More implicit and more explicit motor imagery tasks for exploring the mental representation of hands and feet in action.

The mental representation of the body in action can be explored using motor imagery (MI) tasks. MI tasks can be allocated along a continuum going from more implicit to more explicit tasks, where the discriminant is the degree of action monitoring required to solve the tasks (which is the awareness of using the mental representation of our own body to monitor our motor imagery). Tasks based on laterality judgments, such as the Hand Laterality Task (HLT) and the Foot Laterality Task (FLT), provide an example of more implicit tasks (i.e., less action monitoring is required). While, an example of a more explicit task is the Mental Motor Chronometry task (MMC) for hands and feet, where individuals are asked to perform or imagine performing movements with their limbs (i.e., more action monitoring is required). In our study, we directly compared hands and feet at all these tasks for the first time, as these body districts have different physical features as well as functions. Fifty-five participants were asked to complete an online version of the HLT and FLT (more implicit measure), and an online version of the MMC task for hands and feet (more explicit measure). The mental representation of hands and feet in action differed only when the degree of action monitoring decreased (HLT ≠ FLT); we observed the presence of biomechanical constraints only for hands. Differently, when the degree of action monitoring increased hands and feet did not show any difference (MMC hands = MMC feet). Our results show the presence of a difference in the mental representation of hands and feet in action that specifically depends on the degree of action monitoring.

Cognitive Training Improves Disconnected Limbs' Mental Representation and Peripersonal Space after Spinal Cord Injury.

Paraplegia following spinal cord injury (SCI) affects the mental representation and peripersonal space of the paralysed body parts (i.e., lower limbs). Physical rehabilitation programs can improve these aspects, but the benefits are mostly partial and short-lasting. These limits could be due to the absence of trainings focused on SCI-induced cognitive deficits combined with traditional physical rehabilitation. To test this hypothesis, we assessed in 15 SCI-individuals the effects of adding cognitive recovery protocols (motor imagery-MI) to standard physical rehabilitation programs (Motor + MI training) on mental body representations and space representations, with respect to physical rehabilitation alone (control training). Each training comprised at least eight sessions administered over two weeks. The status of participants' mental body representation and peripersonal space was assessed at three time points: before the training (T0), after the training (T1), and in a follow-up assessment one month later (T2). The Motor + MI training induced short-term recovery of peripersonal space that however did not persist at T2. Body representation showed a slower neuroplastic recovery at T2, without differences between Motor and the Motor + MI. These results show that body and space representations are plastic after lesions, and open new rehabilitation perspectives.

Talking with hands: body representation in British Sign Language users.

Body representation (BR) refers to the mental representation of motor, sensory, emotional and semantic information about the physical body. This cognitive representation is used in our everyday life, continuously, even though most of the time we do not appreciate it consciously. In some cases, BR is vital to be able to communicate. A crucial feature of signed languages (SLs), for instance, is that body parts such as hands are used to communicate. Nevertheless, little is known about BR in SL: is the communicative function of the body overwriting the physical constraints? Here, we explored this question by comparing twelve British Sign Language (BSL) learners to seventeen tango dancers (body expertise but not for communication) and fourteen control subjects (no special body expertise). We administered the Body Esteem Scale (BES), the Hand Laterality Task (HLT) and the Mental Motor Chronometry (MMC). To control for visual imagery, we administered ad hoc control tasks. We did not identify parameters able to differentiate between SL users and the other groups, whereas the more implicit parameters distinguished clearly tango dancers from controls. Importantly, neither tasks on visual imagery nor the BES revealed differences. Our findings offer initial evidence that linguistic use of the body not necessarily influences the cognitive components we explored of body representation.

Mental representation of the body in action in Parkinson's disease.

Mixed findings characterize studies in Parkinson's disease (PD): some studies indicate a relationship between physical impairments and the ability to mentally represent the body, while others suggest spared abilities for this cognitive function. To clarify the matter, in the present study we explored the mental representations of the body in action in the same PD patients, taking also into account lateralization of symptoms and visual imagery skills. 10 PD patients with left- (lPD), 10 with right (rPD) lateralized symptoms (lPD), and 20 matched healthy controls have been recruited for the study. All patients were screened for neuropsychological impairments. To explore a more implicit component we used the hand laterality task (HLT), while the mental motor chronometry (MMC) was used to explore a more explicit one. Two control tasks, with objects instead of body parts, were administered to control for visual imagery skills. In the HLT, we detected the effects of biomechanical constraints effects in both controls and PD patients. In the latter group, importantly, this was true independently from lateralization of symptoms. In the MMC, we found the expected positive correlation between executed and imagined movements for both hands in controls only, while all PD patients, again independently form lateralization, only showed this effect for the left hand. In terms of visual imagery, only rPD patients differed from controls when asked to implicitly rotate letters, and in terms of accuracy only. However, this difference is explained by executive functions measured through the neuropsychological assessment rather than by a "pure" visual imagery impairment. In summary, our findings suggest that two different aspects of the mental representations of the body in action, one more implicit and the other more explicit, can be differently affected by PD. These impairments are unlikely explained by a basic visual imagery deficit. When present, impairments concern a higher dimension, related to motor functions and awareness, and not driven by sensory impairments, as shown by the independence of effects from physical laterality of symptoms.

