| Name | Luigi |
| Surname | Trojano |
| Institution | Università degli Studi della Campania Luigi Vanvitelli |
| luigi.trojano@unicampania.it | |
| Address | Department of Psychology, University of Campania 'Luigi Vanvitelli', Viale Ellittico 31, 81100 Caserta, Italy |
The tendency to reproduce figures close to or superimposed on the model in copying tasks, the so-called Closing-in (CI) phenomenon, has been rarely reported in individuals affected by Parkinson's disease and associated dementia (PD-D). We aimed to comprehend the genesis of CI in PD-D individuals by assessing whether reduction of attention/executive resources can increase the tendency to deviate toward the model.
Environmental dependency (ED) phenomena, including utilization behavior and imitation behavior, are clinical manifestations typically observed in patients with the behavioral variant of fronto-temporal dementia (bvFTD), who may also show the closing-in (CI) phenomenon. Here, we explored the neuropsychological correlates of ED and CI in bvFTD, and the association of ED with CI to clarify the mechanisms underlying these clinical manifestations. Thirty-one bvFTD patients underwent a wide cognitive assessment in addition to special tasks to detect occurrence of CI and ED phenomena. Both ED and CI phenomena were present in more than half of the sample. Logistic regression analyses revealed that both ED and CI phenomena were significantly associated with poor scores on frontal neuropsychological tests. Although ED and CI often co-occurred, 3/12 patients with CI did not show ED, and 5/18 patients with ED did not show CI. A logistic regression model showed that the presence of ED was not significantly associated to CI. CI and ED are associated to progressive derangement of frontal functions in bvFTD. However, specific frontal dysfunctions might explain the occurrence of either phenomenon in isolation.
Apathy and depression are behavioral manifestations that may occur often in Alzheimer's disease (AD) patients. AD patients may also show Closing-in (CI) phenomenon, in graphic copying tasks. Recent evidence would suggest that apathetic symptoms are related to frontal dysfunctions in AD patients, whereas the cognitive bases of depressive symptoms in AD are still unclear. Recent studies demonstrated that frontal dysfunctions are also involved in the genesis of CI in AD patients.
Apathy is defined as lack of motivation affecting cognitive, emotional, and behavioral domains and is usually assessed by standardized scales, such as the Apathy Evaluation Scale (AES). Recently, apathy has been recognized as a frequent behavioral symptom in multiple sclerosis (MS).
Apathy is a behavioural disturbance occurring alone or in concomitance with depression in Parkinson's disease (PD). Here we present a validation study for the self-report version of the Apathy Evaluation Scale (AES-S), carried out in a sample of 60 non-demented, non-depressed untreated, drug-naïve, de novo PD patients; 20 patients of the sample (33.3%) were classified as apathetic according to current clinical criteria. All enrolled patients completed the AES-S and a neurological and cognitive assessment. Mean AES-S score was 34.43. AES-S did not show floor or ceiling effect. Cronbach's alpha was 0.872. Principal component analysis revealed three factors: the first (34.4% of the variance) represented constitutive aspects of the construct of apathy; the second (8.5% of the variance) represented a social dimension; the third factor (7.9% of the variance) represented a dimension related to insight. With respect to clinical criteria for apathy considered as the gold standard, receiver operating characteristics curve analysis showed that a cut-off of 36/37 has the maximum discrimination power. High sensitivity and negative predictive values were obtained with cut-off scores of 33/34 or lower; high specificity and positive predictive values were obtained with cut-off scores of 38/39 or higher. AES-S score correlated with scores on frontal tasks, but not on Beck Depression Inventory, Unified Parkinson's Disease Rating Scale, Hoehn and Yahr scale. The AES-S is a reliable and valid questionnaire for detecting apathy in PD. For screening purposes a 33/34 cut-off score is indicated, but a 38/39 cut-off score is necessary when a high specificity is desired.
Ongoing signals from one's own body (interoception) allow experience of self-feeling. In early studies interoception strictly referred to the awareness of visceral sensation but recent theories have expanded this concept to denote the ongoing status of the body. Here we asked left and right focal brain-damaged patients to answer questions about their interoceptive feelings, and correlated their responses to a quantitative measure of their lesions (voxel-based symptom-lesion mapping). By these means we could reveal that three key structures contribute to building up the feeling of self, namely insula (interoceptive modulator), amygdala (emotional modulator) and putamen (motor modulator). This brain network may be necessary for the integrity of self-feeling. A dysfunction of this network might impair perception of the inner body state, and also account for psychological disturbances, such as the somatic symptom disorders, in which individuals experience subjective symptoms suggesting physical illness or injury despite medical test results which are normal, and clinical examination do not disclose relevant medical conditions.
Attentional biases toward threats (ABTs) have been described in high anxious individuals and in clinical samples whereas they have been rarely reported in non-clinical samples (Bar-Haim et al., 2007; Cisler and Koster, 2010). Three kinds of ABTs have been identified (facilitation, difficulty of disengagement, and avoidance) but their mechanisms and time courses are still unclear. This study aimed to understand ABTs mechanisms and timing in low trait anxiety (LTA) and high trait anxiety (HTA) anxious individuals. In particular, in an exogenous cueing task we used threatening or neutral stimuli as peripheral cues with three presentation times (100, 200, or 500 ms). The main results showed that HTA individuals have an attentional facilitation bias at 100 ms (likely automatic in nature) whereas LTA individuals show attentional avoidance and difficulty to disengage from threatening stimuli at 200 ms (likely related to a strategic processing). Such findings demonstrate that threat biases attention with specific mechanisms and time courses, and that anxiety levels modulate attention allocation.
To study psychological distress in a sample of caregivers of patients affected by prolonged disorders of consciousness during hospital stay in the Neurorehabilitation Unit.
Progressive prosopagnosia (PP) is a clinical syndrome characterized by a progressive and selective inability to recognize and identify faces of familiar people. Here we report a patient (G.S.) with PP, mainly related to a prominent deficit in recognition of familiar faces, without a semantic (cross-modal) impairment. An in-depth evaluation showed that his deficit extended to other classes of objects, both living and non-living. A follow-up neuropsychological assessment did not reveal substantial changes after about 1 year. Structural MRI showed predominant right temporal lobe atrophy. Diffusion tensor imaging was performed to elucidate structural connectivity of the inferior longitudinal fasciculus (ILF) and the inferior fronto-occipital fasciculus (IFOF), the two major tracts that project through the core fusiform region to the anterior temporal and frontal cortices, respectively. Right ILF was markedly reduced in G.S., while left ILF and IFOFs were apparently preserved. These data are in favour of a crucial role of the neural circuit subserved by right ILF in the pathogenesis of PP.
To report clinical conditions and neuropsychological functioning of patients with late recovery of responsiveness at least 5 years after injury.