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In neurorehabilitation, some studies reported the effective use of art therapy for reducing psychological disorders and for enhancing physical functions and cognitive abilities. Neuroaesthetical studies showed that seeing an art masterpiece can spontaneously elicit a widespread brain arousal, also involving motor networks. To combine contemplative and performative benefits of art therapy protocols, we have developed an immersive virtual reality system, giving subjects the illusion that they are able to paint a copy of famous artistic paintings. We previously observed that during this virtual task, subjects perceived less fatigue and performed more accurate movements than when they were asked to color the virtual canvas. We named this upshot the Michelangelo effect. The aim of this study was to test the rehabilitative efficacy of our system. Ten patients with stroke in the subacute phase were enrolled and trained for one month with virtual art therapy (VAT) and physiotherapy. Their data were compared with those of ten patients matched for pathology, age and clinical parameters, trained only with conventional therapy for the same amount of time. The VAT group showed a significantly higher improvements in the Barthel Index score, a measure of independency in activities of daily living (66 ± 33% vs. 31 ± 28%, p = 0.021), and in pinching strength (66 ± 39% vs. 18 ± 33%, p = 0.008), with respect to the group treated with conventional rehabilitation.

Functional movement disorders (FMD) refer to a heterogeneous group of manifestations incongruent with known neurological diseases. Functional neuroimaging studies in FMD indicate the overlap between cerebral regions in which abnormal activation occurs and those considered crucial for theory of mind (ToM), the ability to attribute mental states. The aim of this study was to explore whether FMD might be related to ToM disorders to the extent that they reduce the ability to make inferences about the mental states underlying motor behaviour during social interaction.Eighteen subjects with FMD and 28 matched healthy controls (HC) were given a ToM battery. The severity of FMD was rated by the Simplified-FMD Rating Scale (S-FMDRS). Dissociative symptoms were evaluated by the Dissociative Experiences Scale (DES-II).FMD scored worse than the HC in most ToM tasks: second-order False Beliefs (p = .005), Faux-Pas Recognition Test (p .001) and Reading the Mind in the Eyes Test (p = .020); control questions elicited normal scores. The DES-II indicated dissociative-borderline psychopathology and negatively correlated with accuracy on the second-order False Belief (Spearman's rho = -.444; p = .032); the positive correlation between DES-II and severity of motor symptoms (S-FMDRS) approached significance (Spearman's rho test = .392; p = .054). ToM disorders were not correlated with S-FMDRS, due to the typical variability in FMD over time with regard to the severity of symptoms and the district of body involved.Our results are consistent with the hypothesis that FMD are related to ToM deficits, and future studies are needed to define the specific nature of this relationship.

Healthy ageing has been associated with a bias toward positive information and greater psychological well-being. However, to what extent this positivity bias also applies to prioritizing positive information under emotional competition is unclear. Old and young adults performed a word-face interference task, in which they responded to the valence of positive and negative target-words while ignoring happy or angry distractor-faces that could be affectively congruent or incongruent. A control condition with scrambled neutral distractor-faces was also used. Findings showed small facilitation effects with faster responses when targets and distractors were affectively congruent and large interference effects with slower responses when targets and distractors were affectively incongruent compared to the control condition. Importantly, whereas for younger adults there was a similar pattern of interference from happy and angry distractor-faces, for older adults there was greater interference from angry distractor-faces. The present findings are discussed in the context of emotional bias literature.

It has recently been discovered that during a virtual reality task of painting, if the subjects have the illusion of recreating an artistic masterpiece, they improve their performances and perceive less fatigue compared to simply coloring a virtual canvas. This phenomenon has been called the Michelangelo effect. However, it was unclear if this effect was related to the aesthetic experience of beauty or if it was specific to artistic stimuli. To clarify this point, 26 healthy subjects performed the virtual task of erasing a blank sheet on the canvas, revealing an image that could be a painting or a photo, classified as beautiful or not. Beautiful paintings were famous artistic portraits, non-beautiful paintings were rough reproductions of them. Photos of popular people were matched with paintings according to their similarity for somatic traits, posture, and clothes. Beautiful and non-beautiful photos were classified according to whether the pictured person was famous or not for their beauty. For each stimulus the objective beauty, subjective beauty, and effort to complete the task perceived by the subject were self-assessed on a numerical rating scale, recorded and analyzed. Furthermore, the hand kinematic trajectory was instrumentally recorded and its spatiotemporal parameters were computed. Less fatigue was perceived for the paintings than for the photos (p = .020), but not for beautiful versus non-beautiful stimuli (p = .325). Only in the artistic stimuli, subjective beauty was found to be negatively correlated with perceived fatigue (p = .030) and performed errors (p = .005). The kinematic parameters were found to be affected by the interactions between the gender of the participant and that of the person in the photo. These results supported the idea that the Michelangelo effect was stronger when subjects interacted with artefacts, modulated by the perceived beauty of the artistic stimulus.

