Body Processing in Children and Adolescents with Traumatic Brain Injury: An Exploratory Study.

Dysfunctions in body processing have been documented in adults with brain damage, while limited information is available for children. This study aimed to investigate body processing in children and adolescents with traumatic brain injury (TBI) (N = 33), compared to peers with typical development. Two well-known computerized body-representation paradigms, namely Visual Body Recognition and Visuo-spatial Imagery, were administered. Through the first paradigm, the body inversion and composite illusion effects were tested with a matching to sample task as measures of configural and holistic processing of others' bodies, respectively. The second paradigm investigated with a laterality judgement task the ability to perform first-person and object-based mental spatial transformations of own body and external objects, respectively. Body stimuli did not convey any emotional contents or symbolic meanings. Patients with TBI had difficulties with mental transformations of both body and object stimuli, displaying deficits in motor and visual imagery abilities, not limited to body processing. Therefore, cognitive rehabilitation of body processing in TBI might benefit from the inclusion of both general training on visuo-spatial abilities and specific exercises aimed at boosting visual body perception and motor imagery.

A Neural Circuit for Spirituality and Religiosity Derived From Patients With Brain Lesions.

BACKGROUND: Over 80% of the global population consider themselves religious, with even more identifying as spiritual, but the neural substrates of spirituality and religiosity remain unresolved. METHODS: In two independent brain lesion datasets (N1 = 88; N2 = 105), we applied lesion network mapping to test whether lesion locations associated with spiritual and religious belief map to a specific human brain circuit. RESULTS: We found that brain lesions associated with self-reported spirituality map to a brain circuit centered on the periaqueductal gray. Intersection of lesion locations with this same circuit aligned with self-reported religiosity in an independent dataset and previous reports of lesions associated with hyper-religiosity. Lesion locations causing delusions and alien limb syndrome also intersected this circuit. CONCLUSIONS: These findings suggest that spirituality and religiosity map to a common brain circuit centered on the periaqueductal gray, a brainstem region previously implicated in fear conditioning, pain modulation, and altruistic behavior.

Differential Influence of the Dorsal Premotor and Primary Somatosensory Cortex on Corticospinal Excitability during Kinesthetic and Visual Motor Imagery: A Low-Frequency Repetitive Transcranial Magnetic Stimulation Study.

Consistent evidence suggests that motor imagery involves the activation of several sensorimotor areas also involved during action execution, including the dorsal premotor cortex (dPMC) and the primary somatosensory cortex (S1). However, it is still unclear whether their involvement is specific for either kinesthetic or visual imagery or whether they contribute to motor activation for both modalities. Although sensorial experience during motor imagery is often multimodal, identifying the modality exerting greater facilitation of the motor system may allow optimizing the functional outcomes of rehabilitation interventions. In a sample of healthy adults, we combined 1 Hz repetitive transcranial magnetic stimulation (rTMS) to suppress neural activity of the dPMC, S1, and primary motor cortex (M1) with single-pulse TMS over M1 for measuring cortico-spinal excitability (CSE) during kinesthetic and visual motor imagery of finger movements as compared to static imagery conditions. We found that rTMS over both dPMC and S1, but not over M1, modulates the muscle-specific facilitation of CSE during kinesthetic but not during visual motor imagery. Furthermore, dPMC rTMS suppressed the facilitation of CSE, whereas S1 rTMS boosted it. The results highlight the differential pattern of cortico-cortical connectivity within the sensorimotor system during the mental simulation of the kinesthetic and visual consequences of actions.

Early Brain Damage Affects Body Schema and Person Perception Abilities in Children and Adolescents with Spastic Diplegia.

