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The logopenic variant of primary progressive aphasia (lvPPA) is the most recent variant of primary progressive aphasia (PPA) to be identified; thus far, it has been poorly investigated. Despite being typically associated with Alzheimer disease (AD), lvPPA has recently been linked to frontotemporal lobe degeneration (FTLD), with distinctive cognitive and neural features that are worthy of further investigation. Here, we describe the neuropsychological and linguistic profile, as well as cerebral abnormalities, of an individual exhibiting PPA and carrying a pathogenetic variant in the GRN gene, from a 3-year longitudinal perspective. The individual's initial profile resembled lvPPA because it was characterized by word-finding difficulties and phonological errors in spontaneous speech in addition to sentence repetition and phonological short-term memory impairments. The individual's structural and metabolic imaging data demonstrated left temporal and bilateral frontal atrophy and hypometabolism, respectively. On follow-up, as the pathology progressed, dysprosody, stereotypical speech patterns, agrammatism, and orofacial apraxia appeared, suggesting an overlap with the nonfluent variant of PPA (nfvPPA). Severe sentence comprehension impairment also became evident. Our longitudinal and multidisciplinary diagnostic approach allowed us to better characterize the progression of a GRN-positive lvPPA profile, providing neuropsychological and imaging indicators that might be helpful to improve classification between different PPA variants and to address a nosological issue. Finally, we discuss the importance of early diagnosis of PPA given the possible overlap between different PPA variants during the progression of the pathology.

The implicit and explicit awareness of owning a body and its parts is a constant accompaniment in our everyday life and our interaction with the outside world. The way in which we build and maintain a coherent sense of body ownership is not fully understood. It has been postulated that the integration between exteroceptive, interoceptive, and proprioceptive signals may play a fundamental role in the sense of body ownership. For instance, studies on healthy subjects and brain-damaged patients have suggested that alterations in the sense of body ownership are coupled with autonomic signal changes, such as thermoregulatory reactions. However, the available evidence is conflicting, possibly due to shortcomings in the experimental paradigm that previous studies have adopted. In this study, we explore the relationship between body ownership, thermoregulation, and thermal sensitivity through a novel application of the mirror-box illusion paradigm, overcoming some of the limitations of previous studies. We find a bilateral decrease in hand skin temperature, together with reduced thermal sensitivity for warm thermal stimuli following the induction of the illusion of ownership towards the participant's reflected hand. These findings demonstrate the importance of the orchestration of exteroceptive (e.g., visual), autonomic (e.g., body temperature) and proprioceptive (e.g., position and movement of the body) signals in maintaining a coherent sense of body ownership.

Background: The standardization of outcome measures is needed for comparing studies and using common measures in clinical practice. We aimed to identify cognitive and patient-reported outcomes and timing of assessment for glioma, meningioma, and vascular surgery. Method: A consensus study was conducted. Participants selected cognitive and patient-reported measures among a list of instruments identified through a literature search. Results: Seventeen cognitive tests for the glioma and meningioma’s evaluation, 8 for the vascular diseases, and one questionnaire on quality of life and one on emotional distress were identified. The timing of outcome assessment selected was before surgery, at discharge, and after 3 and 12 months for glioma; before surgery and after 3 months for meningioma; before surgery, at discharge, and after 6 months for vascular diseases. Conclusion: The identification of common outcome measures is the first step toward a shared data collection improving the quality and comparability of future studies.

Creative production (related to art-making) and aesthetic appreciation (related to art-viewing) are inherently linked in visual arts, but their relationship has never been explored explicitly in cognitive neuroscience, nor the nature of such connection. The available literature suggests two cognitive processes as possible foundations of these two experiences: motor simulation or inhibitory control. In a meta-analysis of fMRI studies, we addressed this issue: we investigated whether there are shared neurofunctional underpinnings behind aesthetic and creative experiences in the visual domain; further, we examined whether any shared brain activation may reflect either motor simulation or inhibitory processes. A conjunction analysis revealed a common involvement of the pre-SMA in both classes of studies, a brain region, if anything, more concerned with top-down inhibitory motor and volitional cognitive control rather than bottom-up motor simulation. In the art-viewing domain, this finding was primarily driven by figurative rather than abstract art. The methodological limitations in the available literature are discussed together with possible new ways to expand the existing findings.

The way we perceive signals coming from the inside of the body (i.e., interoception) may influence the processing of information related to the self. In this study, we investigated whether interoceptive sensibility may play a role in autobiographical memory processes. We evaluated 41 healthy participants with a modified version of the Autobiographical Memory Test, also assessing specificity, vividness, emotional valence, and intensity for autobiographical and public memories. Participants completed a self-report questionnaire measuring interoceptive sensibility. Results showed that autobiographical memories were recalled with higher specificity, vividness, and emotional intensity than public memories. Interestingly, we found that participants with (self-reported) high interoceptive sensibility recalled more positive events in the autobiographical compared to the public condition. Our findings provided new evidence on the selective role of physiological aspects of bodily self-awareness in autobiographical memory, suggesting that interoception is fundamental for supporting adaptive emotion regulation processes when recollecting engrams related to the self.

Background Patients suffering from stroke in the acute/post-acute phases often present with depressive mood — which negatively impacts on patients’ prognosis. However, psychometric evaluation of mood in acute stroke patients may be challenging due to cognitive deficits. Tools investigating emotional states via a vertical analogue line may overcome language/visuo-spatial disorders. This study thus aimed at (a) investigating the clinical usability of a Visual Analogue Mood Scale (VAMS) in acute stroke patients and (b) investigating the interplay between mood and cognition in this population. Methods Forty-one acute stroke patients were compared to 41 age-, education- and sex-matched healthy participants (HPs) on the VAMS and on cognitive measures (mental performance in acute stroke, MEPS). A control line bisection (LB) task was administered to control for potential visuo-spatial deficits in patients. Results Patients reported higher depression levels than HPs (lower VAMS scores); this between-group difference stayed significant when covarying for LB scores. MEPS scores discriminated patients from HPs; among cognitive measures, only the Clock drawing test (CDT) was positively associated with VAMS scores. Lesion side did not affect patients’ mood state; however, disease duration was inversely related to VAMS scores. Discussion The VAMS proved to be a suitable tool for assessing mood in acute stroke patients, as being independent from post-stroke cognitive sequelae. The CDT might represent an adequate measure of depression-induced, post-stroke cognitive efficiency decrease. Mood disorders might occur and thus should be adequately addressed also in post-acute phases — likely due to longer hospitalization times and regression of anosognosic features.

