The persistence of physical symptoms, such as pain, fatigue, and dizziness, has been linked to altered interoception, but the mechanisms remain unclear. This study used a novel psychophysical heart rate discrimination task and self-report measures of interoceptive sensibility and awareness to investigate interoceptive deficits in patients with somatic symptom disorder (SSD) and healthy controls from a predictive processing perspective. Both groups underestimated their heart rate, with no differences on sensory precision and discriminability. Patients with SSD reported lower decision confidence and showed higher between-person variation in interoceptive bias, either under- or overestimating their heart rate. Self-report data revealed reductions on regulatory and trusting facets of interoceptive sensibility, related to symptom reporting. Through a predictive processing lens, the pattern found is consistent with heterogeneous priors combined with higher-level cognitive “immunization” that resists disconfirmatory evidence. This study highlights the need for a broader understanding of interoception in persistent physical symptoms, integrating both higher-order and lower-order interoceptive mechanisms.

ABSTRACT Tactile imagery has attracted growing fundamental and clinical interest. Previous studies often investigated neural and functional similarities between imagined and actual touch. Several functional aspects of touch, such as differences between active and passive touch, between different haptic features during active touch or sensitivity of different body parts for passive touch, have also been explored in tactile imagery. Furthermore, considerable individual differences in the ability to engage in tactile imagery have been observed. However, several important aspects, involving different imagery components and a wide variety of touch qualities remain to be explored within a single comprehensive study. The current study therefore aims to provide a wide-ranging assessment of tactile imagery in terms of imagery processing components (vividness, maintenance, transformation), type of touch (active versus passive) and touch qualities (object properties for active touch, different tactile sensations across body sites for passive touch). We developed a comprehensive questionnaire containing 72 items to assess tactile imagery ability. 136 healthy participants were asked to imagine different touch types and rate imagery vividness and their ability to maintain and transform each sensation on 5-point Likert-scales. Active touch varied by object (plastic bottle, modeling clay, sponge) and property (temperature, weight, texture, resistance). Passive touch varied by body site (lip, shin, sole of the foot, lower back) and sensation (stroking, vibration, pinching). Overall, participants were able to perform tactile imagery: the vast majority reported at least some imagery across touch types. Individual variability was substantial: scores bridged both ends of the scale. Active tactile imagery differed significantly between objects, depending on tactile property. Object-property pairs with particularly strong imagery were bottle-temperature, bottle-weight and sponge-texture, whereas bottle-resistance elicited weaker imagery, as did temperature and weight for both sponge and clay. Passive tactile imagery was significantly stronger for body sites with higher receptor density (i.e. lip and foot). Imagery of stroking was significantly weaker than vibration and pinching. Active and passive imagery showed a strong, positive correlation, though some participants had relatively strong active imagery, but weaker passive imagery, or vice versa. Our findings confirm that tactile imagery ability varies across individuals and touch types, underlining the importance of a comprehensive imagery ability assessment tool specific to the tactile domain.

The pleasantness perception of CT-optimal touch is usually assessed with subjective and explicit measures. As these can be prone to biases, it is important to develop implicit measures as well. The vestigial post-auricular muscle reflex (PAR) might be a good candidate, given its sensitivity to pleasant visual and auditory stimuli. As such, we investigated if the PAR can also be modulated by CT-optimal touch. We additionally compared how the PAR responds to social and robotic touch and conducted control experiments to replicate the reflex's specific sensitivity to primary rewards. The sample consisted of 43 non-clinical participants. PAR responses were recorded while participants were touched by an experimenter and a robot, with a velocity of 3 cm/s (CT-optimal touch) and 18 cm/s (CT non-optimal touch). After each trial, participants also subjectively rated the pleasantness of the touch. Although the results revealed that CT-optimal touch was subjectively perceived to be more pleasant than CT non-optimal touch, it did not result in a potentiation of the PAR. Interestingly, social touch was subjectively perceived to be more pleasant than robotic touch and potentiated the PAR. The control experiments confirmed that the PAR is particularly modulated by primary (food, erotica), and not secondary (adventure, cuteness, monetary) rewards. While additional research is needed to further investigate the relation between the PAR and CT-optimal touch, the current results do already suggest that this reflex responds to the primary reward value of social touch.

