Search

IntroductionCervical radiculopathy (CR) is a common cause of pain in the neck and arm region, with a considerable impact on a person’s physical functioning, mental health, and social participation. The current knowledge of CR is mainly based on empirical concepts and early studies. Although action potential conduction slowing or block of a spinal nerve or its roots (i.e., loss of sensory and/or motor function) is a core sign of CR, among guidelines CR is still commonly defined by pain (i.e., gain of function) radiating into the arm. There is no consensus about the gold-standard for the diagnostic procedures for CR but it has been suggested that clinicians should assess CR by subjective and physical examination including a neurological examination, neural mechanosensitive testing and provocative manoeuvres. Among the several clinical tests routinely used to identify loss of function, the neurological examination historically played a role in the differential diagnosis and in the prognostic profile of radiculopathy. However, there is a paucity of studies investigating the diagnostic accuracy of the neurological examination for CR. Thus, the assessment of CR remains a clinical challenge among primary care clinicians. This often leads to an increased risk of misdiagnosis and inappropriate treatment, potentially contributing to delayed recovery and poor health outcomes. Therefore, according to the population, concept, context (PCC) strategy, our scoping review aims to investigate the evidence in regard to diagnostic accuracy (C) of the neurological examination for CR (P) and raise awareness among clinicians on how to appropriately perform this testing.Methods and analysisThis scoping review will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Scoping Reviews checklist and the Joanna Briggs Institute (JBI) Reviewer’s Manual on scoping reviews. The aim of this scoping review is to explore what is already known about the neurological examination and its diagnostic value for CR.Ethics and disseminationThis scoping review will not require ethical approval since it will synthesize information from publicly available studies. Results will be submitted for publication in a peer-reviewed journal, presented at relevant conferences in the field and disseminated through working groups, conferences, webinars, social media.Strengths and limitations of this studyOur review will identify knowledge gaps to inform future research about the neurological examination for CR. Diagnostic values will be reported when available.To the best of the authors’ knowledge, this is the first scoping review to provide a comprehensive overview on the neurological examination for CR.The results will add meaningful information for clinicians to inform assessment of CR. It will also direct future research.A robust clinical recommendation might be limited due to the lack of available literature

Emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants diminishes the efficacy of vaccines and antiviral monoclonal antibodies. Continued development of immunotherapies and vaccine immunogens resilient to viral evolution is therefore necessary. Using coldspot-guided antibody discovery, a screening approach that focuses on portions of the virus spike glycoprotein that are both functionally relevant and averse to change, we identified human neutralizing antibodies to highly conserved viral epitopes. Antibody fp.006 binds the fusion peptide and cross-reacts against coronaviruses of the four genera, including the nine human coronaviruses, through recognition of a conserved motif that includes the S2′ site of proteolytic cleavage. Antibody hr2.016 targets the stem helix and neutralizes SARS-CoV-2 variants. Antibody sd1.040 binds to subdomain 1, synergizes with antibody rbd.042 for neutralization, and, similar to fp.006 and hr2.016, protects mice expressing human angiotensin-converting enzyme 2 against infection when present as a bispecific antibody. Thus, coldspot-guided antibody discovery reveals donor-derived neutralizing antibodies that are cross-reactive with Orthocoronavirinae, including SARS-CoV-2 variants.

Infection with severe acute respiratory syndrome coronavirus 2 associates with diverse symptoms, which can persist for months. While antiviral antibodies are protective, those targeting interferons and other immune factors are associated with adverse coronavirus disease 2019 (COVID-19) outcomes. Here we discovered that antibodies against specific chemokines were omnipresent post-COVID-19, were associated with favorable disease outcome and negatively correlated with the development of long COVID at 1 yr post-infection. Chemokine antibodies were also present in HIV-1 infection and autoimmune disorders, but they targeted different chemokines compared with COVID-19. Monoclonal antibodies derived from COVID-19 convalescents that bound to the chemokine N-loop impaired cell migration. Given the role of chemokines in orchestrating immune cell trafficking, naturally arising chemokine antibodies may modulate the inflammatory response and thus bear therapeutic potential.