Freezing of gait (FoG) is a paroxysmal and sporadic gait impairment that severely affects PD patients' quality of life. This review summarizes current neuroimaging investigations that characterize the neural underpinnings of FoG in PD. The review presents and discusses the latest advances across multiple methodological domains that shed light on structural correlates, connectivity changes, and activation patterns associated with the different pathophysiological models of FoG in PD. Resting-state fMRI studies mainly report cortico-striatal decoupling and disruptions in connectivity along the dorsal stream of visuomotor processing, thus supporting the 'interference' and the 'perceptual dysfunction' models of FoG. Task-based MRI studies employing virtual reality and motor imagery paradigms reveal a disruption in functional connectivity between cortical and subcortical regions and an increased recruitment of parieto-occipital regions, thus corroborating the 'interference' and 'perceptual dysfunction' models of FoG. The main findings of fNIRS studies of actual gait primarily reveal increased recruitment of frontal areas during gait, supporting the 'executive dysfunction' model of FoG. Finally, we discuss how identifying the neural substrates of FoG may open new avenues to develop efficient treatment strategies.

Background Working memory (WM) abilities are frequently impaired in neurological disorders affecting fronto-parietal cortical/sub-cortical structures. WM deficits negatively influence interventional outcomes and everyday functioning. This study thus aimed at the following: (a) developing and standardizing an ecologically valid task for WM assessment ( Ice Cream Test, ICT); (b) validating and norming a novel WM test (Digit Ordering Test, DOT), as well as providing updated norms for digit span (DS) tasks, in an Italian population sample; (c) introducing a novel scoring procedure for measuring WM. Methods One-hundred and sixty-eight Italian healthy participants—73 male, 95 females; age: 48.4 ± 19.1 (18–86); education: 12.1 ± 4.8 (4–21)—underwent a thorough WM assessment—DOT, ICT, and both forward and backward DS tasks (FDS, BDS). The ICT requires participants to act as waiters who have to keep track of customers’ orders. For each task, WM and total (T) outcomes were computed, i.e., the number of elements in the longest sequence and that of recalled sequences, respectively. Norms were derived via the equivalent score (ES) method. Results DS ratios (DSRs) were computed for both WM/S and T outcomes on raw DS measures (BDS divided by FDS). Age and education significantly predicted all WM tasks; sex affected FDS and DSR-T scores (males > females). WM measures were highly internally related. Discussion The present work provides Italian practitioners with a normatively updated, multi-component, adaptive battery for WM assessment (WoMAB) as well as with novel outcomes which capture different WM facets—WM capacity and attentive monitoring abilities.

Both visuo-spatial neglect and visual extinction may occur following right-brain damage. So far, studies on brain-damaged patients have not provided definite evidence about which lesion patterns may lead to the association or dissociation of these deficits. This study was set out to address this issue using Intracranial Electrical Stimulation (IES) in a group of nine patients affected by refractory epilepsy. Cerebral regions associated with visuo-spatial neglect and visual extinction were stimulated, including the right frontal, temporal, and posterior parietal areas. During IES, patients with intracranial implantation involving at least one of these cortical regions were administered with a manual line bisection task (N = 9) to assess visuo-spatial neglect, and a computerized task (N = 8) assessing visual extinction. Results showed that parietal IES induced a rightward bias at the manual bisection task, together with a general improvement in reaction times at bilateral and unilateral visual stimuli detection at the extinction task. The occurrence of visual extinction did not vary across stimulations. By adopting a complementary approach to anatomo-clinical correlation studies, our work corroborates the notion that lesions to the right inferior parietal lobule play a pivotal role in the pathogenesis of visuo-spatial neglect. Importantly, our results also suggest that temporarily interfering with the activity of this region is not sufficient per se to generate visual extinction, which instead may involve a broader and/or different network, possibly extending beyond the cerebral regions considered here, posing important theoretical and clinical implications.

In healthy subjects, the transient perturbation of body part ownership is accompanied by regional skin temperature decrease. This observation leaves an open question about a possible body part-specific thermoregulatory response in pathological conditions, in which the sense of ownership over that body part is altered. For instance, Body Integrity Dysphoria (BID), a poorly understood neuropsychiatric disorder, is characterised by the non-acceptance of one or more of one's extremities. This unsettling feeling pervasively captures the individuals' attention towards the unwanted limb. Previous studies characterised BID in terms of absent ownership feeling with preserved ownership judgment. We explored for the first time whether this altered feeling is also associated with a specific thermoregulatory response. We recorded thermal image sequences of circumscribed regions of the limbs' skin in seven individuals with BID desiring to remove one leg while they were invited to focus their attention toward one particular limb (arm or leg). Their event-related thermoregulatory pattern was compared to a group of healthy matched controls. In individuals with BID but not in control persons, we found a bilateral decrease in leg temperature when focusing their attention on either the unwanted or accepted leg. The event-related thermoregulatory response for both upper limbs was similar between individuals with BID and healthy controls. Our results suggest that the alteration of the sense of body ownership in neuropsychiatric conditions such as BID may critically rest on specific event-related thermoregulatory patterns in response to modulation of attention to body parts.

Risk-taking behaviour is an essential aspect of our interactions with the environment. Here we investigated whether vestibular inputs influence behavioural measurement of risk-taking propensity. We have combined bipolar Galvanic Vestibular Stimulation (GVS) with a well-known and established risk-taking behaviour task, namely the Balloon Analogue Risk Task (BART). A sham stimulation was used to control for non-specific effects. Left-anodal and right-cathodal GVS (L-GVS), which preferentially activates the vestibular projections in the right hemisphere, decreased the willingness to take risk during the BART compared with right-anodal and left-cathodal GVS (R-GVS), which activates the left hemisphere. This proved a specific vestibular effect which depends on GVS polarity. Conversely, no generic vestibular effect, defined as the adjusted average of L-GVS and R-GVS conditions compared to sham, emerged, excluding non-specific vestibular effects. Our results confirmed recent findings of a vestibular contribution to decision-making and strategy control behaviour. We suggest that the vestibular-mediated balancing of risk seeking behaviour is an important element of the brain's capacity to adapt to the environment.

