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Biomedical subjects

Paolo Nichelli

Publications and source records attributed to Paolo Nichelli.

At least 19 recordsLinked to original sources

List effect in apraxia assessment.

Imitation tests encompassing intermingled meaningful and meaningless items are normally used to assess ideomotor apraxia, implicitly assuming that they would test the lexical and the non-lexical route, respectively. However, these mixed lists might induce a "list composition" effect similar to that found in word recognition studies where familiar material can be processed via the non-lexical route. This hypothesis was put to test by examining praxis skills of 23 left-hemisphere damaged patients using the same gestures in two formats: pure and mixed lists (i.e., meaningless or meaningful gestures administered separately or intermingled, respectively). Results showed that patients performed better on the imitation task when pure lists were used. Moreover, asymmetries of performance were observed. Patient SL scored better in the imitation of meaningful gestures in the pure list than in the mixed list condition. Patient CA performed poorly in the imitation of meaningless gestures only in the mixed list condition. Dissociations observed in imitation tasks could be biased by the use of mixed lists. Also "pure" lists should be used for the diagnosis of imitation deficits in apraxia.

Adult↗

Total antioxidant capacity of cerebrospinal fluid is decreased in patients with motor neuron disease.

Oxidative stress has been associated with motor neuron disease (MND). The human body has several antioxidant defense systems to repair the damage caused by oxidative stress. The activity of these systems is thought to be reduced in neurodegenerative diseases, which may increase the level of oxidative damage and be a contributing factor to motor neuron death. In the present study, we compared the total antioxidant capacity (TAC) of human serum and cerebrospinal fluid (CSF) of MND patients with that of a control group including patients with migraine, tension headache and psychiatric disorders. Within-subject serum and CSF TAC were strongly correlated (r=0.639; p=0.000), and CSF TAC was significantly lower in MND patients as compared to controls after adjustment for known influencing factors (112.7 micromol Fe/L+/-11.7 versus 135.2 micromol Fe/L+/-19.7; p=0.012). No differences in serum or CSF TAC were observed among the clinical forms of MND considered in this work. In conclusion, the CSF TAC was strongly correlated with serum TAC, and a decrease in CSF TAC was demonstrated in MND patients compared to controls that was not independent from serum antioxidants, this translating in a systemic (but prevailing in the CNS) oxidative damage in this pathology.

Adolescent↗

Left ipsilesional neglect for visual imagery: a mental image generation impairment?

In this article, we describe a patient, CN, with unilateral left posterior brain damage, who shows a rare occurrence of left ipsilesional neglect limited to mental representations. CN's clinical pattern is consistent with the hypothesis that different mechanisms underlie perceptual and representational neglect. We also discuss an interpretation of representational neglect based on the different involvement of the two hemispheres in visual imagery processes. In particular, left brain lesions do not present the typical strong contralesional bias and may lead to an impairment of mental generation of either side of the image, depending on pre-morbid and methodological factors.

Aged↗

Amyotrophic lateral sclerosis: prognostic indicators of survival.

Amyotrophic lateral sclerosis (ALS) has a fatal outcome in about three years, but survival is known to vary considerably, making it difficult to predict disease duration in individual cases. The aim of this study was to investigate possible early prognostic factors of ALS survival. We included 123 probable or definite cases of ALS, with disease onset between 1989 and 1998, and with a follow-up of at least one year. Survival functions were obtained using both the Kaplan-Meier and the actuarial methods. Subgroups, formed on the basis of gender, area of residence, work, and age at and site of onset, were compared using the logrank test and Cox's proportional hazards method (survival functions), and applying the Grizzle, Starmer, Koch (1969), and Koch, Johnson, Tolley (1972) methods (one-year survival probability trends). The survival curves dipped sharply in the first three years, followed by a flattening trend, with 50% of patients dying within 2.5 years, and 89% over seven years. The clinical form with lower limb onset was associated with longer survival than the upper limb onset and bulbar forms (median survival: 39, 27, and 25 months, respectively). Survival was also affected by age at onset (median survival: 34, 27, and 23 months for onset <60, 60-75, and >75 years, respectively), area of residence (median survival: 24 months in mountainous areas, 32 elsewhere), and type of work (median survival: 25 months in agricultural workers, 33.5 in others). Gender did not influence survival, whereas percutaneous endoscopic gastrostomy placement and invasive ventilation did. The estimation of individual ALS survival is important to allow the patient to plan for his future and to make optimal use of medical and community resources. Although age at and site of onset, area of residence, and agricultural work were found to influence survival, there remains an unexplained heterogeneous progression of the disease, suggesting the influence of other, as yet unknown, prognostic factors. The identification of a definite set of prognostic factors may allow physicians to make more reliable survival predictions at diagnosis.

