Handedness modulates proprioceptive drift in the rubber hand illusion

Neural correlates of bilateral proprioception and adaptation with training

Bilateral proprioception includes the ability to sense the position and motion of one hand relative to the other, without looking. This sensory ability allows us to perform daily activities seamlessly, and its impairment is observed in various neurological disorders such as cerebral palsy and stroke. It can undergo experience-dependent plasticity, as seen in trained piano players. If its neural correlates were better understood, it would provide a useful assay and target for neurorehabilitation for people with impaired proprioception. We designed a non-invasive electroencephalography-based paradigm to assess the neural features relevant to proprioception, especially focusing on bilateral proprioception, i.e., assessing the limb distance from the body with the other limb. We compared it with a movement-only task, with and without the visibility of the target hand. Additionally, we explored proprioceptive accuracy during the tasks. We tested eleven Controls and nine Skilled musicians to assess whether sensorimotor event-related spectral perturbations in μ (8-12Hz) and low-β (12-18Hz) rhythms differ in people with musical instrument training, which intrinsically involves a bilateral proprioceptive component, or when new sensor modalities are added to the task. The Skilled group showed significantly reduced μ and low-β suppression in bilateral tasks compared to movement-only, a significative difference relative to Controls. This may be explained by reduced top-down control due to intensive training, despite this, proprioceptive errors were not smaller for this group. Target visibility significantly reduced proprioceptive error in Controls, while no change was observed in the Skilled group. During visual tasks, Controls exhibited significant μ and low-β power reversals, with significant differences relative to proprioceptive-only tasks compared to the Skilled group-possibly due to reduced uncertainty and top-down control. These results provide support for sensorimotor μ and low-β suppression as potential neuromarkers for assessing proprioceptive ability. The identification of these features is significant as they could be used to quantify altered proprioceptive neural processing in skill and movement disorders. This in turn can be useful as an assay for pre and post sensory-motor intervention research.

Relationship between pain and proprioception among individuals with rotator cuff-related shoulder pain

BACKGROUND

Individuals with rotator cuff-related shoulder pain (RCRSP) have altered proprioception. The relationship between shoulder pain and proprioception is not well understood.

PURPOSE

This study aimed to investigate the relationship between shoulder pain and proprioception.

STUDY DESIGN

This was a cross-sectional comparative study.

METHODS

Twenty-two participants with RCRSP (mean age 27.6 ± 4.8 years) and 22 matched pain-free participants (23.4 ± 2.5 years) performed two upper limb active joint position sense tests: (1) the Upper Limb Proprioception Reaching Test (PRO-Reach; reaching toward seven targets) in centimeters and (2) Biodex System at 90% of maximum internal rotation in degrees. Participants performed three memorization and three reproduction trials blindfolded. The proprioception error (PE) is the difference between the memorized and estimation trials. Pain levels were captured pre- and post-evaluation (11-point Likert Numerical Pain Rating Scale). Relationships between PE and pain were investigated using independent t-tests and Spearman rank correlations.

RESULTS

Overall, 22.7% RCRSP participants indicated an increase in pain following the PRO-Reach (X̅ increase of 1.4 ± 1.5 points), while 59% did so with the Biodex (X̅ increase of 2.3 ± 1.8 points), reflecting a clinically important increase in pain. Weak-to-moderate correlations between pain and PEs were found with the Biodex (r = 0.39-0.53) and weak correlations with the PRO-Reach (r = -0.26 to 0.38). Concerning PEs, no significant differences were found between groups with the Biodex (p = 0.32, effect size d = -0.31 [-0.90 to 0.29]). The RCRSP participants demonstrated lower PEs with the PRO-Reach in elevation compared to pain-free participants (global X̅ = 4.6 ± 1.2 cm vs 5.5 ± 1.5 cm; superior 3.8 ± 2.1 cm vs 5.7 ± 2.9 cm; superior-lateral nondominant targets 4.3 ± 2.2 cm vs 6.1 ± 2.8 cm; p = 0.02-0.05, effect size d = 0.72-0.74 [0.12-1.3]).

CONCLUSIONS

Individuals with RCRSP demonstrated better upper limb proprioception in elevation, suggesting a change to interoception (sensory reweighting) in the presence of pain.

