Unisensory and multisensory Self-referential stimulation of the lower limb: An exploratory fMRI study on healthy subjects

Vieira, Ana Isabel; Almeida, Patrícia; Canário, Nádia; Castelo-Branco, Miguel; Nunes, Maria Vânia; Castro-Caldas, Alexandre

http://hdl.handle.net/10400.26/39785

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Authors

Vieira, Ana Isabel

Almeida, Patrícia

Canário, Nádia

Castelo-Branco, Miguel

Nunes, Maria Vânia

Castro-Caldas, Alexandre

Abstract(s)

Background: The holistic view of the person is the essence of the physiotherapy. Knowledge of approaches that develop the whole person promotes better patient outcomes. Multisensory Selfreferential stimulation, more than a unisensory one, seems to produce a holistic experience of the Self (“Core-Self”). Objectives: (1) To analyze the somatotopic brain activation during unisensory and multisensorial Self-referential stimulus; and (2) to understand if the areas activated by multisensorial Self-referential stimulation are the ones responsible for the “Core-Self.” Methods: An exploratory functional magnetic resonance imaging (fMRI) study was performed with 10 healthy subjects, under the stimulation of the lower limbs with three Self-referential stimuli: unisensory auditory-verbal, unisensory tactile-manual, and multisensory, applying the unisensory stimuli simultaneously. Results: Unisensory stimulation elicits bilateral activations of the temporoparietal junction (TPJ), of the primary somatosensory cortex (S1), of the primary motor cortex (BA4), of the premotor cortex (BA6) and of BA44; multisensory stimulation also elicits activity in TPJ, BA4, and BA6, and when compared with unisensory stimuli, activations were found in: (1) Cortical and subcortical midline structures—BA7 (precuneus), BA9 (medial prefrontal cortex), BA30 (posterior cingulated), superior colliculum and posterior cerebellum; and (2) Posterior lateral cortex—TPJ, posterior BA13 (insula), BA19, and BA37. Bilateral TPJ is the one that showed the biggest activation volume. Conclusion: This specific multisensory stimulation produces a brain activation map in regions that are responsible for multisensory Self-processing and may represent the Core- Self. We recommend the use of this specific multisensory stimulation as a physiotherapy intervention strategy that might promote the Self-reorganization.

Keywords

Auditory-verbal Selfreferential stimulation Brain map Lower-limb Multisensory Self-referential stimulation Self-processing Tactile-manual Selfreferential stimulation