Many recent studies have highlighted that the harmony of physiological walking is based on a specific proportion between the durations of the phases of the gait cycle. When this proportion is close to the so-called golden ratio (about 1.618), the gait cycle assumes an autosimilar fractal structure. In stroke patients this harmony is altered, but it is unclear which factor is associated with the ratios between gait phases because these relationships are probably not linear. We used an artificial neural network to determine the weights associable to each factor for determining the ratio between gait phases and hence the harmony of walking. As expected, the gait ratio obtained as the ratio between stride duration and stance duration was found to be associated with walking speed and stride length, but also with hip muscle forces. These muscles could be important for exploiting the recovery of energy typical of the pendular mechanism of walking. Our study also highlighted that the results of an artificial neural network should be associated with a reliability analysis, being a non-deterministic approach. A good level of reliability was found for the findings of our study.

Abstract. Heart rate variability (HRV) has been linked to effective functioning of prefrontal-subcortical inhibitory circuits. Despite the recognized role of the prefrontal cortex (PFC) in executive functions linked to inhibitory capacity, studies linking HRV to executive functions are inconsistent, likely due to potential confounders. The present study sought to examine this relation in a sample of 50 healthy participants (31 females; Mage = 24.2 years) who underwent assessment of resting HRV and two executive tasks assessing inhibitory control, namely the Rule Shift Cards and the Hayling Sentence Completion Test. Hierarchical multiple regressions showed that HRV predicted performance on both tasks (i.e., time taken to inhibit a strongly activated response) above and beyond the role of sex, body mass index, and impulsivity. Present results disconfirm that the HRV-executive function association is only due to confounders, and corroborate such relationship with the use of two ecological tasks assessing inhibitory control. Current findings support the Neurovisceral Integration Model and provide plausible explanation for previous inconsistent results.

Walking is a repeatable and cyclic locomotor act, presenting standardized biomechanical patterns within the gait cycle in healthy humans. Specifically, both stance and swing durations exhibit high reliability at comfortable speed, maintaining the same proportion between the twos with respect to different contextual features in forward walking. Recently, it was found that this proportion is close to the "golden ratio" (a well-known irrational number equal to 1.618…). While few studies analysed how this ratio is modified due to different contextual factors, no studies are available about different locomotor acts. Thus, aim of the study is to verify whether and how the stance-to-swing ratio is modified during the execution of different locomotor tasks. Twenty healthy young subjects were asked to perform different tasks: forward walking, backward walking, lateral walking, stepping in place, stair ascending and descending, while wearing baropodometric shoe insoles. All tests were performed at comfortable speed, while forward walking was also tested at slow and fast speed. The stance-to-swing ratio did not differ significantly from the golden ratio in forward comfortable walking, backward walking and stair descending. A cluster analysis identified the most frequent cluster centered at 1.63, a value close to the golden ratio. These results supported the idea that golden ratio is the preferred stance-to-swing ratio modality, but at the same time this ratio could be adapted in response to particular contextual requests.

