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The current diagnostic criteria for the behavioural variant of frontotemporal dementia (bvFTD) foresee a relative sparing of long-term memory. Although bvFTD patients were thought to report secondary memory deficits associated with prefrontal dysfunctions, some studies indicated the presence of a “genuine memory deficit” related to mesial temporal lobe dysfunctions. Among various neuropsychological tests, the Free and Cue Selective Reminding Test (FCSRT) has been recommended to distinguish genuine from apparent amnesia. We conducted a systematic review and a random effect Bayesian meta-analysis to evaluate the nature and severity of memory deficit in bvFTD. Our objective was to determine whether the existing literature offers evidence of genuine or apparent amnesia in patients with bvFTD, as assessed via the FCSRT. On 06/19/2021, we conducted a search across four databases (PMC, Scopus, Web of Science, and PubMed). We included all studies that evaluated memory performance using the FCSRT in patients with bvFTD, as long as they also included either cognitively unimpaired participants or AD groups. We tested publication bias through the Funnel plot and Egger’s test. To assess the quality of studies, we used the Newcastle-Ottawa quality assessment scale adapted for cross-sectional studies. We included 16 studies in the meta-analysis. The results showed that bvFTD patients perform better than AD patients (pooled effects between 0.95 and 1.14), as their memory performance stands between AD and control groups (pooled effects between − 2.19 and − 1.25). Moreover, patients with bvFTD present both genuine and secondary memory disorders. As a major limitation of this study, due to our adoption of a rigorous methodology and stringent inclusion criteria, we ended up with just 16 studies. Nonetheless, our robust findings can contribute to the ongoing discussion on international consensus criteria for bvFTD and the selection of appropriate neuropsychological tools to facilitate t

Recentemente, la Realtà Virtuale (virtual reality, VR) è entrata nel campo della ricerca sulla valutazione neuropsicologica. L'impatto di questa tecnologia è attualmente discusso in letteratura, poiché viene considerata come possibile promotrice di un cambio di paradigma per lo sviluppo di nuovi test neuropsicologici. Pertanto, al fine di contribuire a questa discussione in corso, il presente lavoro ha molteplici scopi. In primo luogo, esamina lo stato dell'arte della tecnologia VR e della sua implementazione per lo sviluppo di nuovi strumenti di valutazione, presentando i vantaggi più importanti di questa adozione, le sfide e i potenziali effetti negativi da considerare. Successivamente, l'indagine principale si lega alla comprensione delle differenze tra due tipi di ambienti virtuali immersivi attualmente utilizzati per simulare compiti volti a una valutazione ecologica del funzionamento cognitivo: Model-Based VR e 360°-VR. Per fare ciò, sono stati condotti due esperimenti within-group che hanno confrontato misure relative alle prestazioni e alla user-experience durante l'esecuzione di varianti di attività VR immersive basate sui due tipi di ambienti virtuali sopra menzionati. Le prove raccolte hanno supportato lo sviluppo di un terzo studio, che descrive un test VR pilota presentato come primo esempio assoluto di un test di screening cognitivo multi-dominio basato sulla 360°-VR. È stata valutata la performance di questo nuovo test nel distinguere gli individui con deficit cognitivi dai controlli sani, con un'ulteriore attenzione allo studio dell'usabilità percepita e al possibile insorgenza di sintomi legati alla motion sickness. Infine, come possibile sviluppo futuro, viene presentato uno studio di fattibilità che descrive un'estensione del test che include un sistema avanzato per la raccolta dati, basato sull’eye-tracking e sulla speech recognition., Recently, virtual reality (VR) entered the field of neuropsychological assessment research. This technology’s impact is currently discussed in the literature, as it is considered a possible promoter of a paradigm shift for neuropsychological testing. Thus, in order to contribute to this ongoing discussion, the present work has multiple purposes. First, it looks at the state-of-the-art of VR technology and its implementation in developing novel assessment tools, presenting the most important benefits of this adoption and the challenges and potential side effects to consider. Then, the core investigation is related to understanding the differences between two kinds of immersive virtual environments currently used to simulate tasks aimed at an ecological assessment of cognitive functioning: Model-Based VR and 360°-VR. To do this, two within-group experiments were carried out to compare performance and user experience-related measures during the execution of immersive VR task variants based on the two abovementioned kinds of virtual environments. The collected evidence supported the development of a third study describing a pilot VR test presented as a first-time example of a multidomain cognitive screening test based on 360°-VR. The performance of this novel-developed test in distinguishing cognitively impaired individuals from unimpaired controls was assessed, with an additional focus on investigating perceived usability and the possible occurrence of simulation sickness. Finally, a feasibility study presenting an extension of the test, including advanced data collection, such as eye-tracking and speech recognition, is offered as a possible future upgrade.

