Dynamic Relationship between Sense of Agency and Post-Stroke Sensorimotor Deficits: A Longitudinal Case Study

Abstract

Post-stroke sensorimotor deficits impair voluntary movements. This impairment may alter a person’s sense of agency, which is the awareness of controlling one’s actions. A previous study showed that post-stroke patients incorrectly aligned themselves with others’ movements and proposed that their misattributions might be associated with their sensorimotor deficits. To investigate this hypothesis, the present study compared the agency dynamics in a post-stroke patient A (PA) with sensorimotor deficits, who rarely used her paretic upper limbs in her daily life to patient B (PB), who had a paretic upper limb with almost normal functions and activity. At the second, fourth, and eighth weeks following their strokes, PA and PB completed experiments where they performed horizontal movements while receiving visual feedback, and analyzed if the visual feedback represented their own or another’s movements. Consequently, PB made no misattributions each week; whereas, PA made incorrect self-attributions of other’s movements at the fourth week. Interestingly, this misattribution noticeably decreased at the eighth week, where PA, with an improved paretic upper limb, used her limb almost as much as before her stroke. These results suggest that the sense of agency alters according to the sensorimotor deficit severity and paretic upper limb activity.

Intentional Binding Effects in the Experience of Noticing the Regularity of a Perceptual-Motor Task

“…The second is that it is unclear how SoA interacts with motor performance and changes over time. We have reported in a case series that SoA is related to the recovery processes of motor paralysis after a stroke [ 33 ]. Thus, it is necessary to discuss the relationship between SoA and the processes of functional recovery after a brain injury.…”

Impaired Relationship between Sense of Agency and Prediction Error Due to Post-Stroke Sensorimotor Deficits

“…Since the sense of agency can be grounded within the sensorimotor system in motor control [ 3 ], post-stroke sensorimotor deficits may result in altered self-other attribution (i.e., misattribution) through disturbing the sensorimotor system. Our previous studies examined this possibility [ 13 , 14 ]. The results showed that patients with post-stroke sensorimotor deficits compared with healthy elderly participants, significantly misattributed the cursor movements that were provided to participants as visual feedback of their movements [ 13 ].…”

“…The results showed that patients with post-stroke sensorimotor deficits compared with healthy elderly participants, significantly misattributed the cursor movements that were provided to participants as visual feedback of their movements [ 13 ]. Furthermore, a longitudinal case study indicated that such misattributions may depend on the sensorimotor deficit severity and paretic upper limb activity [ 14 ]. These studies suggested that sensorimotor deficits are involved in making misattributions; however, it remains unclear why such patients made the misattributions and how they made self-other attributions.…”

“…These studies suggested that sensorimotor deficits are involved in making misattributions; however, it remains unclear why such patients made the misattributions and how they made self-other attributions. The researchers hypothesized that patients with post-stroke sensorimotor deficits make self-other attributions based not on sensorimotor cues (i.e., prediction errors), but on other agency cues because of the sensorimotor system being disturbed by their deficits [ 13 , 14 ]. These altered strategies for self-other attribution might result in misattributions.…”

The Role of Body in Brain Plasticity

“…Multisensory training may be beneficial in preventing maladaptive brain reorganization and may yield useful information, leading to appropriate clinical treatment when altered sensory information is present. These findings could be relevant in cases in which the sense of agency changes according to the sensorimotor deficit severity and paretic upper limb activity [ 34 ] or, for example, in apraxia [ 35 ]. These stimulating results enhance our knowledge and interest for further basic and clinical investigations on the role of body and action in clinical and rehabilitation [ 26 , 36 , 37 , 38 ].…”