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Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milano, ItalyA few years ago a brief communication on Nature reportedlearning-induced plasticity in the gray matter of the brains ofvolunteers who had learned to juggle (Draganski et al., 2004).These individuals showed a transient and selective structuralchange in brain areas associated with the processing andstorage of complex visual motion. This discovery of astimulus-dependent alteration in the brain's macroscopicstructure contradicted the traditional, and at that time pre-vailing, view that cortical plasticity is associated with func-tional, rather than anatomical, changes (Draganski & May,2008). This finding gave also impetus to the study of neuro-plasticity, suggesting that in the gray matter not only reduc-tion of volume is possible, such as in ageing, but alsoincrement. There may be, however, some abuse of the term“neuroplasticity” (used with “gay abandon”, as suggested byBuchtel, 1978). Following Paillard (see Will, Dalrymple-Alford,Wolff, & Cassel, 2008), changes in the nervous system shouldbe called “plastic” only when the connectivity network of thesystem undergoes lasting changes in the structure that linkstogether its elements. Furthermore, changes,to be considered“plastic”, should be both structural and functional, namelyonly when a given system (here, a set of cortico-subcorticalnetworks) achieves a novel function, either by transformingits pattern of internal connectivity, or by changing the ele-ments of which it is made, or both. Random (backgroundnoise) and systematic variations, namely, operating errorsbeyond the flexibility of the system, as well as vicariousstrategies used to achieve a given behavioral goal should notbe regarded as plastic changes. With reference to the life spanof the living organism, the distinction may be drawn betweenthe structural malleability of the system during development,within the range of genetic competence (termed by Paillardgenetic plasticity), and the capacity of the fully developed sys-tem to change its own structure, and to expand its behavioralrepertoire, namely: the adaptive plasticity of a system whichhas already completed its maturation. The possibility that agiven neural system achieves a novel function does notnecessarily mean that the functional (psychological, cogni-tive) architecture changes. The function may be “novel”, withreference to the previous activity of that neural network, butnot per se, namely: the plastic system may replace, at least inpart, another damaged network, taking over and maintainingthe functional properties of the latter. This is a key assump-tion, in order to make meaningful inferences from the path-ological behavior of brain-damaged patients to the functionalorganizationofthenormalsystem(discussioninVallar,2000).Finally,plasticityreferstoachangeinstructureinresponsetoan external force, and the maintenance of that shape afterremoval of the force, in contrast to “elasticity”, which impliesthe return to the previous form, when the force is removed(Berlucchi & Buchtel, 2009).While convincing empirical evidence suggesting thatplastic changes may occur in the brain is quite recent, therootsof the conceptof “neuroplasticity” maybe tracedback tothe second half of the XIX century. Berlucchi and Buchtel(2009) pointed out that the Italian psychiatrist ErnestoLugaro (1870e1940) was the first to introduce the term “plas-ticity” (also used by the North American psychologist WilliamJames,todenotechangesinnervouspathsassociatedwiththeestablishment of habits) in order to link neuroplasticity tosynaptic plasticity as early as 1906. By this term Lugaro meantthat the anatomoefunctional relations between neuronsmight change in an adaptive way along our life span, in orderto allow psychic maturation, learning, as well as functionalrecovery after brain damage. Lugaro's concept of plasticitywas inspired by a neural hypothesis of learning and memoryput forward in 1893 by his mentor Eugenio Tanzi, whopostulated that practice and experience promote neuronalgrowth and identified the articulation between neurons assites of neural plasticity. Cajal (references in Berlucchi &

Transcranial direct current stimulation (tDCS) is a non-invasive tool, which effectively modulates behavior, and related brain activity. When applied to the primary motor cortex (M1), tDCS affects motor function, enhancing or decreasing performance of both healthy participants and brain-damaged patients. Beyond M1, the posterior parietal cortex (PPC) is also crucially involved in controlling and guiding movement. Therefore, we explored whether the modulation of cortical excitability within PPC can also affect hand motor function in healthy right-handed participants. In Experiment 1, anodal tDCS (2mA, 10min) was applied to PPC and to M1 of both hemispheres. Skilled motor function of the non-dominant left hand, measured using the Jebsen-Taylor Hand Function Test (JTT), improved after anodal tDCS of the right, contralateral M1, as well as after the anodal stimulation of the left, ipsilateral PPC. Conversely, in Experiment 2, cathodal tDCS of the left PPC, or of the right M1, reduced motor performance of the left hand. Finally, Experiment 3 shows that the anodal tDCS of the left PPC selectively facilitated action planning, while the anodal tDCS of the right M1 modulated action execution only.This evidence shows that motor improvement induced by left parietal and right motor stimulations relies on substantial different mechanisms, opening up novel perspectives in the neurorehabilitation of stroke patients with motor and apraxic disorders. © 2014 Elsevier Ltd.