Background. Skill learning (e.g., reading, spelling and maths) has been predominantly treated separately in the neuropsychological literature. However, skills (as well as their corresponding deficits), tend to partially overlap. We recently proposed a multi-level model of learning skills (based on the distinction among competence, performance, and acquisition) as a framework to provide a unitary account of these learning skills. In the present study, we examined the performance of an unselected group of third- to fifth-grade children on standard reading, spelling, and maths tasks, and tested the relationships among these skills with a network analysis, i.e., a method particularly suited to analysing relations among different domains. Methods. We administered a battery of reading, spelling, and maths tests to 185 third-, fourth-, and fifth-grade children (103 M, 82 F). Results. The network analysis indicated that the different measures of the same ability (i.e., reading, spelling, and maths) formed separate clusters, in keeping with the idea that they are based on different competences. However, these clusters were also related to each other, so that three nodes were more central in connecting them. In keeping with the multi-level model of learning skills, two of these tests (arithmetic facts subtest and spelling words with ambiguous transcription) relied heavily on the ability to recall specific instances, a factor hypothesised to underlie the co-variation among learning skills. Conclusions. The network analysis indicated both elements of association and of partial independence among learning skills. Interestingly, the study was based on standard clinical instruments, indicating that the multi-level model of learning skills might provide a framework for the clinical analysis of these learning skills.

Introduction: Patients with obstructive sleep apnea (OSA) suffer from several neurocognitive deficits. We investigated the cognitive and socio-cognitive profiles of patients with severe OSA, controlling for potentially relevant mediating variables (i.e. age, body-mass index, cognitive reserve and depression). Moreover, we studied the neuropsychological profile of a high-risk OSA phenotype characterized by severe OSA and severe nocturnal hypoxemia.Method: We assessed 29 previously untreated severe OSA patients with a mean age of 55.6 (± 9.9 years) and a mean apnea-hypopnea index (AHI) of 53.1 (± 17.4). A control group of 34 healthy participants was also enrolled. Participants completed an extensive neuropsychological battery that included social cognition, a relatively new investigation area among OSA patients.Data analysis: Data were analyzed with a Bayesian approach. Specifically, Bayesian ANCOVA was used to investigate whether the grouping variable could predict test performance. Age, body-mass index, cognitive reserve and state of depression were added as covariates to the null model to weight the effects of these potential confounding factors. Three groups were analyzed: healthy controls (H), OSA with severe apnea and severe nocturnal oxygen desaturation (D+), and OSA with severe apnea non-desaturators (D-). Performances on the various neuropsychological tests were treated as the dependent variables.Results: The results indicate that non-verbal reasoning, the theory of mind skills, and mental shifting ability were impaired in OSA patients. Patients with severe nocturnal hypoxemia underperformed compared to patients with the same severity of apnea but non-desaturators. Additionally, we observed a trend toward a worse performance among OSA desaturator patients in the following abilities: constructional ability, short term verbal memory, phonological fluency, and the ability to inhibit automatic and dominant responses.Conclusion: The data suggest a key role of hypo

The representation of the body in the brain is constantly updated to allow optimal sensorimotor interactions with the external world. In addition to dynamic features, body representation holds stable features that are still largely unknown. In the present work we explored the hypothesis that body parts have preferential associations with relative spatial locations. Specifically, in three experiments, we found consistent preferential associations between the index finger and the top position, and between the thumb and the bottom position. This association was found in a tactile sensory discrimination task, which was conducted both with and without vision, as well as at the implicit conceptual association level. These findings show that body parts and spatial locations are stably associated. Therefore, not only are body segments dynamically mapped in space for perception and action, but they also hold intrinsic spatial information that contributes to somatosensory spatial processing

The crossmodal congruency task is a consolidated paradigm for investigating interactions between vision and touch. In this task, participants judge the elevation of a tactile target stimulus while ignoring a visual distracter stimulus that may occur at a congruent or incongruent elevation, thus engendering a measure of visuo-tactile interference (crossmodal congruency effect, CCE). The CCE reflects perceptual, attentional, and response-related factors, but their respective roles and interactions have not been set out yet. In two experiments, we used the original version of the crossmodal congruency task as well as ad hoc manipulations of the experimental setting and of the participants’ posture for characterizing the contributions of multisensory integration, body-mediated attention, and response conflict to the CCE. Results of the two experiments consistently showed that the largest amount of variance in the CCE is explained by the reciprocal elevation of visual and tactile stimuli. This finding is compatible with a major role of response conflict for the CCE. Weaker yet distinguishable contributions come from multisensory integration, observed in the absence of response conflict, and from hand-mediated attentional binding, observed with the modified posture and in the presence of response conflict. Overall, this study informs the long-standing debate about mechanisms underlying the CCE by revealing that the visuo-tactile interference in this task is primarily due to the competition between opposite response tendencies, with an additional contribution of multisensory integration and hand-mediated attentional binding

