The SNARC effect: a preregistered study on the interaction of horizontal, vertical, and sagittal spatial-numerical associations.

Small numbers are processed faster through left-sided than right-sided responses, whereas large numbers are processed faster through right-sided than left-sided responses [i.e., the Spatial-Numerical Association of Response Codes (SNARC) effect]. This effect suggests that small numbers are mentally represented on the left side of space, whereas large numbers are mentally represented on the right side of space, along a mental number line. The SNARC effect has been widely investigated along the horizontal Cartesian axis (i.e., left-right). Aleotti et al. (Cognition 195:104111, 2020), however, have shown that the SNARC effect could also be observed along the vertical (i.e., small numbers-down side vs. large numbers-up side) and the sagittal axis (i.e., small numbers-near side vs. large numbers-far side). Here, we investigated whether the three Cartesian axes could interact to elicit the SNARC effect. Participants were asked to decide whether a centrally presented Arabic digit was odd or even. Responses were collected through an ad hoc-made response box on which the SNARC effect could be compatible for one, two, or three Cartesian axes. The results showed that the higher the number of SNARC-compatible Cartesian axes, the stronger the SNARC effect. We suggest that numbers are represented in a three-dimensional number space defined by interacting Cartesian axes.

Limited evidence for neuropsychological dysfunction in patients initially affected by severe COVID-19.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), resulting in coronavirus disease 2019 (COVID-19), has caused a pandemic. There is now considerable evidence that neuropsychological functions could be affected. We further tested this hypothesis on a sample of post COVID-19 patients, who, initially, had been severely affected. METHODS: We tested 22 post COVID-19 patients who, after the intensive care unit (all but one), were admitted to our rehabilitation unit to be treated for severe post COVID-19 sequelae. All patients were administered a comprehensive neuropsychological battery including measures assessing perceptual, attentive, mnestic, linguistic, and executive functions, and overall cognitive status. The patients were also administered rehabilitation measures including scales for investigating aerobic capacity/endurance deficits, dyspnea, and fatigue. RESULTS: Our findings revealed that evidence of neuropsychological disorders in post COVID-19 patients was very limited. Furthermore, COVID-19 severity and other relevant variables were not correlated with patients' scores on the neuropsychological tests. CONCLUSIONS: We suggest that the relation between COVID-19 and neuropsychological disorders is unclear. New studies and metanalyses are highly required to shed light on this highly complex issue.

Aphasia and Math: Deficits with Basic Number Comprehension and in Numerical Activities of Daily Living.

OBJECTIVE: In the present study, we explored numerical problems in individuals with aphasia. We investigate whether numerical deficits, usually accompanying aphasia, can be observed on number comprehension tasks that do not necessarily require an oral response. METHOD: Individuals with aphasia were classified into anterior, posterior, and global subgroups according to the lesion type. To investigate numerical cognition, we used a relatively recent tool, the Numerical Activities of Daily Living (NADL). RESULTS: The results showed that individuals with aphasia have problems with tasks of basic number comprehension as well as in most NADL. In the formal part of the NADL, anterior aphasic patients made comparatively more errors than the posterior aphasic patients. Global aphasic patients presented an invariably poor performance on almost all tasks. CONCLUSION: The results provide insight into how numerical deficits may impair an individual with aphasia in activities of daily living. This study is a preliminary attempt to start the validation process of the NADL for the Greek population.

Association between childhood asthma and history of assisted reproduction techniques: a systematic review and meta-analysis.