Emergence of SARS-CoV-2 variants diminishes the efficacy of vaccines and antiviral monoclonal antibodies. Continued development of immunotherapies and vaccine immunogens resilient to viral evolution is therefore necessary. Using coldspot-guided antibody discovery, a screening approach that focuses on portions of the virus spike that are both functionally relevant and averse to change, we identified human neutralizing antibodies to highly conserved viral epitopes. Antibody fp.006 binds the fusion peptide and cross-reacts against coronaviruses of the fourgenera, including the nine human coronaviruses, through recognition of a conserved motif that includes the S2’ site of proteolytic cleavage. Antibody hr2.016 targets the stem helix and neutralizes SARS-CoV-2 variants. Antibody sd1.040 binds to subdomain 1, synergizes with antibody rbd.042 for neutralization and, like fp.006 and hr2.016, protects mice when present as bispecific antibody. Thus, coldspot-guided antibody discovery reveals donor-derived neutralizing antibodies that are cross-reactive withOrthocoronavirinae, including SARS-CoV-2 variants.One sentence summaryBroadly cross-reactive antibodies that protect from SARS-CoV-2 variants are revealed by virus coldspot-driven discovery.

Infection by SARS-CoV-2 leads to diverse symptoms, which can persist for months. While antiviral antibodies are protective, those targeting interferons and other immune factors are associated with adverse COVID-19 outcomes. Instead, we discovered that antibodies against specific chemokines are omnipresent after COVID-19, associated with favorable disease, and predictive of lack of long COVID symptoms at one year post infection. Anti-chemokine antibodies are present also in HIV-1 infection and autoimmune disorders, but they target different chemokines than those in COVID-19. Monoclonal antibodies derived from COVID- 19 convalescents that bind to the chemokine N-loop impair cell migration. Given the role of chemokines in orchestrating immune cell trafficking, naturally arising anti-chemokine antibodies associated with favorable COVID-19 may be beneficial by modulating the inflammatory response and thus bear therapeutic potential.One-Sentence Summary:Naturally arising anti-chemokine antibodies associate with favorable COVID-19 and predict lack of long COVID.

Ungulates in alpine ecosystems are constrained by winter harshness through resource limitation and direct mortality from weather extremes. However, little empirical evidence has definitively established how current climate change and other anthropogenic modifications of resource availability affect ungulate winter distribution, especially at their range limits. Here, we used a combination of historical (1997–2002) and contemporary (2012–2015) Eurasian roe deer (Capreolus capreolus) relocation datasets that span changes in snowpack characteristics and two levels of supplemental feeding to compare and forecast probability of space use at the species’ altitudinal range limit. Scarcer snow cover in the contemporary period interacted with the augmented feeding site distribution to increase the elevation of winter range limits, and we predict this trend will continue under climate change. Moreover, roe deer have shifted from historically using feeding sites primarily under deep snow conditions to contemporarily using them under a wider range of snow conditions as their availability has increased. Combined with scarcer snow cover during December, January, and April, this trend has reduced inter-annual variability in space use patterns in these months. These spatial responses to climate- and artificial resource-provisioning shifts evidence the importance of these changing factors in shaping large herbivore spatial distribution and, consequently, ecosystem dynamics.

The pandemic emergency caused by the spread of COVID-19 has stressed the importance of promptly identifying new epidemic clusters and patterns, to ensure the implementation of local risk containment measures and provide the needed healthcare to the population. In this framework, artificial intelligence, GIS, geospatial analysis and space assets can play a crucial role. Social media analytics can be used to trigger Earth Observation (EO) satellite acquisitions over potential new areas of human aggregation. Similarly, EO satellites can be used jointly with social media analytics to systematically monitor well-known areas of aggregation (green urban areas, public markets, etc.). The information that can be obtained from the Earth Cognitive System 4 COVID-19 (ECO4CO) are both predictive, aiming to identify possible new clusters of outbreaks, and at the same time supervisorial, by monitoring infrastructures (i.e. traffic jams, parking lots) or specific categories (i.e. teenagers, doctors, teachers, etc.). In this perspective, the technologies described in this paper will allow us to detect critical areas where individuals can be involved in risky aggregation clusters. The ECO4CO data lake will be integrated with ad hoc data obtained by health care structures to understand trends and dynamics, to assess criticalities with respect to medical response and supplies, and to test possibilities useful to tackle potential future emergencies. The System will also provide geographical information on the spread of the infection which will allow an appropriate context-specific public health response to the epidemic. This project has been co-funded by the European Space Agency under its Business Applications programme.

