Aportes neurocientíficos sobre interocepción cardíaca, emociones y redes insulares

El estudio de la Ínsula de Reil, ha cobrado un reciente interés por la que fuera un área cerebral poco mencionada en la neurociencia cognitiva moderna. Sucesivas revisiones de trabajos de campos diversos como estudios clínicos, modelos experimentales, y neuroimágenes, han revelado la participación de la ínsula en múltiples tareas cognitivas, afectivas y perceptuales. Un posible marco teórico integrador de estos variados procesos, es la interocepción o censado del estado homeostático y visceral. El procesamiento insular y su comunicación a áreas homólogas motrices como la corteza cingulada anterior (CCA), desencadenaría y regularía comportamientos que entrañan un contenido afectivo-emocional esencial para el mantenimiento de la consciencia corporal a nivel individual. En este artículo, se analiza evidencia que involucra a la interocepción y al procesamiento insular integrativo en el surgimiento de estados emocionales conscientes haciendo especial énfasis en el papel de los estudios de lesiones y el uso de técnicas de conectividad funcional en resonancia magnética funcional (RMf). Además, se revisa la conceptualización de la interocepción cardíaca, su estudio a través de la evaluación de pacientes con patología cerebral vascular isquémica y patología cardíaca en el marco de los de las interacciones corazón-cerebro, nuevo campo de estudio de las neurociencias.The insula of Reil has recently became an interesting research topic, in despite of its few mention in modern cognitive neuroscience. Several studies in different areas like clinical reports, experimental models and neuroimaging have revealed the role of the insula in cognitive, emotional and visceral perception tasks. In this article, we revise different studies in patients with stroke and cardiac disease regarding cardiac interoception. Particularly, it has been suggested that the insular processing through its connections with the anterior cingulate cortex is required for the representation of the visceral state of the body and critical for the emerging of emotional awareness. Furthermore, evidence from different methodologies such as lesion studies and functional connectivity analysis of magnetic resonance imaging support those hypotheses. We conclude that the understanding of this new field of research in neuroscience, the heart-brain relationships, would highly benefit from the study of insular integration and the arise of conscious emotional states while make emphasis on the convergent use of lesion and functional neuroimaging approaches as a powerful research strategy.Fil: García Cordero, Indira. Instituto de Neurología Cognitiva. Laboratorio de Psicología Experimental y Neurociencia; Argentina. Universidad Favaloro; ArgentinaFil: Couto, Juan Blas Marcos. Instituto de Neurología Cognitiva. Laboratorio de Psicología Experimental y Neurociencia; Argentina. Universidad Favaloro. Facultad de Medicina. Instituto de Neurociencias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ibanez Barassi, Agustín Mariano. Instituto de Neurología Cognitiva. Laboratorio de Psicología Experimental y Neurociencia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Diego Portales; Chil

Interoception and insular cortex:multimodal convergence and the emergence of body awareness

Recent research have suggested that interoception, defined as the sensing of homeostatic and visceral state, is a prerequisite for the emerging of conscious body feelings (Craig, 2009). Parasympathetic and spinothalamic pathways coding such information from the body have their final station in insular cortex neurons. At the same time, several other cognitive functions related to awareness, have been associated with insular activation such as intentionality, decision making, sensory-motor consciousness, time perception, recognition of self´s image, or trust on someone else (Craig, 2009; Ibanez et al., 2010). Lesion studies and functional neuroimaging research is in line with this evidence, suggesting that anterior insular cortex would be engaged in integrate multimodal cognitive, emotional and social information in order to modulate motivational behavior leading to the survival of the individual. In this review, we analyze last research works on interoception and integrative insular processing through lesion studies and functional connectivity in functional magnetic resonance imaging (FC-fMRI).Fil: Couto, Juan Blas Marcos. Universidad Favaloro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Sedeño, Lucas. Universidad Favaloro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ibañez, Agustin Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Favaloro; Argentina. Universidad Diego Portales; Chil

