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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
Three conditions must be met in order to confirm the presence of mirror touch synesthesia. The first condition is that the synaesthetic response, which is defined as the sensation synesthetes feel after observing someone else being touched, should feel like conscious experiences. The second condition is that synesthetic responses are induced by a stimulus that normally does not induce that response. The third condition is that the synesthetic experiences must occur automatically, without conscious thought. In order to examine the prevalence of this condition, a study was conducted at the University College London and University of Sussex. 567 undergraduate participants were recruited and given a questionnaire. From the questionnaire, it was determined that approximately 2.5% of the population experienced mirror-touch synesthesia symptoms. Further studies have shown the prevalence to be 1.6%, meaning that this condition is one of the more common types of synesthesia, along with grapheme-color synesthesia (1.4%) and day-color synesthesia (2.8%). At the moment it is believed that there are two subtypes of the condition. The first type causes a person to feel sensations on the part of their body that mirrors the observed touch. The second type causes a person to feel sensations on the same side of their body as the observed touch.
Studies have attempted to more explicitly define the of synesthetic responses. In most studies, participants are asked to observe someone else being touched and report what kind of synesthetic response they experience. In one particular instance, video clips were used to show different types of observed touch. The of the synesthetic touch is not affected by the location of the observed touch (arm, leg, hand, etc.); however, it is sometimes affected by the spatial orientation of the observed touch. When crossed hands are touched, the hands become uncrossed in the perception of synesthetes. However when the observed hand is upside down, the observed touch does not get rotated. Intensity is also not affected if the observed act consists of someone touching themselves, versus someone touching them. Additionally, the type of object doing the touching has a significant effect on the intensity of the response. If a finger or knife tip is used, a much higher intensity is experienced than if a feather is used. Finally, watching a dummy being touched decreases the intensity of the observed touch significantly. For this reason, it is suspected that in order to experience a synesthetic touch, synesthetes must observe somebody who is capable of feeling sensations.
Mirror touch responses are not limited to feeling touch. Mirror touch synesthetes have a higher ability to feel empathy than non-synesthetes, and can therefore feel the same emotions that someone else may be observed to feel. Additionally, some individuals experience pain when observing someone else in pain, and this is a condition usually developed from birth. Approximately 30% of the normal population experience some form of this condition and around 16% of amputees report synesthetic pain after an amputation. This condition can either be acquired or developed. In the congenital condition, synesthetes experience pain in the same location as the observed pain; however, in the acquired condition, high intensity pain is felt at the same location as the trauma.
Mirror-touch synesthesia is a rare condition which causes individuals to experience the same sensation (such as touch) that another person feels. For example, if someone with this condition were to observe someone touching their cheek, they would feel the same sensation on their own cheek. Synesthesia, in general, is described as a condition in which a stimulus causes an individual to experience an additional sensation. Synesthesia is usually a developmental condition; however, recent research has shown that mirror touch synesthesia can be acquired after sensory loss following amputation.
Synesthesia is found in at least 4.4% of the population, as a high estimate, which is equivalent to 1 in 23 people. This study had also concluded that one common form of synesthesia—grapheme-color synesthesia (colored letters and numbers) – is found in more than one percent of the population, and this latter prevalence of graphemes-color synesthesia has now been independently verified in a yet larger sample. Earlier estimates of the prevalence of synesthesia were based on "best-guess" estimations only ("e.g." 1 in 250,000) or had limitations in their methodologies because they required synesthetes to refer themselves for study ("e.g." 1 in 2000) and for this reason the authors of those studies had been moderate in their claims. Also, some individuals will not self-classify as synesthetes because they do not realize that their perceptions are different from those of everyone else.
The most common forms of synesthesia are those that trigger colors, and the most prevalent of all is day-color. Also relatively common is grapheme-color synesthesia. We can think of "prevalence" both in terms of how common is synesthesia (or different forms of synesthesia) within the population, or how common are different forms of synesthesia within synesthetes. So within synesthetes, forms of synesthesia that trigger color also appear to be the most common forms of synesthesia with a prevalence rate of 86% within synesthetes. In another study, music-color is also prevalent at 18–41%. Some of the rarest are reported to be auditory-tactile, mirror-touch, and lexical-gustatory.
There is research to suggest that the likelihood of having synesthesia is greater in people with autism.
Other forms of synesthesia have been reported, but little has been done to analyze them scientifically. There are at least 80 different types of synesthesia.