Agudelo et al. discover expanded clones of similar antibodies from the memory B cells of tick-borne encephalitis virus–infected and vaccinated donors; however, the most potent and broadly neutralizing antibodies derive from donors recovering from natural infection., Tick-borne encephalitis virus (TBEV) is an emerging human pathogen that causes potentially fatal disease with no specific treatment. Mouse monoclonal antibodies are protective against TBEV, but little is known about the human antibody response to infection. Here, we report on the human neutralizing antibody response to TBEV in a cohort of infected and vaccinated individuals. Expanded clones of memory B cells expressed closely related anti-envelope domain III (EDIII) antibodies in both groups of volunteers. However, the most potent neutralizing antibodies, with IC50s below 1 ng/ml, were found only in individuals who recovered from natural infection. These antibodies also neutralized other tick-borne flaviviruses, including Langat, louping ill, Omsk hemorrhagic fever, Kyasanur forest disease, and Powassan viruses. Structural analysis revealed a conserved epitope near the lateral ridge of EDIII adjoining the EDI–EDIII hinge region. Prophylactic or early therapeutic antibody administration was effective at low doses in mice that were lethally infected with TBEV.

Neutralizing antibodies that target the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein are among the most promising approaches against COVID-191,2. A bispecific IgG1-like molecule (CoV-X2) has been developed on the basis of C121 and C135, two antibodies derived from donors who had recovered from COVID-193. Here we show that CoV-X2 simultaneously binds two independent sites on the RBD and, unlike its parental antibodies, prevents detectable spike binding to the cellular receptor of the virus, angiotensin-converting enzyme 2 (ACE2). Furthermore, CoV-X2 neutralizes wild-type SARS-CoV-2 and its variants of concern, as well as escape mutants generated by the parental monoclonal antibodies. We also found that in a mouse model of SARS-CoV-2 infection with lung inflammation, CoV-X2 protects mice from disease and suppresses viral escape. Thus, the simultaneous targeting of non-overlapping RBD epitopes by IgG-like bispecific antibodies is feasible and effective, and combines the advantages of antibody cocktails with those of single-molecule approaches. The bispecific IgG1-like CoV-X2 prevents SARS-CoV-2 spike binding to ACE2, neutralizes SARS-CoV-2 and its variants of concern, protects against disease in a mouse model, whereas the parental monoclonal antibodies generate viral escape.

During the COVID-19 pandemic, SARS-CoV-2 infected millions of people and claimed hundreds of thousands of lives. Virus entry into cells depends on the receptor binding domain (RBD) of the SARS-CoV-2 spike protein (S). Although there is no vaccine, it is likely that antibodies will be essential for protection. However, little is known about the human antibody response to SARS-CoV-21–5. Here we report on 149 COVID-19 convalescent individuals. Plasmas collected an average of 39 days after the onset of symptoms had variable half-maximal neutralizing titers ranging from undetectable in 33% to below 1:1000 in 79%, while only 1% showed titers >1:5000. Antibody cloning revealed expanded clones of RBD-specific memory B cells expressing closely related antibodies in different individuals. Despite low plasma titers, antibodies to three distinct epitopes on RBD neutralized at half-maximal inhibitory concentrations (IC50s) as low as single digit ng/mL. Thus, most convalescent plasmas obtained from individuals who recover from COVID-19 do not contain high levels of neutralizing activity. Nevertheless, rare but recurring RBD-specific antibodies with potent antiviral activity were found in all individuals tested, suggesting that a vaccine designed to elicit such antibodies could be broadly effective.

