Facial expressions and identities recognition in Parkinson disease.

Parkinson's Disease (PD) is associated with motor and non-motor symptoms. Among the latter are deficits in matching, identification, and recognition of emotional facial expressions. On one hand, this deficit has been attributed to a dysfunction in emotion processing. Another explanation (which does not exclude the former) links this deficit with reduced facial expressiveness in these patients, which prevents them from properly understanding or embodying emotions. To disentangle the specific contribution of emotion comprehension and that of facial expression processing in PD's observed deficit with emotions we performed two experiments on non-emotional facial expressions. In Experiment 1, a group of PD patients and a group of Healthy Controls (HC) underwent a task of non-emotional expression recognition in faces of different identity and a task of identity recognition in faces with different expression. No differences were observed between the two groups in accuracies. In Experiment 2, PD patients and Healthy Controls underwent a task where they had to recognize the identity of faces encoded through a non-emotional facial expression, through a rigid head movement, or as neutral. Again, no group differences were observed. In none of the two experiments hypomimia scores had a specific effect on expression processing. We conclude that in PD patients the observed impairment with emotional expressions is likely due to a specific deficit for emotions to a greater extent than for facial expressivity processing.

The role of preSMA and STS in face recognition: A transcranial magnetic stimulation (TMS) study.

Current models propose that facial recognition is mediated by two independent yet interacting anatomo-functional systems: one processing facial features mainly mediated by the Fusiform Face Area and the other involved in the extraction of dynamic information from faces, subserved by Superior Temporal Sulcus (STS). Also, the pre-Supplementary Motor Area (pre-SMA) is implicated in facial expression processing as it is involved in its motor mimicry. However, the literature only shows evidence of the implication of STS and preSMA for facial expression recognition, without relating it to face recognition. In addition, the literature shows a facilitatory role of facial motion in the recognition of unfamiliar faces, particularly for poor recognizers. The present study aimed at studying the role of STS and preSMA in unfamiliar face recognition in people with different face recognition skills. 34 healthy participants received repetitive transcranial magnetic stimulation over the right posterior STS, pre-SMA and as sham during a task of matching of faces encoded through: facial expression, rigid head movement or as static (i.e., absence of any facial or head motion). All faces were represented without emotional content. Results indicate that STS has a direct role in recognizing identities through rigid head movement and an indirect role in facial expression processing. This dissociation represents a step forward with respect to current face processing models suggesting that different types of motion involve separate brain and cognitive processes. PreSMA interacts with face recognition skills, increasing the performance of poor recognizers and decreasing that of good recognizers in all presentation conditions. Together, the results suggest the use of at least partially different mechanisms for face recognition in poor and good recognizers and a different role of STS and preSMA in face recognition.

The Complexity of Reading Revealed by a Study with Healthy Older Adults.

Aging, even when healthy, involves changes in cognitive functioning that can gradually affect the everyday activities and well-being of older people. Reading, which requires the integrity of several functions and their integration, is important to maintaining high cognitive and emotional stimulation over time. Our study aimed to investigate whether reading ability declines with aging. To explore also why reading would decline, we explored the changes in the performance of visual and attention tasks. A group of 58 neurologically healthy older people aged from 65 to 75 underwent neuropsychological assessment to investigate their global cognitive functioning, reading skills, crowding, and attention components. We found a decline in reading abilities as a function of aging (ß = 0.34, p < 0.05). We did not find an increase in crowding or difficulties in visual acuity. Furthermore, we found no decline with age in tasks of simple reaction times, visuospatial attention, and other single components of attention. Interestingly, we instead found a worsening with age in the Symbol Digit Modalities Test (ß = -0.26, p < 0.05), involving attention, working memory, and processing speed, which explains part of the reading decline. Our results suggest that task complexity is a fundamental aspect to account for aging changes.

Transcranial magnetic stimulation on the right dorsal attention network modulates the center-surround profile of the attentional focus.