Implicit Mental Motor Imagery Task Demonstrates a Distortion of the Body Schema in Patients With Eating Disorders.

OBJECTIVES: A rich body of literature has established the role of body image distortion and dissatisfaction in the development and maintenance of eating disorders. However, many of the currently used techniques require explicit comparison of the person's body to an external stimulus. As the body schema is a largely unconscious construct, explicit comparison tasks may reflect a proxy, rather than the body schema itself. METHODS: Here we use an implicit mental motor imagery (MMI) task to interrogate the body schema in healthy control participants (N=40) and participants at a residential eating disorder treatment center (N=42). By comparing the time it takes to imagine making a movement along a part of the body to the time it takes to actually make the same movement, we were able to assess participants' mental image of their body (i.e., body schema). RESULTS: We found that participants with eating disorders, but not healthy controls, exhibited distortions of the body schema such that they believed their abdomen, buttocks, and thighs to be larger than they really are. Additionally, the MMI task used here provided information above and beyond traditional self-report measures (i.e., Body Shape Questionnaire). Together the MMI task and traditional measures provide the most information. CONCLUSIONS: Findings using the novel MMI task are in line with the literature; participants with eating disorders consider themselves to be larger than they truly are. Taken together, results of this study suggest that MMI tasks provide complementary information to traditional self-report measures. (JINS, 2018, 24, 715-723).

Explaining body size beliefs in anorexia.

INTRODUCTION: Cognitive neuropsychiatry has had much success in providing theoretical models for the causal origins of many delusional beliefs. Recently, it has been suggested that some anorexia nervosa patients' beliefs about their own body size should be considered delusions. As such, it seems high time the methods of cognitive neuropsychiatry were turned to modelling the false body size beliefs of anorexics. METHODS: In this paper, I adopt an empiricist approach to modelling the causal origins of false body size beliefs in anorexia. Within the background of cognitive neuropsychiatry, empiricist models claim that abnormal beliefs are grounded by abnormal experiences bearing similar content. RESULTS: I discuss the kinds of abnormal experiences of body size anorexics suffer from which could ground their false beliefs about body size. These oversized experiences come in three varieties: false self-other body comparisons, spontaneous mental imagery of a fat body and distorted perception of affordances. CONCLUSIONS: Further theoretical and empirical research into the oversized experiences which anorexics suffer from presents a promising avenue for understanding and treating the disorder.

"Like the palm of my hands": Motor imagery enhances implicit and explicit visual recognition of one's own hands.

A key point in motor imagery literature is that judging hands in palm view recruits sensory-motor information to a higher extent than judging hands in back view, due to the greater biomechanical complexity implied in rotating hands depicted from palm than from back. We took advantage from this solid evidence to test the nature of a phenomenon known as self-advantage, i.e. the advantage in implicitly recognizing self vs. others' hand images. The self-advantage has been actually found when implicitly but not explicitly judging self-hands, likely due to dissociation between implicit and explicit body representations. However, such a finding might be related to the extent to which motor imagery is recruited during implicit and explicit processing of hand images. We tested this hypothesis in two behavioural experiments. In Experiment 1, right-handed participants judged laterality of either self or others' hands, whereas in Experiment 2, an explicit recognition of one's own hands was required. Crucially, in both experiments participants were randomly presented with hand images viewed from back or from palm. The main result of both experiments was the self-advantage when participants judged hands from palm view. This novel finding demonstrate that increasing the "motor imagery load" during processing of self vs. others' hands can elicit a self-advantage in explicit recognition tasks as well. Future studies testing the possible dissociation between implicit and explicit visual body representations should take into account the modulatory effect of motor imagery load on self-hand processing.

Projecting the self outside the body: Body representations underlying proprioceptive imagery.

Recent research has shown that proprioception relies on distorted representations of body size and shape. By asking participants to localise multiple landmarks on their occluded hand, perceptual maps of hand size and shape can be constructed and compared to actual hand structure. These maps are different from the actual size and shape of the occluded hand, revealing underestimation of finger length and overestimation of hand width. Here we tested whether the same distorted body model underlies proprioceptive imagery (i.e. imagining the hand at a specific location, and in a different posture than it actually is). In Experiment 1, participants placed their left hand under an occluding board (real condition) or imagined their left hand under the board (imagined condition). Highly similar distortions were found in both conditions. Furthermore, results across the two conditions were strongly correlated. In Experiment 2, participants completed the real condition and two imagined conditions. In the imagined-fist condition, participants held their left hand in a fist, in their lap, while in the imagined-flat condition, participants held their left hand flat, with palm down, in their lap. In both imagined conditions, participants were asked to imagine their left hand lying flat, with palm down, under the occluding board. A similar pattern of distortions was found in all three conditions. These results suggest that both proprioception and proprioceptive imagery reply on a common stored model of the body's metric properties.

[Mirror therapy for inflammatory rheumatic pain: Potentials and limitations]. / Spiegeltherapie bei entzündlich-rheumatischen Schmerzen: Potenzial und Grenzen.