Interoception and insular cortex:multimodal convergence and the emergence of body awareness

Recent research have suggested that interoception, defined as the sensing of homeostatic and visceral state, is a prerequisite for the emerging of conscious body feelings (Craig, 2009). Parasympathetic and spinothalamic pathways coding such information from the body have their final station in insular cortex neurons. At the same time, several other cognitive functions related to awareness, have been associated with insular activation such as intentionality, decision making, sensory-motor consciousness, time perception, recognition of self´s image, or trust on someone else (Craig, 2009; Ibanez et al., 2010). Lesion studies and functional neuroimaging research is in line with this evidence, suggesting that anterior insular cortex would be engaged in integrate multimodal cognitive, emotional and social information in order to modulate motivational behavior leading to the survival of the individual. In this review, we analyze last research works on interoception and integrative insular processing through lesion studies and functional connectivity in functional magnetic resonance imaging (FC-fMRI).Fil: Couto, Juan Blas Marcos. Universidad Favaloro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Sedeño, Lucas. Universidad Favaloro; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ibañez, Agustin Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Favaloro; Argentina. Universidad Diego Portales; Chil

Detaching from the negative by reappraisal: the role of right superior frontal gyrus (BA9/32)

The ability to reappraise the emotional impact of events is related to long-term mental health. Self-focused reappraisal (REAPPself), i.e., reducing the personal relevance of the negative events, has been previously associated with neural activity in regions near right medial prefrontal cortex, but rarely investigated among brain-damaged individuals. Thus, we aimed to examine the REAPPself ability of brain-damaged patients and healthy controls considering structural atrophies and gray matter intensities, respectively. Twenty patients with well-defined cortex lesions due to an acquired circumscribed tumor or cyst and 23 healthy controls performed a REAPPself task, in which they had to either observe negative stimuli or decrease emotional responding by REAPPself. Next, they rated the impact of negative arousal and valence. REAPPself ability scores were calculated by subtracting the negative picture ratings after applying REAPPself from the ratings of the observing condition. The scores of the patients were included in a voxel-based lesion-symptom mapping (VLSM) analysis to identify deficit related areas (ROI). Then, a ROI group-wise comparison was performed. Additionally, a whole-brain voxel-based-morphometry (VBM) analysis was run, in which healthy participant's REAPPself ability scores were correlated with gray matter intensities. Results showed that (1) regions in the right superior frontal gyrus (SFG), comprising the right dorsolateral prefrontal cortex (BA9) and the right dorsal anterior cingulate cortex (BA32), were associated with patient's impaired down-regulation of arousal, (2) a lesion in the depicted ROI occasioned significant REAPPself impairments, (3) REAPPself ability of controls was linked with increased gray matter intensities in the ROI regions. Our findings show for the first time that the neural integrity and the structural volume of right SFG regions (BA9/32) might be indispensable for REAPPself. Implications for neurofeedback research are discussed.Fil: Falquez, Rosalux. University of Heidelberg; AlemaniaFil: Couto, Juan Blas Marcos. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Ibáñez Barassi, Agustín Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Freitag, Martin T.. German Cancer Research Center; AlemaniaFil: Berger, Moritz. German Cancer Research Center; AlemaniaFil: Arens, Elisabeth A.. University of Heidelberg; AlemaniaFil: Lang, Simone. University of Heidelberg; AlemaniaFil: Barnow, Sven. University of Heidelberg; Alemani

Preliminary evidence about the effects of meditation on interoceptive sensitivity and social cognition