Supernumerary phantom limb is a condition where the affected individual believes and receives sensory information from limbs of the body that do not actually exist, and never have existed, in contradistinction to phantom limbs, which appear after an individual has had a limb removed from the body and still receives input from it.
An fMRI study of a subject with a supernumerary phantom left arm was done by Khateb "et al." at the Laboratory of Experimental Neuropsychology at the University of Geneva. When the subject was told to touch her right cheek with the phantom limb, there was increased activity in the motor cortex of her brain in the area roughly corresponding to the left arm. When she announced that she had touched the phantom limb to her cheek, activity was monitored in the area of the somatosensory cortex that corresponded to the right cheek. At times during the experiment, the subject was asked to move the phantom limb to a location that was obstructed or otherwise unfeasible. In these instances, there was similar activation of the motor cortex but no such activity in the somatosensory cortex.
Grapheme-color synaesthesia or colored grapheme synesthesia is a form of synesthesia in which an individual's perception of numerals and letters is associated with the experience of colors. Like all forms of synesthesia, Grapheme-color synesthesia is involuntary, consistent, and memorable. Grapheme-color synesthesia is one of the most common forms of synesthesia, and because of the extensive knowledge of the visual system, one of the most studied.
While it is extremely unlikely that any two synesthetes will report the same colors for all letters and numbers, studies of large numbers of synesthetes find that there are some commonalities across letters (e.g., "A" is likely to be red). Early studies argued that grapheme-color synesthesia was not due to associative learning, such as from playing with colored refrigerator magnets. However, one recent study has documented a case of synesthesia in which synesthetic associations could be traced back to colored refrigerator magnets. Despite the existence of this individual case, the majority of synesthetic associations do not seem to be driven by learning of this sort. Rather, it seems that more frequent letters are paired with more frequent colors, and some meaning-based rules, such as ‘b’ being blue, drive most synesthetic associations.
There has been a lot more research as to why and how synesthesia occurs with more recent technology and as synesthesia has become more well known. It has been found that grapheme-color synesthetes have more grey matter in their brain. There is evidence of an increased grey matter volume in the left caudal intra- parietal sulcus (IPS). There was also found to be an increased grey matter volume in the right fusiform gyrus. These results are consistent with another study on the brain functioning of grapheme-color synesthetes. Grapheme-color synesthetes tend to have an increased thickness, volume, and surface area of the fusiform gyrus. Furthermore, the area of the brain where word, letter, and color processing are located, V4a, is where the most significant difference in make-up was found. Though not certain, these differences are thought to be part of the reasoning for the presence of grapheme-color synesthesia.
Allochiria (from the Greek meaning "other hand") is a neurological disorder in which the patient responds to stimuli presented to one side of their body as if the stimuli had been presented at the opposite side. It is associated with spatial s, usually symmetrical, of stimuli from one side of the body (or of the space) to the opposite one. Thus a touch to the left side of the body will be reported as a touch to the right side, which is also known as somatosensory allochiria. If the auditory or visual senses are affected, sounds (a person's voice for instance) will be reported as being heard on the opposite side to that on which they occur and objects presented visually will be reported as having been presented on the opposite side. Often patients may express allochiria in their drawing while copying an image. Allochiria often co-occurs with unilateral neglect and, like hemispatial neglect, the disorder arises commonly from damage to the right parietal lobe.
Allochiria is often confused with alloesthesia, also known as false allochiria. True allochiria is a symptom of dyschiria and unilateral neglect. Dyschiria is a disorder in the localization of sensation due to various degrees of dissociation and cause impairment in one side causing the inability to tell which side of the body was touched.
One approach that has received public interest is the use of a mirror box. The mirror box provides a reflection of the intact hand or limb that allows the patient to "move" the phantom limb, and to unclench it from potentially painful positions.
As of 2011, however, the quality of evidence is low. There is a wide range in the effectiveness of this approach. The potential for a person to benefit from mirror therapy is not predictable and appears to be related to the subjective ability of the patient to internalize the reflection of a complete limb as their own limb. About 40% of people do not benefit from mirror therapy.
Most approaches to treatment over the past two decades have not shown consistent symptom improvement. Treatment approaches have included medication such as antidepressants, spinal cord stimulation, vibration therapy, acupuncture, hypnosis, and biofeedback. Reliable evidence is lacking on whether any treatment is more effective than the others.
Most treatments are not very effective. Ketamine or morphine may be useful around the time of surgery. Morphine may be helpful for longer periods of time. Evidence for gabapentin is mixed. Perineural catheters that provide local anesthetic agents have poor evidence when placed after surgery in an effort to prevent phantom limb pain.
