Experimentally induced pain does not influence updating of peripersonal space and body representations following tool-use

This is the final version. Available from the publisher via the DOI in this record.The data is available on the Open Science Framework. URL: https://osf.io/4v938/. DOI: 10.17605/OSF.IO/4V938.Representations of the body and peripersonal space can be distorted for people with some chronic pain conditions. Experimental pain induction can give rise to similar, but transient distortions in healthy individuals. However, spatial and bodily representations are dynamic, and constantly update as we interact with objects in our environment. It is unclear whether induced pain disrupts the mechanisms involved in updating these representations. In the present study, we sought to investigate the effect of induced pain on the updating of peripersonal space and body representations during and following tool-use. We compared performance under three conditions (pain, active placebo, neutral) on a visuotactile crossmodal congruency task and a tactile distance judgement task to measure updating of peripersonal space and body representations, respectively. Consistent with previous findings, the difference in crossmodal interference from visual distractors in the same compared to opposite visual field to the tactile target was less when tools were crossed than uncrossed. This suggests an extension of peripersonal space to incorporate the tips of the tools. Also consistent with previous findings, estimates of the felt tactile distance judgements decreased after active tool-use. In contrast to our predictions, however, we found no evidence that pain interfered with performance on either task when compared to the control conditions. Our findings suggest that the updating of peripersonal space and body representations is not disrupted by induced pain. That is, experiencing acute pain does not give rise to distorted representations of the body and peripersonal space that can be present in people with chronic pain conditions.Medical Research Council (MRC

Altered updating of bodily and spatial representations following tool-use in complex regional pain syndrome

This is the author accepted manuscript. The final version is available from Lippincott, Williams & Wilkins via the DOI in this record.  Distorted representations of the body and peripersonal space are common in Complex Regional Pain Syndrome (CRPS), and might modulate its symptoms (e.g. asymmetric limb temperature). In pain-free people, such representations are malleable, and update when we interact with objects in our environment (e.g. during tool-use). Distortions are also common after immobilisation, but quickly normalise once movement is regained. We tested the hypothesis that people with CRPS have problems updating bodily and spatial representations, which contributes to the maintenance of their distorted representations by preventing normalization. We also explored spatially defined modulations of hand temperature asymmetries, and any influence of updating bodily and spatial representations on this effect. Thirty-six people with unilateral CRPS (18 upper limb, 18 lower limb) and 36 pain-free controls completed tool-use tasks considered to alter body and peripersonal space representations (measured using tactile distance judgements and a visuotactile crossmodal congruency task, respectively). We also tested how the arrangement (crossed, uncrossed) of the hands and tools affected hand temperature. In upper limb CRPS the non-affected arm representation updated normally, but the affected arm representation updated in the opposite to normal direction. A similar pattern was seen in lower limbs CRPS, although not significant. Furthermore, people with CRPS showed more pronounced updating of peripersonal space than the controls. We did not observe any modulation of hand temperature asymmetries by the arrangement of hands or tools. Our findings show enhanced malleability of bodily and spatial representations in CRPS, which may suggest that central mechanisms are altered in this condition.Medical Research Counci

Characterising sensorimotor adaptation in Complex Regional Pain Syndrome

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordData availability: Materials and data from this study are available at https://osf.io/6jpfg/files/It has been suggested that sensorimotor conflict contributes to the maintenance of some pathological pain conditions, implying that there are problems with the adaptation processes that normally resolve such conflict. We tested whether sensorimotor adaptation is impaired in people with Complex Regional Pain Syndrome (CRPS) by characterising their adaption to lateral prismatic shifts in vision. People with unilateral upper-limb CRPS Type I (n = 17), and pain-free individuals (n = 18; matched for age, sex, and handedness) completed prism adaptation with their affected/non-dominant and non-affected/dominant arms. We examined 1) the rate at which participants compensated for the optical shift during prism exposure (i.e., strategic recalibration), 2) endpoint errors made directly after prism adaptation (sensorimotor realignment) and the retention of these errors, and 3) kinematic markers associated with strategic control. Direct comparisons between people with CRPS and controls revealed no evidence of any differences in strategic recalibration, including no evidence for differences in a kinematic marker associated with trial-by-trial changes in movement plans during prism exposure. All participants made significant endpoint errors after prism adaptation exposure, indicative of sensorimotor realignment. Overall, the magnitude of this realignment did not differ between people with CRPS and pain-free controls. However, when endpoint errors were considered separately for each hand, people with CRPS made greater errors (indicating more rather than less realignment) when using their affected hand than their non-affected hand. No such difference was seen in controls. Taken together, these findings provide no evidence of impaired strategic control or sensorimotor realignment in people with CRPS. In contrast, they provide some indication that there could be a greater propensity for sensorimotor realignment in the CRPS-affected arm, consistent with more flexible representations of the body and peripersonal space. Our study challenges an implicit assumption of the theory that sensorimotor conflict might underlie some pathological pain conditions.GW4 BioMed Medical Research Council Doctoral Training PartnershipNetherlands Organisation for Scientific Research (NWO