Background: Interoception refers to the conscious perception of body signals. Mindfulness is a meditation practice that encourages individuals to focus on their internal experiences such as bodily sensations, thoughts, and emotions. In this study, we selected a behavioral measure of interoceptive sensitivity (heartbeat detection task, HBD) to compare the effect of meditation practice on interoceptive sensitivity among long term practitioners (LTP), short term meditators (STM, subjects that completed a Mindfulness-Based Stress Reduction (MBSR) program) and controls (non-meditators). All participants were examined with a battery of different tasks including mood state, executive function and social cognition tests (emotion recognition, empathy and theory of mind). Findings: Compared to controls, both meditators’ groups showed lower levels of anxiety and depression, but no improvement in executive function or social cognition performance was observed (except for lower scores compared to controls only in the personal distress dimension of empathy). More importantly, meditators’ performance did not differ from that of nonmeditators regarding cardiac interoceptive sensitivity. Conclusion: Results suggest no influence of meditation practice in cardiac interoception and in most related social cognition measures. These negative results could be partially due to the fact that awareness of heartbeat sensations is not emphasized during mindfulness/vipassana meditation and may not be the best index of the awareness supported by the practice of meditation.Fil: Melloni, Margherita. Instituto de Neurologia Cognitiva. Laboratorio de Psicologia Experimental y Neurociencia; Argentina. Universidad Favaloro. Facultad de Medicina. Instituto de Neurociencias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Sedeño, Lucas. Instituto de Neurologia Cognitiva. Laboratorio de Psicologia Experimental y Neurociencia; Argentina. Universidad Favaloro. Facultad de Medicina. Instituto de Neurociencias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Couto, Juan Blas Marcos. Instituto de Neurologia Cognitiva. Laboratorio de Psicologia Experimental y Neurociencia; Argentina. Universidad Favaloro. Facultad de Medicina. Instituto de Neurociencias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Reynoso, Martín. Universidad Favaloro. Facultad de Medicina. Instituto de Neurociencias; Argentina. Instituto de Neurologia Cognitiva. Laboratorio de Psicologia Experimental y Neurociencia; ArgentinaFil: Gelormini Lezama, Carlos. Instituto de Neurologia Cognitiva. Laboratorio de Psicologia Experimental y Neurociencia; Argentina. Universidad Favaloro. Facultad de Medicina. Instituto de Neurociencias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Favaloro, Roberto. Universidad Favaloro. Facultad de Medicina. Instituto de Neurociencias; Argentina. Instituto de Neurologia Cognitiva. Laboratorio de Psicologia Experimental y Neurociencia; ArgentinaFil: Canales Johnson, Andres. Universidad Diego Portales; ChileFil: Sigman, Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Física de Buenos Aires; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física. Laboratorio de Neurociencia Integrativa; Argentina. Universidad Torcuato Di Tella; ArgentinaFil: Manes, Facundo Francisco. Instituto de Neurologia Cognitiva. Laboratorio de Psicologia Experimental y Neurociencia; Argentina. Universidad Favaloro. Facultad de Medicina. Instituto de Neurociencias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ibanez Barassi, Agustin Mariano. Universidad Favaloro. Facultad de Medicina. Instituto de Neurociencias; Argentina. Instituto de Neurologia Cognitiva. Laboratorio de Psicologia Experimental y Neurociencia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Tracking the cognitive, social, and neuroanatomical profile in early neurodegeneration: Type III Cockayne syndrome

