Welcoming back my arm: Affective touch increases body ownership following right hemisphere stroke

Abstract

Right hemisphere stroke can impair the ability to recognise ones contralesional body parts as belonging to ones self. The study of this so-called disturbed sense of limb ownership (DSO) can provide unique insights into the neurocognitive mechanisms of body ownership. Here, we address a hypothesis built upon experimental studies on body ownership in healthy volunteers. These studies have shown that affective (pleasant) touch, an interoceptive modality associated with unmyelinated, slow-conducting C tactile afferents, has a unique role in the sense of body ownership. Here we systematically investigated whether affective touch stimulation could increase body ownership in patients with DSO following right hemisphere stroke. An initial feasibility study in 16 adult, acute stroke patients enabled us to optimise and calibrate an affective touch protocol to be administered by the bedside. The main experiment, conducted with a different sample of 26 right hemisphere patients, assessed changes in limb ownership elicited following self-(patient) versus other-(experimenter) generated tactile stimulation, using a velocity known to optimally activate C-tactile fibres (i.e. 3cm/s), and a second velocity that is suboptimal for C-tactile activation (i.e. 18cm/s). We further examined the specificity and mechanism of observed changes in limb ownership in secondary analyses looking at (1) the influence of perceived intensity and pleasantness of touch, (2) touch laterality, and (3) level of DSO on ownership change, as well as (4) changes in unilateral neglect arising from touch. Findings indicated a significant increase in limb ownership following experimenter-administered, CT-optimal touch. Voxel-based Lesion-Symptom Mapping (VLSM) identified damage to the right insula and, more substantially, the right corpus callosum, associated with a failure to increase body ownership following experimenter-administered, affective touch. Our findings suggest that affective touch can increase the sense of body-part ownership following right hemisphere stroke, potentially due to its unique role in the multisensory integration processes that underlie the sense of body ownership.