Genetic and environmental factors during early development may influence lung growth and impact lung function. We performed a meta-analysis of epidemiological studies examining the association between conception history of assisted reproduction techniques (ART) and childhood asthma. We searched PubMed and Embase up to November 2020 for relevant observational studies and synthesized data data under a fixed or random effects model as appropriate. Heterogeneity was assessed using the I2 metric. We identified 13 individual studies including 3,226,386 participants. We did not observe a statistically significant association between ART and physician-diagnosed asthma (n = 9, random OR 1.16; 95% CI 0.94-1.43; I2 61%). We observed a statistically significant association between ART and prescription of asthma medications (n = 6, fixed OR 1.27; 95% CI 1.23-1.32; I2 0%). Wheezing was also associated with ART (n = 4, fixed OR 1.71; 95% CI 1.08-2.72; I2 0%). When we combined studies using any asthma definition, a statistically significant association was observed (random OR 1.19; 95% CI 1.05-1.34; I2 80%).Conclusion: The available observational evidence suggests that the risk of asthma is higher among children born after ART. The mechanism and potential sources of bias behind this association are under scrutiny, and further work is needed to establish causality. What is Known: • "Positive" epidemiological signals for the association between assisted reproduction techniques and asthma stemming from large studies were not replicated by subsequent research. • Any available research synthesis effort so far bears no quantitative aspect. What is New: • The available observational evidence suggests that the risk of asthma is higher among children born after ART. • The mechanism and potential sources of bias behind this association are under scrutiny.

Pitch height and brightness both contribute to elicit the SMARC effect: a replication study with expert musicians.

Pitch-height can be represented in a spatial format. Reaction times (RTs) to lower pitch-heights are faster when responses are executed in the lower side of space, whereas RTs to higher pitch-heights are faster when responses are executed in the upper side of space. This effect is called the Spatial-Music Association of Response Codes (SMARC) effect. We investigated how pitch-height and the brightness of a tone's timbre might contribute in eliciting the SMARC effect as a function of music expertise by comparing the results of 24 musicians with the results we gathered previously (Pitteri et al., 2017) with 24 non-musicians. Three experimental conditions were used: pitch-height varied, brightness varied; pitch-height varied, brightness fixed; pitch-height fixed, brightness varied. We found that the coherent modulation of both pitch-height and brightness elicited the strongest SMARC effect, independently of music expertise. These results add evidence to the hypothesis that the strongest SMARC effect does not belong to pitch-height or brightness, but to pitch-height and brightness together.

COVID-19 presenting with agraphia and conduction aphasia in a patient with left-hemisphere ischemic stroke.

COVID-19 following infection by SARS-CoV-2 can affect the brain causing confusion, depression, and dementia-like signs. Nonetheless, the presence of more specific neuropsychological signs because of COVID-19 remains unexplored. We report on LA, a patient who was affected by a left-hemisphere ischemic stroke, probably because of SARS-CoV-2. The patient showed a highly specific neuropsychological profile characterized by severe agraphia and some signs of conduction aphasia. All other cognitive and sensorimotor functions remained intact. We sustain that specific neuropsychological signs can be observed in patients with COVID-19. Therefore, in-depth and comprehensive neuropsychological assessment should be included to better explore and qualify the neuropsychological consequences of COVID-19. This is a new challenge for diagnosis and rehabilitation, with important consequences for the involved neuropsychological services.

Increased Cognitive Load Reveals Unilateral Neglect and Altitudinal Extinction in Chronic Stroke.

OBJECTIVE: Neuropsychological studies suggest that the ability to compensate for the presence of spatial neglect highly depends on the attentional resources a patient can rely on. The present research aimed to study neglect in situations where attentional resources are limited due to multitasking. METHOD: We examined two patients more than 3 years after a right-hemispheric stroke. Both had received neuropsychological rehabilitation for left neglect and did not show any impairment in standard tests. We used a dual-task paradigm combining a peripheral target detection task with a central shape recognition task. Peripheral targets could appear in left/right positions but also in lower/upper positions. RESULTS: In patient #1, dual-task condition exacerbated left neglect and extinction. Patient #2 did not show any sign of neglect along the horizontal axis, but omitted half of the lower targets when they were presented simultaneously with upper targets under dual-task condition. This behavior reflects altitudinal extinction as the detection of single targets appearing either in upper or lower position was preserved. CONCLUSION: The present findings show that dual-tasking is a sensitive tool for the quantitative and qualitative assessment of spatial attention deficits, which are often overlooked by standard methods, especially in chronic stage. (JINS, 2019, 25, 644-653).

