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Gainotti G. Does the right hemisphere retain functional characteristics typical of the emotional adaptive system? An evolutionary approach to the problem of brain asymmetries. Neurosci Biobehav Rev 2024; 164:105777. [PMID: 38914178 DOI: 10.1016/j.neubiorev.2024.105777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/04/2024] [Accepted: 06/17/2024] [Indexed: 06/26/2024]
Abstract
The right and left hemispheres host two complementary adaptive systems with a right-sided prevalence of automatic and unconscious processing modes, typical of the 'emotional system', and a left-sided prevalence of propositional and conscious processing modes typical of the 'cognitive system' The principal right hemispheric syndromes (and the functioning modes typical of this hemisphere) are, indeed, characterized by automatic and unconscious processing modalities. Thus, the unilateral neglect syndrome discloses a defective automatic (and spared intentional) spatial orienting of attention; face and voice recognition disorders are due to disruption of mechanisms that automatically generate familiarity feelings and anosognosia seems due to the unconscious loss of personal significance attributed by the patient to the pathological event. Since emotions were the only adaptive system existing before the development of language (which is provided of a strong capacity to develop and shape cognition), the persistence in the right hemisphere of mechanisms typical of the emotional system strongly supports an evolutionary model of brain laterality. (160 words).
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Affiliation(s)
- Guido Gainotti
- Institute of Neurology, Università Cattolica del Sacro Cuore, Fondazione Policlinico A. Gemelli, IRCCS, Rome, Italy.
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Nakamura T, Kurosaki S, Baba M, Irisawa H, Mizushima T. Effectiveness of rehabilitation for young patients with extensive right hemisphere cerebral infarction: A report of two cases. Clin Case Rep 2024; 12:e9328. [PMID: 39135767 PMCID: PMC11317890 DOI: 10.1002/ccr3.9328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 07/22/2024] [Accepted: 08/05/2024] [Indexed: 08/15/2024] Open
Abstract
Key Clinical Message In younger patients, including those with extensive infarction involving the anterior and middle cerebral artery regions of the right hemisphere, appropriate treatment for rare causes and goal-oriented long-term rehabilitation could improve severe hemiplegia and higher brain dysfunction, and allow for further education and employment. Abstract Although the number of young stroke patients is small, many have serious sequelae and rare causes. In addition to independence in activities of daily living, education and employment are desired. We present two cases of extensive infarction in the right cerebrum in patients who underwent rehabilitation with good outcomes.
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Affiliation(s)
- Tomoyuki Nakamura
- Department of Rehabilitation MedicineDokkyo Medical UniversityShimotsuga‐gunTochigiJapan
- Department of Rehabilitation MedicineJapanese Red Cross Ashikaga HospitalAshikagaTochigiJapan
| | - Shuhei Kurosaki
- Department of Rehabilitation MedicineJapanese Red Cross Ashikaga HospitalAshikagaTochigiJapan
| | - Mikoto Baba
- Department of Rehabilitation MedicineJapanese Red Cross Ashikaga HospitalAshikagaTochigiJapan
| | - Hiroshi Irisawa
- Department of Rehabilitation MedicineDokkyo Medical UniversityShimotsuga‐gunTochigiJapan
| | - Takashi Mizushima
- Department of Rehabilitation MedicineDokkyo Medical UniversityShimotsuga‐gunTochigiJapan
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Gainotti G. Some historical notes orienting towards brain mechanisms that could underlie hemispheric asymmetries. Cortex 2023; 163:26-41. [PMID: 37054549 DOI: 10.1016/j.cortex.2023.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/07/2023] [Accepted: 03/14/2023] [Indexed: 04/05/2023]
Abstract
The first minor aim of this synthetical historical survey consisted in showing that the discovery of the internal organization of language within the left hemisphere has been mainly determined by theoretical models and cultural factors, whereas the discovery of the left lateralisation of language and of the right lateralization of emotions and of other cognitive and perceptual functions has been mainly determined by empirical observations. A second more relevant aim of the survey consisted in discussing historical and more recent data suggesting that the different lateralisation of language and emotions has influenced not only the asymmetrical representation of other cognitive, affective and perceptual functions, but also (thank to the shaping influence of language on human cognition) of asymmetries regarding more general aspects of thought (such as the distinctions between 'propositional vs automatic' and 'conscious vs unconscious' ways of functioning). In the last part of the review, these data will be included in a more general discussion, concerning the brain functions that could be subsumed by the right hemisphere for three main reasons: (a) to avoid conflicts with the language mediated activities of the left hemisphere; (b) because of unconscious and automatic aspects of its non-verbal organisation or (c) due to the competition for cortical space determined by the development of language within the left hemisphere.