The golden ratio (GR) is an irrational number (close to 1.618) that repeatedly occurs in nature as well as in masterpieces of art. The GR has been considered a proportion perfectly representing beauty since ancient times, and it was investigated in several scientific fields, but with conflicting results. This study aims at investigating if this proportion is associated with a judgment of beauty independently of the type of the stimulus, and the factors that may affect this aesthetic preference. In Experiment 1, an online psychophysical questionnaire was administered to 256 volunteers asked to choose among three possible proportions between the parts of the same stimulus (GR, 1.5, and 1.8). In Experiment 2, we recorded eye movements in 15 participants who had to express an aesthetic judgment on the same stimuli of Experiment 1. The results revealed a slight overall preference for GR (53%, p .001), with higher preferences for stimuli representing humans, anthropomorphic sculptures, and paintings, regardless of the cultural level. In Experiment 2, a shorter dwell time was significantly associated with a better aesthetic judgment (p = .005), suggesting the possibility that GR could be associated with easier visual processing, and it could be hence considered as a visual affordance.

(1) Background: We made a comprehensive evaluation of executive functions (EFs) and attention processes in a group of adolescents and young adults with mild intellectual disability (ID). (2) Methods: 27 adolescents and young adults (14 females and 13 males) with ID, aged between 15.1 and 23 years (M = 17.4, SD = 2.04), were compared to a control group free of cognitive problems and individually matched for gender and age. (3) Results: As for EFs, individuals with ID were severely impaired on all subtests of the Behavioral Assessment of Dysexecutive Syndrome (BADS) battery. However, we also found appreciable individual differences, with eight individuals (approximately 30%) scoring within normal limits. On the attention tests, individuals with ID were not generally slower but presented specific deficits only on some attention tests (i.e., Choice Reaction Times, Color Naming and Color&ndash, Word Interference, and Shifting of Attention for Verbal and for Visual Targets).The role of a global factor (i.e., cognitive speed) was modest in contributing to the group differences, i.e., when present, group differences were selectively associated with specific task manipulations, not global differences in cognitive speed. (4) Conclusions: The study confirmed large group differences in EFs, deficits in attentional processing were more specific and occurred primarily in tasks taxing the selective dimension of attention, with performance on intensive tasks almost entirely spared.

Patient’s active participation in therapy is a key component of successful rehabilitation. In fact, low participation has been shown to be a prognostic factor of poor outcome; however, participation is rarely assessed in clinical settings. The Pittsburgh Rehabilitation Participation Scale (PRPS) is a validated, quick, and accurate measure of participation, relying on clinicians’ observation, and not requiring any self-report by patients. The aim of this study was to validate an Italian version of the PRPS. Following forward and back-translation of PRPS into Italian, the translated version was validated in a total of 640 therapy sessions, related to a cohort of 32 patients admitted to an Italian hospital. It was tested for concurrent validity, finding significant correlations with Barthel Index (R > 0.58, p < 0.001) and SF-36 Physical and Mental Health (R > 0.4, p < 0.02), for predictive validity, finding significant correlation with the effectiveness of rehabilitation (R = 0.358, p = 0.045), and for inter-rater and intra-rater reliability, computing an Intra-class correlation coefficient (ICC = 0.926 and 0.756, respectively). These psychometric properties results were similar to those of the original version of this scale. The proposed PRPS can be helpful for Italian clinicians in the assessment of patient’s participation during rehabilitation.

OBJECTIVE This study examines the perceived needs, experience, and satisfaction of informal caregivers (ICGs) in in-hospital settings, related to their involvement in the design and delivery of services together with hospital staff, namely co-production. DESIGN To obtain a picture of current ICG-staff relationship, a multicenter observational study was carried out. Participants were 75 ICGs recruited in five dedicated in-patient neurorehabilitation wards. Participants answered a self-report questionnaire tapping perceived information/communication needs, emotional/social needs, and their satisfaction; family-centered practices implemented by the staff (namely involving practices and cooperative communication); and ICGs' satisfaction with the service. RESULTS Need satisfaction related positively to staff practices aimed at involving IGCs in treatment and training, but not in decision-making. Involving practices concerning treatment also related positively to ICGs' information/communication needs. In addition, the more the staff involved ICGs in decision-making and promoted cooperative communication regarding treatment, the more ICGs felt that their collaboration in the healthcare process was valuable. Finally, all involvement practices and cooperative communication were positively related to ICGs' overall satisfaction with the service. CONCLUSION The results of the study help to identify gaps in meeting ICGs' needs and to promote strategies to implement family participation toward co-production in in-hospital settings.