Background: A core symptom of anorexia nervosa (AN) is a distorted body representation. AN often has an onset in puberty. Therefore, it is pivotal to gain a better understanding of these distortions in adolescents with AN. This study aimed to capture the multidimensional perspective of body representation and investigate to what extent adolescent girls with AN differ from adolescent girls without AN on five domains of body representation, namely bodily cognitions and attitudes, body checking and body avoidant behaviors, visual perception, tactile perception, and affordance perception. Methods: Thirty-one adolescent girls with AN and 33 without AN (aged 14-18 years) were included in this study. Body representation was measured using questionnaires (Body Attitude Test, Body Appreciation Scale-2, and Body Checking and Avoidant Questionnaire) and experimental tasks (visual, tactile, and affordance estimation tasks). Results: Findings demonstrated a difference on all domains of body representation; adolescent girls with AN self- reported to experience more negative cognitions and attitudes toward their bodies, self-reported to engage in more body checking and body avoidant behaviors, and showed higher percentages of visual, tactile, and affordance overestimation compared to adolescent girls without AN. Conclusions: Adolescent girls with AN appear to have a more severely distorted body representation when compared to adolescent girls without AN, and may benefit from intensifying body-oriented interventions.

Tactile perception is a subjective experience, yet it can be physiologically quantified. This offers new avenues for studying sensory processing in contexts where verbal feedback is limited or unreliable. A growing body of research uses changes in pupil size, showing that stronger tactile stimuli lead to greater pupil dilation. Building on this, we investigated whether pupil responses could serve as an objective measure of tactile sensitivity. To explore this, we pharmacologically manipulated tactile sensitivity in healthy participants (n = 32). In separate sessions, an anaesthetic cream or a placebo cream was applied to one forearm. At the beginning and/or end of each session, Von Frey assessments and a vibrotactile detection task were conducted to confirm the efficacy of the anaesthetic cream in reducing tactile sensitivity. During each session, pupil responses to vibrotactile stimuli applied to both the cream and non-cream arms were recorded. Our results confirmed that the anaesthetic cream significantly reduced the perceived intensity of tactile stimulation, an effect that persisted throughout the session. Crucially, we observed weaker pupil dilation responses to vibrotactile stimuli applied to the anaesthetised arm compared to the placebo or non-cream arm. Exploratory analyses showed that participants for whom the anaesthetic cream was most effective in reducing tactile sensitivity also showed the weakest pupil responses when the anaesthetised arm was stimulated. Overall, these findings demonstrate that the pupil response is a reliable and objective index of tactile sensitivity, highlighting its potential for studying sensory processing in populations where verbal feedback is limited or unreliable.

Touch is important for many aspects of our daily activities. One of the most important tactile characteristics is its perceived intensity. However, quantifying the intensity of perceived tactile stimulation beyond subjective self-reports remains challenging. Here, we show that pupil responses can objectively index the intensity of tactile stimulation in the absence of overt participant responses. In Experiment 1 (n=32), we stimulated three reportedly differentially sensitive body locations (finger, forearm, calf) with a single tap of a tactor while tracking pupil responses. Tactile stimulation resulted in greater pupil dilation than a baseline without stimulation. Furthermore, pupils dilated more for the more sensitive location (finger) than for the less sensitive locations (forearm, calf). In Experiment 2 (n=20) we extended these findings by manipulating the intensity of the stimulation with three different intensities, here a short vibration, always at the little finger. Again, pupils dilated more when being stimulated at higher intensities as compared to lower intensities. In summary, pupils dilated more for more sensitive parts of the body at constant stimulation intensity and for more intense stimulation at constant location. Taken together, the results show that the intensity of perceived tactile stimulation can be objectively measured with pupil responses – and that such responses are a versatile marker for touch research. Our findings may pave the way for previously impossible objective tests of tactile sensitivity, for example in minimally conscious state patients.