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Affiliation(s)
- Guido Gainotti
- Institute of Neurology, Catholic University of the Sacred Heart, Roma, Italy.
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Rubia K. Neurotherapeutics for ADHD: Do they work? Psych J 2022; 11:419-427. [PMID: 35359026 PMCID: PMC10083951 DOI: 10.1002/pchj.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/07/2022] [Indexed: 11/08/2022]
Abstract
This paper reflects on the use of neurotherapeutics for attention-deficit/hyperactivity disorder (ADHD). ADHD is the most imaged child psychiatric disorder, with over 3 decades of magnetic resonance imaging (MRI) research. Findings are relatively homogeneous compared to other psychiatric conditions with consistent evidence for differences, albeit small, relative to healthy controls in the structure and function of several frontal, parietotemporal, and striatal brain regions as well as their inter-regional structural and functional connections. The functional deficits have been targeted with modern neurotherapeutics, including neurofeedback (using most commonly electroencephalography and more recently functional near-infrared spectroscopy and functional MRI) and non-invasive brain stimulation (such as repetitive transcranial magnetic stimulation, transcranial direct current stimulation, or external trigeminal nerve stimulation). Except for electroencephalography-neurofeedback, the majority of neurotherapeutic studies have been relatively small, with very heterogenous research protocols and outcome measures and-likely as a consequence-inconsistent findings. Furthermore, most brain stimulation studies have tested effects on cognitive functions rather than clinical symptoms. So far, findings have not been very promising. Future studies require systematic testing of optimal protocols in large samples or homogenous subgroups to understand response prediction that could lead to individualized treatment.
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Affiliation(s)
- Katya Rubia
- Department of Child & Adolescent Psychiatry/PO46, Institute of Psychiatry, Psychology & NeurosciencesKing's College LondonLondonUK
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OUP accepted manuscript. Arch Clin Neuropsychol 2022; 37:1185-1198. [DOI: 10.1093/arclin/acac009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 11/13/2022] Open
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Block G, Jannati A, Maynard TR, Pascual-Leone A, O’Connor MG. Personality in Autism Spectrum Disorder: Associations With Face Memory Deficit and Theory of Mind. Cogn Behav Neurol 2021; 34:117-128. [PMID: 34074866 PMCID: PMC8186733 DOI: 10.1097/wnn.0000000000000271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 09/28/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To examine the personality profiles of adults with autism spectrum disorder (ASD) using a standard personality assessment and to investigate the association between personality, ASD-related face memory deficit (FMD), and theory of mind (ToM). In a broader context, to examine whether there are distinct clinical phenotypes in the ASD population that have implications for personality development and treatment. METHOD Fifty-five adults with ASD and 22 neurotypical (NT) adults underwent a battery of neuropsychological tests, including measures of personality, face memory, and ToM. We compared ASD and NT groups in terms of their Personality Assessment Inventory (PAI) profiles. Additional analyses focused on the association between specific PAI scales and FMD. Performance on the Eyes Test was compared across groups and was examined in relation to FMD. RESULTS Adults with ASD demonstrated significant elevations on several PAI scales compared with NT adults. The presence of FMD was associated with differing PAI profiles among the ASD adults. The ASD adults with FMD scored significantly higher on scales that are sensitive to positive impression management and treatment rejection and significantly lower on scales that are sensitive to borderline personality, anxiety, depression, schizophrenia, and stress. There was a significant association between performance on the Eyes Test and FMD in the ASD group. CONCLUSION Adults with ASD have a unique personality profile. Further, ASD adults with FMD have reduced insight into their difficulties with emotional processing and may not be as sensitive as ASD adults without FMD to the emotions of others.
