Dieter Kleinböhl

Action and perception in the rubber hand illusion

Voluntary motor control over artificial hands has been shown to provoke a subjective incorporation of the artificial limb into body representations. However, in most studies projected or mirrored images of own hands were presented as ‘artificial’ body parts. Using the paradigm of the rubber hand illusion (RHI), we assessed the impact of tactile sensations and voluntary movements with respect to an unambiguously body-extraneous, artificial hand. In addition to phenomenal self-reports and pointing movements towards the own hand, we introduced a new procedure for perceptual judgements enabling the assessment of proprioceptive drift and judgement reliability regarding perceived hand location. RHI effects were comparable for tactile sensations and voluntary movements, but characteristic discrepancies were found for pointing movements. They were differently affected by the induction methods, and RHI effects were uncorrelated between both methods. These observations shed new light on inconsistent results concerning RHI effects on motor responses.

Subclinical hyperthyroidism: Physical and mental state of patients

SummaryWe investigated whether subclinical hyperthyroidism [subnormal basal thyroid-stimulating hormone (TSH) level, attenuated TSH response to thyrotropin-releasing hormone (TRH) stimulation, peripheral thyroid hormones within normal range] is accompanied by physical and mental changes. Thirty-five subclinically hyperthyroid patients (27 female, 8 male) were compared with 60 overtly hyperthyroid patients (51 female, 9 male) and with 28 euthyroid control patients (18 female, 10 male) with respect to physical symptoms, affective state, short-term memory, ability to concentrate and psychomotor performance. Patients with subclinical hyperthyroidism ranged between the other two groups. The major difference between controls and subclinically hyperthyroid patients was an increase in frequency of nervous symptoms and symptoms due to an increase of metabolic rate and thermal regulation changes. The major differences between subclinically hyperthyroid and overtly hyperthyroid patients were psychomotor impairment and symptoms of increased metabolic rate. Self-ratings of affective state tended to be similar in patients with subclinical and overt hyperthyroidism. The ability to concentrate and short-term memory were not impaired in any group. Symptoms in patients with subclinical hyperthyroidism probably result from central changes which lead to attenuated TSH responses to TRH, or from elevated but still normal thyroxine levels, which possibly enhance the effect of catecholamines.

Operant learning of perceptual sensitization and habituation is impaired in fibromyalgia patients with and without irritable bowel syndrome.

&NA; The important role of operant learning in the development and maintenance of chronic pain is widely recognized. A specific type of reinforcement based on the reduction of painful stimulation when a person’s perception changes in the desired direction has been termed intrinsic reinforcement of pain. In the present study, the role of intrinsic operant learning in chronic pain was tested in fibromyalgia (FM) patients with and without comorbid irritable bowel syndrome (IBS) compared with healthy persons. A previously established operant learning task was used to enhance perceptual sensitization or habituation through intrinsic reinforcement. In addition to subjective pain ratings, pain sensitivity was implicitly measured by a behavioral discrimination task. In accordance with the operant learning task, healthy participants learned enhanced perceptual sensitization and habituation, depending on the experimental condition. Whereas healthy persons learned perceptual changes according the experimental protocol, both patient groups failed to show normal operant perceptual learning: FM patients without IBS demonstrated sensitization learning comparable to that in healthy persons, but unexpectedly these patients learned even more pronounced sensitization in the habituation learning condition, contradicting the experimental protocol; FM patients with IBS demonstrated neither learning of enhanced sensitization nor enhanced habituation; no signs of differential operant learning were observable. Thus, operant perceptual learning was impaired in FM patients; whether learning of both enhanced perceptual sensitization and habituation was impaired depended on the presence of comorbid IBS and could not be explained by other clinical characteristics of the patients such as pain threshold, duration of pain, depressive symptoms, or anxiety. While healthy participants learned sensitization and habituation according to an operant task, FM patients without IBS showed enhanced sensitization and FM with IBS no learning.