Psychophysical observations indicate that the spatial profile of visuospatial attention includes a central enhancement around the attentional focus, encircled by a narrow zone of reduced excitability in the immediate surround. This inhibitory ring optimally amplifies relevant target information, likely stemming from top-down frontoparietal recurrent activity modulating early visual cortex activations. However, the mechanisms through which neural suppression gives rise to the surrounding attenuation and any potential hemispheric specialization remain unclear. We used transcranial magnetic stimulation to evaluate the role of two regions of the dorsal attention network in the center-surround profile: the frontal eye field and the intraparietal sulcus. Participants performed a psychophysical task that mapped the entire spatial attentional profile, while transcranial magnetic stimulation was delivered either to intraparietal sulcus or frontal eye field on the right (Experiment 1) and left (Experiment 2) hemisphere. Results showed that stimulation of right frontal eye field and right intraparietal sulcus significantly changed the center-surround profile, by widening the inhibitory ring around the attentional focus. The stimulation on the left frontal eye field, but not left intraparietal sulcus, induced a general decrease in performance but did not alter the center-surround profile. Results point to a pivotal role of the right dorsal attention network in orchestrating inhibitory spatial mechanisms required to limit interference by surrounding distractors.

Broken Ring enVision Search (BReViS): A New Clinical Test of Attention to Assess the Effect of Layout and Crowding on Visual Search.

The assessment of attention in neuropsychological patients could be performed with visual search tests. The Broken Rings enVision Search test (BReViS) here proposed represents a novel open access paper-and-pencil tool in which layout and crowding are varied among four cards. These manipulations allow the assessment of different components of attention: a selective component, the visuo-spatial orientation of attention, and the focal attention, involved in a crowding phenomenon. Our purpose was to determine the characteristics of the BReViS test, provide specific normative data, and assess these components across the lifespan. The test was administered to a sample of 550 participants aged between 20 and 79 years old and to a series of patients. Three indexes targeting different components of visuo-spatial attention (selective attention, strategic orientation of visual attention, focal attention) were obtained by combining execution times and accuracy together with the total errors. The results showed that age, education and gender influenced, in different combinations, the four indexes, for which specific norms were developed. Regression-based norms were provided in percentiles and equivalent scores. All patients showed pathological scores and specific patterns of attentional deficits. The BreViS test proved to be a free and easy valuable tool which can be used in the clinical environment to assess attentional deficits in neuropsychological patients.

Look at me now! Enfacement illusion over computer-generated faces.

According to embodied cognition research, one's bodily self-perception can be illusory and temporarily shifted toward an external body. Similarly, the so-called "enfacement illusion" induced with a synchronous multisensory stimulation over the self-face and an external face can result in implicit and explicit changes in the bodily self. The present study aimed to verify (i) the possibility of eliciting an enfacement illusion over computer-generated faces and (ii) which multisensory stimulation condition was more effective. A total of 23 participants were asked to look at a gender-matched avatar in three synchronous experimental conditions and three asynchronous control conditions (one for each stimulation: visuotactile, visuomotor, and simple exposure). After each condition, participants were asked to complete a questionnaire assessing both the embodiment and the enfacement sensations to address different facets of the illusion. Results suggest a stronger effect of synchronous vs. asynchronous stimulation, and the difference was more pronounced for the embodiment items of the questionnaire. We also found a greater effect of visuotactile and visuomotor stimulations as compared to the simple exposure condition. These findings support the enfacement illusion as a new paradigm to investigate the ownership of different face identities and the specific role of visuotactile and visuomotor stimulations with virtual reality stimuli.

Age-related differences in the statistical learning of target selection and distractor suppression.