Perception of the external world is based on the integration of inputs from different sensory modalities. Recent experimental findings suggest that this phenomenon is present in lower-level cortical areas at early processing stages. The mechanisms underlying these early processes and the organization of the underlying circuitries are still a matter of debate. Here, we investigate audiovisual interactions by means of a simple neural network consisting of two layers of visual and auditory neurons. We suggest that the spatial and temporal aspects of audio-visual illusions can be explained within this simple framework, based on two main assumptions: auditory and visual neurons communicate via excitatory synapses; and spatio-temporal receptive fields are different in the two modalities, auditory processing exhibiting a higher temporal resolution, while visual processing a higher spatial acuity. With these assumptions, the model is able: i) to simulate the sound-induced flash fission illusion; ii) to reproduce psychometric curves assuming a random variability in some parameters; iii) to account for other audio-visual illusions, such as the sound-induced flash fusion and the ventriloquism illusions; and iv) to predict that visual and auditory stimuli are combined optimally in multisensory integration. In sum, the proposed model provides a unifying summary of spatio-temporal audio-visual interactions, being able to both account for a wide set of empirical findings, and be a framework for future experiments. In perspective, it may be used to understand the neural basis of Bayesian audio-visual inference. © 2014 Elsevier Inc.

This study investigates whether the rubber hand illusion (RHI) can induce a remission of somatoparaphrenia, a somatic delusion usually following righthemisphere damage, which typically manifests as a defective sense of ownership of one's contralesional body parts. First, we show that patients with somatoparaphrenia can experience a reliable RHI, exhibiting illusory effects similar to those reported by healthy participants. Moreover, synchronous touches applied to the patients' visible disowned left hand (rather than to the rubber hand), and to their right invisible unimpaired hand, induce an immediate self-attribution of the disowned hand, without affecting other sensorimotor or attentional disorders. The higher-level representation of the body concerned with ownership, deranged as a somatic delusion in patients with somatoparaphrenia, is penetrable, and can be restored by multisensory stimulations. © 2014 American Academy of Neurology.

In line bisection right-brain-damaged patients with left spatial neglect show a rightward deviation, with respect to the line's physical center. In word bisection ortho-phonological features of the stimulus' final (right-sided) part modulate performance of both patients and healthy participants (Veronelli, Vallar, Marinelli, Primativo, & Arduino, 2014). We investigated the role of linguistic factors in sentence bisection, in patients with and without neglect, and control participants. The effects of information in the right-sided part of the sentence (Experiment #1), and of lexical and syntactic violations (Experiment #2) were assessed. Neglect patients showed an overall rightward bias, larger than those of patients without neglect and controls. The neglect patients' bias was modulated by stimulus type, decreasing from lines, to letter strings and to all types of sentences. In sum, in visuo-manual sentence bisection a basic linguistic mechanism, such as sentence readability, brings about a more leftward appreciation of the stimulus, reducing the neglect patients' rightward bias. (C) 2014 Elsevier Inc. All rights reserved.

In recent years we reported three right-brain-damaged patients, who exhibited a left-sided disprortionate expansion of drawings, both by copying and from memory, contralateral to the side of the hemispheric lesion (Neurology, 67: 1801, 2006, Neurocase 14: 369, 2008). We proposed the term "hyperschematia" for such an expansion, with reference to an interpretation in terms of a lateral leftward distortion of the representation of extra-personal space, with a leftward anisometric expansion (relaxation) of the spatial medium. The symptom-complex shown by right-brain-damaged patients with "hyperschematia" includes: (1) a disproportionate leftward expansion of drawings (with possible addition of details), by copy and from memory (also in clay modeling, in one patient); (2) an overestimation of left lateral extent, when a leftward movement is required, associated in some patients with a perceptual underestimation; (3) unawareness of the disorder; (4) no unilateral spatial neglect. In most right-brain-damaged patients, left "hyperschematia" involves extra-personal space. In one patient the deficit was confined to a body part (left half-face: personal "hyperschematia"). The neural underpinnings of the disorder include damage to the fronto-temporo-parietal cortices, and subcortical structures in the right cerebral hemisphere, in the vascular territory of the middle cerebral artery. Here, four novel additional patients are reported. Finally, "hypeschematia" is reconsidered, in its clinical components, the underlying pathological mechanisms, as well as its neural underpinnings.

Right-brain-damaged patients with left unilateral spatial neglect typically set the mid-point of horizontal lines to the right of the objective center. By contrast, healthy participants exhibit a reversed bias (pseudoneglect). The same effect has been described also when bisecting orthographic strings. In particular, for this latter kind of stimulus, some recent studies have shown that visuo-perceptual characteristics, like stimulus length, may contribute to both the magnitude and the direction bias of the bisection performance (Arduino et al. in Neuropsychologia 48:2140-2146, 2010). Furthermore, word stress was shown to modulate reading performances in both healthy participants, and patients with left spatial neglect and neglect dyslexia (Cubelli and Beschin in Brain Lang 95:319-326, 2005; Rusconi et al. in Neuropsychology 18:135-140, 2004). In Experiment I, 22 right-brain-damaged patients (11 with left visuo-spatial neglect) and 11 matched neurologically unimpaired control participants were asked to set the subjective mid-point of word letter strings, and of lines of comparable length. Most patients exhibited an overall disproportionate rightward bias, sensitive to stimulus length, and similar for words and lines. Importantly, in individual patients, biases differed according to stimulus type (words vs. lines), indicating that at least partly different mechanisms may be involved. In Experiment II, the putative effects on the bisection bias of ortho-phonological information (i.e., word stress endings), arising from the non-neglected right hand side of the stimulus were investigated. The orthographic cue induced a rightward shift of the perceived mid-point in both patients and controls, with short words stressed on the antepenultimate final sequence inducing a smaller rightward deviation with respect to short words stressed on the penultimate final sequence. In conclusion, partly different mechanisms, including both visuo-spatial and lexical factors, may support line and word bisection performance of right-brain-damaged patients with left spatial neglect, and healthy participants.