The importance of time limits in detecting signs of left visual peripersonal neglect: a multiple single-case, pilot study.

We developed a new visual search test to assess signs of left visual peripersonal neglect. Five right-hemisphere-damaged patients, 10 healthy controls, and 10 orthopedic controls were administered the test in four conditions: easy task (no distractors)/time-limited (45''), easy task (no distractors)/time-unlimited, difficult task (distractors)/time-limited (45''), difficult task (distractors)/time-unlimited. With respect to controls, most RHDP showed signs of left visual peripersonal neglect in the time-limited condition, but not in the time-unlimited condition, particularly on the difficult task. We suggest that the presence of appropriate time limits, in difficult visual search tasks, could considerably improve the diagnosis of left visual peripersonal neglect.

Naturally together: pitch-height and brightness as coupled factors for eliciting the SMARC effect in non-musicians.

Pitch-height is often labeled spatially (i.e., low or high) as a function of the fundamental frequency of the tone. This correspondence is highlighted by the so-called Spatial-Musical Association of Response Codes (SMARC) effect. However, the literature suggests that the brightness of the tone's timbre might contribute to this spatial association. We investigated the SMARC effect in a group of non-musicians by disentangling the role of pitch-height and the role of tone-brightness. In three experimental conditions, participants were asked to judge whether the tone they were listening to was (or was not) modulated in amplitude (i.e., vibrato). Participants were required to make their response in both the horizontal and the vertical axes. In a first condition, tones varied coherently in pitch (i.e., manipulation of the tone's F0) and brightness (i.e., manipulation of the tone's spectral centroid); in a second condition, pitch-height varied whereas brightness was fixed; in a third condition, pitch-height was fixed whereas brightness varied. We found the SMARC effect only in the first condition and only in the vertical axis. In contrast, we did not observe the effect in any of the remaining conditions. The present results suggest that, in non-musicians, the SMARC effect is not due to the manipulation of the pitch-height alone, but arises because of a coherent change of pitch-height and brightness; this effect emerges along the vertical axis only.

What is a number? The interplay between number and continuous magnitudes.

Leibovich et al. argue that it is impossible to control for all continuous magnitudes in a numerical task. We contend that continuous magnitudes (i.e., perimeter, area, density) can be simultaneously controlled. Furthermore, we argue that shedding light on the interplay between number and continuous magnitudes - rather than considering them independently - will provide a much more fruitful approach to understanding mathematical abilities.

High-Resolution Computed Tomography Examinations for Chronic Suppurative Lung Disease in Early Childhood: Radiation Exposure and Image Quality Evaluations With Iterative Reconstruction Algorithm Use.

PURPOSE: High radiosensitivity of children undergoing repetitive computed tomography examinations necessitates the use of iterative reconstruction algorithms in order to achieve a significant radiation dose reduction. The goal of this study is to compare the iDose iterative reconstruction algorithm with filtered backprojection in terms of radiation exposure and image quality in 33 chest high-resolution computed tomography examinations performed in young children with chronic bronchitis. METHODS: Fourteen patients were scanned using the filtered backprojection protocol while 19 patients using the iDose protocol and reduced milliampere-seconds, both on a 64-detector row computed tomography scanner. The iDose group images were reconstructed with different iDose levels (2, 4, and 6). Radiation exposure quantities were estimated, while subjective and objective image qualities were evaluated. Unpaired t tests were used for data statistical analysis. RESULTS: The iDose application allowed significant effective dose reduction (about 80%). Subjective image quality evaluation showed satisfactory results even with iDose level 2, whereas it approached excellent image with iDose level 6. Subjective image noise was comparable between the 2 groups with the use of iDose level 4, while objective noise was comparable between filtered backprojection and iterative reconstruction level 6 images. CONCLUSIONS: The iDose algorithm use in pediatric chest high-resolution computed tomography reduces radiation exposure without compromising image quality. Further evaluation with iterative reconstruction algorithms is needed in order to establish high-resolution computed tomography as the gold standard low-dose method for children suffering from chronic lung diseases.

