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Di Pietro M, Russo M, Dono F, Carrarini C, Thomas A, Di Stefano V, Telese R, Bonanni L, Sensi SL, Onofrj M, Franciotti R. A Critical Review of Alien Limb-Related Phenomena and Implications for Functional Magnetic Resonance Imaging Studies. Front Neurol 2021; 12:661130. [PMID: 34566830 PMCID: PMC8458742 DOI: 10.3389/fneur.2021.661130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 07/06/2021] [Indexed: 11/27/2022] Open
Abstract
Consensus criteria on corticobasal degeneration (CBD) include alien limb (AL) phenomena. However, the gist of the behavioral features of AL is still “a matter of debate.” CBD-related AL has so far included the description of involuntary movements, frontal release phenomena (frontal AL), or asomatognosia (posterior or “real” AL). In this context, the most frequent symptoms are language and praxis deficits and cortical sensory misperception. However, asomatognosia requires, by definition, intact perception and cognition. Thus, to make a proper diagnosis of AL in the context of CBD, cognitive and language dysfunctions must be carefully verified and objectively assessed. We reviewed the current literature on AL in CBD and now propose that the generic use of the term AL should be avoided. This catchall AL term should instead be deconstructed. We propose that the term AL is appropriate to describe clinical features associated with specific brain lesions. More discrete sets of regionally bound clinical signs that depend on dysfunctions of specific brain areas need to be assessed and presented when posing the diagnosis. Thus, in our opinion, the AL term should be employed in association with precise descriptions of the accompanying involuntary movements, sensory misperceptions, agnosia-asomatognosia contents, and the presence of utilization behavior. The review also offers an overview of functional magnetic resonance imaging-based studies evaluating AL-related phenomena. In addition, we provide a complementary set of video clips depicting CBD-related involuntary movements that should not mistakenly be interpreted as signs of AL.
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Affiliation(s)
- Martina Di Pietro
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University, Chieti, Italy
| | - Mirella Russo
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University, Chieti, Italy
| | - Fedele Dono
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University, Chieti, Italy
| | - Claudia Carrarini
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University, Chieti, Italy
| | - Astrid Thomas
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University, Chieti, Italy
| | - Vincenzo Di Stefano
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), University of Palermo, Palermo, Italy
| | - Roberta Telese
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,IRCCS C. Mondino Foundation, Pavia, Italy
| | - Laura Bonanni
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University, Chieti, Italy
| | - Stefano L Sensi
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University, Chieti, Italy
| | - Marco Onofrj
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. D'Annunzio" University, Chieti, Italy.,YDA Foundation, Institute of Immune Therapy and Advanced Biological Treatment, Pescara, Italy
| | - Raffaella Franciotti
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti-Pescara, Chieti, Italy
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Pacella V, Ricciardi GK, Bonadiman S, Verzini E, Faraoni F, Scandola M, Moro V. The Role of White Matter Disconnection in the Symptoms Relating to the Anarchic Hand Syndrome: A Single Case Study. Brain Sci 2021; 11:brainsci11050632. [PMID: 34069300 PMCID: PMC8156999 DOI: 10.3390/brainsci11050632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 01/28/2023] Open
Abstract
The anarchic hand syndrome refers to an inability to control the movements of one’s own hand, which acts as if it has a will of its own. The symptoms may differ depending on whether the brain lesion is anterior, posterior, callosal or subcortical, but the relative classifications are not conclusive. This study investigates the role of white matter disconnections in a patient whose symptoms are inconsistent with the mapping of the lesion site. A repeated neuropsychological investigation was associated with a review of the literature on the topic to identify the frequency of various different symptoms relating to this syndrome. Furthermore, an analysis of the neuroimaging regarding structural connectivity allowed us to investigate the grey matter lesions and white matter disconnections. The results indicated that some of the patient’s symptoms were associated with structures that, although not directly damaged, were dysfunctional due to a disconnection in their networks. This suggests that the anarchic hand may be considered as a disconnection syndrome involving the integration of multiple antero-posterior, insular and interhemispheric networks. In order to comprehend this rare syndrome better, the clinical and neuroimaging data need to be integrated with the clinical reports available in the literature on this topic.
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Affiliation(s)
- Valentina Pacella
- Npsy.Lab-VR, Dipartimento di Scienze Umane, Università di Verona, Lungadige Porta Vittoria, 17-37129 Verona, Italy; (V.P.); (F.F.); (M.S.)
- Brain Connectivity and Behaviour Laboratory, Sorbonne Universities, 75006 Paris, France
- Groupe d’Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives-UMR 5293, CNRS, CEA University of Bordeaux, 33076 Bordeaux, France
| | - Giuseppe Kenneth Ricciardi
- Neuroradiology, AOUVR Azienda Ospedaliera Universitaria Integrata di Verona, Piazzale Stefani, 1-37126 Verona, Italy;
| | - Silvia Bonadiman
- IRCSS, Ospedale Sacro Cuore-Don Calabria, Via Rizzardi, 4-37024 Negrar di Valpolicella, Italy; (S.B.); (E.V.)
| | - Elisabetta Verzini
- IRCSS, Ospedale Sacro Cuore-Don Calabria, Via Rizzardi, 4-37024 Negrar di Valpolicella, Italy; (S.B.); (E.V.)
| | - Federica Faraoni
- Npsy.Lab-VR, Dipartimento di Scienze Umane, Università di Verona, Lungadige Porta Vittoria, 17-37129 Verona, Italy; (V.P.); (F.F.); (M.S.)
| | - Michele Scandola
- Npsy.Lab-VR, Dipartimento di Scienze Umane, Università di Verona, Lungadige Porta Vittoria, 17-37129 Verona, Italy; (V.P.); (F.F.); (M.S.)
| | - Valentina Moro
- Npsy.Lab-VR, Dipartimento di Scienze Umane, Università di Verona, Lungadige Porta Vittoria, 17-37129 Verona, Italy; (V.P.); (F.F.); (M.S.)
- Correspondence: ; Tel.: +39-45-8028370
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Di Pietro M, Di Stefano V, Cannella R, Di Blasio F, De Angelis MV. Fetal variant of posterior cerebral artery: just a physiologic variant or a window for possible ischemic stroke? Neurol Sci 2021; 42:2535-2538. [PMID: 33389246 DOI: 10.1007/s10072-020-05018-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/18/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Martina Di Pietro
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Vincenzo Di Stefano
- Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy.
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), University of Palermo, Via del Vespro 143, 90127, Palermo, Italy.
| | - Roberto Cannella
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BiND), University of Palermo, Via del Vespro 143, 90127, Palermo, Italy
| | - Francesco Di Blasio
- Urgent Neurology Clinic and Stroke Unit, Department of Emergency, Santo Spirito Hospital, Pescara, Italy
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Tolla AS, Schichtel LT, Alboudi A, Sanders AK. Anterior choroidal artery infarct presenting as right hemichoreoathetosis. BMJ Case Rep 2020; 13:13/5/e234861. [PMID: 32398250 DOI: 10.1136/bcr-2020-234861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Azam S Tolla
- Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA .,Hauenstein Neurosciences, Mercy Health Saint Mary's, Grand Rapids, Michigan, USA
| | - Luke T Schichtel
- Michigan State University College of Osteopathic Medicine, East Lansing, Michigan, USA
| | - Ayman Alboudi
- Hauenstein Neurosciences, Mercy Health Saint Mary's, Grand Rapids, Michigan, USA
| | - Audrey K Sanders
- Hauenstein Neurosciences, Mercy Health Saint Mary's, Grand Rapids, Michigan, USA
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