Disturbi cognitivi nell'epilessia del lobo temporale in età evolutiva

Objectives. To describe the impact of childhood temporal lobe epilepsy (TLE) on cognitive functions. Material and methods. Nine patients with TLE aged 11-17 years and 18 healty controls were investigated with a comprehensive neuropsychological assessment. Results. The performance of children with TLE was significantly worse across language, verbal short term memory and semantic tests, compared with the controls. Verbal and non-verbal recall was also impaired. A supplementary investigation of recognition memory showed a selective impairment in topographical memory. Conclusions. In our patients, the episodic memory impairment is similar, although less severe, to that reported in developmental hippocampal amnesia. Nevertheless, in our patients there are also impairments in semantic memory and more general language disorders. These data suggest that in TLE patients there is a more general dysfunction of the medial temporal left functions

Benign nocturnal alternating hemiplegia of childhood: a new case with unusual findings

It has been described a neuro developmental disorder labelled “Benign nocturnal alternating hemiplegia of childhood” (BNAHC) characterized by recurrent attacks of nocturnal hemiplegia without progression to neurological or intellectual impairment. We report a female patient who at 11 months revealed a motionless left arm, unusual crying without impairment of consciousness and obvious precipitating factors. The attacks occur during sleep in the early morning with lack of ictal and interictal electroencephalographic abnormalities, progressive neurological deficit, and cognitive impairment. Unlike previous reports of BNAHC our patient come from a family with a history of both migraine, hemiplegic migraine, and sleep disorders. Our study remarks on the typical features described in previous studies and stresses the uncommon aspects that could help to identify the disorder which is likely to have been underestimated. Despite some clinical similarities between BNAHC and familiar hemiplegic migraine and alternating hemiplegia of childhood, the genetic analyses of our patient did not reveal genetic mutations found in both disorders

Reduction of drive for thinness and body dissatisfaction in people with self-reported dysregulated eating behaviors after intermittent theta burst stimulation (iTBS) of the left dorsolateral prefrontal cortex

Aim: This study aimed to explore the effect of intermittent theta burst stimulation (iTBS) of the right and left dorsolateral prefrontal cortex (DLPFC) in people with self-reported dysregulated eating behaviors but without a diagnosis of eating disorders (EDs). Methods: Participants were randomly divided into two equivalent groups according to the side (right or left) of the hemisphere to be stimulated and they were tested before and after a single iTBS session. Outcome measurements were scores on self-report questionnaires assessing psychological dimensions related to eating behaviors (EDI-3), anxiety (STAI-Y), and tonic electrodermal activity. Results: The iTBS interfered with both psychological and neurophysiological measures. Significant variations of physiological arousal after iTBS of both the right and left DLPFC were witnessed by increased mean amplitude of non-specific skin conductance responses. With regard to the psychological measures, the iTBS on the left DLPFC significantly reduced the scores of the EDI-3 subscales drive for thinness and body dissatisfaction. Interestingly, these two scales are two of the three EDI-3 clinic scales (drive for thinness, body dissatisfaction, and bulimia) used as specific markers to assess the onset and/or maintenance of eating disorders. Conclusion: Our results show that the left DLPFC iTBS has an impact on the psychological dimensions that are risk factors for the onset of eating disorders, suggesting that an altered hemispheric asymmetry similar to that encountered in clinical populations is present in normal subjects even in the absence of clinical symptoms

Transcranial Magnetic Stimulation Trains at 1 Hz Frequency of the Right Posterior Parietal Cortex Facilitate Recognition Memory

Neuroimaging, neuropsychological, and brain stimulation studies have led to contrasting findings regarding the potential roles of the lateral parietal lobe in episodic memory. Studies using brain stimulation methods reported in the literature do not offer unequivocal findings on the interactions with stimulation location (left vs. right hemisphere) or timing of the stimulation (encoding vs. retrieval). To address these issues, active and sham 1 Hz repetitive transcranial magnetic stimulation (rTMS) trains of 600 stimuli were applied over the right or left posterior parietal cortex (PPC) before the encoding or before the retrieval phase of a recognition memory task of unknown faces in a group of 40 healthy subjects. Active rTMS over the right but not the left PPC significantly improved non-verbal recognition memory performance without any significant modulation of speed of response when applied before the retrieval phase. In contrast, rTMS over the right or the left PPC before the encoding phase did not modulate memory performance. Our results support the hypothesis that the PPC plays a role in episodic memory retrieval that appears to be dependent on both the hemispheric lateralization and the timing of the stimulation (encoding vs. retrieval)

Modulating memory performance in healthy subjects with Trancranial Direct Current Stimulation over the right dorsolateral prefrontal cortex