Recent studies show that CT-optimal touch, gentle slow stroking of the skin, can reduce pain. However, much is unknown regarding the factors influencing its pain-ameliorating effect, such as tactile attention and touch application site. The current study investigates in 36 healthy individuals, whether CT-optimal touch can reduce temporal summation of second pain (TSSP) compared to CT non-optimal touch and tapping the skin. TSSP refers to activation of the C-nociceptors; by stimulating these fibers a burning and/or tingling sensation can be elicited. All participants underwent three conditions on both the contralateral and ipsilateral side of pain induction. The results show that tapping the skin did not reduce TSSP, meaning that pain reduction through touch cannot be explained by tactile attention effects. CT non-optimal touch only reduced TSSP when applied on the ipsilateral side. Importantly, CT-optimal touch effectively reduced TSSP when applied on the contralateral or ipsilateral side. Furthermore, CT-optimal touch was more effective in reducing TSSP compared to CT non-optimal touch and Tapping. This study shows that that CT-optimal touch can reduce TSSP and this effect appears to be independent of touch application site, which is highly relevant for implementing CT-optimal touch as a treatment.

Complex Regional Pain Syndrome (CRPS) is a condition of chronic pain, predominantly affecting one limb. CRPS is characterised by motor changes including slowed or uncoordinated movements. Cognitive processes that drive movement planning and/or execution might contribute to these changes. We aimed to investigate the potential alterations to such cognitive mechanisms using an 'object affordance' paradigm. Object affordance refers to the observation that viewing an object modulates associated motor responses, presumably due to the automatic activation of a motor plan. We hypothesised that people with CRPS would show reduced object affordance effects for their affected compared to unaffected hand, and compared to pain-free controls. First, we validated an online object affordance task involving button press responses to everyday objects with handles, in pain-free participants (n = 63; Experiment 1). Object affordance was reflected by faster and more accurate responses when the object handle was aligned to the responding hand ("aligned") compared to when the handle was aligned to the other hand ("non-aligned"). These results were similar for the online task as when administered in person. Second, in a case-control study, we administered the online object affordance task to people with CRPS predominantly affecting the upper limb (n = 25), and age-matched pain-free controls (n = 68; Experiment 2). People with CRPS responded faster and more accurately in the aligned versus non-aligned condition (ie, an object affordance effect), both for the affected and unaffected hands. There were no differences to pain-free participants. Therefore, object affordance effects were seen in people with CRPS, providing no evidence for altered motor planning. PERSPECTIVE: This article presents research investigating cognitive processes related to motor planning in Complex Regional Pain Syndrome (CRPS). Using an online object affordance paradigm, validated in pain-free controls, the authors found that people with CRPS showed intact object affordance effects in the affected and unaffected hand, suggesting unaltered motor planning. DATA AVAILABILITY: The experiment materials, data, pre-processing scripts, and analysis scripts can be found via Open Science Framework (https://osf.io/nc825/files/osfstorage).

One of the most underdiagnosed and undertreated non-motor symptoms of Parkinson's Disease is chronic pain. This is generally treated with analgesics which is not always effective and can cause several side-effects. Therefore, new ways to reduce chronic pain are needed. Several experimental studies show that CT-optimal touch can reduce acute pain. However, little is known about the effect of CT-optimal touch on chronic pain. The aim of the current study is to investigate whether CT-optimal touch can reduce the chronic pain experience in Parkinson patients. In this intervention study, 17 Parkinson patients underwent three conditions; no touch, CT-optimal touch and CT non-optimal touch with a duration of one week each. During each touch week, participants received touch from their partners twice a day for 15 minutes. Results show that both types of touch ameliorate the chronic pain experience. Furthermore, it appears that it is slightly more beneficial to apply CT-optimal touch also because it is perceived as more pleasant. Therefore, we argue that CT-optimal touch might be used when immediate pain relief is needed. Importantly, this study shows that CT-optimal touch can reduce chronic pain in Parkinson's Disease and can be administered by a partner which makes it feasible to implement CT-optimal touch as daily routine.