During the COVID-19 pandemic, SARS-CoV-2 infected millions of people and claimed hundreds of thousands of lives. Virus entry into cells depends on the receptor binding domain (RBD) of the SARS-CoV-2 spike protein (S). Although there is no vaccine, it is likely that antibodies will be essential for protection. However, little is known about the human antibody response to SARS-CoV-21-5. Here we report on 149 COVID-19 convalescent individuals. Plasmas collected an average of 39 days after the onset of symptoms had variable half-maximal pseudovirus neutralizing titres: less than 1:50 in 33% and below 1:1,000 in 79%, while only 1% showed titres above 1:5,000. Antibody sequencing revealed expanded clones of RBD-specific memory B cells expressing closely related antibodies in different individuals. Despite low plasma titres, antibodies to three distinct epitopes on RBD neutralized at half-maximal inhibitory concentrations (IC50 values) as low as single digit nanograms per millitre. Thus, most convalescent plasmas obtained from individuals who recover from COVID-19 do not contain high levels of neutralizing activity. Nevertheless, rare but recurring RBD-specific antibodies with potent antiviral activity were found in all individuals tested, suggesting that a vaccine designed to elicit such antibodies could be broadly effective.

The purpose of this study was to analyze the characteristics of individuals working in the field of neuropsychology in Italy, as part of a larger study examining the practice of neuropsychology across various countries. They were asked about their background, professional training, current work situation, types of assessment, preferred diagnostic procedures, as well as the rehabilitation techniques, their targeted populations, teaching responsibilities, and research activities. A total of 154 professionals completed an online survey from April 28, 2016 through June 30, 2016. The majority of participants were women, with a mean age of 42.6 years. Participants reported working for the National Health System, in private practice, or in private rehabilitation facilities. Overall, they reported being very satisfied with their work. Those who identified themselves as neuropsychologists primarily assessed individuals with dementia, stroke, movement disorders, and traumatic brain injury. While the majority of participants declared no problems with the instruments they used, others reported complaints, including but not limited to the financial cost of current neuropsychological tests and the lack of psychometric support. The main perceived obstacles were the lack of willingness to collaborate among professionals, the scarcity of academic training programs, and the lack of clinical training opportunities.

Background Endogenous ovarian hormones as well as exogenous oestradiol and progesterone play an important role in cognitive processing. Specifically, these hormones play a role in different aspects of memory, both in terms of storage capacity and temporal duration of the mnemonic track. These hormones also have various effects on different types of memory (i.e., verbal, visuo-spatial, prospective). This study investigated the effects of hormones on topographic memory, a type of memory specifically needed to recall a pathway and to acquire spatial information about locations, distances, and directions. Methods We compared 25 naturally cycling women (NCW) in two different cycling phases, the early follicular phase (4th - 5th days) and the mid-luteal phase (20th-21st days), with 26 women taking oral contraceptives (OC) tested in the active pill phase (20th to 21st day of OC cycle) and the inactive pill phase (2nd to 4th day of OC cycle). Both groups performed the Walking Corsi Test to assess topographic memory in their respective cycling phases. Women were instructed to learn an eight-step sequence path and recall the path five minutes later. Results We found that the two groups differed in terms of learning the 8-step sequence path; OC users were always better (4–5 days vs. 20–21 days) than NCW. No differences emerged in the delayed recall of the same path. Conclusions As already observed in other memory domains (i.e., verbal memory, emotional memory), OC users showed an advantage in terms of topographic learning. Our results might be explained by hormonal mechanisms and may suggest the future application of OC in women with topographic disorders or visuo-spatial difficulties.

Incontinentia Pigmenti (IP, OMIM#308300) is a rare X-linked genomic disorder (about 1,400 cases) that affects the neuroectodermal tissue and Central Nervous System (CNS). The objective of this study was to describe the cognitive-behavioural profile in children in order to plan a clinical intervention to improve their quality of life. A total of 14 girls (age range: from 1 year and 2 months to 12 years and 10 months) with IP and the IKBKG/NEMO gene deletion were submitted to a cognitive assessment including intelligence scales, language and visuo-spatial competence tests, learning ability tests, and a behavioural assessment. Five girls had severe to mild intellectual deficiencies and the remaining nine had a normal neurodevelopment. Four girls were of school age and two of these showed no intellectual disability, but had specific disabilities in calculation and arithmetic reasoning. This is the first description of the cognitive-behavioural profile in relation to developmental age. We stress the importance of an early assessment of learning abilities in individuals with IP without intellectual deficiencies to prevent the onset of any such deficit.