Right-brain-damaged patients with unilateral spatial neglect are usually unaware (anosognosic) about their spatial deficits. However, in the scientific literature there is a lack of systematic and quantitative evaluation of this kind of unawareness, despite the negative impact of anosognosia on rehabilitation programs. This study investigated anosognosia for neglect-related impairments at different clinical tasks, by means of a quantitative assessment. Patients were tested in two different conditions (before and after execution of each task), in order to evaluate changes in the level of awareness of neglect-related behaviours triggered by task execution. Twenty-nine right-brain-damaged patients (17 with left spatial neglect) and 27 neurologically unimpaired controls entered the study. Anosognosia for spatial deficits is not pervasive, with different tasks evoking different degrees of awareness about neglect symptoms. Indeed, patients showed a largely preserved awareness about their performance in complex visuo-motor spatial and reading tasks; conversely, they were impaired in evaluating their spatial difficulties in line bisection and drawing from memory, showing over-estimation of their performance. The selectivity of the patients' unawareness of specific manifestations of spatial neglect is further supported by their preserved awareness of performance at a linguistic task, and by the absence of anosognosia for hemiplegia. This evidence indicates that discrete processes are involved in the aware monitoring of cognitive and motor performance, which can be selectively compromised by brain damage. Awareness of spatial difficulties is supported by a number of distinct components, and influenced by the specific skills required to perform a given task. (C) 2014 Elsevier Ltd. All rights reserved.

We studied the effects of transcutaneous electrical nerve stimulation (TENS) in six right-brain-damaged patients with left unilateral spatial neglect (USN), using both standard clinical tests (reading, line, and letter cancelation, and line bisection), and electrophysiological measures (steady-state visual-evoked potentials, SSVEP). TENS was applied on left neck muscles for 15', and measures were recorded before, immediately after, and 60' after stimulation. Behavioral results showed that the stimulation temporarily improved the deficit in all patients. In cancelation tasks, omissions and performance asymmetries between the two hand-sides were reduced, as well as the rightward deviation in line bisection. Before TENS, SSVEP average latency to stimuli displayed in the left visual half-field [LVF (160 ms)] was remarkably longer than to stimuli shown in the right visual half-field [RVF (120 ms)]. Immediately after TENS, latency to LVF stimuli was 130 ms; 1 h after stimulation the effect of TENS faded, with latency returning to baseline. TENS similarly affected also the latency SSVEP of 12 healthy participants, and their line bisection performance, with effects smaller in size. The present study, first, replicates evidence concerning the positive behavioral effects of TENS on the manifestations of left USN in right-brain-damaged patients; second, it shows putatively related electrophysiological effects on the SSVEP latency. These behavioral and novel electrophysiological results are discussed in terms of specific directional effects of left somatosensory stimulation on egocentric coordinates, which in USN patients are displaced toward the side of the cerebral lesion. Showing that visual-evoked potentials latency is modulated by proprioceptive stimulation, we provide electrophysiological evidence to the effect that TENS may improve some manifestations of USN, with implications for its rehabilitation.

This study assessed whether numerical magnitude affects the setting of basic spatial coordinates and reference frames, namely the subjective straight ahead. Three tasks were given to 24 right-handed healthy participants: a proprioceptive and a visuo-proprioceptive task, requiring pointing to the subjective straight ahead, and a visual task, requiring a perceptual judgment about the straight ahead position of a light moving left-to-right, or right-to-left. A control task, requiring the bisection of rods of different lengths, was also given. The four tasks were performed under conditions of passive auditory numerical (i.e., listening to small, “2”, and large, “8”, numbers), and neutral auditory-verbal (“blah”) stimulation. Numerical magnitude modulates the participants’ deviations in the visual straight ahead task, when the movement of the light is from left to right, with the small number bringing about a leftward deviation, the large number a rightward deviation. This result suggests that the spatial effects induced by the activation of the mental number line extend to an egocentric frame of reference. A similar directional modulation was found in the rod bisection task, in line with previous evidence. No effects of numerical magnitude were found on the proprioceptive and visuo-proprioceptive straight ahead tasks. These results suggest that the spatial effects induced by the activation of the mental number line extend to an egocentric frame of reference but only when a portion of horizontal space has to be “actively” explored.

