Body representation and sensorimotor function as agents for brain reorganization and behavior change: from chronic pain to immobility and dementia

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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 procedures 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 sensorimotor processing and immobility may be important in disease progression. We employ novel implicit and explicit assessment methods of these perceptual and neuronal changes involving psychophysics, computational modeling, physiological recordings and brain imaging methods. These studies are the basis for mechanistic treatment approaches and also advance basic research on body representation and multisensory integration.