Objective Several authors have proposed that the cerebellum has an important role in functions of higher order as a general mode of sequence detection, independently from the nature of the information. The aim of this study was to verify whether the cerebellum mediates the processing of navigational sequential information and to determine whether it is influenced by the modality of the stimuli presentation. Method We tested 12 cerebellar patients and 12 healthy age-matched participants in 2 comparable navigational tasks (Walking Corsi Test and the Magic Carpet) requiring to memorizing a sequence of spatial locations. The 2 tasks differ each other for the modality of stimuli presentation: in the Walking Corsi Test the sequence is shown by an examiner that walks on the carpet, whereas in the Magic Carpet it is shown by a computer that lights up the tiles in the sequence. We hypothesize that different mental processes are implicated between the Walking Corsi Test and the Magic Carpet. Indeed, whereas watching the examiner, who performs the sequence on the carpet, allows the patient to simulate the action mentally in the Walking Corsi Test, such simulation cannot be triggered in the Magic Carpet. Results Our results showed that cerebellar patients obtained scores significantly lower than control participants only in the Magic Carpet. Conclusions We interpreted the patients' performance as a specific deficit in detecting and ordering single independent stimuli as a sequence, when the maintenance of stimulus-response associations is more demanding. (PsycINFO Database Record

Developmental topographical disorientation (DTD) causes impaired spatial orientation and navigation from early childhood with no evidence of cerebral damage. Using fMRI and a landmark sequencing task, we investigated the hypothesis that Dr Wai's abnormal cerebral activation pattern was related to his peculiar behavioral profile. Although Dr Wai was able to correctly perform landmark sequencing, he showed a lack of activity in regions activated in all control subjects and activity in areas that were not activated in any control subject. These results are discussed in light of cognitive and functional model of navigation, with relevant implications for DTD physiology.

Part 1Development and calibration of suitably accurate functional assays for BRCA1 RING domain and BRCT domain missense substitutions could dramatically accelerate clinical classification of rare missense substitutions observed in that gene. Leveraging data from 68,000 full sequence tests of BRCA1 and BRCA2, plus data from the limited number of already classified BRCA1 RING domain missense substitutions, we used logistic regression and related techniques to evaluate three BRCA1 RING domain assays. These were recently described high throughput yeast 2-hybrid and E3 ubiquitin ligase assays, plus a newly developed mammalian 2-hybrid assay. While there were concerns about the accuracy of the yeast 2-hybrid assay and the indirect nature of the ubiquitin ligase assay, the mammalian 2-hybrid assay had excellent correlation with existing missense substitution classifications. After calibration, this assay contributed to classification of one newly reported BRCA1 missense substitution. In principal, the mammalian 2-hybrid assay could be converted to a high-throughput format that would likely retain suitable accuracy.Part 2How does one achieve clinically applicable classification of the vast majority of all possible sequence variants in disease susceptibility genes? BRCA1 is a high-risk susceptibility gene for breast and ovarian cancer. Pathogenic protein truncating variants are scattered across the open reading frame, but all known missense substitutions that are pathogenic because of missense dysfunction are located in either the amino-terminal RING domain or the carboxy-terminal BRCT domain. Heterodimerization of the BRCA1 and BARD1 RING domains is a molecularly defined obligate activity. Hence, we tested every BRCA1 RING domain missense substitution that can be created by a single nucleotide change for heterodimerization with BARD1 in a Mammalian 2-hybrid (M2H) assay. Downstream of the M2H laboratory assay, we addressed three additional challenges: assay calibration, validation thereof, and integration of the calibrated results with other available data such as computational evidence and patient/population observational data to achieve clinically applicable classification. Overall, we found that about 20% of BRCA1 RING domain missense substitutions are pathogenic. Using a Bayesian point system for data integration and variant classification, we achieved clinical classification of about 89% of observed missense substitutions. Moreover, among missense substitutions not present in the human observational data used here, we find an additional 47 with concordant computational and functional assay evidence in favor of pathogenicity; these are particularly likely to be classified as Likely Pathogenic once human observational data become available.

