The phantom head

Grey matter volume predicts improvement in geriatric depression in response to Tai Chi compared to Health Education

OBJECTIVES

Geriatric depression (GD) is associated with cognitive impairment and brain atrophy. Tai-Chi-Chih (TCC) is a promising adjunct treatment to antidepressants. We previously found beneficial effects of TCC on resting state connectivity in GD. We now tested the effect of TCC on gray matter volume (GMV) change and the association between baseline GMV and clinical outcome.

PARTICIPANTS

Forty-nine participants with GD (>=60 y) underwent antidepressant treatment (38 women).

INTERVENTION

Participants completed 3 months of TCC (N = 26) or health and wellness education control (HEW; N = 23).

MEASUREMENTS

Depression and anxiety symptoms and MRI scans were acquired at baseline and 3-month follow-up. General linear models (GLMs) tested group-by-time interactions on clinical scores. Freesurfer 6.0 was used to process T1-weighted images and to perform voxel-wise whole-brain GLMs of group on symmetrized percent GMV change, and on the baseline GMV and symptom change association, controlling for baseline symptom severity. Age and sex served as covariates in all models.

RESULTS

There were no group differences in baseline demographics or clinical scores, symptom change from baseline to follow-up, or treatment-related GMV change. However, whole-brain analysis revealed that lower baseline GMV in several clusters in the TCC, but not the HEW group, was associated with larger improvements in anxiety. This was similar for right precuneus GMV and depressive symptoms.

CONCLUSIONS

While we observed no effect on GMV due to the interventions, baseline regional GMV predicted symptom improvements with TCC but not HEW. Longer trials are needed to investigate the long-term effects of TCC on clinical symptoms and neuroplasticity.

Age-related changes in visuo-proprioceptive processing in perceived body position

This study investigated age-related change in visuo-proprioceptive processing in the perceived body position using mirror hand/foot illusions, focusing on its temporal characteristics, its dependency on body parts, and its association with older adults’ fall risk. Either immediately or 15 s after the exposure to the mirror-induced inconsistency of visuo-proprioceptive signals regarding the right hand or foot position, participants performed a reaching task using the unseen, illusion-affected hand or foot. Results showed clear age group differences. Specifically, older adults exhibited larger reaching errors than younger adults in the hand condition, and after the 15 s delay in the foot condition. Further, the reaching errors were constant across time for older adults but decreased after the delay in young adults, regardless of the tested body part. Particularly, older adults’ risk of falling, which was assessed by the timed up-and-go test, was negatively correlated with the reduction of reaching error across time. This suggests that older adults, especially those with a high risk of falling, face difficulties in appropriately processing visual and proprioceptive information for body perception in accordance with their external environment.

Multisensory integration involved in the body perception of community-dwelling older adults

This study investigates how the multisensory integration in body perception changes with increasing age, and whether it is associated with older adults’ risk of falling. For this, the rubber hand illusion (RHI) and rubber foot illusion (RFI) were used. Twenty-eight community-dwelling older adults and 25 university students were recruited. They viewed a rubber hand or foot that was stimulated in synchrony or asynchrony with their own hidden hand or foot. The illusion was assessed by using a questionnaire, and measuring the proprioceptive drift and latency. The Timed Up and Go Test was used to classify the older adults into lower and higher fall-risk groups. No difference was observed in the RHI between the younger and older adults. However, several differences were observed in the RFI. Specifically, the older adults with a lower fall-risk hardly experienced the illusion, whereas those with a higher fall-risk experienced it with a shorter latency and no weaker than the younger adults. These results suggest that in older adults, the mechanism of multisensory integration for constructing body perception can change depending on the stimulated body parts, and that the risk of falling is associated with multisensory integration.

"Fake it till You Make it"! Contaminating Rubber Hands ("Multisensory Stimulation Therapy") to Treat Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a deeply enigmatic psychiatric condition associated with immense suffering worldwide. Efficacious therapies for OCD, like exposure and response prevention (ERP), are sometimes poorly tolerated by patients. As many as 25% of patients refuse to initiate ERP mainly because they are too anxious to follow exposure procedures. Accordingly, we proposed a simple and tolerable (immersive yet indirect) low-cost technique for treating OCD that we call “multisensory stimulation therapy.” This method involves contaminating a rubber hand during the so-called “rubber hand illusion” (RHI) in which tactile sensations may be perceived as arising from a fake hand. Notably, Jalal et al. (2015) showed that such fake hand contamination during the RHI provokes powerful disgust reactions in healthy volunteers. In the current study, we explored the therapeutic potential of this novel approach. OCD patients (n = 29) watched as their hidden real hand was being stroked together with a visible fake hand; either synchronously (inducing the RHI; i.e., the experimental condition; n = 16) or asynchronously (i.e., the control condition; n = 13). After 5 min of tactile stimulation, the rubber hand was contaminated with fake feces, simulating conventional exposure therapy. Intriguingly, results suggested sensory assimilation of contamination sensations into the body image via the RHI: patients undergoing synchronous stimulation did not report greater contamination sensations when the fake hand was initially contaminated relative to asynchronous stroking. But contrary to expectations, they did so after the rubber hand had been contaminated for 5 min, as assessed via disgust facial expressions (a secondary outcome) and in vivo exposure (upon discontinuing the illusion). Further, to our surprise, synchronous and asynchronous stroking induced an equally vivid and fast-emerging illusion, which helps explain why both conditions initially (5 min after initiating tactile stimulation) provoked contamination reactions of equal magnitude. This study is the first to suggest heightened malleability of body image in OCD. Importantly, it may pave the way for a tolerable technique for the treatment of OCD—highly suitable for poorly resourced and emergency settings, including low-income and developing countries with minimal access to high-tech solutions like virtual reality.