Autoscopy is the experience in which an individual perceives the surrounding environment from a different perspective, from a position outside of his or her own body. Autoscopy comes from the ancient Greek ("self") and ("watcher").
Autoscopy has been of interest to humankind from time immemorial and is abundant in the folklore, mythology, and spiritual narratives of most ancient and modern societies. Cases of autoscopy are commonly encountered in modern psychiatric practice. According to neurological research, autoscopic experiences are hallucinations.
Individuals with grapheme-color synesthesia rarely claim that their sensations are problematic or unwanted. In some cases, individuals report useful effects, such as aid in memory or spelling of difficult words.
These experiences have led to the development of technologies intended to improve the retention and memory of graphemes by individuals without synesthesia. Computers, for instance, could use "artificial synesthesia" to color words and numbers to improve usability. A somewhat related example of "computer-aided synesthesia" is using letter coloring in a web browser to prevent IDN homograph attacks. (Someone with synesthesia can sometimes distinguish between barely different looking characters in a similar way.)
Experiences - are characterized by the presence of the following three factors:
- disembodiment, an apparent location of the self outside one's body;
- impression of seeing the world from an elevated and distanced visuo-spatial perspective or extracorporeal, but egocentric visuo-spatial perspective;
- impression of seeing one's own body from this perspective (autoscopy).
Laboratory of Cognitive Neuroscience, École Polytechnique Fédérale de Lausanne, Lausanne, and Department of Neurology, University Hospital, Geneva, Switzerland, have reviewed some of the classical precipitating factors of autoscopy. These are sleep, drug abuse, and general anesthesia as well as neurobiology. They have compared them with recent findings on neurological and neurocognitive mechanisms of the autoscopy. The reviewed data suggest that autoscopic experiences are due to functional disintegration of lower-level multisensory processing and abnormal higher-level self-processing at the temporoparietal junction.
There are multiple theories that explain the outcome of allochiria. The current and most widely accepted explanation of allochiria is Hammond's Theory. This theory assumes that there is an almost complete decussation of sensory fibers within the grey matter. He concludes that with a lesion on one posterior side, this would reach center in the corresponding hemisphere, and thus, the sensation is then referred by this hemisphere to the opposite side of the body. Hammond goes on to say that if another unilateral lesion supervened at a different level from the first, the sensation that was previously deflected to the wrong hemisphere was now redirected by meeting with another obstacle and so arrived at its proper hemisphere. Allochiria occurs equally with and lesions as long as they are asymmetrical. Another theory is Huber's theory which assumes that an appearance of a new lesion on the opposite side from that of the block redirecting the impulse towards its original destination. Disappearance of symptoms due to retrogression of the lesion and track are cleared.
Pharmacological techniques are often continued in conjunction with other treatment options. Doses of pain medications needed often drop substantially when combined with other techniques, but rarely are discontinued completely. Tricyclic antidepressants, such as amitriptyline, and sodium channel blockers, mainly carbamazepine, are often used to relieve chronic pain, and recently have been used in an attempt to reduce phantom pains. Pain relief may also be achieved through use of opioids, ketamine, calcitonin, and lidocaine.
Mirror box therapy allows for illusions of movement and touch in a phantom limb by inducing somatosensory and motor pathway coupling between the phantom and real limb. Many patients experience pain as a result of a clenched phantom limb, and because phantom limbs are not under voluntary control, unclenching becomes impossible. This theory proposes that the phantom limb feels paralyzed because there is no feedback from the phantom back to the brain to inform it otherwise. Vilayanur S. Ramachandran believes that if the brain received visual feedback that the limb had moved, then the phantom limb would become unparalyzed.
Although the use of mirror therapy has been shown to be effective in some cases there is still no widely accepted theory of how it works. In a 2010 study of phantom limb pain, Martin Diers and his colleagues found that "In a randomized controlled trial that used graded motor imagery...and mirror training, patients with complex regional pain syndrome or phantom limb pain showed a decrease in pain as well as an improvement in function post-treatment and at the 6-month follow-up. And it was shown that the order of treatment mattered." This study found that mirrored imagery produced no significant cortical activity in patients with phantom limb pain and concluded that "The optimal method to alter pain and brain representation, and the brain mechanisms underlying the effects [of] mirror training or motor imagery, are still unclear."