Skin temperature changes in response to body ownership modulation vary according to the side of stimulation

A growing body of research has shown that a unilateral alteration in the sense of limb ownership is associated with the cooling of a limb's temperature. However, the recent emergence of contradictory results calls into question the existence of a relationship between this physiological reaction and the sense of body ownership. In the light of evidence that the malleability of the sense of hand ownership differs based on the preferential motor use of the hand to which the illusion is applied, one might observe the same lateralised pattern in the skin temperature cooling. In particular, if skin temperature change is a signature of body ownership, we expected a stronger illusion and reduction in skin temperature when altering ownership alteration of the left hand compared to the right hand in dextral individuals. To test this hypothesis, we selectively perturbated body ownership of the left or right hand in 24 healthy participants in different experimental sessions using the Mirror-Box Illusion (MBI) paradigm. Participants were asked to tap synchronously or asynchronously at a constant rhythm with their left and right index fingers against two parallel mirrors while looking at their reflected right/left hand. Skin temperature was measured before and after each MBI application, and explicit judgments of ownership and proprioceptive drift were collected. The results showed a consistent cooling of the hand's temperature only when the illusion was performed on the left hand. Proprioceptive drift exhibited the same pattern. In contrast, the explicit judgment of ownership of the reflected hand was similar across the two hands. These data provide evidence in favor of a specific laterality effect of the physiological response to an induced alteration of body part ownership. Moreover, they highlight the possibility of a direct link between proprioception and skin temperature.

Abrupt visibility modifications affect specific subjective (not objective) aspects of body ownership

The sense of body ownership builds on proper multisensory integration mechanisms. The Rubber-Hand Illusion (RHI) paradigm exploits a visuo-tactile multisensory conflict to induce illusory body ownership toward a fake hand, assessed by multidimensional subjective ratings and univocal objective measurements. Considering the controversy as to whether viewing the rubber hand is necessary or not to induce the illusion, we investigated the effects of targeted manipulations of visibility on subjective and objective aspects of the RHI. To this aim, we collected questionnaire and proprioceptive drift data from thirty participants receiving visuo-tactile stimulation in a setup that allowed for increasing and decreasing the visibility (illumination) of the rubber hand. We found that specific subjective ratings (Movement and Loss of Ownership) were sensitive to the interaction between rubber hand's visibility and illusory ownership. The interaction was not significant for the Embodiment subjective component and for the objective one (proprioceptive drift). Since different degrees of visibility did not differentially affect the RHI, these findings highlight that relatively abrupt changes in the visibility of the rubber hand can differentially impact subjective versus objective components of body ownership. This understanding may be critical for neuroscientific theories on the relationship between multisensory integration and body consciousness.

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.

EXPRESS: The Rubber Hand Illusion: Top-Down Attention Modulates Embodiment

The Rubber Hand Illusion (RHI) creates distortions of body ownership through multimodal integration of somatosensory and visual inputs. This illusion largely rests on bottom-up (automatic multisensory and perceptual integration) mechanisms. However, the relative contribution from top-down factors, such as controlled processes involving attentional regulation, remains unclear. Following previous work that highlights the putative influence of higher-order cognition in the RHI, we aimed to further examine how modulations of working memory load and task instructions—two conditions engaging top-down cognitive processes—influence the experience of the RHI, as indexed by a number of psychometric dimensions. Relying on exploratory factor analysis for assessing this phenomenology within the RHI, our results confirm the influence of higher-order, top-down mental processes. Whereas task instruction strongly modulated embodiment of the rubber hand, cognitive load altered the affective dimension of the RHI. Our findings corroborate that top-down processes shape the phenomenology of the RHI and herald new ways to improve experimental control over the RHI.

Decreased Tactile Sensitivity Induced by Disownership: An Observational Study Utilizing the Rubber Hand Illusion

The sense of body ownership, the feeling that one’s own body belongs to oneself, is generated from the integration of visual, tactile, and proprioceptive information. However, long-term non-use of parts of the body due to physical dysfunction caused by trauma or illness may disturb multisensory integration, resulting in a decreased sense of body ownership. The rubber hand illusion (RHI) is an experimental method of manipulating the sense of ownership (SoO). In this illusion, subjects feel as if the rubber hand in front of them were their own hand. The RHI elicits the disownership phenomenon; not only does the rubber hand feels like one’s own hand, but one’s own hand does not feel like one’s own hand. The decrease of ownership of one’s own body induced by the bodily illusion is accompanied by neurophysiological changes, such as attenuation of somatosensory evoked potential and decreases in skin temperature. If the loss of the SoO is associated with decreased neurophysiological function, the dysfunction of patients complaining of the loss of ownership can be exacerbated; appropriate rehabilitation prescriptions are urgently required. The present study attempted to induce a sense of disownership of subjects’ own hands using the RHI and investigated whether the tactile sensitivity threshold was altered by disownership. Via questionnaire, subjects reported a decrease of ownership after the RHI manipulation; at the same time, tactile sensitivity thresholds were shown to increase in tactile evaluation using the Semmes-Weinstein monofilaments test. The tactile detection rate changes before and after the RHI were negatively correlated with the disownership-score changes. These results show that subjects’ sense of disownership, that their own hands did not belong to them, led to decreases in tactile sensitivity. The study findings also suggest that manipulating of illusory ownership can be a tool for estimating the degree of exacerbation of sensory impairment in patients. Consideration of new interventions that optimize the sense of body ownership may contribute to new rehabilitation strategies for post-stroke sensory impairment.