The benefits of mindfulness meditation among clinical and non-clinical populations have been largely reported in literature. Existing mindfulness-based programs are particularly useful in targeting specific populations while researchers have pointed out the possibility of developing programs adapted to the audience and the context. In this two-groups pre-post experimental design we developed a mindfulness-based social intervention program to target individuals from the general population. Here we present a two-groups pre-post experimental design to investigate its effectiveness on participants&rsquo, psychological functioning assessed by eight self-reported questionnaires (CORE-OM, FFMQ, SWLS, PANAS, PSS, SCS, WEMWBS, SHS) which encompass different domains of well-being, mindfulness and emotional functioning. Participants, recruited on voluntary basis, were randomly allocated to treated or passive control groups and were aware of group allocation. The intervention comprises a 12-week meditation training in a big group that represents the social aspect of meditation. Data were analysed via a linear mixed effect model and intention to treat. Statistically significant results were obtained for global score of CORE-OM (&beta, = &minus, 0.20 [&minus, 0.30, &minus, 0.10], p = 0.0002), FFMQ (&beta, = 0.20 [0.12, 0.28], p &lt, 0.0001), SWLS (&beta, = 1.43 [0.42, 2.45], p = 0.006), positive PANAS (&beta, = 1.99 [0.95, 3.04], p = 0.0002), negative PANAS (&beta, 1.67 [&minus, 2.92, 0.43], p = 0.009), PSS (&beta, 2.98 [&minus, 4.25, 1.71], p &lt, 0.0001), WEMWBS (&beta, = 4.38 [2.93, 5.83], p &lt, 0.0001) and SHS (&beta, 2.45], p = 0.006). Our intervention is causally associated with an improvement of the psychological functioning and hence can be considered as a preventive measure that may potentially reduce the risk of developing psychological problems and improve the subject&rsquo, s general well-being. Given the voluntary recruitment, our inference only applies to those individuals who have decided to experience meditation as a way to well-being and not to a random person from the general population.

There are few things as irrefutable as the evidence that our limbs belong to us. However, persons with body integrity dysphoria (BID) [1] deny the ownership of one of their fully functional limbs and seek its amputation [2]. We tapped into the brain mechanisms of BID, examining sixteen men desiring the removal of the left healthy leg. The primary sensorimotor area of the to-be-removed leg and the core area of the conscious representation of body size and shape (the right superior parietal lobule [rSPL]) [3, 4] were less functionally connected to the rest of the brain. Furthermore, the left premotor cortex, reportedly involved in the multisensory integration of limb information [5-7], and the rSPL were atrophic. The more atrophic the rSPL, the stronger the desire for amputation, and the more an individual pretended to be an amputee by using wheelchairs or crutches to solve the mismatch between the desired and actual body. Our findings illustrate the pivotal role of the connectivity of the primary sensorimotor limb area in the mediation of the feeling of body ownership. They also delineate the morphometric and functional alterations in areas of higher-order body representation possibly responsible for the dissatisfaction with a standard body configuration. The neural correlates of BID may foster the understanding of other neuropsychiatric disorders involving the bodily self. Ultimately, they may help us understand what most of us take for granted, i.e., the experience of body and self as a seamless unity.

The sense of body ownership is a fundamental feature that refers to the ability to recognize our body as our own, allowing us to interact properly with the outside world. Usually, it is explored by means of the Rubber Hand Illusion (RHI) during which a dummy hand is incorporated in the mental representation of one's own body throughout a multisensory (visuo-tactile) integration mechanism. Particular attention has been paid to the neurofunctional counterparts of this mechanism highlighting the pivotal role of an occipito-parieto-frontal network involving the Ventral Premotor area (PMv). To date, the specific role of the PMv in generating the sense of ownership is still unknown. In this study, we aimed at exploring the role of PMv in generating and experiencing the RHI. Off-line repetitive Transcranial Magnetic Stimulation (rTMS) was applied to a group of 24 healthy participants whilst changes in proprioceptive judgment and self-reported illusion sensations were collected and analysed separately. The PMv was not directly implicated in generating the sense of ownership. Indeed, its inhibition affected the explicit detection of the visuo-tactile congruence without interfering with the illusion experience itself. We hypothesized that the conscious visuo-tactile congruence detection may be independent from the conscious illusion experience. Also, our results support the view that the RHI grounds on a complex interaction between bottom-up and top-down processes, as the visuo-tactile integration per se may be not sufficient to trigger the subjective illusion.

Spinal cord injury can cause cognitive impairments even when no cerebral lesion is appreciable. As patients are forced to explore the environment in a non-canonical position (i.e., seated on a wheelchair), a modified relation with space can explain motor-related cognitive differences compared to non-injured individuals. Peripersonal space is encoded in motor terms, that is, in relation to the representation of action abilities and is strictly related to the affordance of reachability. In turn, affordances, the action possibilities suggested by relevant properties of the environment, are related to the perceiver's peripersonal space and motor abilities. One might suppose that these motor-related cognitive abilities are compromised when an individual loses the ability to move. We shed light on this issue in 10 patients with paraplegia and 20 matched controls. All have been administered an affordances-related reachability judgement task adapted from Costantini, Ambrosini, Tieri, Sinigaglia, and Committeri (2010, Experimental Brain Research, 207, 95) and neuropsychological tests. Our findings demonstrate that patients and controls show the same level of accuracy in estimating the location of their peripersonal space boundaries, but only controls show the typical overestimation of reaching range. Secondly, patients show a higher variability in their judgements than controls. Importantly, this finding is related to the patients' ability to perform everyday tasks. Finally, patients are not faster in making their judgements on reachability in peripersonal space, while controls are. Our results suggest that not moving freely or as usual in the environment impact decoding of action-related properties even when the upper limbs are not compromised.

Dyslexia can have different manifestations: this has motivated different theories on its nature, on its underlying brain bases and enduring controversies on how to best treat it. The relative weight of the different manifestations has never been evaluated using both behavioural and fMRI measures, a challenge taken here to assess the major systems called into play in dyslexia by different theories. We found that adult well-compensated dyslexics were systematically impaired only in reading and in visuo-phonological tasks, while deficits for other systems (e.g., motor/cerebellar, visual magnocellular/motion perception) were only very occasional. In line with these findings, fMRI showed a reliable hypoactivation only for the task of reading, in the left occipito-temporal cortex (l-OTC). The l-OTC, normally a crossroad between the reading system and other systems, did not show the same level of intersection in dyslexics; yet, it was not totally silent because it responded, in segregated parts, during auditory phonological and visual motion perception tasks. This minimal behavioural and functional anatomical comorbidity demonstrates that a specific deficit of reading is the best description for developmental dyslexia, at least for adult well-compensated cases, with clear implications for rehabilitation strategies. The reduced intersection of multiple systems in the l-OTC suggests that dyslexics suffer from a coarser connectivity, leading to disconnection between the multiple domains that normally interact during reading.

