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Il meccanismo più adoperato per “ridimensionare” il nazismo e renderlo più accettabile è affermare che in ogni epoca ci sono stati fenomeni simili, che vanno a fare parte di un generico “male”, e quello del Nazismo non presenta peculiarità degne di nota. L’obiettivo di questo lavoro è proprio quello di affermare l’inaccettabilità di una tesi di tal tipo. Partendo da una descrizione dello scenario generale in cui si inquadra la storia delle neuroscienze nel Terzo Reich, giustamente descritte da Shevell come un microcosmo della medicina in quel periodo storico, dunque rappresentative della avvenuta corruzione, si affrontano in dettaglio diversi aspetti della tematica, suddivisibili in: 1) la degiudeizzazione delle neuroscienze; 2) l’igiene razziale (Rassenhygiene) e i programmi di sterilizzazione; 3) l’eutanasia attiva; 4) il caso Hallervorden. Ugualmente in tutti e quattro i casi, l’inizio dei procedimenti persecutori avviene in sordina, attraverso atti legislativi di per sè relativamente innocui negli enunciati generali, ma perversi nella loro efficacia applicativa, in cui viene meno l’assunzione di responsabilità da parte del singolo individuo, favorendo così la parcellizzazione di un atto responsabile unico in tanti frammenti, tali da non poter essere più identificati in una attribuzione di senso comprensivo e quindi non moralmente e legalmente perseguibili.

Background: Tourette syndrome (TS) is a chronic neurodevelopmental disorder characterised by the presence of multiple motor and phonic tics. Recent brain imaging investigations with diffusion tensor imaging (DTI) techniques found reduced measures of connectivity in the corpus callosum of children with TS compared with healthy controls, thus raising the hypothesis that the reduced interhemispherical connectivity in TS reflects neural plasticity processes. Methods: We assessed corpus callosum white-matter connectivity with fractional anisotropy (FA) index from magnetic resonance-DTI in two monozygotic twins (male sex; age 20) discordant for the diagnosis of TS. Results: Both conventional morphological magnetic resonance images and fibre-tracking reconstruction failed to show any difference between the two twins. On the other hand, mean corpus callosum FA values were significantly lower in the affected twin than in the unaffected twin (p<0.01). The differences in FA values were highest in the posterior portions of the corpus callosum, and lowest in the central area. Conclusions: Our findings of reduced interhemispherical white-matter connectivity in the affected twin support the hypothesis that plastic remodelling in the corpus callosum possibly represents an adaptation mechanism in TS.

Over the last few years, functional neuroimaging studies have provided new insights into cerebral activity in subjects with severe brain damage leading to coma and other clinical states characterized by unresponsiveness. The present paper introduces the clinical picture of patients with impaired consciousness, and reviews the nosological criteria and functional neuroanatomical basis for brain death, coma, vegetative state, minimally conscious state, and the locked-in syndrome. Converging evidence suggests that disrupted activity in higher-order association areas, especially prefrontal and posteromedial parietal regions, plays a pivotal role within the neural correlates of impaired consciousness in the unresponsive patient.

Gilles de la Tourette syndrome is a neurodevelopmental disorder consisting of multiple motor and one or more vocal/phonic tics. Tourette's syndrome is increasingly recognized as a common neuropsychiatric disorder usually diagnosed in early childhood, and comorbid neuropsychiatric disorders occur in approximately 90% of patients; the most common of these are attention deficit hyperactivity disorder and obsessive-compulsive disorder. Depression is also common, with a lifetime risk of 10% of patients. Moreover, a high prevalence of personality disorders has been reported in preliminary investigations on Tourette's syndrome populations. This paper provides an updated review of the literature on the multifaceted phenotype of Tourette's syndrome, with special attention to the behavioral problems and the relationship between Tourette's syndrome and comorbid neuropsychiatric conditions. The issue of whether Tourette's syndrome should still be considered as a unitary nosological entity is also addressed.