In recent years, the use of implicit mechanisms based on statistical learning (SL) has emerged as a strong factor in biasing visuospatial attention, so that target selection is improved at frequently attended locations and distractor filtering is facilitated at frequently suppressed locations. Although these mechanisms have been consistently described in younger adults, similar evidence in healthy aging is scarce. Therefore, we studied the learning and persistence of SL of target selection and distractor suppression in younger and older adults in visual search tasks where the frequency of target (Experiment 1) or distractor (Experiment 2) was biased across spatial locations. The results show that SL of target selection was preserved in the older adults so, similar to their younger counterparts, they showed a strong and persistent advantage in target selection at locations more frequently attended. However, unlike young adults, they did not benefit from implicit SL of distractor suppression, so that distractor interference was maintained throughout the experiment independently of the contingencies associated with distractor locations. Taken together, these results provide novel evidence of distinct developmental patterns for SL of task-relevant and task-irrelevant visual information, likely reflecting differences in the implementation of proactive suppression attentional mechanisms between younger and older adults. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Teleneuropsychology: normative data for the assessment of memory in online settings.

INTRODUCTION: The COVID-19 pandemic has forced significant changes in clinical practice. Psychologists and neuropsychologists had to modify their settings to assess patients' abilities, switching from an in-person modality to a remote setting by using video calling platforms. Consequently, this change brought about the need for new normative data tailored to remote settings. AIM AND METHODS: The study aimed to develop normative data for the online assessment of neuropsychological memory tests and to compare it with the published norms obtained in standard settings. Two hundred and four healthy Italian volunteers performed three verbal memory tests through the Google Meet platform: the Digit Span (Backward and Forward), the Rey Auditory Verbal Learning, and the Verbal Paired Associated Learning Test. RESULTS: This research provides specific norms that consider the influence of demographic characteristics. Their comparison with published norms shows a medium to high agreement between systems. The present study provides a reference for the clinical use of neuropsychological instruments to assess verbal memory in a remote setting and offers specific recommendations.

The rehabilitation of object agnosia and prosopagnosia: A systematic review.

BACKGROUND: Agnosia for objects is often overlooked in neuropsychology, especially with respect to rehabilitation. Prosopagnosia has been studied more extensively, yet there have been few attempts at training it. The lack of training protocols may partially be accounted for by their relatively low incidence and specificity to sensory modality. However, finding effective rehabilitations for such deficits may help to reduce their impact on the social and psychological functioning of individuals. OBJECTIVE: Our aim in this study was to provide clinicians and researchers with useful information with which to conduct new studies on the rehabilitation of object agnosia and prosopagnosia. To accomplish this, we performed a systematic and comprehensive review of the effect of neuropsychological rehabilitation on visual object and prosopagnosia. METHODS: The Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were followed. In addition, the Single-Case Experimental Design (SCED) and the Critical Appraisal Skills Programme (CASP) scales were used to assess the quality of reporting. RESULTS: Seven articles regarding object agnosia, eight articles describing treatments for prosopagnosia, and two articles describing treatments for both deficits were included. CONCLUSIONS: In the light of the studies reviewed, treatments based on analysis of parts seem effective for object agnosia, while prosopagnosia appears to benefit most from treatments relying on holistic/configural processing. However, more attempts at rehabilitation of face and object agnosia are needed to clarify the mechanisms of these processes and possible rehabilitations. Moreover, a publication bias could mask a broader attempt to find effective treatments for visual agnosia and leaving out studies that are potentially more informative.

Normative Values of the Groffman Visual Tracing Test for the Assessment of Oculomotor Performance in the Adult Population.

The Groffman visual tracing (GVT) test is an indirect psychometric measure of oculomotor performance, used for the clinical assessment of eye movements. The test consists of two cards with five contorted lines of increasing overlap, crowding, and difficulty. The task starts from each of the letters at the top of the page, follows the line from the letter to the corresponding number at the bottom of the page, and the number is named. Although the GVT test was developed for the evaluation of children, it has also been applied to adults with visual and cognitive deficits. However, it lacks reference values. Therefore, the aim of the study was to assess oculomotor behavior across the typical human lifespan and to define normative data in an adult population. A total of 526 adults aged between 20 and 79 years, all without neurological or psychiatric deficits, were enrolled in the study. The results were analyzed by considering the accuracy and execution times separately. An influence of age, education and sex for accuracy was found, and age for the execution times was found. Norms for adults were developed considering the specific structure of the test and the accuracy and the execution time separately. The GVT test can now be applied in healthy and neurological adult populations for the evaluation of oculomotor performance.

