RESUMEN
Despite the historically consolidated psychopathological perspective, on the one hand, contemporary organicistic psychiatry often highlights abnormalities in neurotransmitter systems like dysregulation of dopamine transmission, neural circuitry, and genetic factors as key contributors to schizophrenia. Neuroscience, on the other, has so far almost entirely neglected the first-person experiential dimension of this syndrome, mainly focusing on high-order cognitive functions, such as executive function, working memory, theory of mind, and the like. An alternative view posits that schizophrenia is a self-disorder characterized by anomalous self-experience and awareness. This view may not only shed new light on the psychopathological features of psychosis but also inspire empirical research targeting the bodily and neurobiological changes underpinning this disorder. Cognitive neuroscience can today address classic topics of phenomenological psychopathology by adding a new level of description, finally enabling the correlation between the first-person experiential aspects of psychiatric diseases and their neurobiological roots. Recent empirical evidence on the neurobiological basis of a minimal notion of the self, the bodily self, is presented. The relationship between the body, its motor potentialities and the notion of minimal self is illustrated. Evidence on the neural mechanisms underpinning the bodily self, its plasticity, and the blurring of self-other distinction in schizophrenic patients is introduced and discussed. It is concluded that brain-body function anomalies of multisensory integration, differential processing of self- and other-related bodily information mediating self-experience, might be at the basis of the disruption of the self disorders characterizing schizophrenia.
Asunto(s)
Esquizofrenia , Humanos , Esquizofrenia/fisiopatología , Autoimagen , Ego , Psicología del Esquizofrénico , Imagen Corporal , Encéfalo/fisiopatologíaRESUMEN
Sensory integration is increasingly acknowledged as being crucial for the development of cognitive and social abilities. However, its developmental trajectory is still little understood. This systematic review delves into the topic by investigating the literature about the developmental changes from infancy through adolescence of the Temporal Binding Window (TBW) - the epoch of time within which sensory inputs are perceived as simultaneous and therefore integrated. Following comprehensive searches across PubMed, Elsevier, and PsycInfo databases, only experimental, behavioral, English-language, peer-reviewed studies on multisensory temporal processing in 0-17-year-olds have been included. Non-behavioral, non-multisensory, and non-human studies have been excluded as those that did not directly focus on the TBW. The selection process was independently performed by two Authors. The 39 selected studies involved 2859 participants in total. Findings indicate a predisposition towards cross-modal asynchrony sensitivity and a composite, still unclear, developmental trajectory, with atypical development associated to increased asynchrony tolerance. These results highlight the need for consistent and thorough research into TBW development to inform potential interventions.
Asunto(s)
Desarrollo Infantil , Humanos , Lactante , Adolescente , Niño , Desarrollo Infantil/fisiología , Preescolar , Percepción Auditiva/fisiologíaRESUMEN
Cervical aortic arch is a rare malformation that often has anatomical abnormalities of the supra-aortic trunks and may also be associated with aortic stenosis, aneurysms, or cardiac malformations. To correct them, symptomatic patients undergo surgery, which usually consists of a prosthetic graft repair, aortoplasty patch, or an end-to-end anastomosis. In addition, circulatory arrest and deep hypothermia are often required, as in aortic arch surgery. We report the case of a 13-year-old patient who underwent correction of a right cervical aortic arch stenosis with a post-stenotic aneurysm between the origin of the right carotid artery and the right subclavian artery. The anatomy of the aortic branches was abnormal. The surgical procedure consisted of an extensive resection with direct end-to-end anastomosis, without the use of a prosthetic graft, using moderate hypothermic cardiopulmonary bypass and without circulatory arrest.
Asunto(s)
Aneurisma , Aneurisma de la Aorta Torácica , Paro Cardíaco , Cardiopatías Congénitas , Humanos , Adolescente , Aorta Torácica/cirugía , Resultado del Tratamiento , Puente Cardiopulmonar , Aneurisma de la Aorta Torácica/cirugíaRESUMEN
In this study we carried out a behavioral experiment comparing action language comprehension in L1 (Italian) and L2 (English). Participants were Italian native speakers who had acquired the second language late (after the age of 10). They performed semantic judgments on L1 and L2 literal, idiomatic and metaphorical action sentences after viewing a video of a hand performing an action that was related or unrelated to the verb used in the sentence. Results showed that responses to literal and metaphorical L1 sentences were faster when the action depicted was related to the verb used rather than when the action depicted was unrelated to the verb used. No differences were found for the idiomatic condition. In L2 we found that all responses to the three conditions were facilitated when the action depicted was related to the verb used. Moreover, we found that the difference between the unrelated and the related modalities was greater in L2 than in L1 for the literal and the idiomatic condition but not for the metaphorical condition. These findings are consistent with the embodied cognition hypothesis of language comprehension.