Early brain damage leading to cerebral palsy is associated to core motor impairments and also affects cognitive and social abilities. In particular, previous studies have documented specific alterations of perceptual body processing and motor cognition that are associated to unilateral motor deficits in hemiplegic patients. However, little is known about spastic diplegia (SpD), which is characterized by motorial deficits involving both sides of the body and is often associated to visuospatial, attentional, and social perception impairments. Here, we compared the performance of a sample of 30 children and adolescents with SpD (aged 7-18 years) and of a group of age-matched controls with typical development (TD) at two different tasks tapping on body representations. In the first task, we tested visual and motor imagery abilities as assessed, respectively, by the object-based mental rotation of letters and by the first-person transformations for whole-body stimuli. In the second task, we administered an inversion effect/composite illusion task to evaluate the use of configural/holistic processing of others' body. Additionally, we assessed social perception abilities in the SpD sample using the NEPSY-II battery. In line with previously reported visuospatial deficits, a general mental imagery impairment was found in SpD patients when they were engaged in both object-centered and first-person mental transformations. Nevertheless, a specific deficit in operating an own-body transformation emerged. As concerns body perception, while more basic configural processing (i.e., inversion effect) was spared, no evidence for holistic (i.e., composite illusion) body processing was found in the SpD group. NEPSY-II assessment revealed that SpD children were impaired in both the theory of mind and affect recognition subtests. Overall, these findings suggested that early brain lesions and biased embodied experience could affect higher-level motor cognition and perceptual body processing, thus pointing to a strict link between motor deficits, body schema alterations, and person processing difficulties.

Transcutaneous Vagus Nerve Stimulation Affects Implicit Spiritual Self-Representations.

Recently, the empirical interest in religiousness and spirituality has grown, showing the association between the activity of a complex network of subcortical and fronto-parietal areas and explicit and implicit religious/spiritual representations. Importantly, while the causal link between parietal stimulation and implicit religiousness/spirituality has been demonstrated, the role of subcortical and medial cortical areas has not been directly investigated. Here, we assessed how implicit and explicit religious or spiritual representations are modulated by transcutaneous Vagus Nerve Stimulation (tVNS), a novel non-invasive method to stimulate subcortical and medial cortical structures. Implicit and explicit representations were tested with Religious, Spiritual and Self-esteem (as control) Implicit Association Tests and questionnaires. Active-tVNS, compared to sham-tVNS, affected implicit spiritual, but not religious or control self-representations, reducing the strength of the automatic association between the self and the spiritual dimension. Explicit self-representations were left unchanged. Findings shed new light on the neurobiological mechanisms of implicit spirituality.

Visual perception and spatial transformation of the body in children and adolescents with brain tumor.

Representations of own and others' body play a crucial role in social interaction. While extensive knowledge has been gathered on the neuropsychological deficits affecting body representation in adult brain lesion patients, little is known on how acquired damage to a developing brain may affect this process. We tested it on pediatric brain tumor survivors, comparing the abilities of 30 children and adolescents (aged 8-16 years) surviving from a supratentorial tumor (STT) or an infratentorial tumor (ITT) in two different tasks of body representation. Thirty children with typical development (TD) served as control group. In the first task, we tested configural (body inversion effect) and holistic (composite illusion effect) processing of others' bodies. In the second task, we tested the ability to perform first-person and object-based mental spatial transformations of own body and external objects, respectively. Configural processing was spared in all patients. Conversely, ITT, but not STT patients, were impaired in the holistic processing of body stimuli. STT patients performed overall worse than both controls and ITT patients at mental spatial transformations of both own body and external objects. ITT children presented selective alteration in using the first-person transformation strategies with body stimuli. Results suggest that body-representation abilities may be heavily affected in pediatric brain tumor survivors. STTs may be associated to greater difficulties in mental visuo-spatial transformation abilities, likely reflecting damage to fronto-parietal circuits. Conversely, ITTs may be associated to specific disturbances of visual body perception abilities that require motor simulation processes, reflecting direct or indirect damage to cerebellar areas.

Excitatory stimulation of the right inferior parietal cortex lessens implicit religiousness/spirituality.

Although religiousness and spirituality (RS) are considered two fundamental constituents of human life, neuroscientific investigation has long avoided the study of their neurocognitive basis. Nevertheless, recent investigations with brain imaging and brain damaged patients, and more recently with brain stimulation methods, have documented important associations between RS beliefs and experiences and frontoparietal neural activity. In this study, we further investigated how individuals' implicit RS self-representations can be modulated by changes in right inferior parietal lobe (IPL) excitability, a key region associated to RS. To this end, we combined continuous theta burst stimulation (cTBS), intermittent TBS (iTBS), and sham TBS with RS-related, Implicit Association Test (IAT) and with a control self-esteem (SE) IAT in a group of fourteen healthy adult individuals. A specific decrease of implicit RS, as measured with the IAT effect, was induced by increasing IPL excitability with iTBS; conversely cTBS, which is supposedly inhibitory, left participants' implicit RS unchanged. The performance in the control SE-IAT was left unchanged by any TBS stimulation. These data showed the causative role of right IPL functional state in mediating plastic changes of implicit RS. Implications of these results are also discussed in the light of the variability of behavioral effects associated with TBS.