Neurologically intact individuals usually show a leftward bias in line bisection, a tendency known as “pseudoneglect”, likely reflecting a right-hemisphere dominance in controlling the allocation of spatial attention. Studies in brain-damaged patients with left visuospatial neglect have reported that auditory stimulation may reduce the deficit, both in a spatially dependent and in a spatially independent way. Here we show for the first time that the concurrent binaural presentation of auditory white noise affects healthy individuals' performance in both visual and haptic bisection, reducing their leftward error. We suggest that this effect depends on the noise boosting alertness and restoring the hemispheric activation balance. Our data clearly show that task-irrelevant auditory noise crossmodally affects the allocation of spatial resources in both the haptic and the visual space; future research may clarify whether these effects are specific for the type of auditory stimulation.

OBJECTIVE: To assess the role of the superior longitudinal fascicle, the inferior fronto‐occipital fascicle, and the posterior parietal lobe in visuospatial attention in humans during awake brain surgery. EXPERIMENTAL DESIGN: Seven patients with hemispheric gliomas (six in the right hemisphere) entered the study. During surgery in asleep/awake anesthesia, guided by Diffusion Tensor Imaging Fiber Tractography, visuospatial neglect was assessed during direct electrical stimulation by computerized line bisection. PRINCIPAL OBSERVATIONS: A rightward deviation, indicating left visuospatial neglect, was induced in six of seven patients by stimulation of the parietofrontal connections, in a location consistent with the trajectory of the second branch of the superior longitudinal fascicle. Stimulation of the medial and dorsal white matter of the superior parietal lobule (corresponding to the first branch of the superior longitudinal fascicle), of the ventral and lateral white matter of the supramarginal gyrus (corresponding to the third branch of the superior longitudinal fascicle), and of the inferior occipitofrontal fasciculus, was largely ineffective. Stimulation of the superior parietal lobule (Brodmann's area 7) caused a marked rightward deviation in all of the six assessed patients, while stimulation of Brodmann's areas 5 and 19 was ineffective. CONCLUSIONS: The parietofrontal connections of the dorso‐lateral fibers of the superior longitudinal fascicle (i.e., the second branch of the fascicle), and the posterior superior parietal lobe (Brodmann's area 7) are involved in the orientation of spatial attention. Spatial neglect should be assessed systematically during awake brain surgery, particularly when the right parietal lobe may be involved by the neurosurgical procedure. Hum Brain Mapp 35:1334–1350, 2014. © 2013 Wiley Periodicals, Inc.

Prism adaptation improves a wide range of manifestations of left spatial neglect in right-brain-damaged patients. The typical paradigm consists in repeated pointing movements to visual targets, while patients wear prism goggles that displace the visual scene rightwards. Recently, we demonstrated the efficacy of a novel adaptation procedure, involving a variety of every-day visuo-motor activities. This “ecological” procedure proved to be as effective as the repetitive pointing adaptation task in ameliorating symptoms of spatial neglect, and was better tolerated by patients. However, the absence of adaptation and aftereffects measures for the ecological treatment did not allow for a full comparison of the two procedures. This is important in the light of recent findings showing that the magnitude of prism-induced aftereffects may predict recovery from spatial neglect. Here, we investigated prism-induced adaptation and aftereffects after ecological and pointing adaptation procedures. Forty-eight neurologically healthy participants (young and aged groups) were exposed to rightward shifting prisms while they performed the ecological or the pointing procedures, in separate days. Before and after prism exposure, participants performed proprioceptive, visual, and visual-proprioceptive tasks to assess prism-induced aftereffects. Participants adapted to the prisms during both procedures. Importantly, the ecological procedure induced greater aftereffects in the proprioceptive task (for both the young and the aged groups) and in the visual-proprioceptive task (young group). A similar trend was found for the visual task in both groups. Finally, participants rated the ecological procedure as more pleasant, less monotonous, and more sustainable than the pointing procedure. These results qualify ecological visuo-motor activities as an effective prism-adaptation procedure, suitable for the rehabilitation of spatial neglect.

Pain can be modulated by several contextual factors. For example, simply viewing one's own body can reduce pain, suggesting that the visual context may influence the processing of nociceptive stimuli. We studied changes in electroencephalographic (EEG) oscillatory activity related to visual modulation of nociception, comparing cortical oscillations during innocuous or noxious contact heat, while participants viewed either their own hand or a neutral object at the same location. Viewing the body compared with viewing the object reduced the intensity ratings of noxious stimuli, but not of innocuous heat. Time-frequency analysis of EEG data revealed that noxious, as opposed to warm, stimulation was associated with reduced beta (15-25 Hz) power. Classically, such decreases in oscillatory power indicate increases in sensory cortical activation. These event-related oscillatory changes were moreover modulated by the visual context; viewing one's own body increased noxious stimulation-induced beta oscillatory activity bilaterally, relative to viewing a neutral object, possibly indicating inhibition of cortical nociceptive processing. These results demonstrate that visual-nociceptive interactions involve changes in sensorimotor EEG rhythms.