Virtually no neurologist nor psychiatrist today can be unaware of the diagnosis of Gilles de la Tourette syndrome (GTS). Although the eponymous description by Dr. Georges Gilles de la Tourette was published in 1885, familiarity with this syndrome has been achieved only recently. In this article, the two most renown accounts of exceptional individuals retrospectively diagnosed with GTS are critically analyzed: British lexicographer Samuel Johnson and Austrian musician Wolfgang Amadeus Mozart. In both cases, clinical descriptions have been retrieved from written documents predating Gilles de la Tourette's original publication. The case for Samuel Johnson having GTS is strong, mainly based on Boswell's extensive biographical account. Johnson was reported to have a great range of tics and compulsions, including involuntary utterances, repetitive ejaculations, and echo-phenomena. On the other hand, there is circumstantial evidence that Mozart may have had hyperactivity, restlessness, sudden impulses, odd motor behaviors, echo/palilalia, love of nonsense words, and scatology, the latter being documented in autograph letters ("coprographia"). However, the evidence supporting the core features of GTS, i.e., motor and vocal tics, is rather inconsistent. Thus, GTS seems to be an implausible diagnosis in Mozart's medical history and completely unrelated to his undisputed musical genius.

Pathological gambling symptoms (PGS), that is, the subjective urge to gamble and the actual gambling behaviors, are currently acknowledged as relatively common symptoms among Western countries, with an estimated point prevalence of 0.6-1.1% in the general population. Converging evidence suggests that PGS are overrepresented in patients with neurological conditions affecting dopaminergic reward pathways, and can be expressed in both impulse control disorders and obsessive-compulsive spectrum disorders. This study explored the clinical correlates of PGS in patients with epilepsy. Eighty-eight consecutive adult outpatients recruited at three epilepsy clinics in northern Italy were assessed using the Gambling-Symptom Assessment Scale (G-SAS), along with a battery of psychometric instruments to index depression (Beck Depression Inventory [BDI]), anxiety (Spielberger State-Trait Anxiety Inventory [STAI]), and obsessionality (Yale-Brown Obsessive Compulsive Scale [YBOCS]) symptoms. On the G-SAS, patients with a diagnosis of temporal lobe epilepsy (TLE) reported a mean [sd] G-SAS score of 2.0 [5.7], significantly higher than patients with frontal lobe epilepsy (FLE) (0.6 [1.7]) and idiopathic generalized epilepsy (IGE) (0.4 [1.4]). Moreover, multiple regression analysis showed that G-SAS scores were selectively predicted by YBOCS scores, thus suggesting an association between the expression of obsessional spectrum symptoms and PGS in patients with TLE. Alterations in the mesolimbic reward system could represent the putative neuropathological substrate for this multifaceted clinical picture.

Ictal alterations of the level of general awareness and subjective content of consciousness play a pivotal role in the clinical phenomenology of epilepsy, and reflect the pathological involvement of different neurobiological substrates. However, no self-reported measures have been proposed for patients experiencing altered conscious states during seizures. This study describes the development and validation of a new scale for the quantitative assessment of the level and content of ictal consciousness, the Ictal Consciousness Inventory (ICI). The ICI is a 20-item questionnaire generated on the basis of interviews with patients, literature review, and consultation with experts. It was tested on a sample of 110 patients attending three different epilepsy clinics in Northern Italy, who also completed standardized clinical scales. Standard psychometric methods were used to demonstrate that this scale satisfies criteria for acceptability, reliability, and validity. The ICI is proposed as a user-friendly and clinically sound instrument for the measurement of ictal alterations of consciousness in patients with epilepsy.

