Claudia Denke

A neural substrate for nonpainful phantom limb phenomena.

&NA; Activity in the cerebral cortex associated with non‐painful phantom limb sensation was studied in 14 upper extremity amputees. In four subjects, repetitive tactile stimulation of the digits or the lower corner of the mouth elicited non‐painful phantom sensation in the amputated limb, in the remaining 10 patients no sensation could be evoked. Neuroelectric source imaging revealed significantly elevated activity in SI and posterior parietal cortex, and significantly decreased activity in ipsilateral SII cortex when referred sensations were present. However, nonpainful referred phantom sensations were not associated with a shift of the cortical representation of the mouth into the hand region, as previously suggested. Non‐painful phantom limb experiences seem to have widely distributed neural networks in multiple cortical regions.

Retracted: Physical Activity within a CBT Intervention Improves Coping with Pain in Traumatized Refugees: Results of a Randomized Controlled Design

OBJECTIVEnMany traumatized refugees experience both posttraumatic stress disorder and chronic pain. Based on Mutual Maintenance Theory and the Perpetual Avoidance Model, this study examined the additional effect of physical activity within a biofeedback-based cognitive behavioral therapy (CBT-BF) for traumatized refugees.nnnDESIGNnIn a controlled design, 36 patients were randomized into one of three conditions (CBT-BF, CBT-BF with physical activity [CBT-BF+active], and a waiting list control group [WL]). Thirty patients (n=10 in each group) completed the treatment and a follow-up assessment 3 months later. Participants coping strategies, pain and mental health status, and physiological reactivity were assessed before and after the intervention and at 3-month follow-up. Treatment effects were analyzed using analyses of variance with baseline scores as covariates (ANCOVAs) and the Reliable Change Index.nnnRESULTSnThe CBT-BF and CBT-BF+active groups showed improvements in all outcome measures relative to the WL group. The effect sizes for the main outcome measures were higher in the CBT-BF+active group than in the CBT-BF group. Repeated measures analyses of covariance showed significant group effects for coping strategies--in particular, for the cognitive restructuring and counter-activities subscales as well as a marginally significant group effect for perceived self-competence--with the CBT-BF+active group showing more favorable outcomes than the CBT-BF group. Moreover, 60% of participants in the CBT-BF+active group showed clinically reliable intraindividual change in at least one subscale of the pain coping strategies questionnaire, compared with just 30% of participants in the CBT-BF group.nnnCONCLUSIONnFindings of improved coping strategies, larger effect sizes, and higher rates of clinical improvement in the CBT-BF+active group suggest that physical activity adds value to pain management interventions for traumatized refugees. Given the small sample size, however, these preliminary results need replication in a larger trial.

Biofeedback for pain management in traumatised refugees

Chronic pain (CP) and posttraumatic stress disorder (PTSD) are both frequent and often comorbid in refugees. To date, few controlled trials have studied the efficacy of treatments targeting this comorbidity; no treatment guidelines yet exist. The authors examined the feasibility and efficacy of short-term cognitive behavioural biofeedback (BF) addressing CP in traumatised refugees. The sample comprised 11 severely traumatised refugees with CP and PTSD (mean age = 36 years, SD = 6), who underwent assessment with the Mini International Neuropsychiatric Interview, Posttraumatic Diagnostic Scale, Pain Disability Index, and Visual Rating Scale. Additionally, coping with pain and psychotherapy tolerance were assessed. Acceptance of BF was high. Pre-post effects were small to medium for increased pain management and associated heart rate reactivity but large for coping with pain. The results encourage further research to confirm whether BF is indicated as a treatment component, but not a stand-alone treatment, for traumatised refugees with comorbid CP and PTSD.

Lying and the Subsequent Desire for Toothpaste: Activity in the Somatosensory Cortex Predicts Embodiment of the Moral-Purity Metaphor

It is well known from literature and religious ceremonies that there is a link between physical cleansing and moral transgressions. Only recently, psychological experiments explored this association and demonstrated that a threat to moral purity increases the demand of physical cleansing. Moreover, it has been shown that physical cleansing is actually efficacious to cope with threatened morality. This so-called Macbeth effect has been explained by an embodiment of the moral-purity metaphor. We tested this hypothesis by means of an functional magnetic resonsce imaging (fMRI) experiment. Participants were instructed to enact scenarios including either an immoral act (lying) or a moral deed (telling the truth). Subsequently, the participants were asked to rate the desirableness of various products. Results revealed that participants rated cleansing products (but not other goods) more desirable after performing an immoral than after a moral act. This Macbeth effect was accompanied by an active cortical network including sensorimotor brain areas during rating of cleansing products (but not while evaluating noncleansing goods). The results demonstrate neurobiological evidence for an embodiment of the moral-purity metaphor. Thus, abstract thoughts about morality can be grounded in sensory experiences.

Rough primes and rough conversations: evidence for a modality-specific basis to mental metaphors

How does our brain organize knowledge? Traditional theories assume that our knowledge is represented abstractly in an amodal conceptual network of formal logic symbols. The theory of embodied cognition challenges this view and argues that conceptual representations that constitute our knowledge are grounded in sensory and motor experiences. We tested this hypothesis by examining how the concept of social coordination is grounded metaphorically in the tactile sensation of roughness. Participants experienced rough or smooth touch before being asked to judge an ambiguous social interaction. Results revealed that rough touch made social interactions appear more difficult and adversarial, consistent with the rough metaphor. This impact of tactile cues on social impressions was accompanied by a network including primary and secondary somatosensory cortices, amygdala, hippocampus and inferior prefrontal cortex. Thus, the roughness of tactile stimulation affected metaphor-relevant (but not metaphor-irrelevant) behavioral and neural responses. Receiving touch from a rough object seems to trigger the application of associated ontological concepts (or scaffolds) even for unrelated people and situations (but not to unrelated or more general feelings). Since this priming was based on somatosensory brain areas, our results provide support for the theory that sensorimotor grounding is intrinsic to cognitive processes.