Research on body image in eating disorders has predominantly focused on negative body image, only recently shifting to positive body image. Findings suggest that enhancing positive body image can, amongst other things, serve as a protective mechanism against (re)developing a negative body image. One suggested way of enhancing positive body image is to focus on enhancing body functionality appreciation. Although studies show promising effects, this research is mainly conducted in non-clinical samples. The current study investigated the levels of positive and negative body image in an online community sample of patients with an eating disorder (PAT, n = 227), patients recovered from an eating disorder (REC, n = 102) and controls (HC, n = 175) (self-reported diagnosis, not confirmed). In addition, we tested whether body functionality appreciation was associated with appearance dissatisfaction (negative body image) and body appreciation (positive body image). REC showed similar results to controls to most of the body image measures except for how much importance one places on their appearance (no different between REC and PAT), and how satisfied one is with certain body parts. For this measure, REC scored in-between PAT and HC. We further found functionality appreciation to be significantly associated with of both positive and negative body image, except for appearance evaluation in patients with an eating disorder. This study showed a positive association between body functionality appreciation and positive body image and a negative association between body functionality appreciation and negative body image. Further research is required to investigate the effectiveness of interventions targeting body functionality appreciation in clinical settings. People with an eating disorder often suffer from a negative body image. This negative body image has been found to be hard to treat. Recently researchers started to not only look at ways to decrease negative body image but also enhance positive body image. It has been found that it is beneficial for people with a negative body image to learn to focus on appreciating the functions of the body (body functionality appreciation), as this leads to a more positive body image. However, this research was done on people without an eating disorder. In this questionnaire study, we looked at whether there is a relationship between body functionality appreciation and body image in patients with a (self-reported) eating disorder diagnosis and those who are recovered from an eating disorder. We found that functionality appreciation is associated with increased positive body image and decreased negative body image in all groups. Further studies should investigate the effectiveness of clinical interventions that focus on body functionality appreciation to enhance body image

BACKGROUND:Adolescence is a period marked by important physical and social changes, which often leads to an increase of body dissatisfaction. Recent studies have shown an association between interoception and body dissatisfaction in female adolescents. One variable that may contribute to the association between interoceptive awareness and body dissatisfaction is intolerance of uncertainty (IU). This study aims to investigate multiple facets of interoceptive awareness, IU, and their relations with body dissatisfaction in adolescent girls.METHODS:In a cross-sectional study, a convenience sample of 307 adolescent girls (mean age = 17.73; SD = 1.02) was recruited in the Netherlands in 2022. Three questionnaires were completed measuring interoceptive awareness, IU, and body dissatisfaction. A moderation analyses using a multiple hierarchical regression was used to investigate associations between variables.RESULTS:Correlation analyses indicated that several facets of lower interoceptive awareness (Not distracting, Not worrying and Trusting) were related to higher levels of body dissatisfaction. IU only marginally moderated the relationship between several domains of interoceptive awareness (Notice, Attention regulation and Emotional awareness) and body dissatisfaction.DISCUSSION:Findings suggest that experiencing bodily signals as ambiguous and uncertain may result in more complex body image issues. Within certain domains of interoceptive awareness, IU may affect the process of appraising bodily signals. Furthermore, adolescent girls who do not feel safe in their body and who find it difficult to distract their thoughts when experiencing pain or discomfort in their body may be particularly at risk for developing more complex body image disturbances and may benefit from interventions improving both interoceptive awareness and IU. Moreover, future research should focus on interoceptive awareness and IU as potential underlying mechanisms for body image issues.

