Hendrik Christiaan Dijkerman

Tactile body image disturbance in anorexia nervosa

Body image disturbances are central to anorexia nervosa (AN). Previous studies have focused mainly on attitudinal and visual aspects. Studies on somatosensory aspects thus far have been scarce. We therefore investigated whether AN patients and controls differed in tactile perception, and how this tactile body image related to visual body image and body dissatisfaction. The Tactile Estimation Task (TET) measured tactile body image: Two tactile stimuli were applied to forearm and abdomen, and, while blindfolded, participants estimated the distance between the two tactile stimuli between their thumb and index finger. The Distance Comparison Task (DCT) measured visual body image. Compared to controls (n=25), AN patients (n=20) not only visualized their body less accurately, but also overestimated distances between tactile stimuli on both the arm and abdomen, which might reflect a disturbance in both visual and tactile body image. High levels of body dissatisfaction were related to more severe inaccuracies in the visual mental image of the body, and overestimation of tactile distances. Our results imply that body image disturbances in AN are more widespread than previously assumed as they not only affect visual mental imagery, but also extend to disturbances in somatosensory aspects of body image.

Aberrant somatosensory perception in Anorexia Nervosa

Anorexia Nervosa (AN) patients have a disturbed experience of body size and shape. Previously it has been shown that these body representation disturbances extend to enlarged perception of tactile distances. Here we investigated whether misperception of tactile size could be related to inaccurate elementary somatosensory perception. Tactile size perception was measured with the Tactile Estimation Task (TET) (see Keizer et al., 2011). Elementary somatosensory perception was assessed with a pressure detection task and two point discrimination (TPD). Compared to controls (n=28), AN patients (n=25) overestimated tactile size, this effect was strongest for the abdomen. Elementary tactile perception deviated in AN as well: Patients had a lower threshold for detecting pressure on their abdomen, and a higher threshold for TPD on both the arm and abdomen. Regression results implied that group membership predicted tactile size estimation on the arm. Both group membership and TPD predicted tactile size estimation on the abdomen. Our results show that AN patients have a disturbance in the metric properties of the mental representation of their body as they overestimate the size of tactile stimuli compared to controls. Interestingly, AN patients and controls differ in elementary somatosensory perception as well. However, this could not solely explain misperception of tactile distances, suggesting that both bottom-up and top-down processes are involved.

The role of self-touch in somatosensory and body representation disorders after stroke

Somatosensory impairments occur in about half of the cases of stroke. These impairments range from primary deficits in tactile detection and the perception of features, to higher order impairments in haptic object recognition and bodily experience. In this paper, we review the influence of active- and self-touch on somatosensory impairments after stroke. Studies have shown that self-touch improves tactile detection in patients with primary tactile deficits. A small number of studies concerned with the effect of self-touch on bodily experience in healthy individuals have demonstrated that self-touch influences the structural representation of ones own body. In order to better understand the effect of self-touch on body representations, we present an informal study of a stroke patient with somatoparaphrenia and misoplegia. The role of self-touch on body ownership was investigated by asking the patient to stroke the impaired left hand and foreign hands. The patient reported ownership and a change in affect over all presented hands through self-touch. The time it took to accomplish ownership varied, based on the resemblance of the foreign hand to the patients own hand. Our findings suggest that self-touch can modulate impairments in body ownership and affect, perhaps by helping to reinstate the representation of the body.

Interference of grasping observation during prehension, a behavioural study.

During the last 10xa0years a considerable number of neurophysiological and functional imaging studies have provided evidence that observation and execution of movements activate common representations. Furthermore, several behavioural studies suggest that action observation can influence the performance of movements. Recently it was shown that viewing incongruent movements interferes with the execution of non-object oriented sinusoidal arm movements (Kilner et al. in Curr Biol 13:522–525, 2003). In the current study, we investigated whether interference of action observation also occurs during goal-directed prehension movements. Participants were required to grasp cubes of different sizes while simultaneously observing an actor performing grasping or pointing movements. The actors’ movement could be directed at objects that were identical, or different in size to the cube grasped by the participant. The results showed that maximum grip aperture was affected by observation of grasping towards larger objects. No effect of object size was found during observation of pointing movements. These results suggest that observation of grasping movements can interfere with the on-line control of prehension movements and provides further evidence for overlapping networks for grasping observation and execution.

The influence of object identity on obstacle avoidance reaching behaviour

When reaching for target objects, we hardly ever collide with other objects located in our working environment. Behavioural studies have demonstrated that the introduction of non-target objects into the workspace alters both spatial and temporal parameters of reaching trajectories. Previous studies have shown the influence of spatial object features (e.g. size and position) on obstacle avoidance movements. However, obstacle identity may also play a role in the preparation of avoidance responses as this allows prediction of possible negative consequences of collision based on recognition of the obstacle. In this study we test this hypothesis by asking participants to reach towards a target as quickly as possible, in the presence of an empty or full glass of water placed about half way between the target and the starting position, at 8 cm either left or right of the virtual midline. While the spatial features of full and empty glasses of water are the same, the consequences of collision are clearly different. Indeed, when there was a high chance of collision, reaching trajectories veered away more from filled than from empty glasses. This shows that the identity of potential obstacles, which allows for estimating the predicted consequences of collision, is taken into account during obstacle avoidance.

