CT-optimal touch and chronic pain experience in Parkinson's Disease; An intervention study.

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.

Spatial factors influencing the pain-ameliorating effect of CT-optimal touch: a comparative study for modulating temporal summation of second pain.

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.

Chronic pain relief after receiving affective touch: A single case report.

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.

Neural basis of affective touch and pain: A novel model suggests possible targets for pain amelioration.

Pain is one of the most common health problems and has a severe impact on quality of life. Yet, a suitable and efficient treatment is still not available for all patient populations suffering from pain. Interestingly, recent research shows that low threshold mechanosensory C-tactile (CT) fibres have a modulatory influence on pain. CT-fibres are activated by slow gentle stroking of the hairy skin, providing a pleasant sensation. Consequently, slow gentle stroking is known as affective touch. Currently, a clear overview of the way affective touch modulates pain, at a neural level, is missing. This review aims to present such an overview. To explain the interaction between affective touch and pain, first the neural basis of the affective touch system and the neural processing of pain will be described. To clarify these systems, a schematic illustration will be provided in every section. Hereafter, a novel model of interactions between affective touch and pain systems will be introduced. Finally, since affective touch might be suitable as a new treatment for chronic pain, possible clinical implications will be discussed.

The role of neural tuning in quantity perception.

Perception of quantities, such as numerosity, timing, and size, is essential for behavior and cognition. Accumulating evidence demonstrates neurons processing quantities are tuned, that is, have a preferred quantity amount, not only for numerosity, but also other quantity dimensions and sensory modalities. We argue that quantity-tuned neurons are fundamental to understanding quantity perception. We illustrate how the properties of quantity-tuned neurons can underlie a range of perceptual phenomena. Furthermore, quantity-tuned neurons are organized in distinct but overlapping topographic maps. We suggest that this overlap in tuning provides the neural basis for perceptual interactions between different quantities, without the need for a common neural representational code.

Adaptation to visual numerosity changes neural numerosity selectivity.

Perceiving numerosity, i.e. the set size of a group of items, is an evolutionarily preserved ability found in humans and animals. A useful method to infer the neural underpinnings of a given perceptual property is sensory adaptation. Like other primary perceptual attributes, numerosity is susceptible to adaptation. Recently, we have shown numerosity-selective neural populations with a topographic organization in the human brain. Here, we investigated whether numerosity adaptation can affect the numerosity selectivity of these populations using ultra-high field (7 Tesla) functional magnetic resonance imaging (fMRI). Participants viewed stimuli of changing numerosity (1 to 7 dots), which allowed the mapping of numerosity selectivity. We interleaved a low or high numerosity adapter stimulus with these mapping stimuli, repeatedly presenting 1 or 20 dots respectively to adapt the numerosity-selective neural populations. We analyzed the responses using custom-build population receptive field neural models of numerosity encoding and compared estimated numerosity preferences between adaptation conditions. We replicated our previous studies where we found several topographic maps of numerosity-selective responses. We found that overall, numerosity adaptation altered the preferred numerosities within the numerosity maps, resulting in predominantly attractive biases towards the numerosity of the adapter. The differential biases could be explained by the difference between the unadapted preferred numerosity and the numerosity of the adapter, with attractive biases being observed with higher difference. The results could link perceptual numerosity adaptation effects to changes in neural numerosity selectivity.

Distinct temporal mechanisms modulate numerosity perception.

Our ability to process numerical and temporal information is an evolutionary skill thought to originate from a common magnitude system. In line with a common magnitude system, we have previously shown that adaptation to duration alters numerosity perception. Here, we investigate two hypotheses on how duration influences numerosity perception. A channel-based hypothesis predicts that numerosity perception is influenced by adaptation of onset/offset duration channels which also encode numerosity or wire together with numerosity channels (duration/numerosity channels). Hence, the onset/offset duration of the adapter is driving the effect regardless of the total duration of adaptation. A strength-of-adaptation hypothesis predicts that the effect of duration on numerosity perception is driven by the adaptation of numerosity channels only, with the total duration of adaptation driving the effect regardless of the onset/offset duration of the adapter. We performed two experiments where we manipulated the onset/offset duration of the adapter, the adapter's total presentation time, and the total duration of the adaptation trial. The first experiment tested the effect of adaptation to duration on numerosity discrimination, whereas the second experiment tested the effect of adaptation to numerosity and duration on numerosity discrimination. We found that the effect of adaptation to duration on numerosity perception is primarily driven by adapting duration/numerosity channels, supporting the channel-based hypothesis. In contrast, the effect of adaptation to numerosity on numerosity perception appears to be driven by the total duration of the adaptation trial, supporting the strength-of-adaptation hypothesis. Thus, we show that adaptation of at least two temporal mechanisms influences numerosity perception.