Cognitive reserve (CR) has been defined as the ability to optimize or maximize performance through differential recruitment of brain networks. In the present study, we aimed at providing evidence for a consistent brain network underpinning CR in healthy and pathological aging. To pursue this aim, we performed a coordinate-based meta-analysis of 17 functional magnetic resonance imaging studies on CR proxies in healthy aging, Alzheimer’s disease (AD), and mild cognitive impairment (MCI). We found that different brain areas were associated with CR proxies in healthy and pathological aging. A wide network of areas, including medial and lateral frontal areas, that is, anterior cingulate cortex and dorsolateral prefrontal cortex, as well as precuneus, was associated with proxies of CR in healthy elderly patients. The CR proxies in patients with AD and amnesic-MCI were associated with activation in the anterior cingulate cortex. These results were discussed hypothesizing the existence of possible compensatory mechanisms in healthy and pathological aging.

Post-traumatic stress disorder (PTSD) is an anxiety condition that can develop after exposure to trauma such as physical or sexual assault, injury, combat-related trauma, natural disaster or death. Although an increasing number of neurobiological studies carried out over the past 20 years have allowed clarifying the neural substrate of PTSD, the neural modifications underpinning PTSD are still unclear. Here we used activation likelihood estimation meta-analysis (ALE) to determine whether PTSD has a consistent neural substrate. We also explored the possibility that different traumatic events produce different alterations in the PTSD neural network. In neuroimaging studies of PTSD, we found evidence of a consistent neural network including the bilateral insula and cingulate cortex as well as the parietal, frontal and limbic areas. We also found that specific networks of brain areas underpin PTSD after different traumatic events and that these networks may be related to specific aspects of the traumatic events. We discuss our results in light of the functional segregation of the brain areas involved in PTSD.

We describe a patient who, after right hemisphere damage, showed severe, persistent, pure representational neglect but no evidence of perceptual neglect and no deficits in spatial working memory when evaluated with a traditional clinical test (Corsi Block Tapping test). This finding provides evidence against a full explanation of representational neglect within the context of visuo-spatial working memory. Indeed, this patient showed a peculiar deficit in navigational tasks requiring re-orientation in a novel environment by means of his mental representation of the environment. Since no representational neglect was observed in tests requiring mental representation of single or multiple objects (i.e., o'clock test) we suggest that in our patient representational neglect is caused by damage to the cognitive system involved in coding and storing environmental information to be used during navigation.

We tested navigational abilities of brain-damaged patients suffering from representational or perceptual neglect asking them to retrieve a location according to salient spatial cues included in a rectangular empty room. Both groups of patients showed difficulties in learning the spatial definition of the target location in relation to two landmarks. However in a delayed attempt performed after several trials the group of patients with perceptual neglect proved able to easily retrieve the target location. In this condition they performed as controls showing a spared ability to navigate according to a stable representation of the room in long-term memory. In contrast the difficulty of patients with representational neglect remained unchanged across experimental conditions. At variance with clinical assessment, in which patients show asymmetrical performances in describing a well-known environment from memory, this latter result depicts a behavioural counterpart of the disorder, namely the inability to orient in a new environment according to an inner representation. Data are further discussed in order to provide a description of the cognitive mechanisms required for space representation for navigation.

Introduction The coding of space as near and far is not only determined by arm-reaching distance, but is also dependent on how the brain represents the extension of the body space. Recent reports suggest that the dissociation between reaching and navigational space is not limited to perception and action but also involves memory systems. It has been reported that gender differences emerged only in adverse learning conditions that required strong spatial ability. Methods In this study we investigated navigational versus reaching memory in air force pilots and a control group without flight experience. We took into account temporal duration (working memory and long-term memory) and focused on working memory, which is considered critical in the gender differences literature. Results We found no gender effects or flight hour effects in pilots but observed gender effects in working memory (but not in learning and delayed recall) in the nonpilot population (Women's mean = 5.33; SD= 0.90; Men's mean = 5.54; SD= 0.90). We also observed a difference between pilots and nonpilots in the maintenance of on-line reaching information: pilots (mean = 5.85; SD=0.76) were more efficient than nonpilots (mean = 5.21; SD=0.83) and managed this type of information similarly to that concerning navigational space. In the navigational learning phase they also showed better navigational memory (mean = 137.83; SD=5.81) than nonpilots (mean = 126.96; SD=15.81) and were significantly more proficient than the latter group. Discussion There is no gender difference in a population of pilots in terms of navigational abilities, while it emerges in a control group without flight experience. We found also that pilots performed better than nonpilots. This study suggests that once selected, male and female pilots do not differ from each other in visuo-spatial abilities and spatial navigation.