Effects of an 8-week meditation program on the implicit and explicit attitudes toward religious/spiritual self-representations.

Explicit self-representations often conflict with implicit and intuitive self-representations, with such discrepancies being seen as a source of psychological tension. Most of previous research on the psychological effects of mindfulness-meditation has assessed people's self-attitudes at an explicit level, leaving unknown whether mindfulness-meditation promotes changes on implicit self-representations. Here, we assessed the changes in implicit and explicit self-related religious/spiritual (RS) representations in healthy participants following an 8-week mindfulness-oriented meditation (MOM) program. Before and after meditation, participants were administered implicit (implicit association test) and explicit (self-reported questionnaires) RS measures. Relative to control condition, MOM led to increases of implicit RS in individuals whit low pre-existing implicit RS and to more widespread increases in explicit RS. On the assumption that MOM practice may enhance the clarity of one's transcendental thoughts and feelings, we argued that MOM allows people to transform their intuitive feelings of implicit RS as well as their explicit RS attitudes.

Cognitive and brain reserve for mind-body therapeutic approaches in multiple sclerosis: a review.

PURPOSE: Cognitive impairment is one of the most disabling symptoms of multiple sclerosis (MS), affecting a large proportion of patients and having a severe impact on their quality of life. Nevertheless, there exists a large variability in the neuropsychological profiles of MS patients and some of them appear to withstand better than others the MS-related brain pathology before showing cognitive decline. In recent years, many studies have made use of concepts such as cognitive reserve and brain reserve to take account of the inter-individual discrepancy between cognitive impairment and MS pathology. Critically, these studies have left open the fundamental issue of the clinical implications of this research for the treatment of cognitive dysfunction in MS. METHODS AND RESULTS: We provide an updated and extensive overview of the studies that have explored cognitive and brain reserve in MS and discuss their implications for non-pharmacological therapeutic strategies aimed at potentiating patients' reserve. In particular, the possible utility of integrated approaches based on mind-body techniques such as mindfulness-meditation is considered. CONCLUSIONS: We conclude that these techniques represent challenging mental enriching activities that may help cultivating cognitive reserve and more systematic research on their efficacy to protect against cognitive degradation in MS is encouraged.

Mindfulness-oriented meditation improves self-related character scales in healthy individuals.

Previous studies have shown that mindfulness meditation may improve well-being in healthy individuals and be effective in the treatment of mental and neurological disorders. Here, we investigated the effects of an 8-week mindfulness-mediation program on the personality profiles of three groups of healthy individuals with no previous experience with meditation as compared to a control group not enrolled in any training. Personality profiles were obtained through the Temperament and Character Inventory (Cloninger et al., 1993). In the experimental groups, significant increments after the training were obtained in all the three character scales describing the levels of self maturity at the intrapersonal (Self-Directedness), interpersonal (Cooperativeness), and transpersonal (Self-Transcendence) levels. No changes were found in the control group. Strikingly, these effects were significant only in those groups who were engaged in consistent daily meditation practice but not in the group who attended the meditation training but were less consistent in home practice. Since higher scores in the character scales are associated to a lower risk of personality disorder, we propose that the increase of self maturity after the training may be an important mechanism for the effectiveness of mindfulness-oriented meditation in psychotherapeutic contexts.

Virtual lesions of the inferior parietal cortex induce fast changes of implicit religiousness/spirituality.