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Affiliation(s)
- Gabrielle Block
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Ali Jannati
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Taylor R. Maynard
- Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School, Boston, MA
- Hinda and Arthur Marcus Institute for Aging Research and Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA
- Institut Guttman de Neurorehabilitació, Universitat Autónoma de Barcelona, Badalona, Barcelona, Spain
| | - Margaret G. O’Connor
- Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Mayelle A, El Haj M, Antoine P. "What" and "How": A New Perspective for Understanding Unawareness in Alzheimer's Disease Through a Combination of Two Perspectives. Am J Alzheimers Dis Other Demen 2020; 35:1533317520925333. [PMID: 32508159 PMCID: PMC10624057 DOI: 10.1177/1533317520925333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Assessments of unawareness in Alzheimer's disease mainly focus on the objects (the "what") of unawareness. A recent person-centered approach proposes to also assess the processes (the "how"). The present study combines 2 approaches to understand this heterogeneity in assessments of unawareness. METHOD We recruited 46 participants from 8 nursing homes. They underwent a semi-structured interview and were assessed using a prediction-performance paradigm. Spearman correlations were calculated, and generalized additive models were established. RESULTS The 2 approaches are associated through cognitive deficits, confrontation with difficulties and identity changes. Objects (the what), mechanisms, and modes of expression (the how) explain at least 29.6% of the variance of unawareness. CONCLUSIONS Unawareness is more than simply being unaware of something; it is a synergy between the objects and processes of arousal and expression. Moreover, unawareness extends beyond the disease to include the self. Considering the entire person seems to be necessary.
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Affiliation(s)
- Amandine Mayelle
- University Lille, CNRS, UMR 9193 – SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
| | - Mohamad El Haj
- Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), Nantes Université, Univ Angers, F-44000 Nantes, France
- Unité de Gériatrie, Centre Hospitalier de Tourcoing, Tourcoing 59200, France
- Institut Universitaire de France, Paris 75000, France
| | - Pascal Antoine
- University Lille, CNRS, UMR 9193 – SCALab - Sciences Cognitives et Sciences Affectives, F-59000 Lille, France
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Abstract
Eating disorders affect a significant number of individuals across the life span and are found among all demographic groups (including all genders, socioeconomic statuses, and ethnicities). They can cause malnutrition, which can have significant effects on every organ system in the body. Cardiovascular complications are particularly dangerous and cause eating disorders to have the highest mortality rate of all mental illnesses. This article outlines the medical assessment and treatment of malnutrition due to disordered eating.
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Affiliation(s)
- Rebecka Peebles
- Eating Disorder Assessment and Treatment Program, The Children's Hospital of Philadelphia, Perelman School of Medicine at The University of Pennsylvania, Roberts Center for Pediatric Research, 2716 South Street, Room 14360, Philadelphia, PA 19146, USA.
| | - Erin Hayley Sieke
- The Children's Hospital of Philadelphia, 3401 Civic Center Boulevard 9NW55, Philadelphia, PA 19104, USA
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Chen X, D'Souza V, Yu L. The oral health status of residents with different cognitive and dental-related functions in three North Carolina assisted living facilities. Gerodontology 2019; 36:142-148. [PMID: 30724388 DOI: 10.1111/ger.12391] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 11/03/2018] [Accepted: 12/08/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The aim of the study was to describe the oral health status of persons with different cognition and dental-related functions (DRFs). METHODS The present study was a secondary analysis of data collected for a cross-sectional study of residents in three assisted living facilities in North Carolina. The participants were aged 50 years or older, had normal to severely impaired cognition and spoke English. Upon obtaining informed consent, an oral assessment was completed by a trained geriatric dentist. A research team member who was blind to the oral examination outcomes then used the Minimum Data Set Cognition Scale to assess participants' cognition and the dental activities test to evaluate oral self-care and other DRFs. Descriptive statistics were used to describe the demographic, cognitive, functional and oral health status of the study participants. The impacts of cognitive and functional status on oral health measures were examined using simple linear regression models, negative binomial and zero-inflated negative binomial models. RESULTS A total of 91 long-term residents from three long-term care facilities participated in the study. Oral hygiene and gingival health were significantly associated with cognition (P = 0.056 and P = 0.017, respectively) and DRFs (P = 0.013 and P = 0.008, respectively). Residents with poor cognitive and dental-related function also presented with poor oral hygiene and gingival health. CONCLUSION The study results suggest that oral hygiene and gingival health were significantly associated with cognition and DRFs.
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Affiliation(s)
- Xi Chen
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa
| | - Violet D'Souza
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa
| | - Lixi Yu
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa
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Gainotti G. Anosognosia in degenerative brain diseases: The role of the right hemisphere and of its dominance for emotions. Brain Cogn 2018; 127:13-22. [DOI: 10.1016/j.bandc.2018.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 08/20/2018] [Accepted: 08/22/2018] [Indexed: 12/12/2022]
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