The Effect of Partially Exposed Connective Tissue Graft on Root‐Coverage Outcomes: A Systematic Review and Meta‐Analysis

The aim of this systematic review was to compare the root‐coverage outcomes of using a partially exposed connective tissue graft (CTG) technique with a fully covered CTG technique for root coverage. An electronic search up to February 28th, 2017, was performed to identify human clinical studies with data comparing outcomes of root coverage using CTG, with and without a partially exposed graft. Five clinical studies were selected for inclusion in this review. For each study, the gain of keratinized gingiva, reduction of recession depth, number of surgical sites achieving complete root coverage, percentage of root coverage, gain of tissue thickness, and changes of probing depth and clinical attachment level were recorded. Meta‐analysis for the comparison of complete root coverage between the two techniques presented no statistically significant differences. A statistically significant gain of keratinized tissue in favor of the sites with an exposed CTG and a tendency of greater reduction in recession depth were seen at the sites with a fully covered CTG. Based on the results, the use of a partially exposed CTG in root‐coverage procedures could achieve greater gain in keratinized gingiva, while a fully covered CTG might be indicated for procedures aiming to reduce recession depth

Implicit body representations and the conscious body image

Recent studies have revealed that somatosensory processing relies on a class of implicit body representations showing large distortions of size and shape. The relation between these representations and the conscious body image remains unclear. Dissociations have been reported in the clinical literature on eating disorders between different body image measures, with larger and more consistent distortions found with depictive measures, in which participants compare their body to a visual depiction of a body, than metric measures, in which participants compare their body to some non-body standard. Here, we compared implicit body representations underlying position sense to the body image measured with both depictive and metric methods. The body image was measured using both a depictive method (template matching) in which participants judged whether their hand was wider or more slender than a shown hand picture, and a metric method (line length) in which participants judged whether different parts of the their hand were shorter or longer than a presented line. Consistent with previous findings, characteristic distortions were found for the implicit body representation underlying position sense. These distortions were also found in attenuated form for metric – but not depictive – body image measures. While replicating the basic dissociation between implicit body representations and the conscious body image, these results demonstrate that this dissociation is not absolute and specific tasks may utilise both to varying degrees depending on task demands. Metric measures may not be pure measures of body image, but some combination of visual and somatosensory body representations

Inter-hemispheric integration of tactile-motor responses across body parts

In simple detection tasks, reaction times are faster when stimuli are presented to the visual field or side of the body ipsilateral to the body part used to respond. This advantage, the crossed-uncrossed difference (CUD), is thought to reflect inter-hemispheric interactions needed for sensorimotor information to be integrated between the two cerebral hemispheres. However, it is unknown whether the tactile CUD is invariant when different body parts are stimulated. The most likely structure mediating such processing is thought to be the corpus callosum (CC). Neurophysiological studies have shown that there are denser callosal connections between regions that represent proximal parts of the body near the body midline and more sparse connections for regions representing distal extremities. Therefore, if the information transfer between the two hemispheres is affected by the density of callosal connections, stimuli presented on more distal regions of the body should produce a greater CUD compared to stimuli presented on more proximal regions. This is because interhemispheric transfer of information from regions with sparse callosal connections will be less efficient, and hence slower. Here, we investigated whether the CUD is modulated as a function of the different body parts stimulated by presenting tactile stimuli unpredictably on body parts at different distances from the body midline (i.e., Middle Finger, Forearm, or Forehead of each side of the body). Participants detected the stimulus and responded as fast as possible using either their left or right foot. Results showed that the magnitude of the CUD was larger on the finger (~2.6 ms) and forearm (~1.8 ms) than on the forehead (~-0.9 ms). This result suggests that the interhemispheric transfer of tactile stimuli varies as a function of the strength of callosal connections of the body parts

Understanding the populism of the Five Star Movement – and its continuity with the past

Italy’s Five Star Movement has now been in government for over three years, but the party still defies easy classification. Drawing on a new study, Antonio Benasaglio Berlucchi examines how the party is defined by its electoral base

Neural correlates of endogenous attention, exogenous attention and inhibition of return in touch

Selective attention helps process the myriad of information constantly touching our body. Both endogenous and exogenous mechanisms are relied upon to effectively process this information, however, it is unclear how they relate in the sense of touch. In three tasks we contrasted endogenous and exogenous ERP and behavioural effects. Unilateral tactile cues were followed by a tactile target at the same or opposite hand. Clear behavioural effects showed facilitation of expected targets both when the cue predicted targets at the same (endogenous predictive task) and opposite hand (endogenous counter-predictive task), and these effects also correlated with ERP effects of endogenous attention. In an exogenous task, where the cue was non-informative, inhibition of return (IOR) was observed. The electrophysiological results demonstrated early effects of exogenous attention followed by later endogenous attention modulations. These effects were independent in both the endogenous predictive and exogenous tasks. However, voluntarily directing attention away from a cued body part influenced the early exogenous marker (N80). This suggests that the two mechanisms are interdependent, at least when the task requires more demanding shifts of attention. The early marker of exogenous tactile attention, the N80, was not directly related to IOR, which may suggest that exogenous attention and IOR are not necessary two sides of the same coin. This study adds valuable new insight into how we process and select information presented to our body, showing both independent and interdependent effects of endogenous and exogenous attention in touch