Thai visitors’ expectations and experiences of explainer interaction within a science museum context

© The Author(s) 2015. In Western literature, there is evidence that museum explainers offer significant potential for enhancing visitors’ learning through influencing their knowledge, content, action, behaviour and attitudes. However, little research has focused on the role of explainers in other cultural contexts. This study explored interactions between visitors and museum explainers within the setting of Thailand. Two questionnaires were distributed to 600 visitors and 41 museum explainers. The results demonstrated both potential similarities and differences with Western contexts. Explainers appeared to prefer didactic approaches, focussing on factual knowledge rather than encouraging deep learning. Two-way communication, however, appeared to be enhanced by the use of a ‘pseudo-sibling relationship’ by explainers. Traditional Thai social reserve was reduced through such approaches, with visitors taking on active learning roles. These findings have implications for training museum explainers in non-Western cultures, as well as museum communication practice more generally

The role of non-medical therapeutic approaches in the rehabilitation of Complex Regional Pain Syndrome

Purpose of the review: Non-medical therapeutic approaches are fundamental to the management of Complex Regional Pain Syndrome (CRPS) in order to promote the best outcome for patients. This review focuses on three key approaches underpinning CRPS rehabilitation, namely: physiotherapy and occupational therapy, psychological approaches and education and self-management. Recent Findings: Recently published European standards outline the quality of therapeutic care that people with CRPS must receive. Early initiated therapy is essential to optimise outcomes, underpinned by patient education. Therapists should promote early movement of the affected limb and encourage re-engagement with usual activities as immobilisation is known to have negative outcomes. There is evidence to support the possible long-term benefit of graded motor imagery and mirror therapy. Psychological assessment should include identification of depression and post-traumatic stress disorder, as treatment of these conditions may improve the trajectory of CRPS. Novel therapies include neurocognitive approaches and those addressing spatial bias, both of which should provide a focus for future research.Summary: There exists a broad range of non-medical therapeutic approaches to rehabilitation for CPRS that are thought to be important. However, the evidence for their efficacy is limited. Further research using standardised outcomes would be helpful in developing targeted therapies for the future

Prefrontal cortex activation and young driver behaviour: a fNIRS study

Road traffic accidents consistently show a significant over-representation for young, novice and particularly male drivers. This research examines the prefrontal cortex activation of young drivers and the changes in activation associated with manipulations of mental workload and inhibitory control. It also considers the explanation that a lack of prefrontal cortex maturation is a contributing factor to the higher accident risk in this young driver population. The prefrontal cortex is associated with a number of factors including mental workload and inhibitory control, both of which are also related to road traffic accidents. This experiment used functional near infrared spectroscopy to measure prefrontal cortex activity during five simulated driving tasks: one following task and four overtaking tasks at varying traffic densities which aimed to dissociate workload and inhibitory control. Age, experience and gender were controlled for throughout the experiment. The results showed that younger drivers had reduced prefrontal cortex activity compared to older drivers. When both mental workload and inhibitory control increased prefrontal cortex activity also increased, however when inhibitory control alone increased there were no changes in activity. Along with an increase in activity during overtaking manoeuvres, these results suggest that prefrontal cortex activation is more indicative of workload in the current task. There were no differences in the number of overtakes completed by younger and older drivers but males overtook significantly more than females. We conclude that prefrontal cortex activity is associated with the mental workload required for overtaking. We additionally suggest that the reduced activation in younger drivers may be related to a lack of prefrontal maturation which could contribute to the increased crash risk seen in this population

Adaptation to leftward-shifting prisms reduces the global processing bias of healthy individuals.

When healthy individuals are presented with peripheral figures in which small letters are arranged to form a large letter, they are faster to identify the global- than the local-level information, and have difficulty ignoring global information when identifying the local level. The global reaction time (RT) advantage and global interference effect imply preferential processing of global-level information in the normal brain. This contrasts with the local processing bias demonstrated following lesions to the right temporo-parietal junction (TPJ), such as those that lead to hemispatial neglect (neglect). Recent research from our lab demonstrated that visuo-motor adaptation to rightward-shifting prisms, which ameliorates many leftward performance deficits of neglect patients, improved the local processing bias of patients with right TPJ lesions (Bultitude, Rafal, and List, 2009). Here we demonstrate that adaptation to leftward-shifting prisms, which can induce neglect-like performance in neurologically healthy individuals, also reduces the normal global processing bias. Forty-eight healthy participants were asked to identify the global or local forms of hierarchical figures before and after adaptation to leftward- or rightward-shifting prisms. Prior to prism adaptation, both groups had greater difficulty ignoring irrelevant global information when identifying the local level (global interference) compared to their ability to ignore irrelevant local-level information when identifying the global level (local interference). Participants who adapted to leftward-shifting prisms showed a significant reduction in global interference, but there was no change in the performance of the rightward-shifting Prism Group. These results show, for the first time, that in addition to previously demonstrated effects on lateralised attention, prism adaptation can influence non-lateralised spatial attention in healthy individuals

Putting attention on the line: investigating the activation-orientation hypothesis of pseudoneglect.