Implicit evidence on the dissociation of identity and emotion recognition.

Recognition of identity and of emotional facial expressions of individuals are both based on processing of the human face. While most studies show these abilities to be dissociated, some others find evidence of a connection. One possible explanation for these contradictory results comes from neurological evidence, which points to identity recognition being mostly based on holistic processing, while emotion recognition seems to be based on both an explicit, fine-grained process, and an implicit, mostly-holistic one. Our main hypothesis, that would explain the contradictory findings, is that holistic implicit emotion recognition, specifically, would be related to identity recognition, while explicit emotion recognition would be a process separate to identity recognition. To test this hypothesis, we employed an experimental paradigm in which spatial frequencies of visual stimuli are manipulated so that automatic, holistic-based, implicit emotion recognition influences perceived friendliness of unfamiliar faces. We predicted the effect to be related to identity recognition ability, since they both require holistic face processing. After a successful replication study, we employed the paradigm with 140 participants, measuring also identity recognition ability and explicit emotion recognition ability. Results showed that the effect is not moderated by these two variables (p = .807 and .373, respectively), suggesting that the independence of identity and emotion recognition holds even when considering, specifically, implicit emotion recognition.

Prism Adaptation and Optokinetic Stimulation Comparison in the Rehabilitation of Unilateral Spatial Neglect.

Prism adaptation (PA) is one of the most effective treatments for the rehabilitation of unilateral spatial neglect. Optokinetic stimulation (OKS) has also been demonstrated to be effective in ameliorating symptoms of neglect. The aim of this study is to compare the effectiveness of these two methods in a group of neglect patients using a crossover design. A group of 13 post-acute brain-damaged patients with unilateral spatial neglect, who had never been rehabilitated, were treated using PA and OKS. Each treatment was applied for 10 sessions, twice a day, to all patients with both treatments in crossed order (i.e., PA followed by OKS or vice versa). Neuropsychological assessments were performed: before the first (T1), at the end of the first/beginning of the second (T2) and at the end of the second training sessions (T3), and two weeks after the end of treatment (T4). Both procedures produced a significant improvement in clinical tests at T2, independent of the type of training. The results suggest that either PA or OKS induces a significant amelioration of neglect in right brain-damaged patients, mainly in the first block of treatment. Since no differences between treatments were found, they could be applied in clinical practice, according to the requirements of the individual patient.

Automated scoring for a Tablet-based Rey Figure copy task differentiates constructional, organisational, and motor abilities.

Accuracy in copying a figure is one of the most sensitive measures of visuo-constructional ability. However, drawing tasks also involve other cognitive and motor abilities, which may influence the final graphic produced. Nevertheless, these aspects are not taken into account in conventional scoring methodologies. In this study, we have implemented a novel Tablet-based assessment, acquiring data and information for the entire execution of the Rey Complex Figure copy task (T-RCF). This system extracts 12 indices capturing various dimensions of drawing abilities. We have also analysed the structure of relationships between these indices and provided insights into the constructs that they capture. 102 healthy adults completed the T-RCF. A subgroup of 35 participants also completed a paper-and-pencil drawing battery from which constructional, procedural, and motor measures were obtained. Principal component analysis of the T-RCF indices was performed, identifying spatial, procedural and kinematic components as distinct dimensions of drawing execution. Accordingly, a composite score for each dimension was determined. Correlational analyses provided indications of their validity by showing that spatial, procedural, and kinematic scores were associated with constructional, organisational and motor measures of drawing, respectively. Importantly, final copy accuracy was found to be associated with all of these aspects of drawing. In conclusion, copying complex figures entails an interplay of multiple functions. T-RCF provides a unique opportunity to analyse the entire drawing process and to extract scores for three critical dimensions of drawing execution.