Brain imaging studies in humans have shown the existence of a shared somatosensory representation in the primary somatosensory cortex (S1), putatively involved in understanding others' sensations (Keysers et al., 2010); however, the role of S1 in such a high-level process is still unknown. To ascertain the causal involvement of S1, and its possible hemispheric lateralization, in encoding the affective valence of emotional scenes, depicting, or not, a tactile event, we gave to healthy participants a picture-based affective go/no-go task and low-frequency repetitive transcranial magnetic stimulation (rTMS). The dorsolateral prefrontal cortex (DLPFC) was chosen as control site. rTMS over the right, but not the left, S1 selectively increased the participants' latencies in the affective go/no-go task, but only when the affective state was conveyed by touch; intriguingly, this interfering effect was associated with the empathic ability to adopt the subjective perspective of others. The left, not the right, DLPFC is also involved in affective go/no-go performance, but regardless of the sight of touch, and independently of empathic abilities. This novel evidence demonstrates the crossmodal role of right S1 in encoding the pleasant and aversive consequences of others' sensations evoked by touch. © 2013 the authors.

Crossmodal illusions clearly show how perception, rather than being a modular and self-contained function, can be dramatically altered by interactions between senses. Here, we provide evidence for a novel crossmodal "physiological" illusion, showing that sounds can boost visual cortical responses in such a way to give rise to a striking illusory visual percept. In healthy participants, a single-pulse transcranial magnetic stimulation (sTMS) delivered to the occipital cortex evoked a visual percept, i.e., a phosphene. When sTMS is accompanied by two auditory beeps, the second beep induces in neurologically unimpaired participants the perception of an illusory second phosphene, namely the sound-induced phosphene illusion. This perceptual "fission" of a single phosphene, due to multiple beeps, is not matched by a "fusion" of double phosphenes due to a single beep, and it is characterized by an early auditory modulation of the TMS-induced visual responses (~80 ms). Multiple beeps also induce an illusory feeling of multiple TMS pulses on the participants' scalp, consistent with an audio-tactile fission illusion. In conclusion, an auditory stimulation may bring about a phenomenological change in the conscious visual experience produced by the transcranial stimulation of the occipital cortex, which reveals crossmodal binding mechanisms within early stages of visual processing. © 2013 Springer-Verlag Berlin Heidelberg.

Objective: Right-brain-damaged patients with left spatial neglect make perseveration errors in target cancellation tasks. A recent study (Ronchi, Posteraro, Fortis, Bricolo, & Vallar, 2009) showed that perseveration occurred more frequently in star than in letter cancellation, possibly due to different stimulus disposition. In this study we investigated the role of the spatial organization of targets (scattered vs. arranged) of the star and letter cancellation tasks in eliciting omission and perseveration errors; the role of impairments of divided attentional resources; and the lesion correlates of perseveration. Method: Thirty-three right-brain-damaged patients (27 with neglect, and six without neglect; 17 showing perseveration, 16 of them with spatial neglect) were given two versions of the star and letter cancellation tasks (with stimuli scattered or in rows), and a dual task. Results: A scattered target disposition increased omission and perseveration errors. Target type modulated differently omission and perseveration, with the former being more elicited by verbal targets, and the latter occurring more frequently in the star cancellation task, with scattered stimuli. Perseveration behavior was unrelated to deficits of divided attention, as assessed by the dual task. Lesion analysis indicated damage to the right insula as a neural correlate of perseveration. Conclusions: A display including nonverbal (star) and scattered targets brings about more perseveration errors. Target type and organization modulate in a different fashion omission and perseveration, suggesting the involvement of independent pathological mechanisms, which, however, do not implicate deficits of divided attention. The role of insular damage in motor perseveration in spatial neglect is discussed.

The representation of body parts holds a special status in the brain, due to their prototypical shape and the contribution of multisensory (visual and somatosensory-proprioceptive) information. In a previous study (Sposito et al., 2010), we showed that patients with left unilateral spatial neglect exhibit a rightward bias in setting the mid-point of their left forearm, which becomes larger when bisecting a cylindrical object comparable in size. This body part advantage, found also in control participants, suggests partly different processes for computing the extent of body parts and objects. In this study we tested 16 right-brain-damaged patients, and 10 unimpaired participants, on a manual bisection task of their own (real) left forearm, or a size-matched fake forearm. We then explored the effects of adaptation to rightward displacing prism exposure, which brings about leftward aftereffects. We found that all participants showed prism adaptation and aftereffects, with right-brain-damaged patients exhibiting a reduction of the rightward bias for both real and fake forearm, with no overall differences between them. Second, correlation analyses highlighted the role of visual and proprioceptive information for the metrics of body parts. Third, single-patient analyses showed dissociations between real and fake forearm bisections, and the effects of prism adaptation, as well as a more frequent impairment with fake body parts. In sum, the rightward bias shown by right-brain-damaged patients in bisecting body parts is reduced by prism exposure, as other components of the neglect syndrome; discrete spatial representations for real and fake body parts, for which visual and proprioceptive codes play different roles, are likely to exist. Multisensory information seems to render self bodily segments more resistant to the disruption brought about by right-hemisphere injury.