The ability to rapidly distinguish between positive and negative facial expressions of emotions is critical for adaptive social behaviour. Increasing evidence has shown that emotions can be processed even at an unconscious level in adults. Yet, very little is still known about the early ontogeny of the unconscious processing of emotional signals conveyed by faces. Here, we investigated the processing of subliminally presented face emotional stimuli in infants as young as 3–4 months of age and sought to clarify its neural underpinnings by exploring the role of the autonomic nervous system. Using a visual preference paradigm, Experiment 1 determined the visibility threshold for happy and angry faces and established that infants detected both happy and angry faces at 200- but not at 100 msec. By measuring skin conductance response (SCR), Experiment 2 showed that the autonomic nervous system of infants reacted to both subliminally (100 msec) and supraliminally (200 msec) presented face expressions of emotions, and that SCR were higher for angry than happy facial expressions. Results revealed that 3–4 month-old infants respond to positive and negative emotions even at an unconscious level, but also show that angry faces possess an intrinsic alerting characteristics, suggestive of an adaptive meaning of the physiological response. Findings are discussed in terms of subcortical learning of emotions, and the possibility that the amygdala may be involved in such process.

Looking at one's own body might induce visual analgesia. However, the cognitive and physiological mechanisms underlying such visual analgesia are unknown. Because body and pain representations in the brain are multisensory, and have been reported to partially overlap, we herein investigated whether experimentally-induced changes in bodily self-consciousness (BSC) modulate pain. We measured physiological responses to pain (skin conductance response [SCR]) and the subjective experience of pain, under conditions of manipulated BSC. First we investigated whether looking at a virtual body that was associated with BSC (embodiment) reduced responses to pain, which revealed the effect of BSC on pain processing. Second, we manipulated the visual size of the virtual body during painful stimulation, a procedure known to modulate pain processing when used with biological bodies, but never studied with embodied avatars. We found reduced SCR in conditions of illusory embodiment, and a negative correlation between virtual body size and SCR, whereas subjective pain ratings were not affected by these manipulations. These results suggest that pain processing is modulated during illusory states of BSC and that these changes are greater for larger virtual bodies, which sustains that pain and its physiological mechanisms are associated with the bodily self, opening promising avenues for future pain treatments. Perspective We show that BSC affects the processing of painful stimuli with induction of different levels of pain responses for embodied virtual bodies of different sizes. Our data reveal novel links between pain and self and suggest that embodied virtual bodies are a promising technique for future pain treatments.

Peripersonal space is the region closely surrounding our bodies. Within its boundaries, avoidance of threatening objects is crucial for surviving. Here we explored autonomic responses to painful stimuli with respect to the dynamic properties of the peripersonal space in healthy individuals. To this aim, in a series of experiments, we measured the Skin Conductance Response (SCR) to a noxious stimulus approaching and touching the hand, or stopping at different distances (far, near) from it. Results showed that the anticipatory response to an incoming threat is reduced if the stimulus targets a spatial position far away from the body, as compared to a near or bodily location. However, responses to far stimuli change if the boundaries of reachable space are extended further away by active tool use. Noteworthy, SCR is not influenced by a training consisting of a spatial attention task, without active tool use. This evidence sheds novel light on the adaptive role of peripersonal space, showing its importance for the coding of incoming threatening stimuli and its plasticity induced by contingent experience, such as tool use.