We typically misestimate the dimensions of our body e.g., we perceive our fingers as shorter, and our torso as more elongated, than they actually are. It stands to reason that those metric biases may also extend to objects that we interact with, to facilitate attunement with the environment. To explore this hypothesis, we compared the metric representations of seven objects and the subjects' own hand using the Line Length Judgment task, in six experiments involving 152 healthy subjects. We evaluated the size estimation errors made for each target (hand or previously observed objects) by asking subjects to compare the vertical or horizontal dimension of a specific target against the length of a vertical or horizontal line. As expected, we showed that the hand is misperceived in its dimensions. Interestingly, we found that metric biases are also present for daily-life objects, such as a mobile phone and a coffee mug, and are not affected by familiarity with the objects. In contrast, objects that are less likely to be manipulated, either because they are potentially harmful or disgusting, were differently represented. Furthermore, the propensity to interact with an object, rated by an independent sample of subjects, best predicted the pattern of metric biases associated with that object. Taken together, these findings support the hypothesis that biases affecting the hand representation extend to objects that elicit action-oriented behavior, highlighting the importance of studying the body as integrated and active in the environment.

Highlights • Acute DOC patients with favourable outcome show preserved event-related electrodermal response. • Acute DOC patients showed reduced fALFF in the posterior cingulate cortex. • Event-related electrodermal activity correlated with the fALFFs in the PCC in the acute phase., An accurate prognosis on the outcome of brain-injured patients with disorders of consciousness (DOC) remains a significant challenge, especially in the acute stage. In this study, we applied a multiple-technique approach to provide accurate predictions on functional outcome after 6 months in 15 acute DOC patients. Electrophysiological correlates of implicit cognitive processing of verbal stimuli and data-driven voxel-wise resting-state fMRI signals, such as the fractional amplitude of low-frequency fluctuations (fALFF), were employed. Event-related electrodermal activity, an index of autonomic activation, was recorded in response to emotional words and pseudo-words at baseline (T0). On the same day, patients also underwent a resting-state fMRI scan. Six months later (T1), patients were classified as outcome-negative and outcome-positive using a standard functional outcome scale. We then revisited the baseline measures to test their predictive power for the functional outcome measured at T1. We found that only outcome-positive patients had an earlier, higher autonomic response for words compared to pseudo-words, a pattern similar to that of healthy awake controls. Furthermore, DOC patients showed reduced fALFF in the posterior cingulate cortex (PCC), a brain region that contributes to autonomic regulation and awareness. The event-related electrodermal marker of residual cognitive functioning was found to have a significant correlation with residual local neuronal activity in the PCC. We propose that a residual autonomic response to cognitively salient stimuli, together with a preserved resting-state activity in the PCC, can provide a useful prognostic index in acute DOC.

Proprioception acquires a crucial role in estimating the configuration of our body segments in space when visual information is not available. Proprioceptive accuracy is assessed by asking participants to match the perceived position of an unseen body landmark through reaching movements. This task was also adopted to study the perceived hand structure by computing the relative distances between averaged proprioceptive judgments (hand Localization Task). However, the pattern of proprioceptive errors leading to the misperceived hand structure is unexplored. Here, we aimed to characterize this pattern across different hand landmarks, having different anatomo-physiological properties and cortical representations. Furthermore, we sought to describe the error consistency and its stability over time. To this purpose, we analyzed the proprioceptive errors of 43 healthy participants during the hand Localization Task. We found larger but more consistent errors for the fingertips compared to the knuckles, possibly due to poorer proprioceptive signal, compensated by other sources of spatial information. Furthermore, we found a shift (overlap effect) and a temporal drift of the hand perceived position towards the shoulder of origin, which was consistent within and between subjects. The overlap effect had a greater influence on lateral compared to medial landmarks, leading to the hand width overestimation. Our results are compatible with domain-general and body-specific spatial biases affecting the proprioceptive localization of the hand landmarks, thus the apparent hand structure misperception.

Exteroceptive and interoceptive signals shape and sustain the bodily self‐awareness. The existence of a set of brain areas, supporting the integration of information coming from the inside and the outside of the body in building the sense of bodily self‐awareness has been postulated, yet the evidence remains limited, a matter of discussion never assessed quantitatively. With the aim of unrevealing where in the brain interoceptive and exteroceptive signals may converge, we performed a meta‐analysis on imaging studies of the sense of body ownership, modulated by external visuotactile stimulation, and studies on interoception, which involves the self‐awareness for internal bodily sensations. Using a multilevel kernel density analysis, we found that processing of stimuli of the two domains converges primarily in the supramarginal gyrus bilaterally. Furthermore, we found a right‐lateralized set of areas, including the precentral and postcentral, and superior temporal gyri. We discuss these results and propose this set of areas as ideal candidates to match multiple body‐related signals contributing to the creation of a multidimensional representation of the bodily self.

Background and purpose: The number of people suffering from stroke is strongly increasing, giving rise to multiple cognitive deficits which frequently prevent a full recovery. The identification of both spared and impaired cognitive domains has a key role to plan adequate interventions. However, the existing standard tests are either too expensive in terms of time and efforts for patients in acute stage or they derived from instruments addressing different pathologies such as dementia. Methods: We developed a brief neuropsychological battery (mental performance in acute stroke, MEPS) to assess different cognitive domains (language, memory, praxis, visual perception) in acute stroke patients. MEPS was validated by enrolling a sample of 204 patients suffering from stroke in acute stage, and 263 healthy controls participants. Results: The results indicated an adequate construct validity and a high ability in discriminating patients from healthy controls. Conclusions: MEPS can be considered a simple and highly valuable bedside battery, easy to administer, with values of sensitivity and specificity suitable to be proposed as a screening tool for patients with acute stroke.

Visual exposure to extreme-sized bodies elicits explicit self-body image variations. Several features of such modulation remain to be clarified. In this study we explored whether this effect: (i) acts on implicit mechanisms in modifying one’s body-size perception, (ii) is body-exposure-specific also at the implicit level, and (iii) is modulated by interoceptive sensibility. We assigned a covert attention task to 100 women, exposing them to extreme-sized bodies (thin and fat) or extreme-sized objects (thin and fat bottles). Before and after the attentional exposure, we tested the association between the “self/others” and “thin/fat” concepts using an Implicit Association Test. We also collected a measure of interoceptive sensibility by means of a self-report questionnaire. Results showed that participants exposed to fat bodies implicitly presented a stronger association between the “self” and “thin” concepts. This association was significantly weaker in the group exposed to thin bodies. This effect was absent after exposure to thin and fat bottles. Notably, participants with a higher tolerance of negative bodily interoceptive signals were less susceptible to the malleability of body image exerted by the exposure attentional task. Our findings shed new light on the relationship between the perception of internal (e.g., visceral) and external (e.g., visual) signals in the representation of our body.