The aim of this study was to determine whether an egocentric topographical working memory (WM) deficit is present in the early stages of Alzheimer's disease (AD) with respect to other forms of visuospatial WM. Further, we would investigate whether this deficit could be present in patients having AD without topographical disorientation (TD) signs in everyday life assessed through an informal interview to caregivers. Seven patients with AD and 20 healthy participants performed the Walking Corsi Test and the Corsi Block-Tapping Test. The former test requires memorizing a sequence of places by following a path and the latter is a well-known visuospatial memory task. Patients with AD also performed a verbal WM test to exclude the presence of general WM impairments. Preliminary results suggest that egocentric topographical WM is selectively impaired, with respect to visuospatial and verbal WM, even without TD suggesting an important role of this memory in the early stages of AD.

Selective visuo-spatial memory deficits can seriously affect many aspects of daily life; for example, an individual may not remember where he put an object or which path he took to reach his destination. In general, visuo-spatial memory is assessed through pen-and-paper tests that mainly assess memory components in peripersonal space. Recent studies (Piccardi et al. in Exp Brain Res 206:171-177, 2010; Piccardi et al. in Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 18:362-384, 2011) have shown that brain-damaged patients selectively fail on navigation memory tasks but not on other tests of visuo-spatial memory ability. These findings underline the need for a standardized test that measures memory in navigation separately from other types of visuo-spatial memory. Here, we report the validation of the Walking Corsi Test (WalCT: Piccardi et al. in Neurosci Lett 432:127-131, 2008) on 289 individuals aged 15-86 years. The WalCT is a new instrument that assesses topographical memory in real environments and reproduces on a large-scale version the Corsi Block-Tapping Test (CBT: Corsi in Unpublished doctoral dissertation, McGill University, Montreal, 1972). The WalCT has been used in clinical practice and has proven sensitive in detecting navigational memory deficits even in individuals who have no other memory impairments (Piccardi et al. in Exp Brain Res 206:171-177, 2010; Piccardi et al. in Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 18:362-384, 2011; Bianchini et al. in Neuropsychologia 48:1563-1573, 2010 ).

The long-term effects of cannabis on human cognition are still unclear, but, considering that cannabis is a widely used substance and, overall, its potential use in therapeutic interventions, it is important to evaluate them. We hypothesize that the discrepancies among studies could be attributed to the specific cognitive function investigated and that skills subserved by the hippocampus, such as the spatial orientation abilities and, specifically, the ability to form and use cognitive maps, should be more compromised than others. Indeed it has been showed that cannabis users have a reduced hippocampus and that the hippocampus is the brain region in which cannabis has the greatest effect since it contains the highest concentration of cannabinoid receptors. To test this hypothesis we asked 15 heavy cannabis users and 19 nonusers to perform a virtual navigational test, the CMT, that assesses the ability to form and use cognitive maps. We found that using cannabis has no effect on these hippocampus-dependent orientation skills. We discuss the implications of our findings and how they relate to evidence reported in the literature that the intervention of functional reorganization mechanisms in cannabis user allows them to cope with the cognitive demands of navigational tasks.

Quando un individuo trova un ostacolo lungo un percorso, o deve trovare una scorciatoia, o nel caso in cui debba riprodurre al contrario un tragitto precedentemente effettuato, per orientarsi con successo deve essere in grado di riconoscere i landmark precedentemente incontrati, anche se questi vengono visualizzati secondo una prospettiva differente. La capacita di riconoscere una stessa immagine presentata da punti di vista diversi e quindi fondamentale per il buon esito della navigazione.