Adaptation reveals unbalanced interaction between numerosity and time.

Processing quantities such as the number of objects in a set, size, spatial arrangement and time is an essential means of structuring the external world and preparing for action. The theory of magnitude suggests that number and time, among other continuous magnitudes, are linked by a common cortical metric, and their specialization develops from a single magnitude system. In order to investigate potentially shared neural mechanisms underlying numerosity and time processing, we used visual adaptation, a method which can reveal the existence of a dedicated processing system. We reasoned that cross-adaptation between numerosity and duration would concur with the existence of a common processing mechanism, whereas the absence of cross-adaptation would provide evidence against it. We conducted four experiments using a rapid adaptation protocol where participants adapted to either visual numerosity or visual duration and subsequently performed a numerosity or duration discrimination task. We found that adapting to a low numerosity altered the estimation of the reference numerosity by an average of 5 dots, compared to adapting to a high numerosity. Similarly, adapting to a short duration altered the estimation of the reference duration by an average of 43 msec, compared to adapting to a long duration. In the cross-dimensional adaptation conditions, duration adaptation altered numerosity estimation by an average of 1 dot, whereas there was not sufficient evidence to either support or reject the effect of numerosity adaptation on duration judgments. These results highlight that there are partially overlapping neural mechanisms which are dedicated for processing both numerosity and time.

Inducing circular vection with tactile stimulation encircling the waist.

In general, moving sensory stimuli (visual and auditory) can induce illusory sensations of self-motion (i.e. vection) in the direction opposite of the sensory stimulation. The aim of the current study was to examine whether tactile stimulation encircling the waist could induce circular vection (around the body's yaw axis) and to examine whether this type of stimulation would influence participants' walking trajectory and balance. We assessed the strength and direction of perceived self-motion while vision was blocked and while either receiving tactile stimulation encircling the waist clockwise or counterclockwise or no tactile stimulation. Additionally, we assessed participants' walking trajectory and balance while receiving these different stimulations. Tactile stimulation encircling the waist was found to lead to self-reported circular vection in a subset of participants. In this subset of participants, circular vection was on average experienced in the same direction as the tactile stimulation. Additionally, perceived rotatory self-motion in participants that reported circular vection correlated with balance (i.e., sway velocity and the standard error of the mean in the medio-lateral dimension). The fact that, in this subset of participants, subjective reports of vection correlated with objective outcome measures indicates that tactile stimulation encircling the waist might indeed be able to induced circular vection.

Grouping of optic flow stimuli during binocular rivalry is driven by monocular information.

During binocular rivalry, perception alternates between two dissimilar images, presented dichoptically. Although binocular rivalry is thought to result from competition at a local level, neighboring image parts with similar features tend to be perceived together for longer durations than image parts with dissimilar features. This simultaneous dominance of two image parts is called grouping during rivalry. Previous studies have shown that this grouping depends on a shared eye-of-origin to a much larger extent than on image content, irrespective of the complexity of a static image. In the current study, we examine whether grouping of dynamic optic flow patterns is also primarily driven by monocular (eye-of-origin) information. In addition, we examine whether image parameters, such as optic flow direction, and partial versus full visibility of the optic flow pattern, affect grouping durations during rivalry. The results show that grouping of optic flow is, as is known for static images, primarily affected by its eye-of-origin. Furthermore, global motion can affect grouping durations, but only under specific conditions. Namely, only when the two full optic flow patterns were presented locally. These results suggest that grouping during rivalry is primarily driven by monocular information even for motion stimuli thought to rely on higher-level motion areas.

Interaction effects of visual stimulus speed and contrast on postural sway.

Manipulating the characteristics of visual stimuli that simulate self-motion through the environment can affect the resulting postural sway magnitude. In the present study, we address the question whether varying the contrast and speed of a linear translating dot pattern influences medial-lateral postural sway. In a first experiment, we investigated whether the postural sway magnitude increases with increasing dot speed, as was previously demonstrated for expanding and contracting stimuli. In a second experiment, we also manipulated the contrast of the stimuli. For reasons that high-contrast stimuli can be considered 'perceptually' stronger, we expect that higher-contrast stimuli induce more sway than lower-contrast stimuli. The results of the first experiment show that dot speed indeed influences postural sway, although in an unexpected way. For higher speeds, the sway is in the direction of the stimulus motion, yet for lower speeds the sway is in a direction opposite to the stimulus motion. The results of the second experiment show that dot contrast does affect postural sway, but that this depends on the speed of the moving dots. Interestingly, the direction of postural sway induced by a relatively low dot speed (4°/s) depends on dot contrast. Taken together, our results suggest that interactions between the visual, vestibular and proprioceptive system appear to be influenced by an internal representation of the visual stimulus, rather than being influenced by the external visual stimulus characteristics only.

