Bimanual circling in deafferented patients: evidence for a role of visual forward models.

The present study investigated the role of ideation and visual feedback, and their interaction in movement control in the absence of somatosensory feedback, with the hypothesis that visual imagery and internal visual models may play a crucial role in performance even without feedback. Two chronically deafferented participants, GL and IW, circled bimanually two occluded cranks first without vision and then with hand-congruent and hand-incongruent visual feedback provided by visible flags. Without vision, GL was unable to circle the cranks. In contrast, IW performed spontaneously a symmetric pattern. Again without feedback, IW performed an instructed symmetric crank pattern well, but was unable to perform anti-phase cranking. With hand-congruent visual feedback, GL and IW were able to perform both symmetric and anti-phase movements, with symmetry being more accurate. Visual feedback during preceding trials made possible trials without visual feedback in GL and improved anti-phase trials in IW. Frequency-transformed incongruent visual feedback resulted in poor performance in part due to unsuitable hand-related strategies. However, IW improved in the latter task after detailed explanations of the condition. In conclusion, we suggest that both participants use visual imagery and visual forward models to control their hand movements. Visual updating of the forward model also improves performance with no vision. In addition, IW seemed to have been able to move from a focus on hand position to one on the transformed visual feedback to improve movement control in the incongruent feedback/movement condition.