Belief in a just world is associated with activity in insula and somatosensory cortices as a response to the perception of norm violations

Previous studies identified a network of brain regions involved in the perception of norm violations, including insula, anterior cingulate cortex (ACC), and right temporoparietal junction area (RTPJ). Activations in these regions are suggested to reflect the perception of norm violations and unfairness. The current study aimed to test this hypothesis by exploring whether a personal disposition to perceive the world as being just is related to neural responses to moral evaluations. The just-world-hypothesis describes a cognitive bias to believe in a just world in which everyone gets what he or she deserves and deserves what he or she gets. Since it has been demonstrated that ACC, RTPJ, and insula are involved in the perception of unfairness, we hypothesized that individual differences in the belief in a just world are reflected by different activations of these brain areas. Participants were confronted with scenarios describing norm-violating or -confirming behavior. FMRI results revealed an activation of dorsal ACC, RTPJ, and insula when perceiving norm violations, but only activity in insula/somatosensory cortex correlated with the belief in a just world. Thus, our results suggest a role for insula/somatosensory cortex for the belief in a just world.

Mirror-like brain responses to observed touch and personality dimensions

The last years have shown a growing interest in research on the neural mechanisms for perceiving and understanding social interactions. Only very recently, a role for somatosensation in social perception has been suggested. Numerous studies reported vicarious responses in the primary somatosensory cortex (SI) and other areas merely when seeing others being touched. Moreover, it has been demonstrated that these vicarious somatosensory responses can be linked with inter-individual differences in empathy. However, beyond empathy other personality traits have been shown to interact with social perception and behavior. Here we tested if personality traits according to the Five-Factor-Model interact with vicarious activation in somatosensory brain regions. We conducted a functional magnetic resonance imaging (fMRI) study in which subjects viewed video clips showing simple non-painful touch to a hand and a control condition including the same visual and motion parts. Results revealed vicarious somatosensory activation when viewing the touched hand, as expected. Vicarious activation in SI showed a trend for a positive correlation with the personality trait openness to experience. Moreover, mirror-like responses in the insula were strongly correlated with the personality trait conscientiousness, suggesting links to processes of self-control. We conclude that vicarious brain responses to seen touch seem to interact with personality traits.

Dirty deeds and dirty bodies: Embodiment of the Macbeth effect is mapped topographically onto the somatosensory cortex

The theory of embodied cognition claims that knowledge is represented in modal systems derived from perception. Recent behavioral studies found evidence for this hypothesis, for example, by linking moral purity with physical cleansing (the Macbeth effect). Neurophysiological approaches provided further support by showing an involvement of sensorimotor cortices for embodied metaphors. However, the exact role of this brain region for embodied cognitions remains to be cleared. Here we demonstrate that the involvement of the sensorimotor cortex for the embodied metaphor of moral-purity is somatotopically organized. Participants enacted in scenarios where they had to perform immoral or moral acts either with their mouths or their hands. Results showed that mouthwash products were particularly desirable after lying in a voice mail and hand wash products were particularly desirable after writing a lie, thus demonstrating that the moral-purity metaphor is specific to the sensorimotor modality involved in earlier immoral behavior. FMRI results of this interaction showed activation in sensorimotor cortices during the evaluation phase that was somatotopically organized with respect to preceding lying in a voice mail (mouth-area) or in a written note (hand-area). Thus, the results provide evidence for a central role of the sensorimotor cortices for embodied metaphors.

Communicative versus Strategic Rationality: Habermas Theory of Communicative Action and the Social Brain

In the philosophical theory of communicative action, rationality refers to interpersonal communication rather than to a knowing subject. Thus, a social view of rationality is suggested. The theory differentiates between two kinds of rationality, the emancipative communicative and the strategic or instrumental reasoning. Using experimental designs in an fMRI setting, recent studies explored similar questions of reasoning in the social world and linked them with a neural network including prefrontal and parietal brain regions. Here, we employed an fMRI approach to highlight brain areas associated with strategic and communicative reasoning according to the theory of communicative action. Participants were asked to assess different social scenarios with respect to communicative or strategic rationality. We found a network of brain areas including temporal pole, precuneus, and STS more activated when participants performed communicative reasoning compared with strategic thinking and a control condition. These brain regions have been previously linked to moral sensitivity. In contrast, strategic rationality compared with communicative reasoning and control was associated with less activation in areas known to be related to moral sensitivity, emotional processing, and language control. The results suggest that strategic reasoning is associated with reduced social and emotional cognitions and may use different language related networks. Thus, the results demonstrate experimental support for the assumptions of the theory of communicative action.

A Case of Right Alien Hand Syndrome Coexisting with Right-Sided Tactile Extinction.

The alien hand syndrome (AHS) is a fascinating movement disorder. Patients with AHS experience one of their limbs as alien, which acts autonomously and performs meaningful movements without being guided by the intention of the patient. Here, we report a case of a 74-years old lady diagnosed with an atypical Parkinson syndrome by possible corticobasal degeneration. The patient stated that she could not control her right hand and that she felt like this hand had her own life. We tested the patient for ownership illusions of the hands and general tactile processing. Results revealed that when blindfolded, the patient recognized touch to her alien hand only if it was presented separated from touch to the other hand (bilateral asynchronous touch). Delivering touch synchronously to both the alien and the healthy hand resulted in failure of recognizing touch to the alien hand (bilateral synchronous touch). Thus, AHS here co-existed with right-sided tactile extinction and is one of only very few cases in which the alien hand was felt on the right side. We discuss the results in the light of recent research on AHS.