Virtual reality improves embodiment and neuropathic pain caused by spinal cord injury

Objective: To investigate changes in body ownership and chronic neuropathic pain in patients with spinal cord injury (SCI) using multisensory own body illusions and virtual reality (VR). Methods: Twenty patients with SCI with paraplegia and 20 healthy control participants (HC) participated in 2 factorial, randomized, repeated-measures design studies. In the virtual leg illusion (VLI), we applied asynchronous or synchronous visuotactile stimulation to the participant's back (either immediately above the lesion level or at the shoulder) and to the virtual legs as seen on a VR head-mounted display. We tested the effect of the VLI on the sense of leg ownership (questionnaires) and on perceived neuropathic pain (visual analogue scale pain ratings). We compared illusory leg ownership with illusory global body ownership (induced in the full body illusion [FBI]), by applying asynchronous or synchronous visuotactile stimulation to the participant's back and the back of a virtual body as seen on a head-mounted display. Results: Our data show that patients with SCI are less sensitive to multisensory stimulations inducing illusory leg ownership (as compared to HC) and that leg ownership decreased with time since SCI. In contrast, we found no differences between groups in global body ownership as tested in the FBI. VLI and FBI were both associated with mild analgesia that was only during the VLI specific for synchronous visuotactile stimulation and the lower back position. Conclusions: The present findings show that VR exposure using multisensory stimulation differently affected leg vs body ownership, and is associated with mild analgesia with potential for SCI neurorehabilitation protocols.

Multisensory and sensorimotor origins of the sense of self

Polona Pozeg

Cognitive neuroscience has increasingly focused on studying the subject, i.e. the self, of conscious experience. In order to be the subject of an experience, we generally experience owning a physical body, being located within that body, and being able to distinguish the body and its actions from others. These pre-reflective experiences are based on brain mechanisms of multisensory and sensorimotor integration. In this thesis I investigated how our sense of self, in particular the senses of body ownership and of agency, depend on multimodal bodily signals. I achieved this by using approaches developed by cognitive neuroscience to study how the sense of self relates to the processing of bodily signals: creating bodily illusions with multisensory conflicts through the use of virtual reality and robotics. The first part of this thesis describes the investigation of the sense of body ownership in healthy subjects and in spinal cord injury patients, achieved by inducing conflicts between tactile information and visual feedback. The research presented in the second part of the thesis is centered on the experience of self-touch. There, I have first investigated how the manipulation of reference frames influences the perception of the illusion of self-touch, and second, how active self-touch influences the sense of body ownership. Lastly, in the third part of the thesis, I investigated how experimentally induced multisensory and sensorimotor conflicts perturb the sense of self in healthy subjects and induce experiences similar to certain symptoms observed in neurological and psychiatric disorders. I show that particular conflicts between bodily signals not only affect body perception and sense of agency for motor actions but also propagate to higher levels and influence even the sense of agency for mental representations in healthy subjects. Finally, I discuss my results and their relation to existing knowledge on bodily self-consciousness and position them in a broader picture of our current understanding of the self.

EPFL2016

Multisensory and sensorimotor origins of the sense of self

Polona Pozeg

EPFL2016