The disembodied self:Using an experimental approach to study the neural correlates of dissociation

Peritraumatic dissociation, e.g. an out-of-body experience (OBE) during a traumatic event, is an established risk factor for post-traumatic stress disorder (PTSD). However, its neural basis is not yet well understood. Experimental neuroscience and lesion studies suggest that disrupted brain function in the temporo-parietal junction (TPJ), a critical hub for multisensory integration, is associated with such anomalous bodily experiences. To explore neural markers of disrupted embodiment, we investigated how a transcranial magnetic stimulation (TMS)-induced temporary inhibition of the TPJ affects 1) dissociative experiencing including susceptibility to OBEs, and 2) the brain network of body awareness in healthy participants. First, we tested the paradigm to manipulate bodily self-consciousness called the OBE illusion and threat-evoked changes in heart rate as objective marker of OBEs. Secondly, functional connectivity ! patterns and the OBE paradigm were assessed before and after TMS (n = 26) vs. sham TMS (n = 26). It was expected that a virtual lesion at the TPJ increases self-report dissociation, elicit stronger OBE sensations, and disrupt the brain network of body awareness (e.g. insula, posterior parietal cortex, premotor cortex). Results will be discussed within the framework of dissociative processing

Acquisition of ownership illusion with self-disownership in neurological patients

The multisensory regions in frontoparietal cortices play a crucial role in the sense of body and self. Disrupting this sense may lead to a feeling of disembodiment, or more generally, a sense of disownership. Experimentally, this altered consciousness disappears during illusory own-body perceptions, increasing the intensity of perceived ownership for an external virtual limb. In many clinical conditions, particularly in individuals with a discontinuous or absent sense of bodily awareness, the brain may effortlessly create a convincing feeling of body ownership over a surrogate body or body part. The immediate visual input dominates the current bodily state and induces rapid plastic adaptation that reconfigures the dynamics of bodily representation, allowing the brain to acquire an alternative sense of body and self. Investigating strategies to deconstruct the lack of a normal sense of bodily ownership, especially after a neurological injury, may aid the selection of appropriate clinical treatment

Consciousness and the rabbit holes of delirium.

Delirium is a common disorder in hospitalized older adults and the defining characteristic is a disturbance of consciousness. Unfortunately, there are currently no testable measures of consciousness as pertains to its disruption in delirium. Not surprisingly rates of recognition of delirium suffer. Arguably, a greater understanding of the quantum of consciousness may improve delirium diagnosis through better diagnostic tools. Candidate dimensions of consciousness derived from fields of psychology, psychiatry, and philosophy are discussed and relevance to delirium explored. Based upon existing literature in the field of consciousness we identify the pre-reflective state, experiential awareness, and functional networks as candidate sites that may be affected in delirium. Opportunities for clinical instrument development and how these tools can be tested are discussed. We conclude that consciousness content may not hold to a unitary measurement, but facets of its integrity that are impacted in delirium are open to further exploration. Disorders in pre-reflective status, experiential awareness, and functional networks may represent the measurable “rabbit holes” of consciousness disturbance

Peripersonal Space from a multisensory perspective: the distinct effect of the visual and tactile components of Visuo-Tactile stimuli

: Peripersonal Space (PPS) is defined as the space close to the body where all interactions between the individual and the environment take place. Behavioural experiments on PPS exploit multisensory integration, using Multisensory Visuo-Tactile stimuli (MVT), whose visual and tactile components target the same body part (i.e. the face, the hand, the foot). However, the effects of visual and tactile stimuli targeting different body parts on PPS representation are unknown, and the relationship with the RTs for Tactile-Only stimuli is unclear. In this study, we addressed two research questions: (1) if the MVT-RTs are independent of Tactile-Only-RTs and if the latter is influenced by time-dependency effects, and (2) if PPS estimations derived from MVT-RTs depend on the location of the Visual or Tactile component of MVTs. We studied 40 right-handed participants, manipulating the body location (right hand, cheek or foot) and the distance of administration. Visual and Tactile components targeted different or the same body parts and were delivered respectively at five distances. RTs to Tactile-Only trials showed a non-monotonic trend, depending on the delay of stimulus administration. Moreover, RTs to Multisensory Visuo-Tactile trials were found to be dependent on the Distance and location of the Visual component of the stimulus. In conclusion, our results show that Tactile-Only RTs should be removed from Visuo-Tactile RTs and that the Visual and Tactile components of Visuo-Tactile stimuli do not necessarily have to target the same body part. These results have a relevant impact on the study of PPS representations, providing new important methodological information

Acute stress affects peripersonal space representation in cortisol stress responders.

Peripersonal space is the representation of the space near the body. It is implemented by a dedicated multisensory-motor network, whose purpose is to predict and plan interactions with the environment, and which can vary depending on environmental circumstances. Here, we investigated the effect on the PPS representation of an experimentally induced stress response and compared it to a control, non-stressful, manipulation. We assessed PPS representation in healthy humans, before and after a stressful manipulation, by quantifying visuotactile interactions as a function of the distance from the body, while monitoring salivary cortisol concentration. While PPS representation was not significantly different between the control and experimental group, a relation between cortisol response and changes in PPS emerged within the experimental group. Participants who showed a cortisol stress response presented enhanced visuotactile integration for stimuli close to the body and reduced for far stimuli. Conversely, individuals with a less pronounced cortisol response showed a reduced difference in visuotactile integration between the near and the far space. In our interpretation, physiological stress resulted in a freezing-like response, where multisensory-motor resources are allocated only to the area immediately surrounding the body

Lysergic acid diethylamide (LSD) and Psilocybin for the Management of Patients with Persistent Pain: A Potential Role?

Recently, there has been interest in lysergic acid diethylamide (LSD) and psilocybin for depression, anxiety and fear of death in terminal illness. The aim of this review is to discuss the potential use of LSD and psilocybin for patients with persistent pain. LSD and psilocybin are 5-hydroxytryptamine receptor agonists and may interact with nociceptive and antinociceptive processing. Tentative evidence from a systematic review suggests that LSD (7 studies, 323 participants) and psilocybin (3 studies, 92 participants) may be beneficial for depression and anxiety associated with distress in life-threatening diseases. LSD and psilocybin are generally safe if administered by a healthcare professional, although further investigations are needed to assess their utility for patients with persistent pain, especially associated with terminal illnes