Pure left neglect for Arabic numerals.

Arabic numerals are diffused and language-free representations of number magnitude. To be effectively processed, the digits composing Arabic numerals must be spatially arranged along a left-to-right axis. We studied one patient (AK) to show that left neglect, after right hemisphere damage, can selectively impair the computation of the spatial frames underpinning recognition and understanding of Arabic numerals, without impairing the spatial frames for coding alphabetic strings or for coding environmental spatial information. The presence in our brain of these specific and precise spatial frames must be rooted in the paramount importance of Arabic numerals processing in our everyday activities.

How tool use and arm position affect peripersonal space representation.

Experiment 1 investigated whether tool use can expand the peripersonal space into the very far extrapersonal space. Healthy participants performed line bisection in peripersonal and extrapersonal space using wooden sticks up to a maximum of 240 cm. Participants misbisected to the left of the true midpoint, both for lines presented in peripersonal and for those presented in extrapersonal space, confirming a peripersonal space expansion up to a distance of 240 cm. Experiment 2 investigated whether arm position could influence the perception of peripersonal and extrapersonal space during tool use. Participants performed line bisection in the peripersonal and in the extrapersonal space (up to a maximum of 120 cm) using wooden sticks in two different conditions: either with the arm bent or with the arm stretched. Results showed stronger pseudoneglect in the stretched arm condition.

Observations in febrile children with round air space opacities.

BACKGROUND: Community-acquired pneumonia in children is rarely depicted as round opacity. The aim of the present study was therefore to describe the clinical and laboratory characteristics of round pneumonia in children. METHODS: The clinical series consisted of 30 children aged 1-7 years (mean age, 3.4 +/- 1.8 years) who were compared to an equal number of children with segmental or lobar pneumonia aged 3-11 years (mean age, 5.5 +/- 2.7 years). RESULTS: Round pneumonia was localized more often in the lower lobe (17/30), and the right side was more commonly affected (20/30). The same, however, was the case for the control group. The two groups were not different regarding the severity of the disease but cough was much more common in the control patients. The white blood cells were considerably higher in round pneumonia, whereas the other inflammatory indices were not significantly different. All round consolidations responded promptly to antibiotics and resolved radiographically in 8 weeks. CONCLUSION: Round consolidations in febrile children associated with elevated inflammatory indices seem to be attributed to round pneumonia, which responds promptly to antibiotics without complications.

Numerical magnitude, rather than individual bias, explains spatial numerical association in newborn chicks.

We associate small numbers with the left and large numbers with the right side of space. Recent evidence from human newborns and non-human animals has challenged the primary role assigned to culture, in determining this spatial numerical association (SNA). Nevertheless, the effect of individual spatial biases has not been considered in previous research. Here, we tested the effect of numerical magnitude in SNA and we controlled for itablendividual biases. We trained 3-day-old chicks (Gallus gallus) on a given numerical magnitude (5). Then chicks could choose between two identical, left or right, stimuli both representing either 2, 8, or 5 elements. We computed the percentage of Left-sided Choice (LC). Numerical magnitude, but not individual lateral bias, explained LC: LC2 vs. 2>LC5 vs. 5>LC8 vs. 8. These findings suggest that SNA originates from pre-linguistic precursors, and pave the way to the investigation of the neural correlates of the number space association.

