Touch and feel? Using the rubber hand paradigm to investigate self-touch enhancement in right-hemisphere stroke patients.

Following stroke, a patient may fail to report touch administered by another person but claim that she feels touch when it is self-administered. We investigated three explanations for self-touch enhancement: (1) proprioceptive information from the administering hand, (2) attentional modulation, and (3) temporal expectation. Tactile sensation was assessed with vision precluded, and with the affected hand positioned in the left and right hemispace. In four of six experiments, the somatic rubber hand paradigm was used: the Examiner administered stimulation to the patient's affected left hand while guiding the patient's right hand to administer synchronous stimulation to a prosthetic hand. Even though the patient's two hands were not in contact, patients detected the same number of stimulations as when they touched their own hand directly (self-administered condition). Moreover, there was no decline in rates of detection when potentially informative movements of the administering hand were restricted. This demonstrates that patients feel rather than infer stimulation under conditions of self-touch. When patients received stimulation to the affected hand in the opposite hemispace to the hand administering touch to the prosthetic hand, all but one showed self-touch enhancement. Thus, neither proprioceptive information nor attentional modulation at the spatial region of the administering hand provided a sufficient explanation for self-touch enhancement. A follow-up experiment indicated an important role for temporal expectation: a delay, between the patient's stimulation of the prosthetic hand and the Examiner's stimulation of the patient's affected hand, eliminated the self-touch enhancement effect.