensory integration. Neurophysiological and behavioural studies have consistently shown stronger visuo-tactile integration when a visual stimulus is presented close to the tactually stimulate body part in near space (within PPS) than in far space. However, in the majority of these studies, tactile stimuli were delivered to the upper limbs, torso and face. Therefore, it is not known whether the space surrounding the lower limbs is characterised by similar multisensory properties. To address this question, we asked participants to complete two versions of the classic visuo-tactile crossmodal congruency task in which they had to perform speeded elevation judgements of tactile stimuli presented to the dorsum of the hand and foot while a simultaneous visual distractor was presented at spatially congruent or incongruent locations either in near or far space. In line with existing evidence, when the tactile target was presented to the hand, the size of the crossmodal congruency effect (CCE) decreased in far as compared to near space, suggesting stronger visuo-tactile multisensory integration within PPS. In contrast, when the tactile target was presented to the foot, the CCE decreased for visual distractors in near than far space. These findings show systematic differences between the representation of PPS around upper and lower limbs, suggesting that the multisensory properties of the different body part-centred representations of PPS are likely to depend on the potential actions performed by the different body parts.

Mechanisms of the breathing contribution to bodily self-consciousness in healthy humans: Lessons from machine-assisted breathing?

Previous studies investigated bodily self-consciousness (BSC) by experimentally exposing subjects to multisensory conflicts (i.e., visuo-tactile, audio-tactile, visuo-cardiac) in virtual reality (VR) that involve the participant's torso in a paradigm known as the full-body illusion (FBI). Using a modified FBI paradigm, we found that synchrony of visuo-respiratory stimulation (i.e., a flashing outline surrounding an avatar in VR; the flash intensity depending on breathing), is also able to modulate BSC by increasing self-location and breathing agency toward the virtual body. Our aim was to investigate such visuo-respiratory effects and determine whether respiratory motor commands contributes to BSC, using non-invasive mechanical ventilation (i.e., machine-delivered breathing). Seventeen healthy participants took part in a visuo-respiratory FBI paradigm and performed the FBI during two breathing conditions: (a) "active breathing" (i.e., participants actively initiate machine-delivered breaths) and (b) "passive breathing" (i.e., breaths' timing was determined by the machine). Respiration rate, tidal volume, and their variability were recorded. In line with previous results, participants experienced subjective changes in self-location, breathing agency, and self-identification toward the avatar's body, when presented with synchronous visuo-respiratory stimulation. Moreover, drift in self-location was reduced and tidal volume variability were increased by asynchronous visuo-respiratory stimulations. Such effects were not modulated by breathing control manipulations. Our results extend previous FBI findings showing that visuo-respiratory stimulation affects BSC, independently from breathing motor command initiation. Also, variability of respiratory parameters was influenced by visuo-respiratory feedback and might reduce breathing discomfort. Further exploration of such findings might inform the development of respiratory therapeutic tools using VR in patients.

Toward Enhanced Teleoperation Through Embodiment

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

Consistent inter-individual differences in susceptibility to bodily illusions

Illusory senses of ownership and agency (that the hand or effector that we see belongs to us and moves at our will, respectively) support the embodiment of prosthetic limbs, tele-operated surgical devices, and human-machine interfaces. We exposed forty-eight individuals to four different procedures known to elicit illusory ownership or agency over a fake visible rubber hand or finger. The illusory ownership or agency arising from the hand correlated with that of the finger. For both body parts, sensory stimulation across different modalities (visual with tactile or visual with kinesthetic) produced illusions of similar strength. However, the strengths of the illusions of ownership and agency were unrelated within individuals, supporting the proposal that distinct neuropsychological processes underlie these two senses. Developing training programs to enhance susceptibility to illusions of agency or ownership for people with lower natural susceptibility could broaden the usefulness of the above technologies.

Illusory resizing of the painful knee is analgesic in symptomatic knee osteoarthritis

BACKGROUND

Experimental and clinical evidence support a link between body representations and pain. This proof-of-concept study in people with painful knee osteoarthritis (OA) aimed to determine if: (i) visuotactile illusions that manipulate perceived knee size are analgesic; (ii) cumulative analgesic effects occur with sustained or repeated illusions.

METHODS

Participants with knee OA underwent eight conditions (order randomised): stretch and shrink visuotactile (congruent) illusions and corresponding visual, tactile and incongruent control conditions. Knee pain intensity (0-100 numerical rating scale; 0 = no pain at all and 100 = worst pain imaginable) was assessed pre- and post-condition. Condition (visuotactile illusion vs control) × Time (pre-/post-condition) repeated measure ANOVAs evaluated the effect on pain. In each participant, the most beneficial illusion was sustained for 3 min and was repeated 10 times (each during two sessions); paired t-tests compared pain at time 0 and 180s (sustained) and between illusion 1 and illusion 10 (repeated).

RESULTS

Visuotactile illusions decreased pain by an average of 7.8 points (95% CI [2.0-13.5]) which corresponds to a 25% reduction in pain, but the tactile only and visual only control conditions did not (Condition × Time interaction: p = 0.028). Visuotactile illusions did not differ from incongruent control conditions where the same visual manipulation occurred, but did differ when only the same tactile input was applied. Sustained illusions prolonged analgesia, but did not increase it. Repeated illusions increased the analgesic effect with an average pain decrease of 20 points (95% CI [6.9-33.1])-corresponding to a 40% pain reduction.

DISCUSSION

Visuotactile illusions are analgesic in people with knee OA. Our results suggest that visual input plays a critical role in pain relief, but that analgesia requires multisensory input. That visual and tactile input is needed for analgesia, supports multisensory modulation processes as a possible explanatory mechanism. Further research exploring the neural underpinnings of these visuotactile illusions is needed. For potential clinical applications, future research using a greater dosage in larger samples is warranted.