Dynamic motor imagery (dMI) is a motor imagery task associated with movements partially mimicking those mentally represented. As well as conventional motor imagery, dMI has been typically assessed by mental chronometry tasks. In this paper, an instrumented approach was proposed for quantifying the correspondence between upper and lower limb oscillatory movements performed on the spot during the dMI of walking vs. during actual walking. Magneto-inertial measurement units were used to measure limb swinging in three different groups: young adults, older adults and stroke patients. Participants were tested in four experimental conditions: (i) simple limb swinging, (ii) limb swinging while imagining to walk (dMI-task), (iii) mental chronometry task, without any movement (pure MI), (iv) actual level walking at comfortable speed. Limb swinging was characterized in terms of the angular velocity, frequency of oscillations and sinusoidal waveform. The dMI was effective at reproducing upper limb oscillations more similar to those occurring during walking for all the three groups, but some exceptions occurred for lower limbs. This finding could be related to the sensory feedback, stretch reflexes and ground reaction forces occurring for lower limbs and not for upper limbs during walking. In conclusion, the instrumented approach through wearable motion devices adds significant information to the current dMI approach, further supporting their applications in neurorehabilitation for monitoring imagery training protocols in patients with stroke.

Touch, such as affective caress, can be interpreted as being pleasant. The emotional valence that is assigned to touch is related to certain bottom-up factors, such as the optimal activation of C-tactile (CT) afferents. Tactile processing with a hedonic or emotional component has been defined as affective touch—a component that CT fibers are likely to convey. Tactile deficiencies are frequent in the psychiatric population but also in healthy people with disorganized attachment; accordingly, it is likely that affective difficulties in adults with disorganized attachment are reflected in altered perception of affective touch. To test this hypothesis, we combined methods from clinical psychology, psychophysics, and neuroimaging. We found that people with a history of traumatic parental bonds and a disorganized attachment pattern perceive a “caress-like” stimulus as being unpleasant, whereas participants with organized attachment consider the same tactile stimulation to be pleasant. Further, unlike in organized adults, the responses of disorganized adults to CT and non-CT stimulation activated limbic and paralimbic structures in a fight-or-flight manner, suggesting that early experiences with parental deficiencies shape the physiological responses of peripheral CT fibers and central nervous networks.

One of the challenges of providing healthcare services is to enhance its value (for patients, staff and the service) by integrating the informal caregivers into the care process, both concretely managing their patient's health conditions and treatment (co-executing) and participating in the whole healthcare process (co-planning). This study aims at exploring the co-production contribution to the healthcare process, analysing whether and how it is related to higher caregivers' satisfaction with service care and reduced staff burnout, in the eyes of the staff. It also investigated two possible factors supporting caregivers in their role of co-producers, namely relationship among staff and informal caregivers related to knowledge sharing (i.e. an ability determinant supporting co-production) and related to role social conflict (i.e. a willingness determinant reducing co-production). Results of a structural equation model on a sample of 119 healthcare providers employed by neurorehabilitation centers in Italy with severe acquired brain injury confirmed that knowledge sharing positively related with caregivers' co-executing and co-planning. Also, social role conflict was negatively related with co-executing but positively with co-planning. Furthermore, co-planning resulted in being unrelated to both outcomes, whereas co-executing was associated with caregivers' satisfaction, as measured by staff perceptions. Overall, our data provided initial empirical evidence supporting the ability of the determinant's contribution in allowing informal caregivers to assume an active role in both co-production domains. Furthermore, as expected, the role of conflict willingness determinant was found to be a hindering factor for co-executing but, conversely, a trigger for co-planning. This result should be considered more carefully in future studies.

The use of ecological tests to assess executive functions (EFs) in patients with anorexia nervosa (AN) has not examined extensively. The objective of this study was to analyze and compare the performance of patients with AN and healthy controls (HCs) on standard versus ecologically valid tests on EFs. Sixty-two females aged between 16 and 42 who were diagnosed with AN and 70 matched HCs completed 2 neuropsychological test batteries: standard tests (WCST, TMT, Stroop, ToL, fluency test) and the Behavioral Assessment of Dysexecutive Syndrome (BADS). On the standard tests, patients with AN produced more perseverative response and were slower than HCs in the TMT; in contrast, they scored as well as HCs on tasks that assessed categorization, interference in color naming, planning and semantic fluency. Conversely, there were differences in the ecological tests with patients with AN systematically slower in the resolution of complex tasks. Results demonstrated the power of ecological tests in capturing selective impairments in multifaceted and unstructured tests. Patients with AN experienced systematic deceleration in the resolution of ecological tasks. Also, the increased time needed to solve the tasks, was not reflected in overall improvement in performance. This evidence is further discussed with respect to central coherence.

