The role of somatosensation in automatic visuo-motor control: a comparison of congenital and acquired sensory loss.

Studies of chronically deafferented participants have illuminated how regaining some motor control after adult-onset loss of proprioceptive and touch input depends heavily on cognitive control. In this study we contrasted the performance of one such man, IW, with KS, a woman born without any somatosensory fibres. We postulated that her life-long absence of proprioception and touch might have allowed her to automate some simple visually-guided actions, something IW appears unable to achieve. We tested these two, and two age-matched control groups, on writing and drawing tasks performed with and without an audio-verbal echoing task that added a cognitive demand. In common with other studies of skilled action, the dual task was shown to affect visuo-motor performance in controls, with less well-controlled drawing and writing, evident as increases in path speed and reduction in curvature and trial duration. We found little evidence that IW was able to automate even the simplest drawing tasks and no evidence for automaticity in his writing. In contrast, KS showed a selective increase in speed of signature writing under the dual-task conditions, suggesting some ability to automate her most familiar writing. We also tested tracing of templates under mirror-reversed conditions, a task that imposes a powerful cognitive planning challenge. Both IW and KS showed evidence of a visuo-motor planning conflict, as did the controls, for shapes with sharp corners. Overall, IW was much faster than his controls to complete tracing shapes, consistent with an absence of visuo-proprioceptive conflict, whereas KS was slower than her controls, especially as the corners became sharper. She dramatically improved after a short period of practice while IW did not. We conclude that KS, who developed from birth without proprioception, may have some visually derived control of movement not under cognitive control, something not seen in IW. This allowed her to automate some writing and drawing actions, but impaired her initial attempts at mirror-tracing. In contrast, IW, who lost somatosensation as an adult, cannot automate these visually guided actions.