Previous evidence has shown that active tool-use can reshape one's own body schema, extend peripersonal space and modulate the representation of related body parts. Here we investigate the effect of tool-use training on length representation of the contralesional forearm in brain-damaged hemiplegic patients who manifested a pathological embodiment of other people body parts. Four patients and 20 aged-matched healthy-controls were asked to estimate the mid-point of their contralesional forearm before and after 15. min of tool-use training (i.e. retrieving targets with a garbage plier). In the case of patients, training was always performed by the examiner's (alien) arm acting in two different positions, aligned (where the pathological embodiment occurs; E+ condition) or misaligned (where the pathological embodiment does not occur; E- condition) relative to the patients' shoulder. Healthy controls performed tool-use training either with their own arm (action condition) or observing the examiner's arm performing the task (observation condition), handling (observation with-tool condition) or not (observation without-tool condition) a similar tool. Crucially, in the E+ condition, when patients were convinced to perform the tool-use training with their own paralyzed arm, a significant overestimation effect was found (as in the Action condition with normal subjects): patients mislocated their forearm midpoint more proximally to the hand in the post- than in the pre-training phase. Conversely, in the E- condition, they did not show any overestimation effect, similarly to healthy subjects in the observation condition (neither in the with-tool nor in the without-tool condition significant overestimation effects were found). These findings show the existence of a tight link between spatial, motor and bodily representations and provide strong evidence that a pathological sense of body ownership can extend to intentional motor processes and modulate the sensory map of action-rel

Individuals with the peculiar disturbance of '. overcompleteness' experience an intense desire to amputate one of their healthy limbs, describing a sense of disownership for it (Body Integrity Identity Disorder - BIID). This condition is similar to somatoparaphrenia, the acquired delusion that one's own limb belongs to someone else. In ten individuals with BIID, we measured skin conductance response to noxious stimuli, delivered to the accepted and non-accepted limb, touching the body part or simulating the contact (stimuli approach the body without contacting it), hypothesizing that these individuals have responses like somatoparaphrenic patients, who previously showed reduced pain anticipation, when the threat was directed to the disowned limb. We found reduced anticipatory response to stimuli approaching, but not contacting, the unwanted limb. Conversely, stimuli contacting the non-accepted body-part, induced stronger SCR than those contacting the healthy parts, suggesting that feeling of ownership is critically related to a proper processing of incoming threats.

The representation of one's own body sets the border of the self, but also shapes the space where we interact with external objects. Under particular conditions, such as in the rubber hand illusion external objects can be incorporated in one's own body representation, following congruent visuo-tactile stroking of one's own and a fake hand. This procedure induces an illusory sense of ownership for the fake hand and a shift of proprioceptive localization of the own hand towards the fake hand. Here we investigated whether pure visuo-motor, instead of visuo-tactile, congruency between one's own hand and a detached myoelectric-controlled robotic hand can induce similar embodiment effects. We found a shift of proprioceptive hand localization toward the robot hand, only following synchronized real hand/robot hand movements. Notably, no modulation was found of the sense of ownership following either synchronous or asynchronous-movement training. Our findings suggest that visuo-motor synchrony can drive the localization of one's own body parts in space, even when somatosensory input is kept constant and the experience of body ownership is maintained.

Bodily self consciousness is a blooming field of research where a lot of questions are still unsolved. From a psychological point of view de Vignemont (2011) proposed an agenda of main issues wondering what is the fundamental role of body ownership, what grounds the sense of ownership, how is the sense of ownership related to bodily sensations, action and emotion, and whether it is possible to feel a sense of ownership for any extracorporeal object. In the present thesis I am going to present a progression of seven studies where I tried to characterize how body representation interacts with pain processing, investigating either patients presenting with body representation disorders and healthy people experiencing bodily misperceptions, by means of recording responses from the autonomous nervous system and ratings of pain experience under different conditions of body representation distortion. Taken together the studies presented show three main findings: an anticipatory response to incoming noxious stimuli is recordable when stimuli enter in the peripersonal space; an intact body representation is necessary to properly monitor noxious stimuli approaching to our own body; when the sense of ownership is transferred to an external object or a virtual body, a visual treat to that external object elicits anticipatory responses akin to those elicited by a menace directed to our own body. The present set of studies provide novel experimental evidence showing the critical influence of body representation for the mapping of sensory experience, in particular pain processing, and how the sense of ownership critically governs this interaction. Overall, the key contribution of the present work is to provide converging data, gathered from different models ranging from the study of pathological populations to the assessment of neurologically intact individuals by means of experimental manipulations, about the role of body representation for the efficient and safe interaction with