Peripersonal space boundaries around the lower limbs

Neurophysiological investigations in non-human primates have shown that bi- and tri-modal fronto-parietal neurons exist that respond to touch on the body and visual (and/or auditory) stimuli near the body. The receptive fields of these neurons extend into space around the body, producing a zone wherein multisensory information is readily integrated. This space around the body, known as peripersonal space (PPS), has also been investigated behaviourally in humans. Some studies have focused on how far into depth the spatial boundaries of PPS extend. Most of these investigations have focused on the upper body (e.g., hands, face, trunk), while little is known about the size of PPS for the lower body (i.e. legs and feet). Thus, the aim of the current study was to delineate a PPS boundary around the lower limbs in healthy participants using a multisensory interaction task. Participants made speeded responses to the presence of vibrations applied to the toes while a task-irrelevant visual stimulus approached towards (Experiment 1) or receded from (Experiment 2) the feet. Participants responded significantly faster to tactile stimuli when the visual stimulus was within approximately 73xa0cm from the feet, but only when it approached (and not receded from) the legs. This is the first study, to our knowledge, to outline the size of PPS for the lower limbs. These findings could provide insight into the mechanisms underlying multisensory integration in the lower limbs, and add to the current body of knowledge on PPS representations.

Prism adaptation changes the subjective proprioceptive localization of the hands

Prism adaptation involves a proprioceptive, a visual and a motor component. As the existing paradigms are not able to distinguish between these three components, the contribution of the proprioceptive component remains unclear. In the current study, a proprioceptive judgement task, in the absence of motor responses, was used to investigate how prism adaptation would specifically influences the felt position of the hands in healthy participants. The task was administered before and after adaptation to left and right displacing prisms using either the left or the right hand during the adaptation procedure. The results appeared to suggest that the prisms induced a drift in the felt position of the hands, although the after-effect depended on the combination of the pointing hand and the visual deviation induced by prisms. The results are interpreted as in line with the hypothesis of an asymmetrical neural architecture of somatosensory processing. Moreover, the passive proprioception of the hand position revealed different effects of proprioceptive re-alignment compared to active pointing straight ahead: different mechanisms about how visuo-proprioceptive discrepancy is resolved were hypothesized.

The man who lost his body: Suboptimal multisensory integration yields body awareness problems after a right temporoparietal brain tumour

Reports on patients who lack ownership over their entire body are extremely rare. Here, we present patient SA who suffered from complete body disownership after a tumour resection in the right temporoparietal cortex. Neuropsychological assessment disclosed selective bilateral ownership problems, despite intact primary visual and somatosensory senses. SAs disownership seems to stem from a suboptimal multimodal integration, as shown by the rubber hand illusion and the beneficial effect during and after simple exercises aiming at multisensory recalibration.

Body representation does not lag behind in updating for the pubertal growth spurt

Both making perceptual judgments about your own body and successfully moving your body through the world depend on a mental representation of the body. However, there are indications that moving might be challenging when your body is changing. For instance, the pubertal growth spurt has been reported to be negatively correlated to motor competence. A possible explanation for this clumsiness would be that when the body is growing fast, updating the body representation may lag behind, resulting in a mismatch between internal body representation and actual body size. The current study investigated this hypothesis by testing participants ranging from aged 6 to 50u202fyears on both a tactile body image task and a motor body schema task. Separate groups of participants, including those in the age range when pubertal growth spurt occurs, were asked to estimate the distance between two simultaneously applied tactile stimuli on the arm and to move their hand through apertures of different widths. Tactile distance estimations were equal between participants before, during, and after the age range where the pubertal growth spurt is expected. Similarly, Bayesian evaluation of informative hypotheses showed that participants in the age range of the growth spurt did not move through the apertures as if their representation of the hand was smaller than its physical size. These results suggest that body representations do not lag behind in updating for the pubertal growth spurt.

Body ownership and the absence of touch: approaching the rubber hand inside and outside peri-hand space

It is widely accepted that the integration of visual and tactile information is a necessity to induce ownership over a rubber hand. This idea has recently been challenged by Ferri et al. (Proc R Soc B 280:1–7, 2013), as they found that sense of ownership was evident by mere expectation of touch. In our study, we aimed to further investigate this finding, by studying whether the mere potential for touch yields a sense of ownership similar in magnitude to that resulting from actually being touched. We conducted two experiments. In the first experiment, our set-up was the classical horizontal set-up (similar to Botvinick and Cohen, Nature 391:756, 1998). Sixty-three individuals were included and performed the classical conditions (synchronous, asynchronous), an approached but not touched (potential for touch), and a ‘visual only’ condition. In the second experiment, we controlled for differences between the current set-up and the vertical set-up used by Ferri et al. (Proc R Soc B 280:1–7, 2013). Fifteen individuals were included and performed a synchronous and various approaching conditions [i.e., vertical approach, horizontal approach, and a control approach (no hands)]. In our first experiment, we found that approaching the rubber hand neither induced a larger proprioceptive drift nor a stronger subjective sense of ownership than asynchronous stimulation did. Generally, our participants gained most sense of ownership in the synchronous condition, followed by the visual only condition. When using a vertical set-up (second experiment), we confirmed previous suggestions that tactile expectation was able to induce embodiment over a foreign hand, similar in magnitude to actual touch, but only when the real and rubber hand were aligned on the vertical axis, thus along the trajectory of the approaching stimulus. These results indicate that our brain uses bottom-up sensory information, as well as top-down predictions for building a representation of our body.