The Influence of Hand Dominance in Wrist Fracture Post-Operative Functional Evaluation

Sensorimotor testing is used to measure outcomes in surgery, to document results of treatment and rehabilitation, and to compare results between surgeons, therapists, and institutions. When performing sensorimotor testing, failure to address dominant side differences may cause a bias in evaluation of outcomes. This study evaluated the effect of hand dominance on outcomes testing performed on patients following surgery for distal radius fractures (DRF). We hypothesized that the injured dominant hand will perform differently than the injured non-dominant hand. This is a retrospective study of patients following DRF treated surgically and evaluated in therapy. The patients were evaluated at fixed intervals: initially, at 6 weeks, and at 3 months post-surgery. Testing included grip strength, monofilaments, static and moving 2-point discrimination, Moberg testing, and stereognosis. Sixty patients included 46 (76.6%) females. Age averaged 62.1 (standard deviation: 16.9) years, and 54 were right-handed (90%). There were differences between dominant and non-dominant hand injury in 2 of 9 tests of sensibility for each time period, including little finger monofilament and Moberg testing initially, and moving 2-point discrimination in the little finger, monofilament testing of the thumb at 3 months. Both groups improved between initial and 3-month evaluation without differences in amount of improvement. Despite some significant differences in the applied tests between dominant and non-dominant injured hands, our results do not support correction for hand-dominance when using the described examinations in evaluating outcomes following DRF surgery.

Smartphone and the Self: Experimental Investigation of Self-Incorporation of and Attachment to Smartphones

Smartphones are a constant companion in everyday life. Interacting with a smartphone calls for a multimodal input and often leads to a multisensory output. Combining research in human-computer interaction (HCI) and psychology, the present research explored the idea that a smartphone is more than a smart object but represents an object to which people feel emotionally attached to and which is even perceived as a part or an extension of a person’s self. To this end, we used an established rubber hand illusion paradigm to experimentally induce body ownership experiences in young adults (n = 76) in a 4-level mixed-design study. Our results revealed that in contrast to a neutral control object participants indeed felt attached to a smartphone, perceived it as a part of themselves and felt the need to interact with the device. This was specifically pronounced when hedonic characteristics were evaluated as high and when its usage for social communication was highlighted during the experiment. Psychological mechanisms of the incorporation of technologies are discussed and connected to positive and negative effects of smartphone usage on human behavior, its implications for technology design and marketing.

Exploring the Interaction Between Handedness and Body Parts Ownership by Means of the Implicit Association Test

The experience of owning a body is built upon the integration of exteroceptive, interoceptive, and proprioceptive signals. Recently, it has been suggested that motor signals could be particularly important in producing the feeling of body part ownership. One thus may hypothesize that the strength of this feeling may not be spatially uniform; rather, it could vary as a function of the degree by which different body parts are involved in motor behavior. Given that our dominant hand plays a leading role in our motor behavior, we hypothesized that it could be more strongly associated with one’s self compared to its non-dominant counterpart. To explore whether this possible asymmetry manifests as a stronger implicit association of the right hand (vs left hand) with the self, we administered the Implicit Association Test to a group of 70 healthy individuals. To control whether this asymmetric association is human-body specific, we further tested whether a similar asymmetry characterizes the association between a right (vs left) animal body part with the concept of self, in an independent sample of subjects (N = 70, 140 subjects total). Our results revealed a linear relationship between the magnitude of the implicit association between the right hand with the self and the subject’s handedness. In detail, the strength of this association increased as a function of hand preference. Critically, the handedness score did not predict the association of the right-animal body part with the self. These findings suggest that, in healthy individuals, the dominant and non-dominant hands are differently perceived at an implicit level as belonging to the self. We argue that such asymmetry may stem from the different roles that the two hands play in our adaptive motor behavior.