Different physiological signals could be coupled under specific conditions, in some cases related to pathologies or reductions in system complexity. Cardiac-locomotor synchronization (CLS) has been one of the most investigating coupling. The influence of a cognitive task on walking was investigated in dual-task experiments, but how different cognitive tasks may influence CLS has poorly been investigated. Twenty healthy subjects performed a dual-task walking (coupled with verbal fluency vs calculation) on a treadmill at three different speeds (comfortable speed CS; fast-speed: CS + 2 km/h; slow-speed: CS-2 km/h) while cardiac and walking rhythms were recorded using surface electrodes and a triaxial accelerometer, respectively. According to previous studies, we found a cognitive-motor interference for which cognitive performance was affected by motor exercise, but not vice-versa. We found a CLS at the baseline condition, at fast speed in both cognitive tasks, while at comfortable speed only for the verbal fluency task. In conclusion, the cardiac and locomotor rhythms were not coupled at slow speed and at comfortable speed during subtraction task. Cognitive performances generally increased at faster speed, when cardiac locomotor coupling was stronger.

Deficit in planning and problem-solving, affecting a wide range of neuropsychological patients, has been widely investigated using the Tower of London (ToL) test, as developed by Shallice (Philos Trans R Soc Lond Ser B Biol Sci 298:199–209, 1). The ToL taps on several executive functions (EF), such as planning, time for planning or rule breaks, which may be usefully indexed by different ToL measurements. However, in its original version, the different aspects involved in ToL are not evaluated in a specific way. Here, we report the standardization of the ToL, on 896 individuals aged 15–86 years, taking in account individual factors (i.e. gender, age, years of education) which may affect performances on ToL. We computed several indexes on the ToL including score, planning and execution times, perseverations, rule breaks and self-monitoring. We found that these indexes were affected by individual factors such as gender, age and education. Present results not only provide extensive normative data according to gender, as well as different age and education ranges, but also represent a very useful instrument for a more fine-grained diagnosis of EF deficits in a wide range of neuropsychological patients, including traumatic brain injury and brain-damaged patients, as well as Alzheimer’s disease and Parkinson’s disease patients.

We investigated whether the gender differences in working memory are linked to the nature of the stimuli (verbal vs. visuo-spatial) or to the type of processing (active vs. passive). With this aim, we administered two well-known tests: Corsi Block-tapping test (CBT) and the Digit span (DS) using two versions: forward (fCBT and fDS) and backward (bCBT and bDS). During the forward processing (fCBT and fDS), subjects being required to repeat stimuli in the same order they are presented, passive working memory is assessed. Otherwise, during the backward processing (bCBT and bDS), subjects being required repeating stimuli in an order opposite to that of presentation, active working memory is assessed. A total of 208 college students (104 women) were assessed. We found a gender effect on fCBT and bCBT, but not on fDS and bDS, with men outperforming women. The results from the present study support previous findings in which the presence of gender differences emerged in visuo-spatial working memory, that is, when verbal encoding is less efficacious with respect to other strategies. Failing in finding the opposite trend in fDS and bDS, that is, women performing better than men on these tasks, previously documented, may be due to the fact that we selected a sample of young subjects with the same educational level. Indeed, gender differences in verbal working memory have been reported especially for low level of education. Furthermore, our results suggest that such differences are more related to the type of material (verbal vs. visuo-spatial) more than to the type of processing (active vs. passive). This last finding supports the idea that when age and educational level are well matched among sexes, differences due to the stimuli processing disappear.