Left-right orientation, a function related to the parietal lobe, is important for many daily activities. Here, we describe a left-handed patient with a right parietal brain tumour. During awake surgery, electric stimulation of the right inferior parietal lobe resulted in mistakes in his left-right orientation. Postoperatively our patient had no problems in discriminating left right. This case report shows that monitoring of left-right orientation during awake brain tumour surgery is feasible so that this function can be preserved.

Peripersonal space (PPS), the region immediately surrounding the body is essential for bodily protection and goal directed action. Previous studies have suggested that the PPS is anchored to one’s own body and in the current study we investigated whether the PPS could be modulated by changes in perceived body ownership. While theoretically important, this anchoring can also have implications for patients with altered body perception. The rubber hand illusion (RHI) is a way to manipulate body ownership. We hypothesized that after induction of a left hand RHI, the perceived space around the body shifts to the right. Sixty-five participants performed a landmark task before and after a left hand RHI. In the landmark task, participants had to determine whether a vertical landmark line was left or right from the center of a horizontal screen. One group of the participants was exposed to synchronous stroking, the other group experienced asynchronous stroking. Results showed a shift in space to the right (e.g. away from the own arm), but only for the ‘synchronous stroking’ group. These results suggest that the relevant action space becomes linked to the fake hand. Critically, subjective ownership experience did not correlate with this shift, but proprioceptive drift did. This suggests that multisensory integration of bodily information drives this shift in space around the body and not feelings of ownership.

Studies have confirmed the significance of touch for psychological wellbeing. Social distancing regulations during the COVID-19 pandemic reduced people’s ability to engage in interpersonal touch and caused increased an appreciation for observed touch, as well as a longing for touch within the neurotypical population. Yet, while the impact of social distancing and the importance of touch are evident in neurotypical individuals, it remains unclear how these factors manifest in autistic individuals. Previous research has related high levels of autistic traits to reduced levels of perceived pleasantness of touch and a reduced interest in interpersonal touch. Our study aimed to examine the differences in the appreciation of observed touch and longing for touch during social distancing between individuals with low and high levels of autistic traits. We conducted an online survey on autistic traits, the appreciation of observed CT-optimal touch and longing for touch. Consistent with our predictions, our results confirmed that individuals with high levels of autistic traits evaluated videos depicting CT-optimal touch less favorably compared to those with lower scores on autistic traits. Additionally, only the group with low levels of autistic traits exhibited a longing for touch during social distancing, whereas the group with high levels of autistic traits did not. The results provide insights in the appreciation of touch in relation to autistic traits during the unique circumstances of the COVID-19 pandemic.

To combat the spread of the COVID-19, regulations were introduced to limit physical interactions. This could induce a longing for touch in the general population and subsequently impact social, psychological, physical and environmental quality of life (QoL). The aim of this study was to investigate the potential association between COVID-19 regulations, longing for touch and QoL. A total of 1978 participants from different countries completed an online survey, including questions about their general wellbeing and the desire to be touched. In our sample, 83% of participants reported a longing for touch. Longing for touch was subsequently associated with a lower physical, psychological and social QoL. No association was found with environmental QoL. These findings highlight the importance of touch for QoL and suggest that the COVID-19 regulations have concurrent negative consequences for the wellbeing of the general population.