Visual directional anisotropy does not mirror the directional anisotropy apparent in postural sway.

Presenting a large optic flow pattern to observers is likely to cause postural sway. However, directional anisotropies have been reported, in that contracting optic flow induces more postural sway than expanding optic flow. Recently, we showed that the biomechanics of the lower leg cannot account for this anisotropy (Holten, Donker, Verstraten, & van der Smagt, 2013, Experimental Brain Research, 228, 117-129). The question we address in the current study is whether differences in visual processing of optic flow directions, in particular the perceptual strength of these directions, mirrors the anisotropy apparent in postural sway. That is, can contracting optic flow be considered to be a perceptually stronger visual stimulus than expanding optic flow? In the current study we use a breaking continuous flash suppression paradigm where we assume that perceptually stronger visual stimuli will break the flash suppression earlier, making the suppressed optic flow stimulus visible sooner. Surprisingly, our results show the opposite, in that expanding optic flow is detected earlier than contracting optic flow.

Cross-modal, bidirectional priming in grapheme-color synesthesia.

Grapheme-color synesthetes perceive achromatic graphemes to be inherently colored. In this study grapheme-color synesthetes and non-synesthetes discriminated (1) the color of visual targets presented along with aurally presented digit primes, and (2) the identity of aurally presented digit targets presented with visual color primes. Reaction times to visual color targets were longer when the color of the target was incongruent with the synesthetic percept reported for the prime. Likewise, discriminating aurally presented digit targets took longer when the color of the prime was incongruent with the synesthetic percept for the target. These priming effects were absent in non-synesthetes. We conclude that binding between digits and colors in grapheme-color synesthetes can occur bidirectionally across senses. The results are in line with the idea that synesthesia is the result of linking inducing stimuli (e.g. digits) to synesthetic percepts (colors) at an abstract - supra-modal - conceptual level of processing.

Image-based grouping during binocular rivalry is dictated by eye-of-origin.

Prolonged viewing of dichoptically presented images with different content results in perceptual alternations known as binocular rivalry. This phenomenon is thought to be the result of competition at a local level, where local rivalry zones interact to give rise to a single, global dominant percept. Certain perceived combinations that result from this local competition are known to last longer than others, which is referred to as grouping during binocular rivalry. In recent years, the phenomenon has been suggested to be the result of competition at both eye- and image-based processing levels, although the exact contribution from each level remains elusive. Here we use a paradigm designed specifically to quantify the contribution of eye- and image-based processing to grouping during rivalry. In this paradigm we used sine-wave gratings as well as upright and inverted faces, with and without binocular disparity-based occlusion. These stimuli and conditions were used because they are known to result in processing at different stages throughout the visual processing hierarchy. Specifically, more complex images were included in order to maximize the potential contribution of image-based grouping. In spite of this, our results show that increasing image complexity did not lead to an increase in the contribution of image-based processing to grouping during rivalry. In fact, the results show that grouping was primarily affected by the eye-of-origin of the image parts, irrespective of stimulus type. We suggest that image content affects grouping during binocular rivalry at low-level processing stages, where it is intertwined with eye-of-origin information.

Decreasing perceived optic flow rigidity increases postural sway.

Optic flow simulating self-motion through the environment can induce postural adjustments in observers. Some studies investigating this phenomenon have used optic flow patterns increasing in speed from center to periphery, whereas others used optic flow patterns with a constant speed. However, altering the speed gradient of an optic flow stimulus changes the perceived rigidity of such a stimulus. Optic flow stimuli that are perceived as rigid can be expected to provide a stronger sensation of self-motion than non-rigid optic flow, and this may well be reflected in the amount of postural sway. The current study, therefore, examined, by manipulating the speed gradient, to what extent the rigidity of an optic flow stimulus influences posture along the anterior-posterior axis. We used radial random dot expanding or contracting optic flow patterns with three different speed profiles (single-speed, linear speed gradient or quadratic speed gradient) that differentially induce the sensation of self-motion. Interestingly, most postural sway was observed for the non-rigid single-speed optic flow pattern, which contained the least self-motion information of the three profiles. Moreover, we found an anisotropy in that contracting optic flow produced more postural sway than expanding optic flow. In addition, the amount of postural sway increased with increasing stimulus speed, but for contracting optic flow only. Taken together, the results of the current study support the view that visual and sensorimotor systems appear to be tailored toward compensating for rigid optic flow stimulation.

