Vestibular disturbances in epilepsy

Neurophysiologie Clinique/Clinical Neurophysiology

2008

230

163

Summary Body ownership and embodiment are two fundamental mechanisms of selfconsciousness. The present article reviews neurological data about paroxysmal illusions during which body ownership and embodiment are affected differentially: autoscopic phenomena (out-of-body experience, heautoscopy, autoscopic hallucination, feeling-of-a-presence) and the room tilt illusion. We suggest that autoscopic phenomena and room tilt illusion are related to different types of failures to integrate body-related information (vestibular, proprioceptive and tactile cues) in addition to a mismatch between vestibular and visual references. In these patients, altered body ownership and embodiment has been shown to occur due to pathological activity at the temporoparietal junction and other vestibular-related areas arguing for a key importance of vestibular processing. We also review the possibilities of manipulating body ownership and embodiment in healthy subjects through exposition to weightlessness as well as caloric and galvanic stimulation of the peripheral vestibular apparatus. In healthy subjects, disturbed self-processing might be related to interference of vestibular stimulation with vestibular cortex leading to disintegration of bodily information and altered body ownership and embodiment. We finally propose a differential contribution of the vestibular cortical areas to the different forms of altered body ownership and embodiment. Résumé L'attribution du corps propre et de ses éléments constitutifs (body ownership), ainsi que le sentiment d'incarnation (embodiment) -le fait d'habiter ce corps, d'être localisé dans les limites physiques de ce corps -, sont deux éléments fondamentaux de la conscience de soi. Nous faisons ici la synthèse de données issues de la neurologie montrant que des manifestations paroxystiques telles que les phénomènes autoscopiques (expérience de sortie du corps, héautoscopie, hallucination autoscopique, sensation de présence) et l'illusion de bascule de l'environnement (room tilt illusion) se caractérisent par une atteinte différentielle des mécanismes d'attribution du corps propre et du sentiment d'incarnation. Nous faisons l'hypothèse que les différents phénomènes autoscopiques et l'illusion de bascule de l'environnement se caractérisent par différents patrons de déficits d'intégration des informations sensorielles corporelles (informations visuelles, musculaires proprioceptives et tactiles) combinés à une perte de cohérence entre les références visuelles et vestibulaires. Chez les patients souffrant de phénomènes autoscopiques, les déficits d'attribution du corps propre et du sentiment d'incarnation ont été liés à un dysfonctionnement au niveau de la jonction temporopariétale et d'autres régions corticales recevant des informations vestibulaires, suggérant une contribution importante des afférences vestibulaires dans les mécanismes de la conscience de soi. Nous rapportons également des données de la littérature recueillies chez des sujets sains suggérant la possibilité de manipuler l'attribution ...

Section: The Vestibular Cortexmentioning

confidence: 86%

Body ownership and embodiment: Vestibular and multisensory mechanisms

Lopez

Halje

Neurophysiologie Clinique/Clinical Neurophysiology

2008

230

163

“…In patients operated on for focal epilepsy, Penfield (1957) reported that electrical cortical stimulation of the superior temporal gyrus evoked vestibular illusions described as "dizziness, swinging, spinning" (case #94), "sinking feeling and sensation of full head" (case #5), or "head rest seems to be jumping up and down" (case #25). Congruently, epileptic patients with vestibular aurae have epileptic foci and brain lesions surrounding the superior temporal gyrus and the temporo-parietal cortex (Penfield and Kristiansen, 1951;Smith, 1960). This was confirmed more recently by Kahane et al (2003) in a large population of epileptic patients.…”

mentioning

confidence: 90%

“…Based on these clinical and neuroimaging data (see Section 3.1.2), it is therefore not clear whether the human PIVC is located in the posterior insula, inferior parietal lobule, superior temporal gyrus, or at the junction between these regions. On the basis of studies in epileptic patients, Smith (1960) proposed that "the vestibulo-psychic area […] may have its epicenter in the region of the angular gyrus" (Fig. 8A).…”

mentioning

confidence: 99%

The thalamocortical vestibular system in animals and humans

Lopez

2011

Brain Research Reviews

460

379

The vestibular system provides the brain with sensory signals about three-dimensional head rotations and translations. These signals are important for postural and oculomotor control, as well as for spatial and bodily perception and cognition, and they are subtended by pathways running from the vestibular nuclei to the thalamus, cerebellum and the "vestibular cortex."The present review summarizes current knowledge on the anatomy of the thalamocortical vestibular system and discusses data from electrophysiology and neuroanatomy in animals by comparing them with data from neuroimagery and neurology in humans. Multiple thalamic nuclei are involved in vestibular processing, including the ventroposterior complex, the ventroanterior-ventrolateral complex, the intralaminar nuclei and the posterior nuclear group 2 0 1 1 ) 1 1 9 -1 4 6 Abbreviations: 3aHv, 3a-hand-vestibular area; 3aNv, 3a-neck-vestibular area; ASS, anterior suprasylvian cortex; DVN, descending vestibular nucleus; FEF, frontal eye fields; Ig, insula granularis; IL, intralaminar nuclei; LD, lateral dorsal nucleus; LGN, lateral geniculate nucleus; LP, lateral posterior nucleus; LVN, lateral vestibular nucleus; MGmc, medial geniculate nucleus, pars magnocellularis; MGN, medial geniculate nucleus; MIP, medial intraparietal area; MST, medial superior temporal area; MT, middle temporal area; MVN, medial vestibular nucleus; PIVC, parieto-insular vestibular cortex; PO, posterior group of the thalamus; Reipt, area retroinsularis pars parietalis; Ri, area retroinsularis; SGN, suprageniculate nucleus; SVN, superior vestibular nucleus; TPJ, temporo-parietal junction; VA, ventroanterior thalamic nucleus; Vim, nucleus ventralis intermedius; VIP R A I N R E S E A R C H R E V I E W S 6 7 (

“…The core region of the human vestibular cortex [16,39,65] is situated at the TPJ including the posterior insula. Brain damage in this area has been associated with graviceptive vestibular sensations and dysfunctions [15,95]. Several neuropsychological and neuroimaging studies suggest the implication of the TPJ and cortical areas along the intraparietal sulcus in combining tactile, proprioceptive, and visual information in a coordinated reference frame [17,24].…”

Section: Body and Self Processing At The Temporo-parietal Junctionmentioning

confidence: 99%

Out-of-body experience, heautoscopy, and autoscopic hallucination of neurological origin

Möhr

2005

Brain Research Reviews

307

116

Autoscopic phenomena (AP) are rare illusory visual experiences during which the subject has the impression of seeing a second own body in extrapersonal space. AP consist of out-of-body experience (OBE), autoscopic hallucination (AH), and heautoscopy (HAS). The present article reviews and statistically analyzes phenomenological, functional, and anatomical variables in AP of neurological origin (n = 41 patients) that have been described over the last 100 years. This was carried out in order to further our understanding of the underlying mechanisms of AP, much as previous research into the neural bases of body part illusions has demystified these latter phenomena. Several variables could be extracted, which distinguish between or are comparable for the three AP providing testable hypotheses for subsequent research. Importantly, we believe that the scientific demystification of AP may be useful for the investigation of the cognitive functions and brain regions that mediate processing of the corporeal awareness and self consciousness under normal conditions. D 2005 Elsevier B.V. All rights reserved.Theme: Other systems of the Cns Topic: Association cortex and thalamocortical relations, Cognition