Asunto(s)
Cognición , Comprensión , Lenguaje , Humanos , Comprensión/fisiología , Masculino , Cognición/fisiología , Femenino , Adulto , Semántica , Adulto Joven , MultilingüismoRESUMEN
Perception of one's own body in time and space is a fundamental aspect of self-consciousness. It scaffolds our subjective experience of being present, in the here and now, a vital condition for our survival and well-being. Depersonalisation (DP) is characterised by a distressing feeling of being "spaced out," detached from one's self, as well as atypical "flat" time perception. Using an audio-tactile paradigm, we conducted a study looking at the effect of DP experiences on peripersonal space (PPS)-the space close to the body-and time perception. Strikingly, we found no difference in PPS perception in people with higher DP experiences (High DPe) versus low occurrences of DP experiences (Low DPe). To assess time perception, we used the mental time travel (MTT) task measuring the individuals' capacity to take one's present as a reference point for situating personal versus general events in the past and the future. We found an overall poorer performance in locating events in time relative to their present reference point in High DPe. By contrast, Low DPe showed significant variation in performance when answering to relative past events, while High DPe did not. Our study sheds light on the close link between altered sense of self and egocentric spatiotemporal perception in individuals with DP experiences, the third most common psychological symptom in the general population.
RESUMEN
Cardiovascular magnetic resonance (CMR) and computed tomography (CCT) are advanced imaging modalities that recently revolutionized the conventional diagnostic approach to congenital heart diseases (CHD), supporting echocardiography and often replacing cardiac catheterization. This is the second of two complementary documents, endorsed by experts from the Working Group of the Italian Society of Pediatric Cardiology and the Italian College of Cardiac Radiology of the Italian Society of Medical and Interventional Radiology, aimed at giving updated indications on the appropriate use of CMR and CCT in different clinical CHD settings, in both pediatrics and adults. In this article, support is also given to radiologists, pediatricians, cardiologists, and cardiac surgeons for indications and appropriateness criteria for CMR and CCT in the most referred CHD, following the proposed new criteria presented and discussed in the first document. This second document also examines the impact of devices and prostheses for CMR and CCT in CHD and additionally presents some indications for CMR and CCT exams when sedation or narcosis is needed.
Asunto(s)
Consenso , Cardiopatías Congénitas , Humanos , Cardiopatías Congénitas/diagnóstico por imagen , Cardiopatías Congénitas/terapia , Italia , Tomografía Computarizada por Rayos X/normas , Cardiología/normas , Imagen por Resonancia Magnética/normas , Niño , Valor Predictivo de las Pruebas , Adulto , Sociedades Médicas/normasRESUMEN
Introduction: Mulibrey nanism (MUL) is a rare disorder caused by TRIM37 gene variants characterized by growth failure, dysmorphic features, congestive heart failure (CHF), and an increased risk of Wilms' tumor. Although immune system impairment has been documented in MUL, the underlying mechanisms remain poorly understood. Methods: We present a case of MUL with progressive lymphopenia and review similar cases from the literature. Results: Our patient presented with prenatal onset growth restriction, characteristic dysmorphic features, and Wilms' tumor. She developed progressive lymphopenia starting at 10 years of age, leading to the initiation of intravenous immunoglobulin (IVIG) replacement therapy and infection prophylaxis. Genetic analysis detected a likely pathogenic variant on the maternal allele and copy number loss on the paternal allele in TRIM37. Subsequently a cardiac magnetic resonance imaging was conducted revealing signs of pericardial constriction raising concerns for intestinal lymphatic losses. The cessation of IVIG therapy did not coincide with any increase in the rate of infections. The patient exhibited a distinct immunological profile, characterized by hypogammaglobulinemia, impaired antibody responses, and skewed T-cell subsets with an altered CD4+/CD8+ ratio, consistent with previous reports. Normal thymocyte development assessed by artificial thymic organoid platform ruled out an early hematopoietic intrinsic defect of T-cell development. Discussion: The immunological profile of MUL patients reported so far shares similarities with that described in protein-losing enteropathy secondary to CHF in Fontan circulation and primary intestinal lymphangiectasia. These similarities include hypogammaglobulinemia, significant T-cell deficiency with decreased CD4+ and CD8+ counts, altered CD4+/CD8+ ratios, and significantly modified CD4+ and CD8+ T-cell phenotypes toward effector and terminal differentiated T cells, accompanied by a loss of naïve CD45RA+ T lymphocytes. In MUL, CHF is a cardinal feature, occurring in a significant proportion of patients and influencing prognosis. Signs of CHF or constrictive pericarditis have been evident in the case reported here and in all cases of MUL with documented immune dysfunction reported so far. These observations raise intriguing connections between these conditions. However, further investigation is warranted to in-depth define the immunological defect, providing valuable insights into the pathophysiology and treatment strategies for this condition.