Distorted representations of the body are observed in healthy individuals as well as in neurological and psychiatric disorders. Distortions of the body model have been attributed to the somatotopic cerebral representation. Recently, it has been demonstrated that visual biases also contribute to those distortions. To better understand the sources of such distortions, we compared the metric representations across five body parts affording different degrees of tactile sensitivity and visual accessibility. We evaluated their perceived dimensions using a Line Length Judgment task. We found that most body parts were underestimated in their dimensions. The estimation error relative to their length was predicted by their tactile acuity, supporting the influence of the cortical somatotopy on the body model. However, tactile acuity did not explain the distortions observed for the width. Visual accessibility in turn does appear to mediate body distortions, as we observed that the dimensions of the dorsal portion of the neck were the only ones accurately perceived. Coherent with the multisensory nature of body representations, we argue that the perceived dimensions of body parts are estimated by integrating visual and somatosensory information, each weighted differently, based on their availability for a given body part and a given spatial dimension.

Scientific evidence plays an important role in the therapeutic decision-making process. What happens when physicians are forced to make therapeutic decisions under uncertainty? The absence of scientific guidelines at the beginning of a pandemic due to an unknown virus, such as COVID-19, could influence the perceived legitimacy of the application of non-evidence-based therapeutic approaches. This paper reports on a test of this hypothesis, in which we administered an ad hoc questionnaire to a sample of 64 Italian physicians during the first wave of the COVID-19 pandemic in Italy (April 2020). The questionnaire statements regarding the legitimacy of off-label or experimental drugs were framed according to three different scenarios (Normality, Emergency and COVID-19). Furthermore, as the perception of internal bodily sensations (i.e., interoception) modulates the decision-making process, we tested participants’ interoceptive sensibility using the Multidimensional Assessment of Interoceptive Awareness (MAIA). The results showed that participants were more inclined to legitimate non-evidence-based therapeutic approaches in the COVID-19 and Emergency scenarios than the Normality scenario. We also found that scores on the MAIA Trusting subscale positively predicted this difference. Our findings demonstrate that uncertain medical scenarios, involving a dramatic increase in patient volume and acuity, can increase risk-taking in therapeutic decision-making. Furthermore, individual characteristics of health care providers, such as interoceptive ability, should be taken into account when constructing models to prevent the breakdown of healthcare systems in cases of severe emergency.

It is largely recognized that the mesial temporal lobe and its substructure support declarative long-term memory (LTM). So far, different theories have been suggested, and the organization of declarative verbal LTM in the brain is still a matter of debate. In the current study, we retrospectively selected 151 right-handed patients with temporal lobe epilepsy with and without hippocampal sclerosis, with a homogeneous (seizure-free) clinical outcome. We analyzed verbal memory performance within a normalized scores context, by means of prose recall and word paired-associate learning tasks. Patients were tested at presurgical baseline, 6months, 2 and 5years after anteromesial temporal lobe surgery, using parallel versions of the neuropsychological tests. Our main finding revealed a key involvement of the left temporal lobe and, in particular, of the left hippocampus in prose recall rather than word paired-associate task. We also confirmed that shorter duration of epilepsy, younger age, and withdrawal of antiepileptic drugs would predict a better memory outcome. When individual memory performance was taken into account, data showed that females affected by left temporal lobe epilepsy for longer duration were more at risk of presenting a clinically pathologic LTM at 5years after surgery. Taken together, these findings shed new light on verbal declarative memory in the mesial temporal lobe and on the behavioral signature of the functional reorganization after the surgical treatment of temporal lobe epilepsy.

A pediatric cognitive screening tool has been shaped in three versions according to school class to assess spatial and temporal orientation, language, reading, writing, drawing, number knowledge, memory, praxis and executive functions in children aged 6-13. It has been standardized on an Italian sample of 807 children. Raw scores were adjusted for critical variables (child's age and parents' education) and a cut-off for the resulting global cognitive score was made available for clinical practice. In line with previous research, adapting the Mini-Mental State Examination to pediatric neuropsychological assessment turned out to be useful in estimating global cognitive functioning in children.

To retrospectively analyse a single-centre consecutive surgical series of patients with temporal lobe epilepsy (TLE) and negative MRI. To identify factors associated with postoperative seizure outcome among several presurgical, surgical and postsurgical variables. Clinical records of 866 patients who received temporal lobe resections and with a minimum follow-up of 12 months were retrospectively searched for MRI-negative cases. Anamnestic, clinical, neurophysiological, surgical, histopathological and postsurgical data were collected. Seizure outcome was categorised as favourable (Engel’s class I) and unfavourable (Engel’s classes II–IV). Uni- and multivariate statistical analysis was performed to identify variables having a significant association with seizure outcome. Forty-eight patients matched the inclusion criteria. 26 (54.1%) patients required invasive EEG evaluation with Stereo-electro-encephalography (SEEG) before surgery. Histological evaluation was unremarkable in 34 cases (70.8%), revealed focal cortical dysplasias in 13 cases and hippocampal sclerosis in 2. 28 (58.3%) patients were in Engel’s class I after a mean follow-up of 82 months (SD ± 74; range 12–252). Multivariate analysis indicated auditory aura, contralateral diffusion of the discharge at Video-EEG monitoring and use of 18F-FDG PET as variables independently associated with seizure outcome. Carefully selected patients with MRI-negative TLE can be good candidates for surgery. Surgery should be considered with caution in patients with clinical features of neocortical seizure onset and contralateral propagation of the discharge. Use of 18F-FDG PET may be helpful to improve SEEG and surgical strategies. The presented data help in optimising the selection of patients with MRI-negative TLE with good chances to benefit from surgery.

In everyday life, we continuously make decisions, assuming the risk by making choices on material possessions or our body. Bodily signals may support the decision-making process, informing us about possible outcomes. Sensibility for such internal bodily changes influences the way we perceive the environment, and it can boost the body-related stimuli processing. Thus, the question arises of whether the individual sensibility to interoceptive signals modulates decision-making in the presence of biological stimuli. To test this hypothesis, we administered 50 healthy subjects with the Balloon Analogue Risk Task, in which participants were required to inflate a virtual balloon, and a modified version of it, in which they inflated a virtual body. We found that interoceptive sensibility predicted risk-taking behaviour only in the presence of body-related stimuli. Our results provided new evidence on the role of interoceptive sensibility in complex cognitive functions, such as risk-taking behaviour, which impacts the way we act within our society.