Consecutive and temporally distant perseverations after right brain damage: A prospective study.

Objective: Right brain-damaged patients may show omissions and/or additional marks in target cancellation. The latter is classified as perseverative behavior and has been attributed to defective response inhibition or attentional disengagement deficit. This study aimed at (a) verifying that consecutive (immediate) and return (temporally distant) motor perseverations could be due to different mechanisms; (b) investigating the relationships among different types of perseveration (e.g., consecutive, return, scribble), spatial neglect and the impairment in specific components of executive functioning. Method: Seventeen right brain-damaged patients underwent letter, star, bell, and apple cancellation tasks. A global index for each type of perseveration found and Mean Position of Hits, as a neglect index, were calculated. The following components of executive functioning were evaluated: motor programming (Frontal Assessment Battery [FAB] subtest), inhibitory control FAB, interference sensitivity (FAB and Stroop color-word interference test), set-shifting (Weigl sorting test, Phonemic/semantic alternate fluencies), and working memory (Backward Digit span). Results: Ten patients out of 17 showed some degree of perseveration. Regularized linear regression analyses demonstrated that interference sensitivity and Stroop test performances were related to return perseverations and backward digit to scribble ones. No significant relationships were found for consecutive perseverations and between neglect and any type of perseverations. Conclusions: The present study showed that return perseverations might have a distinct etiology from consecutive ones, being related to an inability to update and shift between action programs according to the visual stimuli. A finer classification of perseverations could help in unveiling the neuropsychological mechanisms underlying each type of behavior. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The Focal Attention Window Size Explains Letter Substitution Errors in Reading.

Acquired Neglect Dyslexia is often associated with right-hemisphere brain damage and is mainly characterized by omissions and substitutions in reading single words. Martelli et al. proposed in 2011 that these two types of error are due to different mechanisms. Omissions should depend on neglect plus an oculomotor deficit, whilst substitutions on the difficulty with which the letters are perceptually segregated from each other (i.e., crowding phenomenon). In this study, we hypothesized that a deficit of focal attention could determine a pathological crowding effect, leading to imprecise letter identification and consequently substitution errors. In Experiment 1, three brain-damaged patients, suffering from peripheral dyslexia, mainly characterized by substitutions, underwent an assessment of error distribution in reading pseudowords and a T detection task as a function of cue size and timing, in order to measure focal attention. Each patient, when compared to a control group, showed a deficit in adjusting the attentional focus. In Experiment 2, a group of 17 right-brain-damaged patients were asked to perform the focal attention task and to read single words and pseudowords as a function of inter-letter spacing. The results allowed us to confirm a more general association between substitution-type reading errors and the performance in the focal attention task.

The Brentano Illusion Test (BRIT): An implicit task of perceptual processing for the assessment of visual field defects in neglect patients.

In brain damaged patients with unilateral spatial neglect (USN), the differential diagnosis between the presence and absence of a unilateral visual half-field deficit (VHFD) is hampered by the similarity of their phenomenology. The absence of stimuli detection in the contralateral visual field, indeed, can be due to the co-occurrence of USN and VHFD or the sole presence of the USN. The disentangling of the two conditions is required to devise more specific rehabilitation programmes. Daini et al. [2002. Exploring the syndrome of spatial unilateral neglect through an illusion of length. Experimental Brain Research, 144(2), 224-237.] reported a difference in performance for the two conditions when the tasks required the bisection of Brentano illusory stimuli. Only when USN and VHFD co-occurred, the leftward illusory effect was disrupted. Based on previous findings, in this cross-sectional study, we developed the Brentano Illusion Test (BRIT), a clinical tool that helps the identification of VHFD in USN patients. The BRIT is a simple behavioural test of line bisection aimed at verifying the presence or absence of implicit processing in USN and thus helping the diagnosis of VHFD in USN patients; it also provides normative data for the line bisection task and the length effect.

Impaired mechanism of visual focal attention in posterior cortical atrophy.