Amantadine Sulfate Reduces Experimental Sensitization and Pain in Chronic Back Pain Patients

We investigated if established psychophysical measures of enhanced experimental sensitization in chronic musculoskeletal pain can be reduced by adjuvant treatment with a N-methyl-d-aspartate receptor antagonist, amantadine sulfate, and whether a reduction in sensitization might be accompanied by a concurrent improvement in clinical pain. Sensitization was evaluated by an experimental tonic heat model of short-term sensitization with concurrent subjective and behavioral psychophysical scaling. Twenty-six patients with chronic back pain were included in the randomized, double-blind, placebo-controlled study and received daily dosages of either placebo or 100 mg of amantadine sulfate during a 1-wk treatment. Participants completed quantitative sensory testing of pain thresholds and experimental sensitization before and after treatment and clinical pain ratings before, during, and after treatment. Experimental sensitization and clinical pain were reduced in patients receiving verum. Initially, experimental sensitization was enhanced in patients, with early sensitization at nonpainful intensities of contact heat and enhanced sensitization at painful intensities, as shown previously. After 1 wk of treatment, experimental sensitization was reduced with amantadine sulfate but not with placebo. We conclude that adjuvant chronic pain treatment with N-methyl-d-aspartate receptor antagonists might be beneficial for chronic pain if enhanced sensitization is involved and that the quantitative sensory test of temporal summation may be used to verify this.

Operant conditioning of enhanced pain sensitivity by heat–pain titration

Abstract Operant conditioning mechanisms have been demonstrated to be important in the development of chronic pain. Most experimental studies have investigated the operant modulation of verbal pain reports with extrinsic reinforcement, such as verbal reinforcement. Whether this reflects actual changes in the subjective experience of the nociceptive stimulus remained unclear. This study replicates and extends our previous demonstration that enhanced pain sensitivity to prolonged heat–pain stimulation could be learned in healthy participants through intrinsic reinforcement (contingent changes in nociceptive input) independent of verbal pain reports. In addition, we examine whether different magnitudes of reinforcement differentially enhance pain sensitivity using an operant heat–pain titration paradigm. It is based on the previously developed non‐verbal behavioral discrimination task for the assessment of sensitization, which uses discriminative down‐ or up‐regulation of stimulus temperatures in response to changes in subjective intensity. In operant heat–pain titration, this discriminative behavior and not verbal pain report was contingently reinforced or punished by acute decreases or increases in heat–pain intensity. The magnitude of reinforcement was varied between three groups: low (N1 = 13), medium (N2 = 11) and high reinforcement (N3 = 12). Continuous reinforcement was applied to acquire and train the operant behavior, followed by partial reinforcement to analyze the underlying learning mechanisms. Results demonstrated that sensitization to prolonged heat–pain stimulation was enhanced by operant learning within 1 h. The extent of sensitization was directly dependent on the received magnitude of reinforcement. Thus, operant learning mechanisms based on intrinsic reinforcement may provide an explanation for the gradual development of sustained hypersensitivity during pain that is becoming chronic.

Body posture affects tactile discrimination and identification of fingers and hands

It is an unresolved question whether the posture of single fingers relative to each other is represented in the brain within an external frame of reference. In two experiments, we investigated postural influences on the processing of tactile stimuli at fingers and hands. Healthy subjects received two simultaneous tactile stimuli at the fingertips while the fingers of both hands were either interleaved or not. In speeded response tasks, they were asked to discriminate (experiment 1) or to identify (experiment 2) the touched body parts, either regarding hand laterality or finger type. The results demonstrate that both finger discrimination and finger identification are influenced by body posture. We conclude that the assumption of a solely somatotopic representation of fingers is not tenable and that an external reference system must be available for the detection of single fingers. The results are discussed in terms of a mental segmentation of external space, based on body posture and task requirements.