Neurologically healthy participants systematically misbisect horizontal lines to the left of centre, a phenomenon termed 'pseudoneglect'. According to the activation-orientation hypothesis, the distribution of attention is biased in the direction opposite to the more activated hemisphere. Since visuospatial tasks involve activation of the right hemisphere, the hypothesis suggests that a leftward line-bisection bias might be explained by the uneven distribution of attention to the left and right line segments. A crucial assumption of this explanation is that the more attended half of the line will be perceived as longer than the less attended half. This study uses a tachistoscopic Landmark test and an attention cueing paradigm to explore this assumption. Three conditions were met to demonstrate the relative elongation of the more attended half of the line: (1) attention was biased to the cued end of the line, (2) subjective line midpoint was shifted towards the cued end, and (3) alternative biasing factors were ruled out. The results also demonstrate that increased hemispheric activation, resulting from presentation of stimuli in one or the other visual field, leads to subjective midpoints that are biased away from the more activated hemisphere

Prism adaptation does not alter configural processing of faces.

Patients with hemispatial neglect ('neglect') following a brain lesion show difficulty responding or orienting to objects and events on the left side of space. Substantial evidence supports the use of a sensorimotor training technique called prism adaptation as a treatment for neglect. Reaching for visual targets viewed through prismatic lenses that induce a rightward shift in the visual image results in a leftward recalibration of reaching movements that is accompanied by a reduction of symptoms in patients with neglect. The understanding of prism adaptation has also been advanced through studies of healthy participants, in whom adaptation to leftward prismatic shifts results in temporary neglect-like performance. Interestingly, prism adaptation can also alter aspects of non-lateralised spatial attention. We previously demonstrated that prism adaptation alters the extent to which neglect patients and healthy participants process local features versus global configurations of visual stimuli. Since deficits in non-lateralised spatial attention are thought to contribute to the severity of neglect symptoms, it is possible that the effect of prism adaptation on these deficits contributes to its efficacy. This study examines the pervasiveness of the effects of prism adaptation on perception by examining the effect of prism adaptation on configural face processing using a composite face task. The composite face task is a persuasive demonstration of the automatic global-level processing of faces: the top and bottom halves of two familiar faces form a seemingly new, unknown face when viewed together. Participants identified the top or bottom halves of composite faces before and after prism adaptation. Sensorimotor adaptation was confirmed by significant pointing aftereffect, however there was no significant change in the extent to which the irrelevant face half interfered with processing. The results support the proposal that the therapeutic effects of prism adaptation are limited to dorsal stream processing

Prism adaptation does not alter object-based attention in healthy participants.

Hemispatial neglect ('neglect') is a disabling condition that can follow damage to the right side of the brain, in which patients show difficulty in responding to or orienting towards objects and events that occur on the left side of space. Symptoms of neglect can manifest in both space- and object-based frames of reference. Although patients can show a combination of these two forms of neglect, they are considered separable and have distinct neurological bases. In recent years considerable evidence has emerged to demonstrate that spatial symptoms of neglect can be reduced by an intervention called prism adaptation. Patients point towards objects viewed through prismatic lenses that shift the visual image to the right. Approximately five minutes of repeated pointing results in a leftward recalibration of pointing and improved performance on standard clinical tests for neglect. The understanding of prism adaptation has also been advanced through studies of healthy participants, in whom adaptation to leftward prismatic shifts results in temporary neglect-like performance. Here we examined the effect of prism adaptation on the performance of healthy participants who completed a computerised test of space- and object-based attention. Participants underwent adaptation to leftward- or rightward-shifting prisms, or performed neutral pointing according to a between-groups design. Significant pointing after-effects were found for both prism groups, indicating successful adaptation. In addition, the results of the computerised test revealed larger reaction-time costs associated with shifts of attention between two objects compared to shifts of attention within the same object, replicating previous work. However there were no differences in the performance of the three groups, indicating that prism adaptation did not influence space- or object-based attention for this task. When combined with existing literature, the results are consistent with the proposal that prism adaptation may only perturb cognitive functions for which normal baseline performance is already biased