What is embodiment? a psychometric approach

What is it like to have a body? The present study takes a psychometric approach to this question. We collected structured introspective reports of the rubber hand illusion, to systematically investigate the structure of bodily self-consciousness. Participants observed a rubber hand that was stroked either synchronously or asynchronously with their own hand and then made proprioceptive judgments of the location of their own hand and used Likert scales to rate their agreement or disagreement with 27 statements relating to their subjective experience of the illusion. Principal components analysis of this data revealed four major components of the experience across conditions, which we interpret as: embodiment of rubber hand, loss of own hand, movement, and affect. In the asynchronous condition, an additional fifth component, deafference, was found. Secondary analysis of the embodiment of runner hand component revealed three subcomponents in both conditions: ownership, location, and agency. The ownership and location components were independent significant predictors of proprioceptive biases induced by the illusion. These results suggest that psychometric tools may provide a rich method for studying the structure of conscious experience, and point the way towards an empirically rigorous phenomenology

Roger Sperry, the maverick brain scientist who was haunted by psyche

This paper describes the scientific figure of Roger Sperry as a maverick researcher, an original thinker who arrived at definitive notions about the working of the brain mostly by distancing himself from the prevalent views of his peers. After solving the riddle of the functions of the corpus callosum, he won a Nobel prize in physiology or medicine for identifying the different cognitive abilities of the disconnected right and left hemispheres of the human brain. He could have won another Nobel prize for his work on the prenatal formation of behavioral neuronal networks and their growth and development after birth. In the last part of his life, he fought a courageous but inconclusive battle for demonstrating that mental and spiritual factors can direct brain activity and behavior without violating the laws of orthodox neurophysiology. Some nodal points in his scientific career and some sources of inspirations for his thinking are identified and discussed within the historical background of the neurosciences of the twentieth century

Sensations of skin infestation linked to abnormal frontolimbic brain reactivity and differences in self-representation

Some patients experience skin sensations of infestation and contamination that are elusive to proximate dermatological explanation. We undertook a functional magnetic resonance imaging study of the brain to demonstrate, for the first time, that central processing of infestation-relevant stimuli is altered in patients with such abnormal skin sensations. We show differences in neural activity within amygdala, insula, middle temporal lobe and frontal cortices. Patients also demonstrated altered measures of self-representation, with poorer sensitivity to internal bodily (interoceptive) signals and greater susceptibility to take on an illusion of body ownership: the rubber hand illusion. Together, these findings highlight a potential model for the maintenance of abnormal skin sensations, encompassing heightened threat processing within amygdala, increased salience of skin representations within insula and compromised prefrontal capacity for self-regulation and appraisal

clinical and surgical features of lower brainstem hemangioblastomas in von hippel-Lindau disease

none5BACKGROUND: In the context of von Hippel-Lindau disease (VHL), the medulla oblongata is a relatively frequent site of growth of hemangioblastomas, posing related clinical and surgical difficulties. Their management requires a close correlation between clinical evolution and morphological surveillance. In order to describe their clinical and surgical features, we reviewed our experience in the treatment of these lesions. METHODS: Between 2001 and 2009, 14 patients (9 female and 5 male, mean age 34 years) underwent removal of 15 lower brain stem hemangioblastomas. Based on the review of the clinical records and outpatient long-term follow-up visits, their clinical course was analyzed. Functional evaluation was measured with the Karnofsky Performance Scale (KPS) on admission, at discharge and at the last follow-up. The mean follow-up period was 30.8 months (range 4-99). RESULTS: All the operated hemangioblastomas were located in the dorsal medulla oblongata, in the context of multiple lesions, cerebellar and/or spinal. In ten patients hemangioblastomas were located in a median position at the obex area; in four cases a lateral location was observed. Cystic component was absent in two cases. Clinical onset preceded surgery by a mean of 8.5 months. Preoperatively three patients showed a KPS lower than 80, ten patients between 80 and 90, and one patient scored 100 (asymptomatic). There was no surgical mortality. Nine out of 14 patients showed a temporary surgical morbidity. One patient required a tracheostomy. At follow-up ten patients scored a KPS better than before the operation, while the other four patients remained stable. Permanent morbidity was observed in three patients. CONCLUSIONS: Lower brain stem hemangioblastomas in the context of VHL show an often gradual onset of signs and symptoms except for patients who develop an obstructive hydrocephalus. Although transient surgical complications are possible, surgery provides favorable long-term results.nonePAVESI G; BERLUCCHI S; MUNARI M; MANARA R; SCIENZA R; OPOCHER G.Pavesi, G; Berlucchi, S; Munari, M; Manara, R; Scienza, R; Opocher, Giusepp