Objective: Simultanagnosia, a deficit in holistic visual perception, is among the most prominent features of posterior cortical atrophy (PCA). Deficits in visuoperceptual and attentional mechanisms could contribute to simultanagnosia. In the present study, we explored the impaired visual perception of global configuration with two main hypotheses: (a) It is due to a deficit in processing low-spatial frequency stimuli, and (b) it arises from deficits in adjusting attentional focus. Method: The visuoperceptual mechanism was explored by asking participants (5 PCA patients and 20 age- and education-matched healthy controls) to report the local and global elements of incongruent hierarchical letters. Stimuli were unbiased (black letters/white background) and parvocellular biased (red letters/green background). A cued T-detection task, where the stimulus onset asynchrony and the cues' features varied, was used to explore focal attention. Results: PCA patients systematically failed in reporting the global but not the local element. The parvocellular-biased condition partially improved the performance in only 1 patient. In the T-detection task, controls responded faster to targets cued by red dots and small cues as compared to no cues. Conversely, the cue's features did not affect patients' performance. Conclusions: Results only partially support the hypothesis according to which simultanagnosia is driven by an impairment in processing low-spatial frequencies. Data indicate a deficit in the flexibility of focal attention that prevents PCA patients from adapting the attentional window to the stimulus features. Simultanagnosia in PCA can be conceptualized as a complex result of a deficit involving visuoperceptual and exogenous attentional mechanisms. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

How difficult is it for adolescents to maintain attention? The differential effects of video games and sports.

Despite a large body of evidence suggests positive effects of playing action video games and practising sports on various visual attentional skills, the impact of these activities on the ability to maintain attention over prolonged periods of time (i.e., sustained attention) has been largely neglected. Here, we first explored free-time habits on a group of 310 adolescents by means of a self-reported questionnaire. We found an inverse relationship between the time spent with sports and video games, but not with other extra-scholastic activities: the time spent practising sports and playing video games clearly competed with each other, with the more-intensive-sport practitioners being less involved in video game play. Next, we directly measured sustained attention and other attentional skills in a subgroup of 76 participants, divided as a function of their time spent in sports and action video games. In particular, sustained attention was assessed by means of two tasks: a classic exogenous task, requiring participants to attend to a flashing visual stimulus; and an internal (endogenous) sustained attention task, requiring participants to synchronise their manual responses to the rhythm of auditory pulses presented in an earlier phase. As previously documented, we found that action video game players displayed worse ability to maintain attention over time, as compared with non-action players. In striking contrast, intensive sports practice was associated with an increased ability to maintain attention over time. Overall, these findings unveil distinct cascading effects on sustained attention induced by doing sport and playing action video games.

A comparison of prism adaptation with terminal versus concurrent exposure on sensorimotor changes and spatial neglect.

Prism adaptation (PA) is a technique that induces a temporary change of the alignment between different reference frames. This technique has been shown to reduce many signs of unilateral spatial neglect (USN). Two procedures of prism adaptation have been used. In concurrent exposure participants can see their arm and hand during the movement trajectory, and during terminal exposure, participants can see only the most distal few centimetres. Because the two exposures elicit different proportions of visual and proprioceptive realignment, they could present different rehabilitation efficacies. We compared these procedures in 12 USN patients and 12 healthy participants who performed one session of PA with concurrent exposure and one session with terminal exposure. We compared the effects of the two exposure types on sensorimotor outcomes (visual subjective straight ahead, proprioceptive subjective straight ahead, open loop pointing, and error correction during exposure) and neglect outcomes. We found no significant differences in the effects of the two exposure types on sensorimotor performance of patients and controls, nor on patients' neuropsychological outcomes. Compared with controls, USN patients showed a significant rightward bias in visual subjective straight ahead pre-adaptation, a slower rate of error correction during prism exposure, and some evidence that visual and proprioceptive shift could be influenced by their neglect. Based on these results, we recommend that prism adaptation be conducted with concurrent exposure for easiness of execution.