In cancellation tasks, patients with unilateral spatial neglect typically fail to mark targets within the side of the sheet contralateral to the side of the lesion (contralesional). Moreover, they can show a perseverative behaviour, which consists in repeatedly cancelling stimuli, mainly in the side of the display ipsilateral to the side of the lesion (ipsilesional). We investigated in 13 right-brain-damaged patients with left spatial neglect and perseverative behaviour whether and how different densities of horizontal targets modulated omission and perseverative errors. We found that the density of targets modulated the patients' distribution of neglect (area of omission), but not its extent, as indexed by the percentage of omissions. Specifically, the area of omissions tightened when target density increased leftwards. On the other hand, target density did not affect the distribution of perseverative behaviour (area of perseveration), as well as its extent, as indexed by the percentage of perseverations. Correlation analyses showed that both the extent and the distribution of omissions were positively correlated to clinical measures of spatial neglect. Conversely, perseverations did not show such a correlation. These findings support the view that two different pathological mechanisms might be involved in left spatial neglect and in ipsilesional perseverative behaviour. © 2012 The British Psychological Society.

Humans hold a very accurate representation of the metrics of their body parts. Recent evidence shows that the spatial estimation of body parts length, as assessed through a bisection task, is even more accurate than that of non-corporeal extrapersonal objects (Sposito, Bolognini, Vallar, Posteraro, & Maravita (2009)). In the present paper we show that human participants estimate the mid-point of their forearm, which was kept in a radial posture, to be more distal following a 15-min training with a 60 cm-long tool as compared to pre tool-use. This outcome is compatible with an increased representation of the participants’ forearm length. Control experiments show that this result was not due to a mere distal proprioceptive shift induced by tool-use, and was not replicated following the use of a 20 cm-long, functionally irrelevant tool. These results strongly support the view that, although the inner knowledge of one's own body metrics appears to be one of the more stable features of body representation, body-space interactions requiring the use of tools that extend the natural range of action, entail measurable dynamic changes in the representation of body metrics.

There is evidence that humans represent numbers in the form of a mental number line (MNL). Here we show that the MNL modulates the representation of visual and haptic space both in healthy individuals and right-brain-damaged patients, both with and without left unilateral spatial neglect (USN). Participants were asked to estimate the midpoint of visually or haptically explored rods while listening to task-irrelevant stimuli: a small digit ("2"), a large digit ("8"), or a non-numerical auditory stimulus ("blah"). In a control silent condition, the bisection error of USN patients was biased rightwards (namely, the marker of USN) only in the visual modality. Regardless of the direction of the bisection error committed in silent trials, listening to the small digit shifted the perceived midline leftwards, and listening to the large digit shifted the perceived midline rightwards, compared to a control condition in which a neutral syllable ("blah") was presented. The shift induced by listening to numbers occurred independently of the modality of response (i.e., both in vision and haptics), and in every group of participants. Interestingly, the effect of auditory numbers processing on space estimation was overall larger for haptically than for visually explored space in all participants. In conclusion, the present data show that listening to irrelevant numbers affects space perception also in patients with left USN, indicating that the spatial representation and attention processes disrupted by USN are not involved in these numerical magnitude-spatial effects.

In Italia, la neuropsicologia ha iniziato a svilupparsi a partire dagli anni’ 60 del secolo scorso, inizialmente con finalita puramente di ricerca, poi anche di diagnosi e riabilitazione dei deficit cognitivi ed emotivo-motivazionali causati da lesioni o disfunzioni cerebrali [1]. Introduzioni alla neuropsicologia sono reperibili nei volumi curati da Umilta [2], nel piu vasto contesto delle neuroscienze cognitive, e da Vallar e Papagno [3], con un focus specifico sulla neuropsicologia clinica. Una sintesi della situazione dell’accreditamento professionale del neuropsicologo alla fine degli anni’ 90 del secolo scorso e stata fatta da Vallar e Rusconi [4]. In anni recenti, sono stati pubblicati due volumi dedicati alla diagnosi neuropsicologica: Carlomagno [5] e Barletta-Rodolfi, Gasparini e Ghidoni [6], questo ultimo fresco di stampa, con la supervisione della Societa Italiana di Neuropsicologia (SINP), revisionano itest diagnostici disponibili in Italia. Stracciari, Bianchi e Sartori [7] trattano gli aspetti forensi della neuropsicologia. Mazzucchi [8] presenta una sintesi degli interventi riabilitativi in neuropsicologia, che sono anche oggetto di questo volume. La neuropsicologia ha quindi sviluppato in Italia un’importante componente applicativa [9], come e del resto avvenuto nel resto d’Europa, nelle Americhe e in Asia.