OBJECTIVE:To evaluate whether cognitive and motor therapy (CMT) is more effective than no therapy, motor therapy, or cognitive therapy on motor and/or cognitive outcomes after stroke. Additionally, this study evaluates whether effects are lasting and which CMT approach is most effective. DATA SOURCES:AMED, EMBASE, MEDLINE/PubMed, and PsycINFO databases were searched in October 2022. STUDY SELECTION:Twenty-six studies fulfilled the inclusion criteria: randomized controlled trials published in peer-reviewed journals since 2010 that investigated adults with stroke, delivered CMT, and included at least 1 motor, cognitive, or cognitive-motor outcome. Two CMT approaches exist: CMT dual-task ("classical" dual-task where the secondary cognitive task has a distinct goal) and CMT integrated (where cognitive components of the task are integrated into the motor task). DATA EXTRACTION:Data on study design, participant characteristics, interventions, outcome measures (cognitive/motor/cognitive-motor), results and statistical analysis were extracted. Multilevel random effects meta-analysis was conducted. DATA SYNTHESIS:CMT demonstrated positive effects compared with no therapy on motor outcomes (g=0.49; 95% confidence interval [CI], 0.10, 0.88) and cognitive-motor outcomes (g=0.29; 95% CI, 0.03, 0.54). CMT showed no significant effects compared with motor therapy on motor, cognitive, and cognitive-motor outcomes. A small positive effect of CMT compared with cognitive therapy on cognitive outcomes (g=0.18; 95% CI, 0.01, 0.36) was found. CMT demonstrated no follow-up effect compared with motor therapy (g=0.07; 95% CI, -0.04, 0.18). Comparison of CMT dual-task and integrated revealed no significant difference for motor (F1,141=0.80; P=.371) or cognitive outcomes (F1,72=0.61, P=.439). CONCLUSIONS:CMT was not superior to monotherapies in improved outcomes after stroke. CMT approaches were equally effective, suggesting that training that enlists a cognitive load per se may benefit outcomes.

Affective touch is gentle slow stroking of the skin, which can reduce experimentally induced pain. Our participant, suffering from Parkinson's Disease and chronic pain, received 1 week of non-affective touch and 1 week of affective touch as part of a larger study. Interestingly, after 2 days of receiving affective touch, the participant started to feel less pain. After 7 days, the burning painful sensations fully disappeared. This suggest that affective touch may reduce chronic pain in clinical populations.

The need to feel in control is central to anorexia nervosa (AN). The sense of control in AN has only been studied through self-report. This study investigated whether implicit sense of control (sense of agency; SoA) differs across AN patients, recovered AN (RAN) patients and healthy controls (HC). Furthermore, we assessed whether state anxiety is influenced by negative emotional states. SoA was measured with the intentional binding task (IB) and state-anxiety levels through a questionnaire. We did not find any evidence of differences in SoA between groups. Furthermore, state anxiety was not a significant predictor of SoA. Further research into SoA in AN should focus on other features of the SoA that are not targeted by the IB task.

In this review, we suggest a new model that has its roots in studies with healthy individuals, but may be especially promising for understanding atypical CT optimal touch perception in certain clinical groups. We argue that social touch plays an important role in the development of a secure or insecure attachment style. Insecure attachment is common in psychiatric patients and potentially impacts their perception of CT optimal touch. This direct link between insecure attachment style and touch perception may be modulated by touch deprivation, to which individuals might be predisposed when they are insecurely attached. The links in this model need further exploration, especially in psychiatric patients, and concrete recommendations for future work are provided.

Shaping one owns actions by observing others' actions is driven by the deep-rooted mechanism of perception-action coupling. It typically occurs automatically, expressed as for example the unintentional synchronization of reaction times in interactive games. Theories on perception-action coupling highlight its benefits such as the joint coordination of actions to cooperatively perform tasks properly, the learning of novel actions from others, and the bonding with likable others. However, such functional aspects and how they shape perception-action coupling have never been compared quantitatively. Here we tested a total of hundred-fifteen participants that played a stimulus-response task while, in parallel, they observed videos of agents that played the exact same task several milliseconds in advance. We compared to what degree the reaction times of actions of agents, who varied their behavior in terms of functionality and likability in preceding prisoner dilemma games and quizzes, shape the reaction times of human test participants. To manipulate functionality and likability, we varied the predictability of cooperative behavior and correctness of actions of agents, respectively, resulting in likable (cooperative), dislikable (uncooperative), functional (correct actions), and dysfunctional (incorrect actions) agents. The results of three experiments showed that the participants' reaction times correlated most with the reaction times of agents that expressed functional behavior. However, the likability of agents had no effects on reaction time correlations. These findings suggest that, at least in the current computer task, participants are more likely to adopt the timing of actions from people that perform correct actions than from people that they like.