Interpersonal gargalesthesia

When someone touches, say, your upper arm, mirror neurons in your brain's area S2 fire. These neurons also fire when you merely watch another person being touched. However, you do not literally feel the touch from his arm on your own skin. Consistent with this view, we find when someone's arm is removed, he does start experiencing another's sensations [Ramachandran, V. S., & Brang, D. (2009)]. A congenital variant of this syndrome also exists, as in our subject TC. TC experienced referred touch, referred tickle in her axilla, and was able to tickle herself.

Owning the body in the mirror: The effect of visual perspective and mirror view on the full-body illusion

Mirrors allow us to view our own body from a third-person (observer) perspective. However, how viewing ourselves through a mirror affects central body representations compared with true third-person perspective is not fully understood. Across a series of experiments, multisensory full-body illusions were used to modulate feelings of ownership over a mannequin body that was viewed from a third-person perspective through a mirror, from a third-person perspective without a mirror, and from a first-person perspective. In contrast to non-mirror third-person perspective, synchronously touching the participant’s actual body and the mannequin body viewed in the mirror elicited strong feelings of ownership over the mannequin and increased physiological responses to the mannequin being threatened compared to the equivalent asynchronous (non-ownership) control condition. Subjective reports of ownership viewing the mannequin through a mirror were also statistically equivalent to those following the first-person perspective illusion. These findings suggest that mirrors have a special role for viewing the self. The results also support the importance of egocentric reference frames for body ownership and suggest that mirror reflections of one’s own body are related to peripersonal space, which enables updating of central body representations.

"I Feel Contaminated in My Fake Hand": Obsessive-Compulsive-Disorder like Disgust Sensations Arise from Dummy during Rubber Hand Illusion

Despite its theoretical and clinical interest, there are no experimental studies exploring obsessive-compulsive disorder (OCD)-like disgust sensations through using somatosensory illusions. Such illusions provide important clues to the nature and limits of multisensory integration and how the brain constructs body image; and may potentially inform novel therapies. One such effect is the rubber hand illusion (RHI) in which tactile sensations are referred to a rubber hand; if the experimenter simultaneously strokes a subject's occluded hand together with a visible fake hand, the subject starts experiencing the touch sensations as arising from the dummy. In this study, we explore whether OCD-like disgust may result from contamination of a dummy hand during the RHI; suggesting a possible integration of somatosensory and limbic inputs in the construction of body image. We predicted that participants would experience sensations of disgust, when placing a disgust stimulus (fake feces, vomit or blood) on the dummy hand after establishing the RHI. We found that 9 out of 11 participants experienced greater disgust during the synchronous condition (real hidden hand and fake hand are stroked in synchrony) compared to the asynchronous control condition (real hidden hand and fake hand are stroked in asynchrony); and on average such disgust was significantly greater during the synchronous condition compared to the asynchronous control condition, Z = 2.7, p = .008. These results argue against a strictly hierarchical modular approach to brain function and suggest that a four-way multisensory interaction occurs between vision, touch, proprioception on the one hand and primal emotions like disgust on the other. These findings may inform novel clinical approaches for OCD; that is, contaminating a dummy during the RHI could possibly be used as part of an in-vivo exposure-intervention for OCD.

The Butcher's Tongue Illusion

We report two experiments, based on a novel variant of the Rubber Hand Illusion (RHI), in which tactile stimulation is referred to an artificial (out-of-body) tongue. In the experiments reported here the participant's tongue was stimulated while they looked at a mirrored dummy tongue. On average, the participants agreed with the statement that they felt as if they had been touched in the location where they saw the rubber tongue being touched (experiment 1), thus demonstrating visual capture. When the external tongue was illuminated with a laser pointer (experiment 2), a significant proportion of the participants reported feeling either tactile or thermal stimulation on their own tongue. These results therefore demonstrate that the multisensory integration of visual, tactile, and proprioceptive information that gives rise to the RHI can be extended to the tongue (a body part that is rarely seen directly).

Familiarity promotes the blurring of self and other in the neural representation of threat

Neurobiological investigations of empathy often support an embodied simulation account. Using functional magnetic resonance imaging (fMRI), we monitored statistical associations between brain activations indicating self-focused threat to those indicating threats to a familiar friend or an unfamiliar stranger. Results in regions such as the anterior insula, putamen and supramarginal gyrus indicate that self-focused threat activations are robustly correlated with friend-focused threat activations but not stranger-focused threat activations. These results suggest that one of the defining features of human social bonding may be increasing levels of overlap between neural representations of self and other. This article presents a novel and important methodological approach to fMRI empathy studies, which informs how differences in brain activation can be detected in such studies and how covariate approaches can provide novel and important information regarding the brain and empathy.