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My hand in my ear: a phantom limb re-induced by the illusion of body ownership in a patient with a brachial plexus lesion

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Abstract

Corporeal awareness of body unity, continuity, and integrity is hardwired in the brain, even following massive deafferentation. Following peripheral limb injury, referred phantom sensations are reported frequently on the cheek and, rarely, on the ear. Here, we explore how brain plasticity mechanisms induced by multisensory stimulation of different facial regions (cheek and ear) modulate the feeling that a complete missing limb is still attached to the body. We applied the modified rubber hand illusion (RHI) paradigm following synchronous and asynchronous stimulation of the face–hand and ear–hand in the unusual case of a patient with a brachial plexus lesion, who had lost upper-left limb sensation and developed a phantom sensation of the arm restricted to the ear. He experienced a strong illusion of ownership of the rubber hand during synchronous stroking of the ear but not the cheek and reported more defined tactile sensations in his previously numb body part during the illusion than when simply touching the ear. Phantom experiences are not exclusively based on sensory memories of the once-present body periphery, they are organized into a topographic cortical map with the ear–hand area adjoining but separate from the face. Multimodal experiences specifically modulate possible remapping of ear–hand representations and generate a more defined connection between the brain’s memory of the body and what one feels of the actual physical body. We suggest that RHI is a form of sensory intervention that makes the best use of residual signals from disconnected body parts after peripheral injury, evoking and controlling the limb sensations.

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Acknowledgements

The authors acknowledge research support from ANIA Foundation.

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Authors and Affiliations

  1. Department of Psychology, University of Rome “La Sapienza”, Via dei Marsi 78, 00185, Rome, Italy

    Mariella Pazzaglia, Anna Maria Giannini & Erik Leemhuis

  2. IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00100, Rome, Italy

    Mariella Pazzaglia, Giorgio Scivoletto & Erik Leemhuis

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  1. Mariella Pazzaglia
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  2. Giorgio Scivoletto
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  3. Anna Maria Giannini
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  4. Erik Leemhuis
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Contributions

MP: study concept and design, acquisition of data, analysis and interpretation, writing and drafting of the manuscript, critical revision of the manuscript for important intellectual content. GS: performed acquisition of neurologic data. AG: critical revision of the manuscript for important intellectual content. EL: drafting of the manuscript, critical revision of the manuscript for important intellectual content. All authors read and approved the final manuscript.

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Correspondence to Mariella Pazzaglia.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The patient provided written informed consent to take part in the study.

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Pazzaglia, M., Scivoletto, G., Giannini, A.M. et al. My hand in my ear: a phantom limb re-induced by the illusion of body ownership in a patient with a brachial plexus lesion. Psychological Research 83, 196–204 (2019). https://doi.org/10.1007/s00426-018-1121-5

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  • DOI: https://doi.org/10.1007/s00426-018-1121-5

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