Tactile information counteracts the attenuation of rubber hand illusion attributable to increased visuo-proprioceptive divergence

Sense of body ownership is an immediate and distinct experience of one's body as belonging to oneself. While it is well-recognized that ownership feelings emerge from the integration of visual and somatosensory signals, the principles upon which they are integrated are still intensely debated. Here, we used the rubber hand illusion (RHI) to examine how the interplay of visual, tactile, and proprioceptive signals is governed depending on their spatiotemporal properties. For this purpose, the RHI was elicited in different conditions varying with respect to the extent of visuo-proprioceptive divergence (i.e., the distance between the real and fake hands) and differing in terms of the availability and spatiotemporal complexity of tactile stimulation (none, simple, or complex). We expected that the attenuating effect of distance on illusion strength will be more pronounced in the absence of touch (when proprioception gains relatively higher importance) and absent in the presence of complex tactile signals. Additionally, we hypothesized that participants with greater proprioceptive acuity-assessed using an elbow joint position discrimination task-will be less susceptible to the illusion, but only under the conditions of limited tactile stimulation. In line with our prediction, RHI was attenuated at the farthest distance only when tactile information was absent or simplified, but the attenuation was effectively prevented by the use of complex tactile stimulation-in this case, RHI was comparably vivid at both distances. However, passive proprioceptive acuity was not related to RHI strength in either of the conditions. The results indicate that complex-structured tactile signals can override the influence of proprioceptive signals in body attribution processes. These findings extend our understanding of body ownership by showing that it is primarily determined by informative cues from the most relevant sensory domains, rather than mere accumulation of multisensory evidence.

Hand size representation in healthy children and young adults

Whereas we experience our body as a coherent volumetric object, the brain appears to maintain highly fragmented representations of individual body parts. Little is known about how body representations of hand size and shape are built and evolve during infancy and young adulthood. This study aimed to investigate the effect of hand side, handedness, and age on the development of central hand size representation. The observational study with comparison groups was conducted with 90 typically developing Belgian school children and young adults (48 male and 42 female; age range = 5.0-23.0 years; 49 left-handed and 41 right-handed). Participants estimated their hand size and shape using two different tasks. In the localization task, participants were verbally cued to judge the locations of 10 anatomical landmarks of an occluded hand. An implicit hand size map was constructed and compared with actual hand dimensions. In the template selection task, the explicit hand shape was measured with a depictive method. Hand shape indexes were calculated and compared for the actual, implicit, and explicit conditions. Participants were divided into four age groups (5-8 years, 9-10 years, 11-16 years, and 17-23 years). Implicit hand maps featured underestimation of finger length and overestimation of hand width, which is already present in the youngest children. Linear mixed modeling revealed no influence of hand side on finger length underestimation; nonetheless, a significant main effect of age (p = .001) was exposed. Sinistrals aged 11 to 16 years showed significantly less underestimation (p = .03) than dextrals of the same age. As for the hand shape, the implicit condition differed significantly with the actual and explicit conditions (p < .001). Again, the implicit shape index was subjected to handedness and age effects, with significant differences being found between sinistrals and dextrals in the age groups of 9 and 10 years (p = .029) and 11 to 16 years (p < .001). In conclusion, the implicit metric component of the hand representation in children and young adults is misperceived, featuring shortened fingers and broadened hands since a very young age. Crucially, the finger length underestimation increases with age and shows a different developmental trajectory for sinistrals and dextrals. In contrast, the explicit hand shape is approximately veridical and seems immune from age and handedness effects. This study confirms the dual character of somatoperception and establishes a point of reference for children and young adults.

Relationships Between Personality Features and the Rubber Hand Illusion: An Exploratory Study

The rubber hand illusion paradigm allows investigating human body ownership by inducing an illusion of owning a life-sized fake hand. Despite the wide consensus on the fact that integration of multisensory signals is the main interpretative framework of the rubber hand illusion, increasing amount of data show that additional factors might contribute to the emergence of the illusion and, in turn, explain the strong inter-individual differences of the illusory patterns. Here, we explored whether and how personality features contribute to the emergence of the illusion by administering to healthy participants the rubber hand illusion paradigm along with two well-known personality tests, i.e., the Personality Assessment Inventory (PAI) and the Rorschach test. Results showed that two Rorschach domains (i.e., "Perception and Thinking Problems" and "Self and Other Representation") were positively correlated with the illusory mislocalization of the own left hand toward the fake hand. Further analyses suggested that while the tendency to perceive unconventionally is related to mislocalizing the own hand toward the fake hand, the association of the RHI index and other personality features measured by the Rorschach remain uncertain. However, our findings in general suggest that personality features might have a role in the emergence of the rubber hand illusion. This, in turn, could explain the high inter-individual variability of the illusory effects.