Most of the world modern-day languages are written from left to right ­ but what about numbers? As it turns out, the majority of people also represent numbers using a 'mental line', with smaller numbers on the left and larger numbers on the right. Some researchers argue that this phenomenon results from the way humans learn to read and write: in other words, that it is a by-product of culture, rather than an innate property of the brain. Recent evidence suggests that newborn infants, as well as certain species of monkeys and birds, also associate smaller numbers with the left and larger numbers with the right side of space. This raises the possibility that human mental number line may stem from an ability that evolved before language, in a common ancestor of humans and other animals. Yet, critics claim that findings in infants and non-human species result from a failure to account for individual biases in responding. To resolve this controversy, Rugani et al. trained three-day-old domestic chicks to approach a target board sporting five red squares. Chicks were then given the choice to approach two identical boards, which would both show two, five or eight red squares. Rugani et al. showed that when both boards had two red squares, the chicks tended to approach the left-hand board more often than the right. By contrast, when both boards had eight red squares, the birds approached the right-hand board more often than the left. Importantly, no left-right bias was observed when the number of red squared remained unchanged (five). These results also could not be explained by individual chicks favoring the left or right side. Instead, the findings suggest that even newborn animals tend to associate numbers with positions on a mental number line. Additional research is needed to determine the role of experience ­ or culture ­ in shaping this tendency, and future studies should also examine which brain regions support the association between number and space.

Numbers around Descartes: A preregistered study on the three-dimensional SNARC effect.

The Spatial-Numerical Association of Response Codes (SNARC) effect suggests that numbers are represented along a horizontal left-to-right oriented, mental number line, with small numbers on the left and large numbers on the right. Much less evidence exists for vertical (down-to-up) and sagittal (near-to-far) SNARC effects. This might be due to the employment of different experimental paradigms among studies and to the, sometimes, inexact definition of the vertical and sagittal axes. We investigated for the first time the SNARC effect along the horizontal, vertical, and sagittal axes, by means of a classic SNARC task. Our results suggest the presence of three equally-strong SNARC effects. Our findings can be considered as evidence in favor of a three-dimensional, mental representation of numbers, in the form of a mental number space, defined by Cartesian coordinates.

Acquired neurogenic foreign accent syndrome after right-hemisphere lesion with left cerebellar diaschisis: A longitudinal study.

Patients affected by acquired neurogenic foreign accent syndrome (ANFAS) start speaking with a new accent that resembles that of a foreign language. ANFAS has been reported following left-hemisphere damage, but it is extremely rare after right-hemisphere damage. We described KKE, a right-hemisphere-damaged patient. His cognitive functions were largely intact and he was not aphasic. Nonetheless, KKE showed a marked foreing accent which was mainly judged as Slavic. Positron emission tomography revealed left cerebellar diaschisis, even if the cerebellum did not appear lesioned, on MRI scans. Remarkably, KKE still showed ANFAS three years after lesion onset. We propose that this very rare variant of ANFAS, after right-hemisphere lesion, can be due to the damage of a complex cerebral network involving supra- and infra-tentorial structures.

The spatial representation of numbers: evidence from neglect and pseudoneglect.

The aim of the present paper is to provide an overview of the evidence that links spatial representation with representation of number magnitude. This aim is achieved by reviewing the literature concerning the number interval bisection task in patients with left hemispatial neglect and in healthy participants (pseudoneglect). Phenomena like the Spatial Numerical Association of Response Codes (SNARC) effect and the shifts of covert spatial attention caused by number processing are thought to support the notion that number magnitude is represented along a spatially organized mental number line. However, the evidence provided by chronometric studies is not univocal and is open to alternative, non-spatial interpretations. In contrast, neuropsychological studies have offered convincing evidence that humans indeed represent numbers on a mental number line oriented from left to right. Neglect patients systematically misplace the midpoint of a numerical interval they are asked to bisect (e.g., they say that [5] is halfway between [2] and [6]) and their mistakes closely resemble the typical pattern found in bisection of true visual lines. The presence of dissociations between impaired explicit knowledge and spared implicit knowledge supports the notion that neglect produces a deficit in accessing an intact mental number line, rather than a distortion in the representation of that line. Other results show that the existence of a strong spatial connotation constitutes a specific property of number representations rather than a general characteristic of all ordered sequences.