Increasing evidence suggests that the basic foundations of the self lie in the brain systems that represent the body. Specific sensorimotor stimulation has been shown to alter the bodily self. However, little is known about how disconnection of the brain from the body affects the phenomenological sense of the body and the self. Spinal cord injury (SCI) patients who exhibit massively reduced somatomotor processes below the lesion in the absence of brain damage are suitable for testing the influence of body signals on two important components of the self–the sense of disembodiment and body ownership. We recruited 30 SCI patients and 16 healthy participants, and evaluated the following parameters: (i) depersonalization symptoms, using the Cambridge Depersonalization Scale (CDS), and (ii) measures of body ownership, as quantified by the rubber hand illusion (RHI) paradigm. We found higher CDS scores in SCI patients, which show increased detachment from their body and internal bodily sensations and decreasing global body ownership with higher lesion level. The RHI paradigm reveals no alterations in the illusory ownership of the hand between SCI patients and controls. Yet, there was no typical proprioceptive drift in SCI patients with intact tactile sensation on the hand, which might be related to cortical reorganization in these patients. These results suggest that disconnection of somatomotor inputs to the brain due to spinal cord lesions resulted in a disturbed sense of an embodied self. Furthermore, plasticity-related cortical changes might influence the dynamics of the bodily self.
References
[1]
Deneve S, Pouget A (2004) Bayesian multisensory integration and cross-modal spatial links. Journal of physiology, Paris 98: 249–258.
[2]
Berlucchi G, Aglioti SM (2010) The body in the brain revisited. Experimental brain research 200: 25–35.
[3]
Giummarra MJ, Gibson SJ, Georgiou-Karistianis N, Bradshaw JL (2008) Mechanisms underlying embodiment, disembodiment and loss of embodiment. Neuroscience and biobehavioral reviews 32: 143–160.
[4]
Henderson LA, Gustin SM, Macey PM, Wrigley PJ, Siddall PJ (2011) Functional reorganization of the brain in humans following spinal cord injury: evidence for underlying changes in cortical anatomy. The Journal of neuroscience 31: 2630–2637.
[5]
Penfield W, Rasmussen T (1950) The Cerebral Cortex of Man: A Clinical Study of Localization of Function. New York: Macmillan.
[6]
Simeon D, Guralnik O, Hazlett EA, Spiegel-Cohen J, Hollander E, et al. (2000) Feeling unreal: a PET study of depersonalization disorder. The American journal of psychiatry 157: 1782–1788.
[7]
Gimbel L (1975) The pathology of boredom and sensory deprivation. The Canadian journal of psychiatric nursing 16: 12–13.
[8]
Jauregui-Renaud K, Sang FY, Gresty MA, Green DA, Bronstein AM (2008) Depersonalisation/derealisation symptoms and updating orientation in patients with vestibular disease. Journal of neurology, neurosurgery, and psychiatry 79: 276–283.
[9]
Sang FY, Jauregui-Renaud K, Green DA, Bronstein AM, Gresty MA (2006) Depersonalisation/derealisation symptoms in vestibular disease. J Neurol Neurosurg Psychiatry 77: 760–766.
[10]
Botvinick M, Cohen J (1998) Rubber hands ‘feel’ touch that eyes see. Nature 391: 756.
[11]
Cole J (2004) Still lives. Cambridge: MIT press.
[12]
Moseley GL, Olthof N, Venema A, Don S, Wijers M, et al. (2008) Psychologically induced cooling of a specific body part caused by the illusory ownership of an artificial counterpart. Proceedings of the National Academy of Sciences of the United States of America 105: 13169–13173.
[13]
Kammers MP, Rose K, Haggard P (2011) Feeling numb: temperature, but not thermal pain, modulates feeling of body ownership. Neuropsychologia 49: 1316–1321.
[14]
Sierra M, Berrios GE (2000) The Cambridge Depersonalization Scale: a new instrument for the measurement of depersonalization. Psychiatry research 93: 153–164.
[15]
Simeon D, Kozin DS, Segal K, Lerch B, Dujour R, et al. (2008) De-constructing depersonalization: further evidence for symptom clusters. Psychiatry research 157: 303–306.