A new form of Motor Imagery (MI), called dynamic Motor Imagery (dMI) has recently been proposed. The dMI adds to conventional static Motor Imagery (sMI) the presence of simultaneous actual movements partially replicating those mentally represented. In a previous research conducted on young participants, dMI showed to be temporally closer than sMI in replicating the real performance for some specific locomotor conditions. In this study, we evaluated if there is any influence of the ageing on dMI. Thirty healthy participants were enrolled: 15 young adults (27.1±3.8 y.o.) and 15 older adults (65.9±9.6y.o.). The performance time and the number of steps needed to either walk to a target (placed at 10m from participants) or to imagine walking to it, were assessed. Parameters were measured for sMI, dMI and real locomotion (RL) in three different locomotor conditions: forward walking (FW), backward walking (BW), and lateral walking (LW). Temporal performances of sMI and dMI did not differ between RL in the FW, even if significantly different to each other (p = 0.0002). No significant differences were found for dMI with respect to RL for LW (p = 0.140) and BW (p = 0.438), while sMI was significantly lower than RL in LW (p

Technological innovations are allowing rehabilitation to move toward more integrated processes, with improved efficiency and less long-term impairments. In particular, robot-mediated neurorehabilitation is a rapidly advancing field, which uses robotic systems to define new methods for treating neurological injuries, especially stroke. The use of robots in motor recovery can enhance rehabilitation, but it needs to be used according to well-defined neuroscientific principles. The field of robot-mediated neurorehabilitation brings challenges to both bioengineering and clinical practice (motor and cognitive). The aim of this scoping review is to better understand the role of the technology into application of rehabilitation principle, overcoming the dichotomy between traditional and technological intervention.

The scope of this mini review is to show as neuromotor control often applies mathematical principles and properties improving efficiency of movements. We reported four examples: harmony of human walking is based on the fractal property of self-similarity because based on the golden ratio, anatomy of human hand follows Fibonacci’s sequence for optimizing grasping, the 2/3 power-law at which curvilinear movements obey, and the possibility of brain to predict the movement of falling objects applying an implicit knowledge of the Newton’s gravitational law.

Objective The Hayling and Brixton tests constitute a short test battery that quickly assesses verbal and spatial inhibition and flexibility. This battery has shown high construct validity and strong reliability in clinical and experimental settings. The aim of this study was to develop an Italian version of the Hayling and Brixton tests and obtain normative values. Method We collected normative data from 301 healthy Italian participants aged between 16 and 94 years, taking into account all demographics. To maximize the sample size, we used the overlapping interval strategy. Adjusted scores for demographics were obtained by linear regression analysis. Results The performance on the Hayling and Brixton tests was influenced by age and education. In particular, age affected verbal accuracy and response time on the Hayling Sentence Completion Test, whereas education only affected the former. Differently, the spatial component, as measured by the Brixton Spatial Anticipation Test, was shaped only by age, which decreased the number of correct responses. Conclusions Our study provides normative data that have been adjusted for relevant demographics and percentile grids in an Italian population. Our data support the use of the Hayling and Brixton tests as a valid instrument for performing neuropsychological evaluations and longitudinal analyses of executive functions in clinical practice and for research purposes.

Unilateral spatial neglect (USN) is a frequent consequence of acquired brain injury, especially following right hemisphere damage. Traditionally, unilateral spatial neglect is assessed with cancellation tests such as the Bells test. Recently, a new cancellation test, the Apples test, has been proposed. The present study aims at comparing the accuracy of these two tests in detecting hemispatial neglect, on a sample of 56 right hemisphere stroke patients with a diagnosis of USN. In order to evaluate the agreement between the Apples and Bells tests, Cohen’s kappa and McNemar’s test were used to assess differences between the two methods of evaluation. Poor agreement and statistically significant differences emerged between the Apples and Bells tests. Overall, the Apples test was significantly more sensitive than the Bells test in detecting USN. Based on these results, the use of the Apples test for peripersonal neglect assessment is therefore highly recommended.