Adult↗

Humor comprehension and appreciation: an FMRI study.

Humor is a unique ability in human beings. Suls [A two-stage model for the appreciation of jokes and cartoons. In P. E. Goldstein & J. H. McGhee (Eds.), The psychology of humour. Theoretical perspectives and empirical issues. New York: Academic Press, 1972, pp. 81-100] proposed a two-stage model of humor: detection and resolution of incongruity. Incongruity is generated when a prediction is not confirmed in the final part of a story. To comprehend humor, it is necessary to revisit the story, transforming an incongruous situation into a funny, congruous one. Patient and neuroimaging studies carried out until now lead to different outcomes. In particular, patient studies found that right brain-lesion patients have difficulties in humor comprehension, whereas neuroimaging studies suggested a major involvement of the left hemisphere in both humor detection and comprehension. To prevent activation of the left hemisphere due to language processing, we devised a nonverbal task comprising cartoon pairs. Our findings demonstrate activation of both the left and the right hemispheres when comparing funny versus nonfunny cartoons. In particular, we found activation of the right inferior frontal gyrus (BA 47), the left superior temporal gyrus (BA 38), the left middle temporal gyrus (BA 21), and the left cerebellum. These areas were also activated in a nonverbal task exploring attribution of intention [Brunet, E., Sarfati, Y., Hardy-Bayle, M. C., & Decety, J. A PET investigation of the attribution of intentions with a nonverbal task. Neuroimage, 11, 157-166, 2000]. We hypothesize that the resolution of incongruity might occur through a process of intention attribution. We also asked subjects to rate the funniness of each cartoon pair. A parametric analysis showed that the left amygdala was activated in relation to subjective amusement. We hypothesize that the amygdala plays a key role in giving humor an emotional dimension.

Adult↗

Grammatical gender in the brain: evidence from an fMRI study on Italian.

The grammatical gender of a word is a lexical-syntactic property determining agreement among different sentence parts. Recent fMRI investigations identified the areas involved in the retrieval of grammatical gender near the left Broca's area providing further evidence to confirm the preeminent syntactic role of this area. However, these studies employed categorical designs based on the controversial methodology of the cognitive subtraction of neural activations related to different tasks. In the present study we identified the neural substrates of grammatical gender assignment using an fMRI parametric study. Participants decided the grammatical gender of visually presented Italian words whose gender-to-ending regularity varied. The results showed activation in left and right fronto-temporal areas suggesting an interplay of both hemispheres in the processing of grammatical gender.

Adult↗

"Seeing oneself": a case of autoscopy.

Autoscopy is the experience of seeing an image of one's body in external space. We describe the case of a patient who reported longstanding autoscopic hallucinations following post-eclamptic brain damage. The MR scan demonstrated damage involving the occipital cortex and the basal ganglia bilaterally. We hypothesize that the image was the result of aberrant plasticity mechanisms involving cortical areas that play a central role in high-order body or representation of oneself.

Adult↗

Temporal production and visuospatial processing.

Current models of prospective timing hypothesize that estimated duration is influenced either by the attentional load or by the short-term memory requirements of a concurrent nontemporal task. In the present study, we addressed this issue with four dual-task experiments. In Exp. 1, the effect of memory load on both reaction time and temporal production was proportional to the number of items of a visuospatial pattern to hold in memory. In Exps. 2, 3, and 4, a temporal production task was combined with two visual search tasks involving either pre-attentive or attentional processing. Visual tasks interfered with temporal production: produced intervals were lengthened proportionally to the display size. In contrast, reaction times increased with display size only when a serial, effortful search was required. It appears that memory and perceptual set size, rather than nonspecific attentional or short-term memory load, can influence prospective timing.

Adult↗

Impaired fear processing in right mesial temporal sclerosis: a fMRI study.

Lesion and neuroimaging studies have demonstrated that the mesial temporal lobe is crucial for recognizing emotions from facial expressions. In humans, bilateral amygdala damage is followed by impaired recognition of facial expressions of fear. To evaluate the influence of unilateral mesial temporal lobe damage we examined recognition of facial expressions and functional magnetic resonance (fMRI) brain activation associated with incidental processing of fearful faces in thirteen mesial temporal lobe epilepsy (MTLE) patients (eight with right MTLE, five with left MTLE). We also examined the effect of early versus later damage, comparing subjects with hippocampal-amygdalar sclerosis (MTS) and seizures occurring before five years of age to epilepsy patients with late onset seizures. Fourteen healthy volunteers participated as controls. Neuropsychological testing demonstrated that the ability of right MTLE patients to recognize fearful facial expressions is impaired. Patients with early onset of seizures were the most severely impaired. This deficit was associated with defective activation of a neural network involved in the processing of fearful expressions, which in controls and left MTLE included the left inferior frontal cortex and several occipito-temporal structures of both hemispheres.