Religiousness and spirituality (RS) are two ubiquitous aspects of human experience typically considered impervious to scientific investigation. Nevertheless, associations between RS and frontoparietal neural activity have been recently reported. However, much less is known about whether such activity is causally involved in modulating RS or just epiphenomenal to them. Here we combined two-pulse (10 Hz) Transcranial Magnetic Stimulation (TMS) with a novel, ad-hoc developed RS-related, Implicit Association Test (IAT) to investigate whether implicit RS representations, although supposedly rather stable, can be rapidly modified by a virtual lesion of inferior parietal lobe (IPL) and dorsolateral prefrontal cortex (DLPFC). A self-esteem (SE) IAT, focused on self-concepts nonrelated to RS representations, was developed as control. A specific increase of RS followed inhibition of IPL demonstrating its causative role in inducing fast plastic changes of religiousness/spirituality. In contrast, DLPFC inhibition had more widespread effects probably reflecting a general role in the acquisition or maintenance of task-rules or in controlling the expression of self-related representations not specific to RS.

Body schema and self-representation in patients with bulimia nervosa.

OBJECTIVE: Neuroimaging evidences in eating disorder (ED) patients document dysfunctional neural activity of the posterior parietal cortex, which is engaged in the representation of body schema. Yet a full neuropsychological investigation of body schema representation in ED patients is lacking. We examined mental imagery and body schema representation in patients with bulimia nervosa (BN) and binge eating disorder (BED). METHOD: Consecutive samples of 15 BN patients and 15 BED patients were compared with two groups of 15 age-matched controls in tasks requiring body or object mental transformation. RESULTS: BN, but not BED patients, were selectively impaired in the mental transformation of their own body, although this deficit was not correlated with measures of body dissatisfaction. In contrast, no patient group was impaired in the mental transformation of external objects. DISCUSSION: Results showed altered self-body representation in BN, but not BED patients, as the neuropsychological consequences of posterior parietal cortex dysfunctions.

Controlling memory impairment in elderly adults using virtual reality memory training: a randomized controlled pilot study.

BACKGROUND: Memory decline is a prevalent aspect of aging but may also be the first sign of cognitive pathology. Virtual reality (VR) using immersion and interaction may provide new approaches to the treatment of memory deficits in elderly individuals. OBJECTIVE: The authors implemented a VR training intervention to try to lessen cognitive decline and improve memory functions. METHODS: The authors randomly assigned 36 elderly residents of a rest care facility (median age 80 years) who were impaired on the Verbal Story Recall Test either to the experimental group (EG) or the control group (CG). The EG underwent 6 months of VR memory training (VRMT) that involved auditory stimulation and VR experiences in path finding. The initial training phase lasted 3 months (3 auditory and 3 VR sessions every 2 weeks), and there was a booster training phase during the following 3 months (1 auditory and 1 VR session per week). The CG underwent equivalent face-to-face training sessions using music therapy. Both groups participated in social and creative and assisted-mobility activities. Neuropsychological and functional evaluations were performed at baseline, after the initial training phase, and after the booster training phase. RESULTS: The EG showed significant improvements in memory tests, especially in long-term recall with an effect size of 0.7 and in several other aspects of cognition. In contrast, the CG showed progressive decline. CONCLUSIONS: The authors suggest that VRMT may improve memory function in elderly adults by enhancing focused attention.

Corticospinal facilitation during first and third person imagery.

Motor imagery can be defined as the covert rehearsal of movement. Previous research with transcranial magnetic stimulation (TMS) has demonstrated that motor imagery increases the corticospinal excitability of the primary motor cortex in the area corresponding to the representation of the muscle involved in the imagined movement. This research, however, has been limited to imagery of oneself in motion. We extend the TMS research by contrasting first person imagery and third person imagery of index finger abduction-adduction movements. Motor evoked potentials were recorded from first dorsal interosseous (FDI) and abductor digiti minimi (ADM) during single pulse TMS. Participants performed first and third person motor imagery, visual imagery, and static imagery. Visual imagery involved non biological motion while static imagery involved a first person perspective of the unmoving hand. Relative to static imagery, excitability during imagined movement increased in FDI but not ADM. The facilitation in first person imagery adds to previous findings. A greater facilitation of MEPs recorded from FDI was found in third person imagery where the action was clearly attributable to another person. We interpret this novel result in the context of observed action and imagined observation of self action, and attribute the result to activation of mirror systems for matching the imagined action with an inner visuo-motor template.