Assessment of neurological manifestations in hospitalized patients with COVID-19.

BACKGROUND AND PURPOSE: The objective of this study was to assess the neurological manifestations in a series of consecutive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients, comparing their frequency with a population hospitalized in the same period for flu/respiratory symptoms, finally not related to SARS-CoV-2. METHODS: Patients with flu/respiratory symptoms admitted to Fondazione Policlinico Gemelli hospital from 14 March 2020 to 20 April 2020 were retrospectively enrolled. The frequency of neurological manifestations of patients with SARS-CoV-2 infection was compared with a control group. RESULTS: In all, 213 patients were found to be positive for SARS-CoV-2, after reverse transcriptase polymerase chain reaction on nasal or throat swabs, whilst 218 patients were found to be negative and were used as a control group. Regarding central nervous system manifestations, in SARS-CoV-2-positive patients a higher frequency of headache, hyposmia and encephalopathy always related to systemic conditions (fever or hypoxia) was observed. Furthermore, muscular involvement was more frequent in SARS-CoV-2 infection. CONCLUSIONS: Patients with COVID-19 commonly have neurological manifestations but only hyposmia and muscle involvement seem more frequent compared with other flu diseases.

"Graspability" of objects affects gaze patterns during perception and action tasks.

When grasping an object, our gaze marks key positions to which the fingertips are directed. In contrast, eye fixations during perceptual tasks are typically concentrated on an object's centre of mass (COM). However, previous studies have typically required subjects to either grasp the object at predetermined sites or just look at computer-generated shapes "as a whole". In the current study, we investigated gaze fixations during a reaching and grasping task to symmetrical objects and compared these fixations with those made during a perceptual size estimation task using real (Experiment 1) and computer-generated objects (Experiment 2). Our results demonstrated similar gaze patterns in both perception and action to real objects. Participants first fixated a location towards the top edge of the object, consistent with index finger location during grasping, followed by a subsequent fixation towards the object's COM. In contrast, during the perceptual task to computer-generated objects, an opposite pattern in fixation locations was observed, where first fixations were closer to the COM, followed by a subsequent fixation towards the top edge. Even though differential fixation patterns were observed between studies, the area in which these fixations occurred, between the centre of the object and top edge, was the same in all tasks. These results demonstrate for the first time consistencies in fixation locations across both perception and action tasks, particularly when the same type of information (e.g. object size) is important for the completion of both tasks, with fixation locations increasing relative to the object's COM with increases in block height.

The specificity of learned associations in visuomotor and perceptual processing.

Learned associations between object properties, such as weight and size, allow for quick and accurate manipulations of objects that we encounter repeatedly. This integration of learned sensory information reduces the overall computational load of our visuomotor system when interacting with familiar objects. In the laboratory, even novel associations can be quickly established after only brief training. Haffenden and Goodale in J Cogn Neurosci 12:950-964 (2000) found that learned associations between color and size affected grip scaling for manual estimations of size and visually guided grasping. But, how specific are these learned associations? In the current study, lighter-shaded "untrained" target objects were added to Haffenden and Goodale's color-size association paradigm to determine if the learned associations made by the perception and action systems are equally tolerant to within-category color changes. During perceptual estimations, training was generalized within color categories--manual estimations of size were influenced by both the trained and lighter-shaded untrained colors. In contrast, grasping was not influenced by the untrained colored blocks. These results demonstrate how the perception and action systems differ in their incorporation of learned perceptual information. In contrast to the object specific associations needed for grasping, our perceptual system is more categorical and uses generalized perceptual grouping strategies when relying on learned color information.

Temporal integration limits of stereovision in reaching and grasping.

Even though there have been extensive investigations of the temporal integration limits of binocular vision in perceptual tasks, relatively little is known about temporal integration limits during the completion of visuomotor tasks. To assess the temporal integration limits of binocular disparity within the action domain, accuracy of reach kinematics in a reaching and grasping task under continuous binocular and monocular viewing conditions were compared with those obtained under alternating monocular viewing conditions with interocular delays ranging from 14 to 58 ms. Even the shortest of the interocular delays resulted in larger grip apertures than those in the continuous monocular and binocular viewing conditions. The short temporal integration interval of stereovision obtained in this study cannot be accounted for by differential visual feedback in the binocular and interocular delay conditions, nor is it likely to be a consequence of visual disruption due to the interocular delays. Our findings suggest that the visuomotor system has little tolerance to interocular delay.