Cockayne syndrome (CS) is an autosomal recessive disease associated with premature aging, progressive multiorgan degeneration, and nervous system abnormalities including cerebral and cerebellar atrophy, brain calcifications, and white matter abnormalities. Although several clinical descriptions of CS patients have reported developmental delay and cognitive impairment with relative preservation of social skills, no previous studies have carried out a comprehensive neuropsychological and social cognition assessment. Furthermore, no previous research in individuals with CS has examined the relationship between brain atrophy and performance on neuropsychological and social cognition tests. This study describes the case of an atypical late-onset type III CS patient who exceeds the mean life expectancy of individuals with this pathology. The patient and a group of healthy controls underwent a comprehensive assessment that included multiple neuropsychological and social cognition (emotion recognition, theory of mind, and empathy) tasks. In addition, we compared the pattern of atrophy in the patient to controls and to its concordance with ERCC8 gene expression in a healthy brain. The results showed memory, language, and executive deficits that contrast with the relative preservation of social cognition skills. The cognitive profile of the patient was consistent with his pattern of global cerebral and cerebellar loss of gray matter volume (frontal structures, bilateral cerebellum, basal ganglia, temporal lobe, and occipito-temporal/occipito-parietal regions), which in turn was anatomically consistent with the ERCC8 gene expression level in a healthy donor's brain. The study of exceptional cases, such as the one described here, is fundamental to elucidating the processes that affect the brain in premature aging diseases, and such studies provide an important source of information for understanding the problems associated with normal and pathological aging.Fil: Báez Buitrago, Sandra Jimena. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Diego Portales; Chile. Pontificia Universidad Católica Argentina "Santa María de los Buenos Aires"; Argentina. Universidad Favaloro; Argentina. Instituto de Neurología Cognitiva; ArgentinaFil: Couto, Juan Blas Marcos. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Favaloro; Argentina. Instituto de Neurología Cognitiva; ArgentinaFil: Herrera, Eduar. Universidad Autónoma del Caribe; ColombiaFil: Bocanegra, Yamile. Universidad de Antioquia; Colombia. Universidad de San Buenaventura; ColombiaFil: Trujillo Orrego, Natalia. Universidad de Antioquia; ColombiaFil: Madriga Zapata, Lucia. Universidad de Antioquia; ColombiaFil: Cardona Londoño, Juan Felipe. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Favaloro; Argentina. Instituto de Neurología Cognitiva; ArgentinaFil: Manes, Facundo Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Australian Government, Australian Research Council; Australia. Universidad Diego Portales; Chile. Universidad Favaloro; Argentina. Instituto de Neurología Cognitiva; ArgentinaFil: Ibáñez Barassi, Agustín Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Diego Portales; Chile. Universidad Favaloro; Argentina. Instituto de Neurología Cognitiva; ArgentinaFil: Villegas, Andres. Universidad de Antioquia; Colombi

Structural neuroimaging of social cognition in progressive non-fluent aphasia and behavioral variant of frontotemporal dementia

Social cognition impairments are pervasive in the frontotemporal dementias (FTD). These deficits would be triggered by (a) basic emotion and face recognition processes as well as by (b) higher level social cognition (e.g., theory of mind, ToM). Both emotional processing and social cognition impairments have been previously reported in the behavioral variant of FTD (bvFTD) and also in other versions of FTDs, including primary progressive aphasia. However, no neuroanatomic comparison between different FTD variants has been performed. We report selective behavioral impairments of face recognition, emotion recognition, and ToM in patients with bvFTD and progressive non-fluent aphasia (PNFA) when compared to controls. Voxel-based morphometry (VBM) shows a classical impairment of mainly orbitofrontal (OFC), anterior cingulate (ACC), insula and lateral temporal cortices in patients. Comparative analysis of regional gray matter related to social cognition deficits (VBM) reveals a differential pattern of fronto-insulo-temporal atrophy in bvFTD and an insulo-temporal involvement in PNFA group. Results suggest that in spite of similar social cognition impairments reported in bvFTD and PNFA, the former represents an inherent ToM affectation whereas in the PNFA these deficits could be related to more basic processes of face and emotion recognition. These results are interpreted in the frame of the fronto-insulo-temporal social context network model (SCNM).Fil: Couto, Juan Blas Marcos. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Favaloro; ArgentinaFil: Manes, Facundo Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Favaloro; ArgentinaFil: Montañés, Patricia. Pontificia Universidad Javeriana; ColombiaFil: Matallana, Diana. Pontificia Universidad Javeriana; ColombiaFil: Reyes, Pablo. Pontificia Universidad Javeriana; ColombiaFil: Velasquez, Marcela. Universidad Favaloro; ArgentinaFil: Yoris Magnago, Adrián Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Favaloro; ArgentinaFil: Báez Buitrago, Sandra Jimena. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Favaloro; ArgentinaFil: Ibáñez Barassi, Agustín Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Favaloro; Argentina. Universidad Diego Portales; Chil