Colour-grapheme synesthesia affects binocular vision.

In colour-grapheme synesthesia, non-coloured graphemes are perceived as being inherently coloured. In recent years, it is debated whether visual processing of synesthesia-inducing achromatic graphemes is similar to that of chromatic graphemes. Here, we exploit the phenomenon of binocular rivalry in which incompatible images presented dichoptically compete for conscious expression. Importantly, the competition only arises if the two images are sufficiently different; if the difference between the images is small, the images will fuse into a single mixed percept. We show that achromatic digits that induce synesthetic colour percepts increase the incidence of binocular rivalry compared to achromatic non-digits that do not evoke such percepts. That is, compared to achromatically perceived non-digits, synesthesia-inducing digits increase the predominance of binocular rivalry over binocular fusion. This finding shows that the synesthetic colour experience can provide the conditions for promoting binocular rivalry, much like stimulus features that induce rivalry in normal vision.

What is Grouping during Binocular Rivalry?

During binocular rivalry, perception alternates between dissimilar images presented dichoptically. Although perception during rivalry is believed to originate from competition at a local level, different rivalry zones are not independent: rival targets that are spaced apart but have similar features tend to be dominant at the same time. We investigated grouping of spatially separated rival targets presented to the same or to different eyes and presented in the same or in different hemifields. We found eye-of-origin to be the strongest cue for grouping during binocular rivalry. Grouping was additionally affected by orientation: identical orientations were grouped longer than dissimilar orientations, even when presented to different eyes. Our results suggest that eye-based and orientation-based grouping is independent and additive in nature. Grouping effects were further modulated by the distribution of the targets across the visual field. That is, grouping within the same hemifield can be stronger or weaker than between hemifields, depending on the eye-of-origin of the grouped targets. We also quantified the contribution of the previous cues to grouping of two images during binocular rivalry. These quantifications can be successfully used to predict the dominance durations of different studies. Incorporating the relative contribution of different cues to grouping, and the dependency on hemifield, into future models of binocular rivalry will prove useful in our understanding of the functional and anatomical basis of the phenomenon of binocular rivalry.

False approximations of the approximate number system?

Prior research suggests that the acuity of the approximate number system (ANS) predicts future mathematical abilities. Modelling the development of the ANS might therefore allow monitoring of children's mathematical skills and instigate educational intervention if necessary. A major problem however, is that our knowledge of the development of the ANS is acquired using fundamentally different paradigms, namely detection in infants versus discrimination in children and adults. Here, we question whether such a comparison is justified, by testing the adult ANS with both a discrimination and a detection task. We show that adults perform markedly better in the discrimination compared to the detection task. Moreover, performance on discrimination but not detection, correlated with performance on mathematics. With a second similar experiment, in which the detection task was replaced by a same-different task, we show that the results of experiment 1 cannot be attributed to differences in chance level. As only task instruction differed, the discrimination and the detection task most likely reflect differences at the decisional level. Future studies intending to model the development of the ANS should therefore rely on data derived from a single paradigm for different age groups. The same-different task appears a viable candidate, due to its applicability across age groups.

Suppressed images selectively affect the dominant percept during binocular rivalry.

During binocular rivalry, perception alternates between dissimilar images that are presented dichoptically. It has been argued that perception during the dominance phase of rivalry is unaffected by the suppressed image. Recent evidence suggests, however, that the suppressed image does affect perception of the dominant image, yet the extent and nature of this interaction remain elusive. We hypothesize that this interaction depends on the difference in feature content between the rivaling images. Here, we investigate how sensitivity to probes presented in the image that is currently dominant in perception is affected by the suppressed image. Observers performed a 2AFC discrimination task on oriented probes (Experiment 1) or probes with different motion directions (Experiment 2). Our results show that performance on both orientation and motion direction discrimination was affected by the content of the suppressed image. The strength of interference depended specifically on the difference in feature content (e.g., the difference in orientation) between the probe and the suppressed image. Moreover, the pattern of interference by the suppressed image is qualitatively similar to the situation where this image and the probe are simultaneously visible. We conclude that perception during the dominance phase of rivalry is affected by a suppressed image as if it were visible.