A number of small scale research studies have shown encouraging results, however there is no current consensus as to the effectiveness of mirror therapy. Recent reviews of the published research literature by Mosely and Ezendam concluded that much of the evidence supporting mirror therapy is anecdotal or comes from studies that had weak methodological quality. In 2011, a large scale review of the literature on mirror therapy by Rothgangel summarized the current research as follows:
The prevalence is not known; it is not known whether males or females, or older or younger people, are more likely to have misophonia.
There are no evidence-based treatments for the condition; health care providers generally try to help people cope with it by recognizing what the person is experiencing, and by working on coping strategies with the person. Some small studies have been published on the use of sound therapy similar to tinnitus retraining therapy and on cognitive behavioral therapy and particularly exposure therapy, to help people become less aware of the trigger sound. None of these approaches have been sufficiently studied to determine their effectiveness.
Physical and occupational therapy have low quality evidence to support their use. Physical therapy interventions may include transcutaneous electrical nerve stimulation, progressive weight bearing, tactile desensitization, massage, and contrast bath therapy.
Mirror box therapy uses a mirror box, or a stand-alone mirror, to create a reflection of the normal limb such that the patient thinks they are looking at the affected limb. Movement of this reflected normal limb is then performed so that it looks to the patient as though they are performing movement with the affected limb (although it will be pain free due to the fact it is a normal limb being reflected).
Mirror box therapy appears to be beneficial in early CRPS. However, Lorimer Moseley (University of South Australia) has cautioned that the beneficial effects of mirror therapy for CRPS are still unproven.
One form of treatment that has produced a more integrated body awareness is mirror therapy, in which the individual who denies that the affected limb belongs to their body looks into a mirror at the limb. Patients looking into the mirror state that the limb does belong to them; however body ownership of the limb does not remain after the mirror is taken away.
Anaphia, also known as tactile anesthesia, is a medical symptom in which there is a total or partial absence of the sense of touch.
Anaphia is a common symptom of spinal cord injury and neuropathy.
Somatoparaphrenia is a type of monothematic delusion where one denies ownership of a limb or an entire side of one's body. Even if provided with undeniable proof that the limb belongs to and is attached to their own body, the patient produces elaborate confabulations about whose limb it really is, or how the limb ended up on their body. In some cases, delusions become so elaborate that a limb may be treated and cared for as if it were a separate being.
Somatoparaphrenia differs from a similar disorder, asomatognosia, which is characterized as loss of recognition of half of the body or a limb, possibly due to paralysis or unilateral neglect. For example, asomatognosic patients may mistake their arm for the doctor's. However, they can be shown their limb and this error is temporarily corrected.
Somatoparaphrenia has been reported to occur predominately in the left arm of one's body, and it is often accompanied by left-sided paralysis and anosognosia (denial or lack of awareness) of the paralysis. The link between somatoparaphrenia and paralysis has been documented in many clinical cases and while the question arises as to whether paralysis is necessary for somatoparaphrenia to occur, anosognosia is not, as documented by cases with somatoparaphrenia and paralysis with no anosognosia.
Ordinal-linguistic personification (OLP, or personification for short) is a form of synesthesia in which ordered sequences, such as ordinal numbers, days, months and letters are associated with personalities and/or genders (). Although this form of synesthesia was documented as early as the 1890s (; ) researchers have, until recently, paid little attention to this form (see History of synesthesia research).
Daily oral muscle physical therapy, or the administration of antidepressants have been reported as effective therapy for occlusal dysesthesia patients. Tooth grinding, and the replacement or removal of all dental work should be avoided in patients with occlusal dysesthesia, despite the frequent requests for further surgery often made by these patients.
Antidepressants are also often prescribed for scalp dysesthesia.
Prakash et al. found that many patients suffering from burning mouth syndrome (BMS), one variant of occlusal dysesthesia, also report painful sensations in other parts of the body. Many of the patients suffering from BMS met the classification of restless leg syndrome (RLS). About half of these patients also had a family history of RLS. These results suggest that some BMS symptoms may be caused by the same pathway as RLS in some patients, indicating that dopaminergic drugs regularly used to treat RLS may be effective in treating BMS as well.
Feline hyperesthesia syndrome is an uncommon but recognized condition in cats, particularly Siamese, Burmese, Himalayan, and Abyssinian cats. It can affect cats of all ages, though it is most prevalent in mature animals. The disease can be somewhat difficult to detect as it is characterized by brief bursts of abnormal behavior, lasting around a minute or two. One of its symptoms is also found in dogs that have canine distemper disease (CD) caused by canine distemper virus (CDV).