A complex brain representation of our body allows us to monitor incoming sensory stimuli and plan actions towards the external world. A critical element of such a complex representation is the sense of ownership towards our own body parts. Brain damage may disrupt this representation, leading to the striking neuropsychological condition called somatoparaphrenia, that is, the delusion that one's own limbs belong to someone else. The clinical features characterizing somatoparaphrenia are well known, however, physiological clues of the level at which this condition may disrupt sensory functions are unknown. In the present study we investigated this issue by measuring the anticipatory skin conductance response to noxious stimuli approaching either the affected or the intact body side in a group of patients with somatoparaphrenia (n = 5; three females, age range = 66-84), and in a group of patients with anosognosia for sensory deficits, i.e. preserved ownership but decreased awareness of somatosensory deficit, (n = 5; one female, age range = 62-81 years) and in a group of purely hemiplegic patients (n = 5; two females, age range = 63-74 years) with no deficits of ownership or sensory awareness. Results show that anticipatory skin conductance responses to noxious stimuli directed to the contralesional hand are significantly reduced as compared to noxious stimuli directed to the ipsilesional hand in patients with somatoparaphrenia. By contrast a non-reduced anticipatory skin conductance response was observed in control participants as well as in patients affected by anosognosia for the somatosensory deficit and in patients affected by pure motor deficits. Furthermore, a pain anticipation response was always measured when the stimuli were directed towards the ipsilesional, unaffected hand in all groups. Our results show for the first time that the delusions shown by somatoparaphrenic patients are associated with an altered physiological index of perceptual analysis. The red

Disruption of motor control in the alien hand syndrome might result from a dissociation between intentions and sensory information. We hypothesized that voluntary motor control in this condition could improve by restoring the congruency between motor intentions and visual feedback. The present study shows that, in one patient with right alien hand syndrome, the use of a mirror box paradigm improved motor speed. We speculate that the visual feedback provided by the mirror increases the sense of congruence between intention and sensory feedback, leading to motor improvement.

Looking at one’s own body has been shown to induce analgesia. In the present work we investigated whether illusory self-identification with an avatar, as induced experimentally through visuo-tactile stimulation, modulates the response to painful stimuli. In 30 healthy volunteers, a robotic device was used to stroke the participants’ back, while they viewed either the body of an avatar, a non-body object (control object), or a body avatar with scrambled body parts (control body). All were visually stimulated in either congruent or incongruent fashion with the participant’s body. We collected physiological responses (skin conductance response: SCR) to painful stimuli delivered to the participant’s hand and responses to a questionnaire inquiring about self-identification with the avatar. We expected reduced physiological responses to pain during the observation of a body avatar only during synchronous visuo-tactile stroking and no reduction for the control object and the control body. Results showed a reduced SCR to painful stimuli when participants observed the normal body avatar being stroked synchronously that was also associated with largest self-identification ratings recordable already during the pain anticipation. Moreover, a negative correlation between self-identification and SCR was observed, suggesting that a greater degree of self-identification with the avatar was associated with larger decreases in SCR. These results suggest that during states of illusory self-identification with the avatar, the vision of an alien body (anatomically compatible for the vision and congruently stroked for the touch) is effective in modulating physiological responses to painful stimuli.

Background and Purpose: The mirror box (MB) was developed in the early 1990 s to relieve phantom limb sensations and chronic pain. Although its efficacy has been shown in several clinical populations, the mechanisms underpinning effects still have to be fully understood. Methods: 48 healthy subjects participated in 4 behavioral experiments where kinesthetic sensitivity of the hand inside the MB was tested during the observation of mirror-reflected finger movements, executed with the hand outside the MB. Results: We identified two effects on the hand hidden inside the MB: diminished kinesthetic sensitivity for passive movements, and the occurrence of unconscious, involuntary movements with the finger inside the box, suggesting reduced motor awareness. Such sensory-motor effects were somatotopically specific to the finger moved, were influenced by the contextual presence of the whole hand in the mirror, and occurred for both active and passive movements of the hand outside the MB. Conclusions: The present results suggest that the MB induce a somatotopically and contextually specific overriding of kinesthetic control by vision, compatible with a process of embodiment of the mirror-reflected hand image and provide novel clues to the understanding of the mechanisms underlying MB effects. © 2013 - IOS Press and the authors. All rights reserved.

We describe the clinical manifestations and the lesion patterns of five patients with somatoparaphrenia, the denial of ownership for a paralyzed limb, who showed the rare dissociation from anosognosia for hemiplegia. Similar cases have been only occasionally cited in the literature with scanty descriptions of their symptoms and no detailed anatomical assessment. All patients had extrapersonal and at least mild personal neglect. The lesions pattern was mainly subcortical, with a significant involvement of the right thalamus, the basal ganglia and the internal capsule. A formal comparison between the anatomical pattern previously associated with anosognosia in a study performed in 2005 by Berti and colleagues, and the lesion distribution of each patient clearly shows that our pure somatoparaphrenic patients had a sparing of most of the regions associated with anosognosia for hemiplegia. The behavioral dissociation between SP and anosognosia for hemiplegia, together with this new anatomical evidence, suggests that motor awareness is not sufficient to build up a sense of ownership and therefore these two cognitive abilities are at least in part functionally independent and qualitatively different.