The Wolf-Hirschhorn syndrome (WHS) is a rare genetic disorder that causes a range of intellectual disability from mild to severe. In this study, we used standard tools to psychometrically characterize the specific neuropsychological phenotype of WHS. We studied 57 individuals with WHS, ranging in age from 2.6 to 28.6 years representing 70% of the certified Italian WHS population. Results obtained by administering Griffiths’ Mental Developmental Scales and the Vineland Adaptive Behavior Scale revealed a typical WHS neuropsychological phenotype characterized by specific strengths and weaknesses. Despite their severe cognitive impairment, in both scales, patients showed better communication and social interaction skills compared to visuo-motor abilities. Results of our study could bring to the development of new and more effective treatments for individuals affected by WHS: based on neuropsychological phenotype description, it should be possible to design specific rehabilitation programs. These programs would then be aimed at improving rehabilitation protocols to optimize the developmental potential and personal independence of individuals with WHS and thus to improve their quality of life.

Up to now, rehabilitation of unilateral spatial neglect has focused on egocentric forms of neglect, whereas less is known about the possibility to improve allocentric deficits. The present study aimed to examine the efficacy of prism adaptation (PA) training on patients with different forms of neglect: egocentric, allocentric, or mixed. Twenty-eight patients were assessed with specific neglect tests before (T0) and after (T1) 10 sessions of PA training. Performance in the Apples Cancellation test was used to identify patients with egocentric (n = 6), allocentric (n = 5), or mixed (n = 17) forms of neglect. In the overall group of patients, PA training produced significant improvements in performance across different neglect tests. In terms of the egocentric&ndash, allocentric distinction, the training was effective in reducing omissions in the left part of space in the Apples Cancellation test both for patients with egocentric neglect and mixed neglect. By contrast, errors of commissions (marking the inability to detect the left part of the target stimulus, i.e., allocentric neglect) remained unchanged after PA in patients with allocentric neglect and actually increased marginally in patients with mixed neglect. The PA training is effective in improving egocentric neglect, while it is ineffective on the allocentric form of the disturbance. Notably, the allocentric component of neglect is frequently impaired, although this is most often in conjunction with the egocentric impairment, yielding the mixed form of neglect. This stresses the importance of developing exercises tuned to improving allocentric neglect.

Even when focused on an effortful task we retain the ability to detect salient environmental information, and even irrelevant visual stimuli can be automatically detected. However, to which extent unattended information affects attentional control is not fully understood. Here we provide evidences of how the brain spontaneously organizes its cognitive resources by shifting attention between a selective-attending and a stimulus-driven modality within a single task. Using a spatial cueing paradigm we investigated the effect of cue-target asynchronies as a function of their probabilities of occurrence (i.e., relative frequency). Results show that this accessory information modulates attentional shifts. A valid spatial cue improved participants' performance as compared to an invalid one only in trials in which target onset was highly predictable because of its more robust occurrence. Conversely, cuing proved ineffective when spatial cue and target were associated according to a less frequent asynchrony. These patterns of response depended on asynchronies' probability and not on their duration. Our findings clearly demonstrate that through a fine decision-making, performed trial-by-trial, the brain utilizes implicit information to decide whether or not voluntarily shifting spatial attention. As if according to a cost-planning strategy, the cognitive effort of shifting attention depending on the cue is performed only when the expected advantages are higher. In a trade-off competition for cognitive resources, voluntary/automatic attending may thus be a more complex process than expected.

10 Abstract. PURPOSE: A realistic body representation needs to be constantly updated. In case of physiological modifications, body representations integrate information coming from different sensory sources, including the sense of touch. Previous studies describedtransientmodificationsoftheserepresentationsfollowingillusorydistortions.Inthissinglecasestudy,wedocumented thechangesoccurredinlower-level,primarysomatosensory,andhigher-levelrepresentations,inacaseofupperarmselongation. METHOD: We explored effects of arm lengthening on primary tactile perception (sensitivity and acuity), an implicit perceptual measure of body size (tactile distance judgement), body image (Daurat-Hmelijak test), and peri-personal space representation (audio-tactile interaction task). RESULTS: We show that patient's arm representation was changed after surgery. Specifically, we observed significant changes on tactile distance judgments, body image test and audio-tactile interaction task; also even though no changes were found on primary tactile perception a significant modification emerged in tactile acuity. CONCLUSIONS: These findings are in line with evidence of cortical reorganization after arm elongation. They also support the view that the body representation of achondroplasics are modified after body-size reconstruction, and became similar to that of healthy controls. 11 12 13 14 15 16 17 18 19 20 21 22 23 24