Consciousness as the Emergent Property of the Interaction Between Brain, Body, and Environment

Neuromotor rehabilitation, typically seen with stroke patients, is usually mistakenly focused on the recovery of movements while disregarding the insufficient or missing awareness of the affected part of the body. Thus, the functional recovery of sensorimotor abilities is fundamentally a problem of consciousness. The paper addresses the implications of this concept in the design of optimal robot-assistance in the training of patients, according to the assumption that consciousness is the emergent property of the interaction between brain, body, and environment. Optimal assistance is formulated as a process that follows three basic guidelines: (1) limitation of the assistance level to the minimum value capable of allowing patients to initiate the movements; (2) trial-to-trial reduction of assistance in order to promote the emergence of voluntary control; (3) nonmonotonic modulation from session to session in order to promote memory consolidation.

[1]  M. Kerszberg,et al.  A Neuronal Model of a Global Workspace in Effortful Cognitive Tasks , 2001 .

[2]  G. Edelman,et al.  Theoretical neuroanatomy and the connectivity of the cerebral cortex , 2002, Behavioural Brain Research.

[3]  R. Nudo Mechanisms for recovery of motor function following cortical damage , 2006, Current Opinion in Neurobiology.

[4]  A. Maravita,et al.  Tools for the body (schema) , 2004, Trends in Cognitive Sciences.

[5]  N. A. Bernshteĭn The co-ordination and regulation of movements , 1967 .

[6]  Maura Casadio,et al.  A proof of concept study for the integration of robot therapy with physiotherapy in the treatment of stroke patients , 2009, Clinical rehabilitation.

[7]  E. Bizzi,et al.  Mechanisms underlying achievement of final head position. , 1976, Journal of neurophysiology.

[8]  P. Morasso,et al.  Bilateral robot therapy based on haptics and reinforcement learning: Feasibility study of a new concept for treatment of patients after stroke. , 2009, Journal of rehabilitation medicine.

[9]  E. Bizzi,et al.  Postural force fields of the human arm and their role in generating multijoint movements , 1993, The Journal of neuroscience : the official journal of the Society for Neuroscience.

[10]  K. Heilman,et al.  Phantom limb after stroke: An underreported phenomenon , 2010, Cortex.

[11]  Giulio Sandini,et al.  A biomimetic, force-field based computational model for motion planning and bimanual coordination in humanoid robots , 2009, Auton. Robots.

[12]  V. Ramachandran,et al.  Phantoms in the Brain: Probing the Mysteries of the Human Mind , 1998 .

[13]  P. Morasso,et al.  Self-adaptive robot training of stroke survivors for continuous tracking movements , 2010, Journal of NeuroEngineering and Rehabilitation.

[14]  Maura Casadio,et al.  Minimally assistive robot training for proprioception enhancement , 2009, Experimental Brain Research.

[15]  Olaf Sporns,et al.  The Human Connectome: A Structural Description of the Human Brain , 2005, PLoS Comput. Biol..

[16]  D. Schacter,et al.  Unawareness of deficit and unawareness of knowledge in patients with memory disorders , 1991 .

[17]  R. Melzack Phantom Limbs , 1989, Regional Anesthesia & Pain Medicine.

[18]  M. Mishkin,et al.  Massive cortical reorganization after sensory deafferentation in adult macaques. , 1991, Science.

[19]  Anil K Seth,et al.  Theories and measures of consciousness: an extended framework. , 2006, Proceedings of the National Academy of Sciences of the United States of America.

[20]  Timothy D. Lee,et al.  Motor Control and Learning: A Behavioral Emphasis , 1982 .

[21]  G. Sandini,et al.  Eye-Hand Coordination during Dynamic Visuomotor Rotations , 2009, PloS one.

[22]  Pietro G. Morasso,et al.  A computational theory of targeting movements based on force fields and topology representing networks , 1997, Neurocomputing.

[23]  E. van Lunteren,et al.  Improvement of diaphragm and limb muscle isotonic contractile performance by K+ channel blockade , 2010, Journal of NeuroEngineering and Rehabilitation.

[24]  D. Wallace,et al.  TGF-β1 induction of the adenine nucleotide translocator 1 in astrocytes occurs through Smads and Sp1 transcription factors , 2004 .

[25]  Daniel L. Schacter,et al.  Awareness of deficit after brain injury: Theoretical and clinical aspects , 1991 .

[26]  P. Morasso,et al.  Kinematic networks , 1988, Biological Cybernetics.

[27]  Randall D. Beer,et al.  The brain has a body: adaptive behavior emerges from interactions of nervous system, body and environment , 1997, Trends in Neurosciences.

[28]  J. Lackner Some proprioceptive influences on the perceptual representation of body shape and orientation. , 1988, Brain : a journal of neurology.

[29]  G. Tononi An information integration theory of consciousness , 2004, BMC Neuroscience.

[30]  P. Morasso,et al.  Braccio di Ferro: a new haptic workstation for neuromotor rehabilitation. , 2006, Technology and health care : official journal of the European Society for Engineering and Medicine.