Background. Gilles de la Tourette Syndrome (GTS) is a chronic neuropsychiatric disorder characterised by multiple motor and vocal tics, and associated to specific behavioural disturbances, which bear a significant detrimental impact on the health-related quality of life (HR-QOL) of patients. Aims. To provide the first investigation of the main determinants of HR-QOL in GTS using a disease-specific HR-QOL measure. Methods. A 40-item GTS-specific HR-QOL inventory was generated based on interviews with 120 GTS outpatients attending the Tourette clinic, Queen Square, London, plus literature review and consultation with movement disorders experts. The inventory was then administered to a new sample of 102 adult patients, along with standardised psychometric rating scales for tic severity, obsessionality, anxiety, and depression, and a generic HR-QOL scale. Results. The Physical and Psychological domains of HR-QOL were most affected in our clinical sample. Multiple regression analysis showed that both tic severity and comorbid behavioural problems are strong predictors of GTS-QOL scores. The GTS-QOL inventory showed high convergent validity with the generic HR-QOL measure. Conclusions. The GTS-QOL inventory is proposed as a clinically sound basis for the development of a new measure of disease-specific HR-QOL in patients with GTS, taking into account the complexity of the clinical picture of the syndrome.

In 1976 Julian Jaynes published his controversial book The Origins of Consciousness in the Breakdown of the Bicameral Mind, introducing the hypothesis of a two-chambered brainmind model that preceded the evolutionary development of the conscious mind. Jaynes’ speculative model gave rise to a huge debate, which has reverberated throughout the current neuroscientific and neurophilosophical literature. Has the bicameral mind stood the test of time? To answer this question, the present paper adopts a multidisciplinary perspective and, after briefly summarizing Jaynes’ hypothesis, addresses two main critical issues: the neurological basis of the bicameral model and the philological accuracy of Jaynes’ arguments. Finally, the concept of a non-unitary Self is presented as one of the most relevant contemporary legacies of the bicameral mind.

Objective: The clinical picture of Alzheimer's disease (AD) and other forms of degenerative dementia is characterized by cognitive and neuropsychological dysfunction and progressive loss of reflective consciousness (RC), sometimes referred to as self-awareness. However, limited knowledge is currently available concerning the specific pattern of impairment in RC in different stages and subtypes of dementia. The aim of this study was to investigate RC in a population of patients with degenerative dementia, with special attention being focused on the relationship between alteration of RC and the natural history/neuropsychiatric profile of the disease. Methods: A total of 103 outpatients attending the Dementia Clinic, Department of Neurology, Amedeo Avogadro University, Novara, and the Dementia Clinic, S. Andrea Hospital, Vercelli, Italy, have been recruited. Inclusion criteria were: 1. diagnosis of mild or moderate degenerative dementia according to DSM-IV and NINCDS/ADRDA criteria, and 2. age-corrected mini-mental state examination (MMSE) > 10. All patients underwent a comprehensive neuropsychological examination and neuropsychiatric assessment for behavioural and psychological signs and symptoms of dementia (BPSD). RC was indexed in each subject using the 14-item Self-Consciousness Questionnaire (SCQ). Results: Four groups of patients were studied: 57 patients with Alzheimer's disease (AD); 18 with frontotemporal dementia (FTD); 8 with dementia with Lewy bodies (DLB); 18 with mixed dementia (MD). The four groups did not differ in terms of clinical severity (CDR scores) and cognitive dysfunction (MMSE scores) (Tab. I). However, patients with FTD scored significantly lower (p < 0.05) than other dementia groups on the SCQ (especially questions on moral judgement, introspection, metacognition, and self-evaluation of the affective state), whilst patients with AD showed marked deficits in awareness of identity and self evaluation of affect (Fig. 1). Overall SCQ score

In 1976 American psychologist Julian Jaynes published "The Origins of Consciousness in the Breakdown of the Bicameral Mind". In this controversial book, Jaynes introduced the hypothesis of a two-chambered brain-mind model (right versus left hemisphere) that preceded the evolutionary development of the conscious mind. Jaynes' speculative model gave rise to a huge debate, which has reverberated throughout the current neuroscientific and neurophilosophical literature. Has the bicameral mind model stood the test of time? To answer this question, the present paper adopts a multidisciplinary perspective and, after briefly summarizing Jaynes' hypothesis, addresses two main critical issues: the neurological basis of the bicameral model in the light of recent neurobiological insights and the philological accuracy of Jaynes' arguments. Finally, the concept of a non-unitary Self is presented as one of the most relevant contemporary legacies of the bicameral mind model.