Patient Schn: has Goldstein and Gelb's case withstood the test of time?

The current manuscript takes a critical look at the case of Goldstein and Gelb's patient, Schn, reported to be the first well-defined example of apperceptive visual agnosia. While doubts have been cast on the validity of the original investigations, we propose that perhaps the case of Schn should be reclassified as an example of integrative agnosia. Be that as it may, what is not in doubt is that the case of Schn has had a lasting impact on the development of neuropsychological theorem.

Hemispatial neglect: its effects on visual perception and visually guided grasping.

Hemispatial neglect is a neurological disorder characterized by a failure to represent information appearing in the hemispace contralateral to a brain lesion. In addition to the perceptual consequences of hemispatial neglect, several authors have reported that hemispatial neglect impairs visually guided movements. Others have reported that the extent of the impairment depends on the type of visually guided task. Finally, in some cases, neglect has been shown to impair visual perception without affecting visuomotor control in relation to the very same stimuli. While neglect patients may be able to successfully pick up an object they have difficulty perceiving in its entirety, it does not mean that they are picking up the object in the same way that a neurologically intact individual would. In the current study, patients with hemispatial neglect were presented with irregularly shaped objects, directly in front of them, that lacked clear symmetry and required an analysis of their entire contour in order to calculate stable grasp points. In a perceptual discrimination task, the neglect patients had difficulty distinguishing one object from another on the basis of their shape. In a grasping task, the neglect patients showed more variance in the position of their grasp on the target objects than their control subjects, with an overall shift to the relative right side of the presented objects. The perceptual and visuomotor deficits seen in patients with hemispatial neglect deficits may be the result of an inability to form good structural representations of the entire object for use in visual perception and visuomotor control.

Does a monocularly presented size-contrast illusion influence grip aperture?

The present study tested the idea that if subjects rely more on scene-based pictorial cues when binocular cues are not available, then both their perceptual judgements and their grasp might be influenced by pictorial illusions such as the Ebbinghaus (Titchener) Circles Illusion under monocular viewing conditions. Under binocular viewing conditions, subjects were always able to scale their grip accurately to the true size of the target disc and were unaffected by the illusion. Under monocular viewing, however, subjects appeared to be influenced by the illusion. Thus, when confronted with physically different target discs displayed on backgrounds that made them appear equivalent in size, subjects treated the two discs as equivalent--even when picking them up. These results, combined with earlier work from our laboratory suggests that binocular information plays a critical role in normal human prehension but when this information is not available the visuomotor system is able to "fall back" on the remaining monocular cues, which can cause the visuomotor system to be more susceptible to pictorial illusions.

A functional MRI study of face recognition in patients with prosopagnosia.

An fMRI investigation was conducted to determine whether patients with impaired face recognition, a deficit known as prosopagnosia, would show functional activation in the fusiform gyrus, the neural substrate for face processing, when viewing faces. While the patients did show activation in the fusiform gyrus, with significantly more voxels in posterior areas than their control subjects, this activation was not sufficient for face processing. In one of the patients, the posterior activation was particularly evident in the left hemisphere, which is thought to be involved in feature-based strategies of face perception. We conclude that an increased reliance on feature-based processing in prosopagnosia leads to a recruitment of neurons in posterior regions of the fusiform gyrus, regions that are not ideally suited for processing faces.

Computerized smoking cessation program for the worksite: treatment outcome and feasibility.

This study demonstrated the effectiveness of a computer-delivered smoking cessation program for the worksite. 58 VA Medical Center employees were randomly assigned to a computer group (computerized nicotine fading and stop-smoking contest) or a contest-only group. In comparison with the contest-only group, the computer group had nonsignificantly higher abstinence rates across follow-up, had marginally lower CO levels at the 3- and 6-month follow-ups, and smoked cigarettes with lower nicotine levels at the 10-day and 6-month follow-ups.