The vestibular system plays a pivotal role in behavioural and physiological aspects of body representation. If on the one hand, the stimulation of the vestibular system in healthy subjects provokes body representation distortions, accompanied by a decrease of body temperature, on the other hand, in brain-damaged patients it transiently restores body representation disorders. So far, the physiological counterpart of such behavioural amelioration on patients has never been explored. Here we aimed at investigating body temperature variations following Caloric Vestibular Stimulation (CVS), in a patient affected by somatoparaphrenia who regained the sense of body part ownership after the stimulation. Results showed an increase in body temperature after CVS, which also correlated with the temporary restored sense of limb ownership. Our results support the idea that physiological signals are fundamental to maintain a coherent mental representation of the body.

PURPOSE OF REVIEW The use of deep brain stimulation (DBS) in degenerative diseases involving cognitive impairment raises important ethical issues. This review takes into account the previous publications on the ethical issues of DBS to re-evaluate this technique in the framework of cognitive degenerative diseases, especially Alzheimer's disease and dementia associated to Parkinson's disease. RECENT FINDINGS The serendipitous discovery of the properties of DBS in memory enhancement fostered the expectations of the patients, the experts, and the industry involved in the production of the devices. Nonetheless, there is still a lack of evidence of its effectiveness in slowing or stopping the evolution of the initial cognitive decline into dementia, and a lack of a cognitive model to explain its effects on the memory circuit. SUMMARY Applying the principles for the ethical assessment of new treatments in biomedicine to the use of DBS in cognitive impairment and especially in memory loss, we conclude that any use of this technique for this indication should be reserved to experimental settings, with clear protocols and strict inclusion criteria for the selection of the possible candidates for surgery.

The perception of the bodily self in space is a composite cognitive function requiring a dynamic integrated brain mechanism. Somatoparaphrenia (SP), a delusional belief concerning the experienced disownership for the contralesional paralyzed arm, represents the disruption of such mechanism. In two experiments, we have investigated the alteration of limb disownership after spatial manipulations in a right-brain-damaged patient affected by chronic SP. In experiment 1 the patient's spatial attention was switched between the left and right sides of space. SP signs worsened when the patient was interviewed from the left compared to the right bedside. In the second experiment we showed the first systematic transient remission of SP using left caloric vestibular stimulation (CVS), a physiologic manipulation mainly acting on the spatial frame of reference. Taken together, these results shed further light on the spatial nuance of SP and on the importance of vestibular signals for the generation of a coherent body representation. Furthermore, our case study demonstrated the possibility of eliciting more severe SP signs if the patient is interviewed from the left bedside. Additionally, CVS applications may have an important impact on the rehabilitation of these symptoms.

In adult patients, Spinal Cord Injury (SCI) may influence the mental Body Representation (BR). Currently, there is no evidence on the modulation of SCI on BR during early stages of cognitive development. Here, we investigated BR in a 3-year-old child with complete SCI. The patient was administered with a specific battery assessing different BR components. We found evidence for putative classical neuropsychological dissociation between a preserved topological map with impaired semantic knowledge of the body. This finding sheds new light on the impact of SCI on BR in childhood, as well as on the level of interdependence between BR’s components..

The internal models of our body dimensions are prone to bias, but little evidence exists to explain how the motor system achieves fine-grained control despite these distortions. Previous work showed that the hand representation, assessed in a dynamic task (Proprioceptive Matching Task), was less distorted compared to that measured through a static body representation task (Localization Task), suggesting that either the hand representation was updated or the motor trajectory was adjusted during movement. The present study set out to shed light on this phenomenon by administering the Localization Task before and after either the Proprioceptive Matching Task or a control condition in a within-subjects design. Our results showed that hand map biases decreased during the Proprioceptive Matching Task, but that this increase in accuracy did not carry over to the Localization Task. In other words, more accurate performance in the dynamic body representation task does not reflect a change in how the hand is represented. Rather, it likely reflects a refinement of the motor trajectory, due to the integration of multisensory information, providing interesting insights into how the motor system partially overcomes biases in body representations.

Objectives: To estimate the frequency of prolonged grief disorder (PGD) in 90 primary caregivers of patients with dementia who live in the community dwelling in Milan and to identify the relationship between grief intensity (GI) and other caregiver variables; another aim was to clarify the role of the objective cognitive and functional impairment of the patients and the level of deterioration perceived by caregivers. Design: Cross-sectional study. Results: In all, 16.7% of caregivers had PGD. Caregiver variables increasing GI and the risk of developing PGD were burden, anxiety, and some sociodemographic features. The objective level of patient’s deterioration was irrelevant for PGD probability/GI, while the deterioration level perceived by the caregiver increased PGD probability and GI. Conclusions: Caregivers of patients with dementia may experience grief symptoms that are associated with low educational level, high level of burden and anxiety, and high perceived deterioration of their demented relatives’ cognitive and functional abilities.

Right brain damaged patients sometimes deny that their left arm is paralysed or even claim to have just moved it. This condition is known as anosognosia for hemiplegia (AHP). Here, we used fMRI to study patients with and without AHP during the execution of a motor task. We found that the delusional belief of having moved was preceded by brain activation of the cortical regions that are implicated in motor control in the left intact hemisphere and in the spared motor regions of the right hemisphere; patients without anosognosia did not present with the same degree of activation. We conclude that the false belief of movement is associated with a combination of strategically placed brain lesions and the preceding residual neural activity of the fronto-parietal motor network. These findings provide evidence that the activity of motor cortices contributes to our beliefs about the state of our motor system.

Highlights • Left anodal galvanic vestibular stimulation increased tactile sensitivity. • No effects induced by sham stimulation or right anodal galvanic vestibular stimulation. • Even brief (100 ms) pulses of vestibular stimulation enhanced somatosensory detection. • Vestibular projections in the right hemisphere modulates somatosensory processing., The vestibular system has widespread interactions with other sensory modalities. Here we investigate whether vestibular stimulation modulates somatosensory function, by assessing the ability to detect faint tactile stimuli to the fingertips of the left and right hand with or without galvanic vestibular stimulation (GVS). We found that left anodal and right cathodal GVS, significantly enhanced sensitivity to mild shocks on either hand, without affecting response bias. There was no such effect with either right anodal and left cathodal GVS or sham stimulation. Further, the enhancement of somatosensory sensitivity following GVS does not strongly depend on the duration of GVS, or the interval between GVS and tactile stimulation. Vestibular inputs reach the somatosensory cortex, increasing the sensitivity of perceptual circuitry.