Crossing the hands over the midline reduces left tactile extinction to double simultaneous stimulation in right-brain-damaged patients, suggesting that spatial attentional biases toward the ipsilesional (right) side of space contribute to the patients' contralesional (left) deficit. We investigated (1) whether the position of the left hand, and its vision, affected processing speed of tactile stimuli, and (2) the electrophysiological underpinnings of the effect of hand position. (1) Four right-brain-damaged patients with spatial neglect and contralesional left tactile extinction or somatosensory deficits, and eight neurologically unimpaired participants, performed a speeded detection task on single taps delivered on their left index finger. In patients, placing the left hand in the right (heteronymous) hemi-space resulted in faster reaction times (RTs) to tactile stimuli, compared to placing that hand in the left (homonymous) hemi-space, particularly when the hand was visible. By contrast, in controls placing the left hand in the heteronymous hemi-space increased RTs. (2) Somatosensory event-related potentials (ERPs) were recorded from one patient and two controls in response to the stimulation of the left hand, placed in the two spatial positions. In the patient, the somatosensory P70, N140, and N250 components were enhanced when the left hand was placed in the heteronymous hemi-space, whereas in controls these components were not modulated by hand position. The novel findings are that in patients placing the left hand in the right, ipsilesional hemi-space yields a temporal advantage in processing tactile stimuli, and this effect may rely on a modulation of stimulus processing taking place as early as in the primary somatosensory cortex, as indexed by evoked potentials. Furthermore, vision enhances tactile processing specifically when the left hand is placed in the hemi-space toward which the patients' attentional biases are pathologically directed, namely rightwards.

Studies showing facilitation of behavioural performance by transcranial magnetic stimulation (TMS), and transcranial direct current stimulation (tDCS) in sensory and perceptual domains, spatial attention, working memory, and executive and emotional tasks are reviewed. In these domains the performance of neurologically unimpaired participants may be modulated, with behavioural facilitation or interference, by TMS, and by tDCS. The mapping of the frequency-dependent effects of TMS, and of the polarity-dependent effects of tDCS on behaviour does not systematically and mechanistically result in an increase or decrease of behavioural performance. Factors such as the parameters of the cerebral stimulation (localisation, duration, intensity), and the features of the task (complexity, phase of training) contribute to determine the final net effect on the participants' performance. Non-invasive brain stimulation (NIBS), which modulates learning, and appears to have, under some conditions, long lasting effects, is a promising tool to be used in the rehabilitation of a variety of neurological and cognitive disorders, that typically involve repeated behavioural training sessions.

This study explores whether brain polarization could be effective in modulating multisensory audiovisual interactions in the human brain, as measured by the 'sound-induced flash illusion' (Shams et al., 2000). In different sessions, healthy participants performed the task while receiving anodal, cathodal, or sham tDCS (2 mA, 8 min) to the occipital, temporal, or posterior parietal cortices. We found that up- or down-regulating cortical excitability by tDCS can facilitate or reduce audiovisual illusions, depending on the current polarity, the targeted area, and the illusory percept. Specifically, the perceptual 'fission' of a single flash, due to multiple beeps, was increased after anodal tDCS of the temporal cortex, and decreased after anodal stimulation of the occipital cortex. A reversal of such effects was induced by cathodal tDCS. Conversely, the perceptual 'fusion' of multiple flashes due to a single beep was unaffected by tDCS. This evidence adds novel clues on the cortical substrate of the generation of the sound-flash illusion, and opens new attractive possibilities for modulating multisensory perception in humans: tDCS appears to be an effective tool to modulate the conscious visual experience associated with multisensory interactions, by noninvasively shifting cortical excitability within occipital or temporal areas. (C) 2010 Elsevier Ltd. All rights reserved.

Numerical magnitude is believed to be represented along a mental number line (MNL), and there is evidence to suggest that the activation of the MNL affects the perception and representation of external space. In the present study, we investigated whether a spatial motor task affects numerical processing in the auditory modality. Blindfolded participants were presented with a numerical interval bisection task, while performing a tapping task with either their left or right hand, either in the fronto-central, fronto-left, or fronto-right peripersonal space. Results showed that tapping significantly influenced the participants' numerical bisection, with tapping in the left side of space increasing the original tendency to err leftward, and tapping to the right reducing such bias. Importantly, the effect depended on the side of space in which the tapping activity was performed, regardless of which hand was used. Tapping with either the left or right hand in the fronto-central space did not affect the participants' bias. These findings offer novel support for the existence of bidirectional interactions between external and internal representations of space. © 2010 Springer-Verlag.

