Regarding the volitional control of neurons in completely paralyzed patients, Birbaumer (2006) made the following observation:
“With the lack of reinforcing contingencies [via the body] controlling the maintenance of the stream of thoughts, they [the thoughts of completely paralyzed patients] extinguish slowly.” (p. 525).
This idea conflicts with the more popular notion that “the human brain is capable of generating a well-defined model of the subject’s self even in the absence of somatic sensory signals derived from a physical body.” (Nicolelis 2011, pp. 61). Proprioception and other forms of feedback are central to one’s impression of the self (see Footnote 1). Sherrington (1900, 1918) suggested that the position of the eyes (and hence the body) could be deduced by a feedback signal from the proprioceptors [which has been verified in primates: Chen 2019; Roll and Roll 1987; Roll et al. 1991; Tehovnik and Chen 2015; Valey et al. 1994, 1995, 1997]. Helmholtz, on the other hand, postulated in the 19th century that the brain can predict the future position of the eyes (and by extension the body) by generating a sense of effort or an efference-copy signal (Helmholtz 1962). This debate continues (see: Andersen et al. 1985 versus Goldberg and Bruce 1990). What is clear is that the efference-copy signal comes about after development and/or extensive training, which depends on sensory feedback from the body (Tehovnik and Chen 2015), a feedback that is central to volitional control by the brain.
Footnote 1: Expression of the self by movement/proprioception and other feedback can be done through music or dance; similarly, the self can be expressed through movement of the vocal cords and feedback from the utterances.
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