BACKGROUND: Mirror therapy reduces chronic pain and might also be suitable for the treatment of inflammatory rheumatic pain. OBJECTIVES: On the basis of the relevant literature this article a) characterizes the universal alterations in body perception and body representation in chronic pain, b) describes the potential mechanisms underlying mirror therapy and c) discusses the chances of success of mirror therapy for the treatment of inflammatory rheumatic pain. MATERIAL AND METHODS: Literature search on the effectiveness and mechanisms of mirror therapy and derived procedures for the potential treatment of pain in inflammatory rheumatic disorders. RESULTS: There is evidence that mirror therapy can alleviate chronic pain experiences by correcting the accompanying distorted body perception as well as body representation by multimodal sensory stimulation. As there is probably a similar distortion in persons with chronic pain related to inflammatory rheumatic disorders, mirror therapy might also have positive effects in this field; however, the accompanying characteristics of these disorders, such as motor impairment and motor-evoked pain, may complicate the implementation of this kind of treatment. CONCLUSION: Mirror therapy represents an intervention with few side effects and might have positive effects on the experience of chronic pain in patients with inflammatory rheumatic disorders. Further clinical research is required in order to evaluate the potential of mirror therapy and associated interventional methods for the treatment of inflammatory rheumatic pain.

Tactile mental body parts representation in obesity.

Obese people׳s distortions in visually-based mental body-parts representations have been reported in previous studies, but other sensory modalities have largely been neglected. In the present study, we investigated possible differences in tactilely-based body-parts representation between an obese and a healthy-weight group; additionally we explore the possible relationship between the tactile- and the visually-based body representation. Participants were asked to estimate the distance between two tactile stimuli that were simultaneously administered on the arm or on the abdomen, in the absence of visual input. The visually-based body-parts representation was investigated by a visual imagery method in which subjects were instructed to compare the horizontal extension of body part pairs. According to the results, the obese participants overestimated the size of the tactilely-perceived distances more than the healthy-weight group when the arm, and not the abdomen, was stimulated. Moreover, they reported a lower level of accuracy than did the healthy-weight group when estimating horizontal distances relative to their bodies, confirming an inappropriate visually-based mental body representation. Our results imply that body representation disturbance in obese people is not limited to the visual mental domain, but it spreads to the tactilely perceived distances. The inaccuracy was not a generalized tendency but was body-part related.

Tool use imagery triggers tool incorporation in the body schema.

Tool-use has been shown to modify the way the brain represents the metrical characteristics of the effector controlling the tool. For example, the use of tools that elongate the physical length of the arm induces kinematic changes affecting selectively the transport component of subsequent free-hand movements. Although mental simulation of an action is known to involve -to a large extent- the same processes as those at play in overt motor execution, whether tool-use imagery can yield similar effects on the body representation remains unknown. Mentally simulated actions indeed elicit autonomic physiological responses and follow motor execution rules that are comparable to those associated with the correspondent overt performance. Therefore, here we investigated the effects of the mental simulation of actions performed with a tool on the body representation by studying subsequent free-hand movements. Subjects executed reach to grasp movements with their hand before and after an imagery task performed with either a tool elongating their arm length or, as a control, with their hand alone. Two main results were found: First, in agreement with previous studies, durations of imagined movements performed with the tool and the hand were similarly affected by task difficulty. Second, kinematics of free-hand movements was affected after tool-use imagery, but not hand-use imagery, in a way similar to that previously documented after actual tool-use. These findings constitute the first evidence that tool-use imagery is sufficient to affect the representation of the user's arm.

Spatial cognition, body representation and affective processes: the role of vestibular information beyond ocular reflexes and control of posture.

A growing number of studies in humans demonstrate the involvement of vestibular information in tasks that are seemingly remote from well-known functions such as space constancy or postural control. In this review article we point out three emerging streams of research highlighting the importance of vestibular input: (1) Spatial Cognition: Modulation of vestibular signals can induce specific changes in spatial cognitive tasks like mental imagery and the processing of numbers. This has been shown in studies manipulating body orientation (changing the input from the otoliths), body rotation (changing the input from the semicircular canals), in clinical findings with vestibular patients, and in studies carried out in microgravity. There is also an effect in the reverse direction; top-down processes can affect perception of vestibular stimuli. (2) Body Representation: Numerous studies demonstrate that vestibular stimulation changes the representation of body parts, and sensitivity to tactile input or pain. Thus, the vestibular system plays an integral role in multisensory coordination of body representation. (3) Affective Processes and Disorders: Studies in psychiatric patients and patients with a vestibular disorder report a high comorbidity of vestibular dysfunctions and psychiatric symptoms. Recent studies investigated the beneficial effect of vestibular stimulation on psychiatric disorders, and how vestibular input can change mood and affect. These three emerging streams of research in vestibular science are-at least in part-associated with different neuronal core mechanisms. Spatial transformations draw on parietal areas, body representation is associated with somatosensory areas, and affective processes involve insular and cingulate cortices, all of which receive vestibular input. Even though a wide range of different vestibular cortical projection areas has been ascertained, their functionality still is scarcely understood.