The man who feels two hearts: the different pathways of interoception

Recent advances in neuroscience have provided new insights into the understanding of heart–brain interaction and communication. Cardiac information to the brain relies on two pathways, terminating in the insular cortex (IC) and anterior cingulate cortex (ACC), along with the somatosensory cortex (S1-S2). Interoception relying on these neuroanatomical pathways has been shown to modulate social cognition. We report the case study of C.S., a patient with an external heart (an extracorporeal left-univentricular cardiac assist device, LVAD). The patient was assessed with neural/behavioral measures of cardiac interoception complemented by neuropsychological and social cognition measures. The patients performance on the interoception task (heartbeat detection) seemed to be guided by signals from the artificial LVAD, which provides a somatosensory beat rather than by his endogenous heart. Cortical activity (HEP, heartbeat-evoked potential) was found decreased in comparison with normal volunteers, particularly during interoceptive states. The patient accurately performed several cognitive tasks, except for interoception-related social cognition domains (empathy, theory of mind and decision making). This evidence suggests an imbalance in the patients cardiac interoceptive pathways that enhances sensation driven by the artificial pump over that from the cardiac vagal-IC/ACC pathway. A patient with two hearts, one endogenous and one artificial, presents a unique opportunity to explore models of interoception and heart–brain interaction.Fil: Couto, Juan Blas Marcos. Instituto de Neurología Cognitiva; Argentina. Universidad Favaloro. Facultad de Medicina. Instituto de Neurociencias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Salles, Alejo. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física. Laboratorio de Neurociencia Integrativa; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Sedeño, Lucas. Instituto de Neurología Cognitiva; Argentina. Universidad Favaloro. Facultad de Medicina. Instituto de Neurociencias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Peradejordi Lastras, Margarita Ana. Universidad Favaloro; ArgentinaFil: Barttfeld, Pablo. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física. Laboratorio de Neurociencia Integrativa; ArgentinaFil: Canales Johnson, Andres. Universidad Diego Portales; ChileFil: Vidal Dos Santos, Hector Yamil. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física. Laboratorio de Neurociencia Integrativa; ArgentinaFil: Huepe, David. Universidad Diego Portales; ChileFil: Bekinschtein, Tristán Andrés. Instituto de Neurología Cognitiva; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Sigman, Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Física de Buenos Aires; Argentina. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física. Laboratorio de Neurociencia Integrativa; Argentina. Universidad Torcuato Di Tella; ArgentinaFil: Favaloro, Roberto. Universidad Favaloro; ArgentinaFil: Manes, Facundo Francisco. Instituto de Neurología Cognitiva; Argentina. Universidad Favaloro. Facultad de Medicina. Instituto de Neurociencias; ArgentinaFil: Ibañez, Agustin Mariano. Instituto de Neurología Cognitiva; Argentina. Universidad Favaloro. Facultad de Medicina. Instituto de Neurociencias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Brain structural correlates of executive and social cognition profiles in behavioral variant frontotemporal dementia and elderly bipolar disorder

