valentina moro

Emotional and social cognitive deficits were investigated in a group of 24 individuals with mild cognitive impairment (MCI) and 24 healthy controls. Empathic and visual emotional responses were collected, analyzed and correlated to brain structural imaging data by means of: (i) a pictorial matching-to-sample task with facial and non-facial stimuli; (ii) self-reported questionnaires for cognitive and affective emotional components, and alexithymia; (iii) in-depth assessment of cognitive functions. Results indicated that visual processing of faces in MCI individuals did not benefit from fearful emotional content which in healthy controls facilitates stimulus' recognition (emotional enhancement effect). This implicit visuo-emotional disorder was specific for the faces, did not generalize to other categories, and did not correlate to explicit measures of empathy. Thus, our main finding indicates that in MCI individuals, deficits in visual recognition of facial emotions may arise already in the earliest stages of memorization, during the visual encoding of facial emotions. Voxel-based morphometry revealed its association with atrophy in frontal and occipito-temporal regions, mostly involving the anterior medial prefrontal cortex (P<0.05, multiple-comparison correction). Neural evidences were corroborated by clinical scores showing significant correlation between reduction of Emotion Enhancement Effect and deficits in frontal/executive functions. Crucially, the disorder did not appear to be related to the number of impaired cognitive domains (single or multiple-domain MCI) but rather to the involvement of frontal brain networks and frontal/executive functions. This suggests that in prodromal stages of dementia, frontal symptoms may represent a significant signal of emotional recognition disorders.

Executive functions play an important role in the maintenance of autonomy in day-to-day activities. Nevertheless, there is little research into specific cognitive training for Mild Cognitive Impairment (MCI). We present the results of a program which aims to teach specific strategies and metacognitive abilities in order for patients to be able to carry out attentional and executive tasks. Two groups (A and B) were compared in a cross-over design. After the first evaluation, Group A (but not B) participated in a six month cognitive stimulation program. After a second assessment, only Group B received treatment and then a final evaluation was carried out on both groups. The results show that: i) both groups improved their performance as an effect of training; ii) improvements generalized to memory and general cognitive tasks; iii) in the interval without training, Group B's performance worsened and iv) Group A partially maintained their results over time.

Awareness of cognitive deficits and clinical competence were investigated in 79 mild to moderate Alzheimer's disease patients. Awareness was assessed by the anosognosia questionnaire for dementia, and clinical competence by specific neuropsychological tests such as trail making test-A, Babcock story recall test, semantic and phonemic verbal fluency. The findings show that 66 % of the patients were aware of memory deficits, while the 34 % were unaware. Deficit in awareness correlated with lower scores on the Mini Mental State Examination test that, in the score range from 24.51 to 30 and from 19.50 to 24.50, appeared to be a significant predictor of level of awareness. None of the AD patients had fully preserved clinical competence, only 7 patients (9 %) had partially preserved clinical competence and 72 patients (91 %) had completely lost clinical competence. All the patients with partially preserved clinical competence (9 %) were aware of their memory deficit. The study indicates that neuropsychological tests used for the assessment of executive functions are not suitable for investigating clinical competence. Therefore, additional and specific tools for the evaluation of clinical competence are necessary. Indeed, these might allow clinicians to identify AD patients who, despite their deficits in selected functions, retain their autonomy of choice as well as recognize those patients who should proceed to the nomination of a legal representative.

Somatic misperceptions and misrepresentations, like supernumerary phantom limb and denial of ownership of a given body part, have typically been reported following damage to the right side of the brain. These symptoms typically occur with personal or extrapersonal neglect and extinction of left-sided stimuli, suggesting that all these different symptoms may be linked to the same neural substrate. In the present research, we tested two right brain-damaged (RBD) patients to find out whether changing the position of the hands in space influences tactile extinction and denial of ownership to the same extent. Results showed that manipulation of the spatial position of the hands reduces tactile extinction but leaves denial of ownership of the left hand unaffected. Such a dissociation suggests that delusional misperceptions may be independent from somatic neglect and that representation of hands in space and attribution of ownership are dynamically mapped in at least partly separate neural substrates.