Audio-tactile cues from an object's fall change estimates of one's body height

When we drop an object from our hands, we use internal models of both our body height and object-motion to predict when it will hit the floor. What happens if the sensory feedback finally received from the impact conflicts with this prediction? The present study shows that such conflict results in changes in the internal estimates of our body height: When the object people dropped takes longer than expected to hit the floor, they report feeling taller and behave as if their legs were longer. This provides the first evidence of cross-modal recalibration of body-height representations as a function of changes in the distant environment. Crucially, the recalibration results from a mismatch between the predicted and actual outcome of an action, the ball’s release and impact, which are causally-related but separated in space and time. These results suggest that implicit models of object-motion can interact with implicit and explicit models of one’s body height.

From multisensory integration in peripersonal space to bodily self-consciousness: from statistical regularities to statistical inference

Integrating information across sensory systems is a critical step toward building a cohesive representation of the environment and one's body, and as illustrated by numerous illusions, scaffolds subjective experience of the world and self. In the last years, classic principles of multisensory integration elucidated in the subcortex have been translated into the language of statistical inference understood by the neocortical mantle. Most importantly, a mechanistic systems-level description of multisensory computations via probabilistic population coding and divisive normalization is actively being put forward. In parallel, by describing and understanding bodily illusions, researchers have suggested multisensory integration of bodily inputs within the peripersonal space as a key mechanism in bodily self-consciousness. Importantly, certain aspects of bodily self-consciousness, although still very much a minority, have been recently casted under the light of modern computational understandings of multisensory integration. In doing so, we argue, the field of bodily self-consciousness may borrow mechanistic descriptions regarding the neural implementation of inference computations outlined by the multisensory field. This computational approach, leveraged on the understanding of multisensory processes generally, promises to advance scientific comprehension regarding one of the most mysterious questions puzzling humankind, that is, how our brain creates the experience of a self in interaction with the environment.

The influence of vision, touch, and proprioception on body representation of the lower limbs

Numerous studies have shown that the representation of the hand is distorted. When participants are asked to localize unseen points on the hand (e.g. the knuckle), it is perceived to be wider and shorter than its physical dimensions. Similar distortions occur when people are asked to judge the distance between two tactile points on the hand; estimates made in the longitudinal direction are perceived as significantly shorter than those made in the transverse direction. Yet, when asked to visually compare the shape and size of one's own hand to a template hand, individuals are accurate at estimating the size of their own hands. Thus, it seems that body representations are, at least in part, a function of the most prominent underlying sensory modality used to perceive the body part. Yet, it remains unknown if the representations of other body parts are similarly distorted. The lower limbs, for example, are structurally and functionally very different from the hands, yet their representation(s) are seldom studied. What does the body representation for the leg look like? And is leg representation dependent on which sense is probed when making judgments about its shape and size? In the current study, we investigated what the representation of the leg looks like in visually-, tactually-, and proprioceptively-guided tasks. Results revealed that the leg, like the hand, is distorted in a highly systematic manner. Distortions seem to rely, at least partly, on sensory input. This is the first study, to our knowledge, to systematically investigate leg representation in healthy individuals.

The Bodily Illusion in Adverse Conditions: Virtual Arm Ownership During Visuomotor Mismatch

Classically, body ownership illusions are triggered by cross-modal synchronous stimulations, and hampered by multisensory inconsistencies. Nonetheless, the boundaries of such illusions have been proven to be highly plastic. In this immersive virtual reality study, we explored whether it is possible to induce a sense of body ownership over a virtual body part during visuomotor inconsistencies, with or without the aid of concomitant visuo-tactile stimulations. From a first-person perspective, participants watched a virtual tube moving or an avatar's arm moving, with or without concomitant synchronous visuo-tactile stimulations on their hand. Three different virtual arm/tube speeds were also investigated, while all participants kept their real arms still. The subjective reports show that synchronous visuo-tactile stimulations effectively counteract the effect of visuomotor inconsistencies, but at slow arm movements, a feeling of body ownership might be successfully induced even without concomitant multisensory correspondences. Possible therapeutical implications of these findings are discussed.

Virtual reality improves embodiment and neuropathic pain caused by spinal cord injury

Objective:

To investigate changes in body ownership and chronic neuropathic pain in patients with spinal cord injury (SCI) using multisensory own body illusions and virtual reality (VR).

Methods:

Twenty patients with SCI with paraplegia and 20 healthy control participants (HC) participated in 2 factorial, randomized, repeated-measures design studies. In the virtual leg illusion (VLI), we applied asynchronous or synchronous visuotactile stimulation to the participant's back (either immediately above the lesion level or at the shoulder) and to the virtual legs as seen on a VR head-mounted display. We tested the effect of the VLI on the sense of leg ownership (questionnaires) and on perceived neuropathic pain (visual analogue scale pain ratings). We compared illusory leg ownership with illusory global body ownership (induced in the full body illusion [FBI]), by applying asynchronous or synchronous visuotactile stimulation to the participant's back and the back of a virtual body as seen on a head-mounted display.

Results:

Our data show that patients with SCI are less sensitive to multisensory stimulations inducing illusory leg ownership (as compared to HC) and that leg ownership decreased with time since SCI. In contrast, we found no differences between groups in global body ownership as tested in the FBI. VLI and FBI were both associated with mild analgesia that was only during the VLI specific for synchronous visuotactile stimulation and the lower back position.

Conclusions:

The present findings show that VR exposure using multisensory stimulation differently affected leg vs body ownership, and is associated with mild analgesia with potential for SCI neurorehabilitation protocols.