[16]
Sierra M, Baker D, Medford N, David AS (2005) Unpacking the depersonalization syndrome: an exploratory factor analysis on the Cambridge Depersonalization Scale. Psychological medicine 35: 1523–1532.
[17]
de Vignemont F (2011) Embodiment, ownership and disownership. Consciousness and cognition 20: 82–93.
[18]
Lopez C, Lenggenhager B, Blanke O (2010) How vestibular stimulation interacts with illusory hand ownership. Consciousness and cognition 19: 33–47.
[19]
Zeller D, Gross C, Bartsch A, Johansen-Berg H, Classen J (2011) Ventral premotor cortex may be required for dynamic changes in the feeling of limb ownership: a lesion study. The Journal of neuroscience 31: 4852–4857.
[20]
Carruthers G (2008) Types of body representation and the sense of embodiment. Consciousness and cognition 17: 1302–1316.
[21]
Bors E (1951) Phantom limbs of patients with spinal cord injury. AMA archives of neurology and psychiatry 66: 610–631.
[22]
Burke DC, Woodward SM (1976) Pain and phantom sensation in spinal paralysis. In: Vinken PJ, Bruyn GW, editors. Injuries of the spine and spinal cord; Part II. Amsterdam: North-Holland Publishing Company.
[23]
Curt A, Yengue CN, Hilti LM, Brugger P (2011) Supernumerary phantom limbs in spinal cord injury. Spinal Cord 49: 588–595.
[24]
Simeon D, Abugel J (2006) Feeling unreal: depersonalization disorder and the loss of the self. New York: Oxford University Press, USA.
[25]
Montoya P, Schandry R (1994) Emotional experience and heartbeat perception in patients with spinal cord injury and control subjects. Journal of Psychophysiology 8: 289–296.
[26]
Nizzi MC, Demertzi A, Gosseries O, Bruno MA, Jouen F, et al. (2011) From armchair to wheelchair: How patients with a locked-in syndrome integrate bodily changes in experienced identity. Consciousness and cognition.
[27]
Erwin BJ, Rosenbaum G (1979) Parietal lobe syndrome and schizophrenia: comparison of neuropsychological deficits. Journal of Abnormal Psychology 88: 234–241.
[28]
Rosenbaum G, Cohen BD, Luby ED, Gottlieb JS, Yelen D (1959) Comparison of sernyl with other drugs: simulation of schizophrenic performance with sernyl, LSD-25, and amobarbital (amytal) sodium; I. Attention, motor function, and proprioception. AMA archives of general psychiatry 1: 651–656.
[29]
Moseley GL (2007) Using visual illusion to reduce at-level neuropathic pain in paraplegia. Pain 130: 294–298.
[30]
Blanke O, Metzinger T (2009) Full-body illusions and minimal phenomenal selfhood. Trends in cognitive sciences 13: 7–13.
[31]
Tsakiris M, Haggard P (2005) The rubber hand illusion revisited: visuotactile integration and self-attribution. J Exp Psychol Hum Percept Perform 31: 80–91.
[32]
Bruehlmeier M, Dietz V, Leenders KL, Roelcke U, Missimer J, et al. (1998) How does the human brain deal with a spinal cord injury? The European journal of neuroscience 10: 3918–3922.
[33]
Ehrsson HH, Spence C, Passingham RE (2004) That’s my hand! Activity in premotor cortex reflects feeling of ownership of a limb. Science 305: 875–877.
[34]
Tsakiris M (2010) My body in the brain: a neurocognitive model of body-ownership. Neuropsychologia 48: 703–712.
[35]
Tsakiris M, Hesse MD, Boy C, Haggard P, Fink GR (2007) Neural Signatures of Body Ownership: A Sensory Network for Bodily Self-Consciousness. Cereb Cortex 17: 2235–44.
[36]
Rohde M, Di Luca M, Ernst MO (2011) The Rubber Hand Illusion: feeling of ownership and proprioceptive drift do not go hand in hand. PloS one 6: e21659.