Body ownership and attention in the mirror: insights from somatoparaphrenia and the rubber hand illusion.

The brain receives and synthesises information about the body from different modalities, coordinates and perspectives, and affords us with a coherent and stable sense of body ownership. We studied this sense in a somatoparaphrenic patient and three control patients, all with unilateral right-hemisphere lesions. We experimentally manipulated the visual perspective (direct- versus mirror-view) and spatial attention (drawn to peripersonal space versus extrapersonal space) in an experiment involving recognising one's own hand. The somatoparaphrenic patient denied limb ownership in all direct view trials, but viewing the hand via a mirror significantly increased ownership. The extent of this increase depended on spatial attention; when attention was drawn to the extrapersonal space (near-the-mirror) the patient showed a near perfect recognition of her arm in the mirror, while when attention was drawn to peripersonal space (near-the-body) the patient recognised her arm in only half the mirror trials. In a supplementary experiment, we used the Rubber Hand Illusion to manipulate the same factors in healthy controls. Ownership of the rubber hand occurred in both direct and mirror view, but shifting attention between peripersonal and extrapersonal space had no effect on rubber-hand ownership. We conclude that the isolation of visual perspectives on the body and the division of attention between two different locations is not sufficient to affect body ownership in healthy individuals and right hemisphere controls. However, in somatoparaphrenia, where first-person body ownership and stimulus-driven attention are impaired by lesions to a right-hemisphere ventral attentional-network, the body can nevertheless be recognised as one's own if perceived in a third-person visual perspective and particularly if top-down, spatial attention is directed away from peripersonal space.