Amyotrophic Lateral Sclerosis (ALS) is a motor neuron disease characterized by the progressive atrophy of both the first and the second motor neurons. Although the cognitive profile of ALS patients has already been defined by the occurrence of language dysfunctions and frontal deficit symptoms, it is less clear whether the degeneration of upper and lower motor neurons affects motor imagery abilities. Here, we directly investigated motor imagery in ALS patients by means of an established task that allows to examine the presence of the effects of the biomechanical constraints. Twenty-three ALS patients and 23 neurologically unimpaired participants have been administered with the (1) hand laterality task (HLT) in which participants were asked to judge the laterality of a rotated hand and the (2) mirror letter discrimination task (MLD) in which participants were asked to judge whether a rotated alphanumeric character was in its canonical or mirror-reversed form (i.e. control task). Results show that patients present the same pattern of performance as unimpaired participants at the MLD, while at the HLT, they present only partially with the effects of biomechanical constraints. Taken together, our findings provide evidences that motor imagery abilities, related to the mental simulation of an action, are affected by this progressive disease.

The vestibular system processes information about head movement and orientation. No unimodal vestibular cortex has been identified in the mammalian brain. Rather, vestibular inputs are combined with many other sensory signals in the cortex. This arrangement suggests that vestibular input could influence processing in other sensory modalities. Here we show that vestibular stimulation differentially modulates two submodalities of the somatosensory system, increasing sensitivity to tactile input, and independently reducing sensitivity to nociceptive input. These modulations of touch and pain can clearly be distinguished from supramodal attentional effects of vestibular stimulation, because they are bilateral and operate in different directions. Outside the artificial conditions of laboratory stimulation, the vestibular system codes movements of the head, indicating a new relation between the body and the external world. We suggest the vestibular system participates in a form of sensory signal management, changing the balance between the various sensory systems as the relation between the body and the external environment changes. This sensory rebalancing may be a crucial element in the brain's capacity to reorient towards novel or salient features in the environment.

We describe the clinical manifestations and the lesion patterns of five patients with somatoparaphrenia, the denial of ownership for a paralyzed limb, who showed the rare dissociation from anosognosia for hemiplegia. Similar cases have been only occasionally cited in the literature with scanty descriptions of their symptoms and no detailed anatomical assessment. All patients had extrapersonal and at least mild personal neglect. The lesions pattern was mainly subcortical, with a significant involvement of the right thalamus, the basal ganglia and the internal capsule. A formal comparison between the anatomical pattern previously associated with anosognosia in a study performed in 2005 by Berti and colleagues, and the lesion distribution of each patient clearly shows that our pure somatoparaphrenic patients had a sparing of most of the regions associated with anosognosia for hemiplegia. The behavioral dissociation between SP and anosognosia for hemiplegia, together with this new anatomical evidence, suggests that motor awareness is not sufficient to build up a sense of ownership and therefore these two cognitive abilities are at least in part functionally independent and qualitatively different.

Surgery is an effective treatment for drug resistant focal epilepsy. Predictors of seizure outcome have been extensively addressed in the general population but similar data on older patients are still lacking. The aim of this study is to evaluate effectiveness and safety of surgery for patients over 50 years and to investigate variables associated to seizure outcome.We performed a single center retrospective study including 50 patients over 50 years treated surgically for drug resistant focal epilepsy between 1997 and 2014. We analyzed the rate of success of seizure control, the association of several clinical variables with seizure outcome and the rate of surgery-related complications. We also investigated the impact of surgery on the patients' cognitive performances and mood profile.At last follow-up 78% of our patients were seizure-free, similar to patients younger than 50 years operated on in the same period (p=1). The rate of surgery-related complications was 10%, higher compared to younger patients (p0.0001). Pre-surgical daily seizure frequency (p=0.0040) and the histological diagnosis of LEAT (p=0.0233) were associated to a poorer seizure outcome. No significant differences were evidenced between pre- and postoperative neuropsychological profiles. A slight, not statistically significant improvement of the mood profile was observed postoperatively.Our results suggest that surgery is an effective treatment option also for older epileptic patients, although it is burdened by a higher surgical risk as compared to younger patients. The availability of predictors of outcome also for these patients may be helpful for pre-surgical counseling.

Neuropsychological assessment is critical in both diagnosis and prognosis of patients with epilepsy. Beyond electrophysiological and anatomical alterations, other factors including different ethnic-cultural and linguistic backgrounds might affect neuropsychological performance. Only a few studies considered migration and acculturation effects and they typically concerned nonclinical samples. The current study aimed at investigating the influence of ethnic background and time spent in Italy on a full neuropsychological battery administered to both Italian and foreign-born patients and at providing a brief interview for obtaining relevant information on each patient's transcultural and language-related history. Clinical reports from 43 foreign-born patients with drug-resistant epilepsy were collected from the archives of Milan Niguarda Hospital. Epileptogenic zone, age, education, profession, illness duration, seizure frequency, handedness, and gender were considered in selecting 43 Italian controls. Ethnicity (Italian/foreign-born) and years spent in Italy were analyzed as main predictors on 21 neuropsychological scales by means of General(ized) Linear Models. An additional analysis studied two composite scores of overall verbal and nonverbal abilities. Ethnicity significantly affected the following: the verbal overall score, Verbal Fluency, Naming, Token-test, Digit Span, Attentional Matrices, Trail-Making-Test, Line-Orientation-Test, and Raven matrices; no effects were found on the nonverbal overall score, Word Pairs Learning, Episodic Memory, reading accuracy, visual span, Bells test, Rey Figure, and face memory and recognition. No significant effects of years spent in Italy emerged. While years spent in Italy does not predict neuropsychological performance, linguistic background had a strong impact on it. With respect to Italian-speaking patients, those who were foreign-born showed large task-related variability, with an especially low performance on language-related tests. Hence, language tests should not be considered as valid measures of neuropsychological impairment in this population, not even in foreign-born patients with good Italian fluency. Clinicians should consider such asymmetries in order to improve the accuracy of neuropsychological assessment of foreign-born patients.

The vestibular system is unique among the senses because of the entirely multisensory nature of its cortical projections. Neuroanatomical and neuroimaging studies show that vestibular stimulation activates somatosensory areas, and particularly the so-called parieto-insular vestibular cortex (PIVC) in the monkey, while deactivating visual areas. Further, recent psychophysical studies showed that vestibular stimulation facilitates detection of electrocutaneous stimuli, suggesting a vestibular-somatosensory perceptual interaction. However, the functional mechanism underlying this perceptual facilitation remains unclear. We therefore recorded somatosensory potentials evoked by left median nerve stimulation, before and immediately after left cold caloric vestibular stimulation (CVS), in a small-scale study of eight healthy volunteers. CVS selectively enhanced the N80 component recorded over both ipsilateral and contralateral somatosensory areas, without significantly affecting earlier or later components. Interestingly, the N80 component has been localised to the parietal operculum, which includes the human homologue of the monkey PIVC, and is thus a prime neuroanatomical candidate for vestibular-somatosensory convergence. As a control, we measured visual evoked potentials to reversing checkerboard patterns and found no effects of vestibular stimulation. This rules out explanations based on indirect effects of vestibular modulations, such as general arousal or supramodal spatial attention. We believe our results provide the first clue linking brain structure to function for the interaction between vestibular and somatosensory systems.