I numerosi studi condotti sulla memoria visuo-spaziale nell’arco di vita hanno evidenziato che esistono diversi meccanismi per codificare e memorizzare i differenti tipi di informazioni spaziali (Rauchs et al., 2008; Janzen, van Turennout, 2004; Janzen, Weststeijn, 2007; Postma et al., 2004; Postma et al., 2008; Kessels et al., 2001; Piccardi et al., 2008; Cestari et al., 2007; Mammarella et al., 2006; Pazzaglia, Cornoldi, 1999; Lecerf, de Ribaupierre, 2005).

La memoria di posizione si riferisce all’abilita di ricordare la collocazione di elementi nell’ambiente. Su questa capacita facciamo affidamento, per esempio, ogniqualvolta desideriamo ritrovare un particolare oggetto riposto all’interno di una stanza. A partire dai 13 anni di eta, a differenza di altre abilita visuo-spaziali, la capacita di ricordare la posizione di oggetti risulta essere migliore nei soggetti di sesso femminile, percio una serie di esercizi mirati al potenziamento di tale abilita puo essere di aiuto per migliorare anche nei soggetti di sesso maschile un’abilita importante per la propria autonomia.

L’abilita di navigazione umana include diverse sottocomponenti che contribuiscono indipendentemente alla capacita di orientamento.

Il CD-ROM allegato a questo libro e realizzato con lo scopo di fornire un sussidio virtuale che possa fungere, al tempo stesso, sia da gioco stimolante sia da palestra per lo sviluppo delle abilita navigazionali dei bambini per la fascia di eta che va dai 5 ai 10 anni.

Per mantenere l’orientamento nell’ambiente circostante, l’uomo deve aggiornare le proprie relazioni spaziali egocentriche (vale a dire le informazioni che provengono da se stesso in relazione con l’ambiente) al cambiare della sua posizione nello spazio. Tali aggiornamenti avvengono tramite l’integrazione di diverse fonti di informazioni (visiva, vestibolare, propriocettiva). In particolar modo l’informazione visiva gioca un ruolo fondamentale nell’aggiornamento sia della propria posizione sia di eventuali modifiche subite dall’ambiente (Farrell, Robertson, 2000). Inoltre, attraverso l’esperienza che deriva dal suo movimento nello spazio, l’individuo e in grado di elaborare un’informazione sia propriocettiva (cioe un’informazione sul senso di posizione e movimento degli arti e del corpo, che si ha indipendentemente dalle informazioni visive) sia locomotoria (un’informazione derivante dal proprio movimento indipendentemente dall’informazione visiva). Inoltre, gli studi condotti sui non vedenti ci insegnano che gli individui sono effettivamente in grado di aggiornare la propria posizione anche in assenza dell’informazione visiva (Rieser et al., 1986; Rieser 1989; Seemungal et al., 2007). Quando una persona si muove al buio ricava le informazioni sulla propria posizione basandosi su un processo definito path integration nel quale la posizione viene dedotta sulla base delle informazioni che derivano da segnali inerziali inviati dal sistema vestibolare e da informazioni tattili, attraverso un complicatissimo processo di integrazione che si avvale anche di veri e propri calcoli matematici per addizionare le informazioni vettoriali di movimento (Mittlestaedt, Mittlestaedt, 1980; Glasauer et al., 2002).

Background: It is well known that cognitive and emotional changes occur during pregnancy, but little is known about their magnitude or their time of occurrence and recovery. During pregnancy memory is one of the most impaired cognitive functions. Although long-term aspects of memory have been investigated, other aspects of memory have not yet been explored (i.e., navigational memory and reaching memory). Case presentation: Here we describe the changes in reaching and walking memory that occurred during pregnancy and one year after delivery in an Italian female military pilot (Case 1) with high spatial ability. In memory tests she showed a classical dissociation between performance in reaching and walking distance, which indicated a failure of working memory, learning, and storage in reaching space. This suggests that her expertise served as a protective factor mitigating her low walking memory performance, and saving the topographical component. We compared her performance with that of two non-pregnant control groups (i.e., women pilots and non-pilots) and found that Case 1’s reaching memory performance was significantly worse than that of the control groups. Even one year postpartum, Case 1’s performance was not yet the same as that of the other pilots. Conclusions: These findings contribute to our knowledge of the specific, as yet unexplored, aspects of memory deficits in women pilots during pregnancy and postpartum and suggest the need for better neuropsychological assessment before these women return to work in operational environments.