Objective The role of the Dorsolateral Prefrontal Cortex (DLPFC) in recognition memory has been well documented in lesion, neuroimaging and repetitive Transcranial Magnetic Stimulation (rTMS) studies. The aim of the present study was to investigate the effects of transcranial Direct Current Stimulation (tDCS) over the left and the right DLPFC during the delay interval of a non-verbal recognition memory task. Method 36 right-handed young healthy subjects participated in the study. The experimental task was an Italian version of Recognition Memory Test for unknown faces. Study included two experiments: in a first experiment, each subject underwent one session of sham tDCS and one session of left or right cathodal tDCS; in a second experiment each subject underwent one session of sham tDCS and one session of left or right anodal tDCS. Results Cathodal tDCS over the right DLPFC significantly improved non verbal recognition memory performance, while cathodal tDCS over the left DLPFC had no effect. Anodal tDCS of both the left and right DLPFC did not modify non verbal recognition memory performance. Conclusion Complementing the majority of previous studies, reporting long term memory facilitations following left prefrontal anodal tDCS, the present findings show that cathodal tDCS of the right DLPFC can also improve recognition memory in healthy subjects

Impairments in top down attentional processes in right parietal patients: Paradoxical functional facilitation in visual search

AbstractIt is well known that the right posterior parietal cortex (PPC) is involved in attentional processes, including binding features. It remains unclear whether PPC is implicated in top-down and/or bottom-up components of attention. We aim to clarify this by comparing performance of seven PPC patients and healthy controls (HC) in a visual search task involving a conflict between top-down and bottom-up processes. This task requires essentially a bottom-up feature search. However, top-down attention triggers feature binding for object recognition, designed to be irrelevant but interfering to the task. This results in top-down interference, prolonging the search reaction time. This interference was indeed found in our HCs but not in our PPC patients. In contrast to HC, the PPC patients showed no evidence of prolonged reactions times, even though they were slower than the HCs in search tasks without the conflict. This finding is an example of paradoxical functional facilitation (PFF) by brain damage. The PFF effect enhanced our patients’ performance by reducing the top down interference. Our finding supports the idea that right PPC plays a crucial role in top-down attentional processes. In our search tasks, right PPC induces top-down interference either by directing spatial attention to achieve viewpoint invariance in shape recognition or by feature binding

Boosting Phonological Fluency Following Leftward Prismatic Adaptation: A New Neuromodulation Protocol for Neurological Deficits?

Prism adaptation (PA) has been recently shown to modulate a brain frontal-parieto-temporal network, with an increase of excitation of this network in the hemisphere ipsilateral to the side of prismatic deviation. This effect raises the hypothesis that left prismatic adaptation, modulating the excitability of frontal areas of the left hemisphere could modulate subjects’ performance on linguistic tasks that map on those areas. To test this hypothesis, sixty-one healthy subjects participated in experiments in which leftward, rightward or no-PA were applied before the execution of a phonological fluency task, i.e. a task with the strict left hemispheric lateralization and mapping onto frontal areas. Leftward-PA significantly increased the number of words produced compared with the pre-PA (p = .0017), R-PA (p=.00013) and no-PA (p=.0005) sessions. In contrast, rightward-PA did not significantly modulate phonological fluency compared with the pre-PA (p = .92) and no-PA (p = .99) sessions. The effect of leftward PA on phonological fluency correlated with the magnitude of spatial aftereffect, i.e. the spatial bias towards the side of space opposite to prismatic deviation following prisms removal (r = .51; p = .04). The present findings document for the first time modulation of a language ability following prismatic adaptation. The results could have a huge clinical impact on neurological populations, opening new strategies of intervention for language and executive dysfunctions

Improvement of phonemic fluency following leftward prism adaptation

Anatomo functional studies of prism adaptation (PA) have been shown to modulate a brain frontal-parieto-temporal network, increasing activation of this network in the hemisphere ipsilateral to the side of prism deviation. This effect raises the hypothesis that left prism adaptation, modulating frontal areas of the left hemisphere, could modify subjects' performance on linguistic tasks that map on those areas. To test this hypothesis, 51 healthy subjects participated in experiments in which leftward or rightward prism adaptation were applied before the execution of a phonemic fluency task, i.e., a task with strict left hemispheric lateralization onto frontal areas. Results showed that leftward PA significantly increased the number of words produced whereas rightward PA did not significantly modulate phonemic fluency. The present findings document modulation of a language ability following prism adaptation. The results could have a huge clinical impact in neurological populations, opening new strategies of intervention for language and executive dysfunctions