The rubber hand illusion depends on a congruent mapping between real and artificial fingers

The rubber hand illusion (RHI), in which a visible artificial hand is touched (or moves) synchronously with the participants unseen own hand, indicates that body representations can undergo rapid changes. While several constraints for this illusion have been described, some reports highlight a remarkable flexibility of body representations, even contradicting a priori assumptions regarding body appearance and anatomy (e.g., the subjective embodiment of a third arm). Here we examine the impact of congruence between touches at (or movements of) the real and the artificial hand, as well as the role of predictability of touches (or movements). We implemented two versions of the RHI paradigm, based on passive tactile stimulation and active voluntary movements. The results show that (a) predictability does not modulate perceived embodiment, and that (b) congruent mapping between real and artificial fingers is a necessary condition for both the tactile and the motor RHI. Together with previously reported constraints for bodily illusions, these results are reduced to four principles, which determine subjective embodiment: temporal synchrony, congruence of mapping between real and artificial body parts, body unity and body shape.

Awareness is awareness is awareness? Decomposing different aspects of awareness and their role in operant learning of pain sensitivity

Regarding awareness as a consistent concept has contributed to the controversy about implicit learning. The present study emphasized the importance of distinguishing aspects of awareness in order to determine whether learning is implicit. By decomposing awareness into awareness of contingencies, of the procedure being a learning task, and of the reinforcing stimuli, it was demonstrated that implicit operant learning modulated pain sensitivity. All of these aspects of awareness were demonstrated to not be necessary for learning. Additionally, discrimination of contingencies was not necessary on different levels of processing as demonstrated by a verbal and a behavioral method. It was demonstrated that explicit cognitive processes about ones own behavior, impaired learning, even though these cognitions were not immediately related to the learning process. The results of this study are of special interest in the context of pain, since implicit operant learning can explain the gradual development of hypersensitivity in chronic pain.

Spatiotemporal integration in somatosensory perception: effects of sensory saltation on pointing at perceived positions on the body surface.

In the past, sensory saltation phenomena (Geldard and Sherrick, 1972) have been used repeatedly to analyze the spatiotemporal integration capacity of somatosensory and other sensory mechanisms by means of their psychophysical characteristic. The core phenomenon consists in a systematic mislocalization of one tactile stimulus (the attractee) toward another successive tactile stimulus (the attractant) presented at another location, increasing with shorter intervals. In a series of four experiments, sensory saltation characteristics were studied at the forearm and the abdomen. Participants reported the perceived positions of attractees, attractants, and reference stimuli by pointing. In general, saltation characteristics compared well to those reported in previous studies, but we were able to gain several new insights regarding this phenomenon: (a) the attractee–attractant interval did not exclusively affect the perceived attractee position, but also the perceived attractant position; (b) saltation characteristics were very similar at different body sites and orientations, but did show differences suggesting anisotropy (direction-dependency) in the underlying integration processes; (c) sensory saltation could be elicited with stimulation patterns crossing the body midline on the abdomen. In addition to the saltation-specific results, our experiments demonstrate that pointing reports of perceived positions on the body surface generally show pronounced systematic biases compared to veridical positions, moderate intraindividual consistency, and a high degree of inter-individual variability. Finally, we address methodological and terminological controversies concerning the sensory saltation paradigm and discuss its possible neurophysiological basis.

A new device to present textured stimuli to touch with simultaneous EEG recording

The study of touch has recently grown, due mainly to the extensive use of several types of actuators that stimulate several subsystems of touch. There is a widespread interest in applying these mechanisms to the study of the neurophysiological correlates of tactual perception. In this article, we present a new device (the tactile spinning wheel [TSW]) for delivering textured surfaces to the finger pad. The TSW allows one to control several parameters of the stimulation (angular speed, texture, etc.) and, connected to an EEG recording system, makes it possible to study neural electrophysiological events. The device consists of a rotating platform on which the tactile stimuli are fixed, a system that synchronizes stimuli onset with the EEG system, and an electronic interface that controls the platform. We present the technical details of the TSW, its calibration, and some experimental results we have obtained with this device.