An early stage of behavioral variant frontotemporal dementia (bvFTD) often displays a mix of behavioral disturbances and personality changes hindering a differential diagnosis from elderly bipolar disorder (BD), making this process a big challenge. However, no studies have compared these pathologies from neuropsychological and neuroanatomical perspectives. The aim of the present study was to compare the executive functions (EF) and social cognition profiles as well as the structural neuroimaging of bvFTD and elderly patients with BD. First, we compared the executive and social cognition performances of 16 bvFTD patients, 13 BD patients and 22 healthy controls. Second, we compared grey matter volumes in both groups of patients and controls using voxel-based morphometry. Lastly, we examined the brain regions where atrophy might be associated with specific impairments in bvFTD and BD patients. Compared to controls, bvFTD patients showed deficits in working memory, abstraction capacity, inhibitory control, cognitive flexibility, verbal fluency and theory of mind (ToM). Patients with BD showed lower performance than controls in terms of abstraction capacity and verbal inhibitory control. In bvFTD patients, atrophy of frontal, temporal and insular cortices was related to EF deficits. Atrophy of the amygdala, the hippocampus, the parahippocampal gyrus, the putamen, the insula, the precuneus, the right temporo-parietal junction and superior temporal pole was associated to ToM impairments. No significant associations between atrophy and EF performance were observed in BD patients. BvFTD patients showed greater EF and ToM deficits than BD patients. Moreover, compared to BD, bvFTD patients exhibited a significant decrease in GM volume in frontal, temporal and parietal regions. Our results provide the first comparison of EF, social cognition and neuroanatomical profiles of bvFTD and elderly BD patients. These findings shed light on differential diagnosis of these disorders and may have important clinical implications.Fil: Báez Buitrago, Sandra Jimena. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentina. Universidad de los Andes; ColombiaFil: Pinasco, Clara. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Roca, María. Universidad de los Andes; Colombia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Ferrari, Jesica. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Couto, Juan Blas Marcos. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: García Cordero, Indira Ruth. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Ibáñez Barassi, Agustín Mariano. Universidad de los Andes; Colombia. Universidad Adolfo Ibañez; Chile. Universidad Autónoma del Caribe; Colombia. Australian Research Council; Australia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Cruz, Francy. Pontificia Universidad Javeriana; ColombiaFil: Reyes, Pablo. Pontificia Universidad Javeriana; Colombia. Hospital Universitario San Ignacio; ColombiaFil: Matallana, Diana. Pontificia Universidad Javeriana; ColombiaFil: Manes, Facundo Francisco. Australian Research Council; Australia. Universidad de los Andes; Colombia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Cetcovich, Marcelo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Torralva, Teresa. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; Argentin

A lesion-proof brain? Multidimensional sensorimotor, cognitive, and socio-affective preservation despite extensive damage in a stroke patient

In this study, we report an unusual case of mutidimensional sensorimotor, cognitive, and socio-affective preservation in an adult with extensive, acquired bilateral brain damage. At age 43, patient CG sustained a cerebral hemorrhage and a few months later, she suffered a second (ischemic) stroke. As a result, she exhibited extensive damage of the right hemisphere (including frontal, temporal, parietal, and occipital regions), left Sylvian and striatal areas, bilateral portions of the insula and the amygdala, and the splenium. However, against all probability, she was unimpaired across a host of cognitive domains, including executive functions, attention, memory, language, sensory perception (e.g., taste recognition and intensity discrimination), emotional processing (e.g., experiencing of positive and negative emotions), and social cognition skills (prosody recognition, theory of mind, facial emotion recognition, and emotional evaluation). Her functional integrity was further confirmed through neurological examination and contextualized observation of her performance in real-life tasks. In sum, CG's case resists straightforward classifications, as the extent and distribution of her lesions would typically produce pervasive, multidimensional deficits. We discuss the rarity of this patient against the backdrop of other reports of atypical cognitive preservation, expound the limitations of several potential accounts, and highlight the challenges that the case poses for current theories of brain organization and resilience.Fil: García, Adolfo Martín. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Favaloro; Argentina. Instituto de Neurología Cognitiva; Argentina. Universidad Nacional de Cuyo; ArgentinaFil: Sedeño, Lucas. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Favaloro; Argentina. Instituto de Neurología Cognitiva; ArgentinaFil: Herrera Murcia, Eduar. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Icesi; ColombiaFil: Couto, Juan Blas Marcos. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Favaloro; Argentina. Instituto de Neurología Cognitiva; ArgentinaFil: Ibáñez Barassi, Agustín Mariano. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Favaloro; Argentina. Instituto de Neurología Cognitiva; Argentina. Universidad Autónoma del Caribe; Colombia. Universidad Adolfo Ibañez; Chile. Australian Research Council; Australi