Multisensory integration across exteroceptive and interoceptive domains modulates self-experience in the rubber-hand illusion

Identifying with a body is central to being a conscious self. The now classic "rubber hand illusion" demonstrates that the experience of body-ownership can be modulated by manipulating the timing of exteroceptive (visual and tactile) body-related feedback. Moreover, the strength of this modulation is related to individual differences in sensitivity to internal bodily signals (interoception). However the interaction of exteroceptive and interoceptive signals in determining the experience of body-ownership within an individual remains poorly understood. Here, we demonstrate that this depends on the online integration of exteroceptive and interoceptive signals by implementing an innovative "cardiac rubber hand illusion" that combined computer-generated augmented-reality with feedback of interoceptive (cardiac) information. We show that both subjective and objective measures of virtual-hand ownership are enhanced by cardio-visual feedback in-time with the actual heartbeat, as compared to asynchronous feedback. We further show that these measures correlate with individual differences in interoceptive sensitivity, and are also modulated by the integration of proprioceptive signals instantiated using real-time visual remapping of finger movements to the virtual hand. Our results demonstrate that interoceptive signals directly influence the experience of body ownership via multisensory integration, and they lend support to models of conscious selfhood based on interoceptive predictive coding.