La disciplina del procedimento penale viene presentata sinteticamente al lettore, così da poter e enziare più chiaramente i casi in cui va disposta la perizia, la cui regolamentazione è illustrata nei suoi lineamenti essenziali. A questa esposizione si affianca quella della consulenza tecnica extraperitale, che costituisce una novità introdotta nell’ordinamento italiano dal c.p.p. 1988. Infine, si esaminano le principali questioni che sorgono quando si intenda utilizzare nel processo una cosiddetta nuova prova scientifica, cioè un apparato tecnico-scientifico ritenuto nuovo o controverso e di elevata specializzazione

Unilateral spatial neglect has been mainly investigated in the visual modality; only a few studies compared spatial neglect in different sensory modalities, and explored their multisensory interactions, with controversial results. We investigated the integration between vision and haptics, through a bisection task of a crossmodal length illusion, the Judd variant of the Müller-Lyer illusion. We examined right-brain-damaged patients with (n=7) and without (n=7) left unilateral spatial neglect, and neurologically unimpaired participants (n=14) in the bisection of Judd stimuli under visual, haptic, and visuo-haptic presentation. Neglect patients showed the characteristic rightward bias in the bisection of a baseline stimulus in the visual modality, but not in the haptic and visuo-haptic conditions. The illusory effects were preserved in each group and in each modality, indicating that the processing of the length illusion is independent of the presence of deficits of spatial attention and representation. Spatial neglect can be modality-specific, but visual and tactile sensory inputs are properly integrated.

The Müller-Lyer illusion occurs both in vision and in touch, and transfers cross-modally from vision to haptics [Mancini, F., Bricolo, E., & Vallar, G. Multisensory integration in the Müller-Lyer illusion: From vision to haptics. Quarterly Journal of Experimental Psychology, 63, 818–830, 2010]. Recent evidence suggests that the neural underpinnings of the Müller-Lyer illusion in the visual modality involve the bilateral lateral occipital complex (LOC) and right superior parietal cortex (SPC). Conversely, the neural correlates of the haptic and cross-modal illusions have never been investigated previously. Here we used repetitive TMS (rTMS) to address the causal role of the regions activated by the visual illusion in the generation of the visual, haptic, and cross-modal visuo-haptic illusory effects, investigating putative modality-specific versus cross-modal underlying processes. rTMS was administered to the right and the left hemisphere, over occipito-temporal cortex or SPC. rTMS over left and right occipito-temporal cortex impaired both unisensory (visual, haptic) and cross-modal processing of the illusion in a similar fashion. Conversely, rTMS interference over left and right SPC did not affect the illusion in any modality. These results demonstrate the causal involvement of bilateral occipito-temporal cortex in the representation of the visual, haptic, and cross-modal Müller-Lyer illusion, in favor of the hypothesis of shared underlying processes. This indicates that occipito-temporal cortex plays a cross-modal role in perception both of illusory and nonillusory shapes.

Ce travail est une revue des 56 patients publiés dans la littérature scientifique, présentant, à la suite d’une lésion cérébrale, un délire affectant la partie controlésionnelle du corps ou somatoparaphrénie. Cette pathologie a été décrite, hormis quelques exceptions, chez des patients atteints d’une lésion cérébrale de l’hémisphère droit, avec déficits moteurs, sensitifs et négligence spatiale unilatérale. La somatoparaphrénie est souvent caractérisée par la sensation de non-appartenance des parties gauches du corps. Ce délire peut s’observer en l’absence d’anosognosie pour l’hémiplégie ou de négligence corporelle. Les déficits de la sensiblité tactile et du champ visuel ne semblent pas être essentiels pour la survenue de ce symptôme. En revanche, le déficit de la proprioception paraît jouer un rôle important. Le plus souvent, la somatoparaphrénie est associée à des lésions sous-corticales étendues de l’hémisphère droit ; les lésions uniquement antérieures sont rares. Des mécanismes pathologiques différents peuvent être impliqués, comme une perturbation de la représentation du corps et des déficits d’intégration multisensorielle. Une observation importante est la fréquente association entre somatoparaphrénie et négligence unilatérale pour l’espace extracorporel, suggérant une distinction floue entre les objets corporels à savoir les différentes parties du corps du sujet et les objets extracorporels, c’est-à-dire les parties du corps des autres personnes et les objets non corporels.

Body parts are represented in the brain in a very specific fashion, as compared to other three-dimensional objects, with reference to their prototypic shape and multisensory coding. However, evidence is lacking about the spatial representation of body parts. To address this issue, in Experiment 1 we first compared the metric representation of body parts and of non-bodily objects in 14 right-brain-damaged patients with left unilateral spatial neglect (USN), and in 14 neurologically unimpaired control participants. Participants bisected, by manual pointing, a three-dimensional object, or their own left forearm. Patients showed the well-known ipsilesional rightward displacement of the subjective midpoint, in both forearm and solid bisection. Both USN patients and control participants were overall more accurate in the bisection of their own forearm, relative to the extracorporeal object. In four patients this advantage of the forearm was significant in a single-case analysis, while two patients showed the opposite dissociation, being more accurate with the solid object. In Experiment 2 neurologically unimpaired participants were more accurate in the bisection of a fake forearm, as well as of their own forearm, as compared to the extrapersonal object. Overall, the results indicate that the representation of the metric of the body is more reliable than that of extrapersonal objects, and also more resistant to the disruption of spatial representations brought about by USN, possibly due to the prototypical shape of body parts. Furthermore, the double dissociation found in USN patients suggests that the metrics of body parts and of extrapersonal objects are supported by independent spatial processes.