Adult↗

Telephone-induced seizures: a new type of reflex epilepsy.

PURPOSE: To report a new form of reflex epilepsy in which the seizures are repeatedly and exclusively triggered by answering the telephone. METHODS: Three patients with a history of telephone-induced seizures were studied in detail by means of clinical, EEG, and neuroradiologic investigations. Intensive video-EEG monitoring to record the reflex seizures also was performed in all cases. RESULTS: The patients (two men, one woman, aged 21 to 30 years) had the onset during early adulthood of complex partial and secondarily generalized seizures exclusively triggered by answering the telephone. The seizures were stereotyped, with subjective auditory or vertiginous auras and inability to speak or understand the spoken voices. In one patient, a telephone-induced seizure arising from the dominant temporal lobe was recorded by means of video-EEG technique. In the interictal EEGs, temporal abnormalities were detected in all cases. The patients had a normal neurologic examination and normal magnetic resonance imaging or computed tomography scans. CONCLUSIONS: We suggest that telephone epilepsy is a previously unrecognized form of reflex epilepsy induced by a complex auditory stimulus involving the lateral temporal areas.

Adult↗

Distributed neural systems for temporal production: a functional MRI study.

Using functional magnetic resonance imaging (fMRI), we investigated the neural substrates for computing time intervals. Five right-handed males were asked to judge if a digit probe belonged to a string of digits presented immediately before but to provide their response only after 1.5s had elapsed. This time estimation condition, compared with control working memory and motor tasks, was associated with increased activity in the middle occipital gyri, in the right inferior parietal lobe, and bilaterally in the prefrontal cortex. We argue that activity elicited in the occipital lobe provides duration information about visual stimuli that can be quantified at the level of the inferior parietal lobe. Comparison with time reference information depends on the bilateral prefrontal cortex.

Adult↗

A preliminary study of the cognitive mechanisms supporting time estimation.

Evidence from neuropsychological studies has suggested that verbal and visuospatial abilities might be differentially involved in time perception and that, because there is specialised competence, the two brain hemispheres might play different roles in time-keeping mechanisms. Reported are results of three experiments in which the time estimates of normal adults were tested using a prospective paradigm while they were engaged in concurrent secondary tasks requiring visuospatial or verbal memory and attention. Analysis showed no convincing evidence in support of a differential role of either verbal or visuospatial abilities in time estimation. The greatest disruption in time accuracy was detected when participants performed the time estimation tasks concurrently with secondary working memory tasks. These findings emphasize the importance of the involvement of specific cognitive systems rather than cognitive domains in the processing of temporal information.

Adult↗

Does anticipation of pain affect cortical nociceptive systems?

Anticipation of pain is a complex state that may influence the perception of subsequent noxious stimuli. We used functional magnetic resonance imaging (fMRI) to study changes of activity of cortical nociceptive networks in healthy volunteers while they expected the somatosensory stimulation of one foot, which might be painful (subcutaneous injection of ascorbic acid) or not. Subjects had no previous experience of the noxious stimulus. Mean fMRI signal intensity increased over baseline values during anticipation and during actual stimulation in the putative foot representation area of the contralateral primary somatosensory cortex (SI). Mean fMRI signals decreased during anticipation in other portions of the contralateral and ipsilateral SI, as well as in the anteroventral cingulate cortex. The activity of cortical clusters whose signal time courses showed positive or negative correlations with the individual psychophysical pain intensity curve was also significantly affected during the waiting period. Positively correlated clusters were found in the contralateral SI and bilaterally in the anterior cingulate, anterior insula, and medial prefrontal cortex. Negatively correlated clusters were found in the anteroventral cingulate bilaterally. In all of these areas, changes during anticipation were of the same sign as those observed during pain but less intense ( approximately 30-40% as large as peak changes during actual noxious stimulation). These results provide evidence for top-down mechanisms, triggered by anticipation, modulating cortical systems involved in sensory and affective components of pain even in the absence of actual noxious input and suggest that the activity of cortical nociceptive networks may be directly influenced by cognitive factors.

Adult↗