The dissociation between implicit and explicit forms of awareness has been described in various neurological diseases. The way in which these forms of awareness integrate in order to permit the necessary unitary experience of self remains unclear. Here, the hypothesis that a form of emergent awareness (i.e., the emergence of a verbal acknowledgment of deficits as a consequence of attempting to act) may represent a link between implicit and explicit components is proposed for discussion.

Motor imagery (MI) allows one to mentally represent an action without necessarily performing it. Importantly, however, MI is profoundly influenced by the ability to actually execute actions, as demonstrated by the impairment of this ability as a consequence of lesions in motor cortices, limb amputations, movement limiting chronic pain, and spinal cord injury. Understanding MI and its deficits in patients with motor limitations is fundamentally important as development of some brain-computer interfaces and daily life strategies for coping with motor disorders are based on this ability. We explored MI in a large sample of patients with spinal cord injury (SCI) using a comprehensive battery of questionnaires to assess the ability to imagine actions from a first-person or a third-person perspective and also imagine the proprioceptive components of actions. Moreover, we correlated MI skills with personality measures and clinical variables such as the level and completeness of the lesion and the presence of chronic pain. We found that the MI deficits (1) concerned the body parts affected by deafferentation and deefferentation, (2) were present in first- but not in third-person perspectives, and (3) were more altered in the presence of chronic pain. MI is thus closely related to bodily perceptions and representations. Every attempt to devise tools and trainings aimed at improving autonomy needs to consider the cognitive changes due to the body-brain disconnection.

Presentazione: Molti interrogativi sull'esistenza di strutture cerebrali implicate nella percezione e organizzazione dello schema corporeo nascono già nel diciannovesimo secolo dall'osservazione clinica di pazienti affetti da turbe dell'immagine corporea. Dalle prime descrizioni di ...

... SIMONE PERNIGO E VALENTINA MORO ... Come alterazioni dello schema corporeo verranno invece riportati alcuni dati relativi all'ano-sognosia per emiplegia (Pia, Neppi-Modona, Ricci e Berti, 2004; Berti, Bottini, Gandola, Pia, Smania, Stracciari, Castiglioni, Vallar e Paulesu ...

A preliminary standard neurological examination (Bisiach et al., 1986) showed that ten patients with anterior damage and three patients with posterior damage presented with motor impairment. Moreover, two patients suffered from tactile sensorial deficits (one in the ...

... VALENTINA MORO, GIOVANNI BERLUCCHI E SALVATORE M. AGLIOTI ... d'uso 17/20 Comprensione 38/40 Lettura e scrittura Conservate FUNZIONI VISUO-PERCETTIVE Aprassia costruttiva 8/8 Giudizio di orientamento linee (Benton) 27/30 (cut-off = 24/30) ...

... L'esperienza sul campo mi ha permesso di imbattermi nel passato in riabi-litatori convinti cheun post comatoso traumatizzato cranio-encefalico non potesse capir nulla e che pertanto poteva essere portato su una sedia a rotelle come si porterebbe un sacco. ...

Nowadays, preventing the effects of mental decline is an international priority, but there is little research into cognitive training in mild cognitive impairment (MCI). We present the results of a program aimed at teaching memory strategies and improving metacognitive abilities. This was associated with training to ameliorate caregivers' assistance. Two groups (A and B) were compared in a crossover design. After the first evaluation, group A (but not B) participated in a 6-month cognitive stimulation program. After a second assessment, only B received treatment and then a final evaluation was carried out on both the groups. The results show that (1) both the groups improved their performance as an effect of training; (2) improvements are specific to the functions trained; (3) in the interval without intervention, performance of group B worsened; and (4) group A has maintained their results over time. In conclusion, our results show that specific training may reduce memory impairment in MCI.