When we reach out to grasp objects, vision plays a major role in the control of our movements. Nevertheless, other sensory modalities contribute to the fine-tuning of our actions. Even olfaction has been shown to play a role in the scaling of movements directed at objects. Much less is known about how auditory information might be used to program grasping movements. The aim of our study was to investigate how the sound of a target object affects the planning of grasping movements in normal right-handed subjects. We performed an experiment in which auditory information could be used to infer size of targets when the availability of visual information was varied from trial to trial. Classical kinematic parameters (such as grip aperture) were measured to evaluate the influence of auditory information. In addition, an optimal inference modeling was applied to the data. The scaling of grip aperture indicated that the introduction of sound allowed subjects to infer the size of the object when vision was not available. Moreover, auditory information affected grip aperture even when vision was available. Our findings suggest that the differences in the natural impact sounds of objects of different sizes being placed on a surface can be used to plan grasping movements.

According to recent theories, drug addicted patients suffer of an impaired response inhibition and salience attribution (I-RISA) together with a perturbed connectivity between the nuclei accumbens (NAcs) and the orbito-prefrontal (oPFC) and dorsal prefrontal (dPFC) cortices, brain regions associated with motivation and cognitive control. To empirically test these assumptions, we evaluated the (neuro)psychological trait and the functional organization of the resting state brain networks associated with the NAcs in 18 former cocaine abusers (FCAs), while being in drug abstinence since 5 months. The psychological data were grouped into three empirical variables related with emotion regulation, emotion awareness and strategic and controlled behaviour. Comparison of the resting state patterns between the entire sample of FCAs and 19 controls revealed a reduction of functional connectivity between the NAcs and the dPFC and enhanced connectivity between the NAcs and the dorsal-striatum. In the 8 FCAs who relapsed into cocaine use after 3 months, the level of functional connectivity between the NAcs and dPFC was lower than the functional connectivity estimated in the group of patients that did not relapsed. Finally, in the entire sample of FCAs, the higher the connectivity between the NAc and the oPFC the lower was the level of strategic and controlled behaviour. Taken together, these results are compatible with models of the interactions between the NAcs, the dorsal striatum and frontal cortices in the I-RISA syndrome, showing that such interactions are particularly perturbed in patients at greater risk of relapse into cocaine abuse.

Caloric vestibular stimulation (CVS) is a simple physiological manipulation that has been used for a long time in different clinical fields due to its rapid and relevant effects on behaviour. One of the most debated issues in this research field concerns the degree of specificity of such stimulation, namely whether the effects of CVS can be, and to what extent are, independent of the mere influence of non-specific factors such as general arousal, ocular movements or attentional shift towards the stimulated side. The hypothesis that CVS might cause a shift of attention towards the side of the stimulation has been largely supported; moreover, a large amount of evidence is available nowadays to corroborate the specific effect of CVS, providing behavioural and neurophysiological data in both patients and normal subjects. These data converge in indicating that the effects of CVS can be independent of eye deviation and general arousal, can modulate different symptoms in different directions, and do not merely depend on a general shift of attention. The present article is divided into three main sections. In the first section, we describe classical studies that investigate the effects of CVS on neglect and related symptoms. In the second and third parts, we provide an overview of the modulatory effects of CVS on somatosensory processes and body representation in both brain-damaged patients and healthy subjects. Finally, we conclude by discussing the relevance of these new findings for the understanding of the neural mechanisms underlying the modulatory effects of CVS.

Homeostatic parameters, such as temperature, are related to body representation. In this study, we measured whether caloric vestibular stimulation (CVS) alters body temperature and tactile processing, and if in the direction predicted by a holistic body matrix representation. Skin temperature and tactile two-point discrimination (TPD) acuity were measured for both arms before, immediately after and with a delay from CVS. Participants were also administered a personality questionnaire and an anxiety inventory to rule out confounding factors. Two control experiments were planned to exclude casual variations. Our results show that temperature drops significantly in both arms after CVS. CVS also induces a bilateral improvement in tactile acuity (even though not immediately after but in the delayed condition). Finally, these effects are not due to learning, as demonstrated by the control experiment. In summary, our results suggest that vestibular stimulation updates body representation, supporting the evidence in favor of a body matrix.

Individuals with the peculiar disturbance of '. overcompleteness' experience an intense desire to amputate one of their healthy limbs, describing a sense of disownership for it (Body Integrity Identity Disorder - BIID). This condition is similar to somatoparaphrenia, the acquired delusion that one's own limb belongs to someone else. In ten individuals with BIID, we measured skin conductance response to noxious stimuli, delivered to the accepted and non-accepted limb, touching the body part or simulating the contact (stimuli approach the body without contacting it), hypothesizing that these individuals have responses like somatoparaphrenic patients, who previously showed reduced pain anticipation, when the threat was directed to the disowned limb. We found reduced anticipatory response to stimuli approaching, but not contacting, the unwanted limb. Conversely, stimuli contacting the non-accepted body-part, induced stronger SCR than those contacting the healthy parts, suggesting that feeling of ownership is critically related to a proper processing of incoming threats.

In this study, a series of tests exploring long-term verbal memory (the Short Story Test), attention (a modified version of Attentional Matrices and the Trail Making Test) and frontal functions (a modified version of the Frontal Assessment Battery) have been standardised on an Italian population of 283 children aged 5-14. Raw scores for each test have been adjusted for a series of variables (child's age, years of parents' education, handedness, gender) and transformed in equivalent scores enabling direct comparison across measures. This study was promoted by LICE (the Italian League Against Epilepsy) in order to provide Italian instruments standardised on the developmental age population and to study some of the most frequently impaired cognitive functions in epilepsy.

Neglect of contralesional stimuli and perseverative behavior on ipsilesional stimuli may co-occur on a target cancellation task. Our aim was to investigate whether the presence vs. absence of contralesional targets can modify perseveration on ipsilesional targets. We studied four right brain-damaged patients with left neglect and perseverative behavior on screening cancellation tasks. We compared their cancellation performance in two conditions: (i) targets equally distributed on both sides of space and (ii) targets confined to the right side. One patient showed no significant difference in perseveration between these two conditions; in contrast, three patients perseverated significantly more in condition (i) than in condition (ii). These results suggest that, at least in some patients, information from the ‘neglected’ targets is not completely lost, but rather it affects behavior in the ipsilesional side. The traditional dichotomy ‘bad space–good space’ would not apply here.