Flor H. DFG - Deutsche Forschungsgemeinschaft FL 156/41-1: Reinhart Koselleck Projekt: "Körperrepräsentation und sensomotorische Funktionen modulieren die Reorganisation des Gehirns und Verhaltensänderungen: Vom chronischen Schmerz zur lmmobilität und Demenz ". 07/2015-06/2020.
Brain circuits involved in pain processing and body representation are closely connected and interact more than previously thought. Somatosensory, visual, interoceptive and motor processes contribute to the formation of body perception and can be combined in treatments designed to reestablish normal body representation. Based on the development of novel psychological interventions targeting body representation in phantom limb pain, we devise new virtual and augmented reality-based training pro-cedures to reestablish normal body representation and improve sensory, motor and cognitive function. We apply these interventions in post-injury pain and motor dysfunction, where the counteracting of long-term immobility by feedback of movement should shorten recovery times and preserve muscle function. Another novel application is in chronic musculoskeletal pain, where the systematic shaping of intact body representation including interoception, should reduce pain and pain behaviors and alter maladaptive brain circuits. We expand this approach to early dementia, where the breakdown of sen-sorimotor processing and immobility may be important in disease progression. We employ novel im-plicit and explicit assessment methods of these perceptual and neuronal changes involving psycho-physics, computational modeling, physiological recordings and brain imaging methods. These studies are the basis for mechanistic treatment approaches and also advance basic research on body repre-sentation and multisensory integration.
Flor H. DFG - Deutsche Forschungsgemeinschaft FL 156/35-1: KFO 256 TP 4: Sensory-affective Interaction and Body Perception in BPD. 01/2012-12/2014.
BPD is characterized by an altered perception of the body that includes sensory deficits, such as reduced pain perception, which are related to dissociation and self-injurious behavior. However, it is unknown if these alterations, which occur primarily in aversive affective situations, are a core variable or some type of coping behavior related to the disorder. The specificity for the somatosensory system, the interaction between various sensory modalities, and their relationship to impaired body perception have not yet been investigated. In healthy subjects, a widely distributed neuronal network involving parietal and frontal brain regions is responsible for the integration of multimodal inputs and for the creation of a coherent feeling of one’s own body. In patients with BPD, this coherence might be impaired in some conditions (e.g., dissociative states) which suggests alterations in limbic-frontal interaction, as well as in interactions with parietal regions. Our project aims at specifying the alterations in sensory perception of BPD patients and to identify clinical and neural correlates of these alterations. Specifically, we propose that the sensory perception deficits are not only related to noxious sensory stimuli and that these deficits are enhanced by stress and dissociation. To allow for disorderspecific conclusions, a group of patients with fibromyalgia will be included. The results might ultimately pave the way for novel therapeutic approaches by revealing if and how simple illusory setups might be able to alter somatosensory integration and associated brain activity.