Papers by Laura Veronelli
Experimental Brain Research
Previous studies have identified a ‘defensive graded field’ in the peripersonal front space where... more Previous studies have identified a ‘defensive graded field’ in the peripersonal front space where potential threatening stimuli induce stronger blink responses, mainly modulated by top–down mechanisms, which include various factors, such as proximity to the body, stimulus valence, and social cues. However, very little is known about the mechanisms responsible for representation of the back space and the possible role of bottom–up information. By means of acoustic stimuli, we evaluated individuals’ representation for front and back space in an ambiguous environment that offered some degree of uncertainty in terms of both distance (close vs. far) and front–back egocentric location of sound sources. We aimed to consider verbal responses about localization of sound sources and EMG data on blink reflex. Results suggested that stimulus distance evaluations were better explained by subjective front–back discrimination, rather than real position. Moreover, blink response data were also bett...
The Semantic Association Test (SAT): normative data from healthy Italian participants and a validation study in aphasic patients
Neurological Sciences
Experimental Brain Research
Motor learning interacts with and shapes experience-dependent cerebral plasticity. In stroke pati... more Motor learning interacts with and shapes experience-dependent cerebral plasticity. In stroke patients with paresis of the upper limb, motor recovery was proposed to reflect a process of re-learning the lost/impaired skill, which interacts with rehabilitation. However, to what extent stroke patients with hemiparesis may retain the ability of learning with their affected limb remains an unsolved issue, that was addressed by this study. Nineteen patients, with a cerebrovascular lesion affecting the right or the left hemisphere, underwent an explicit motor learning task (finger tapping task, FTT), which was performed with the paretic hand. Eighteen age-matched healthy participants served as controls. Motor performance was assessed during the learning phase (i.e., online learning), as well as immediately at the end of practice, and after 90 min and 24 h (i.e., retention). Results show that overall, as compared to the control group, stroke patients, regardless of the side (left/right) of ...
Implicit reading in a patient with pure alexia: a behavioral and structural disconnectome study
Annual Meeting of the Milan Center for Neuroscience 2020, 2020
Consecutive and temporally distant perseverations after right brain damage: A prospective study
Neuropsychology, 2021
Objective: Right brain-damaged patients may show omissions and/or additional marks in target canc... more 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).
In line bisection tasks, right-brain damaged patients with unilateral spatial neglect (USN) exhib... more In line bisection tasks, right-brain damaged patients with unilateral spatial neglect (USN) exhibit a rightward deviation with respect to the objective midpoint of the stimulus, while in neurologically unimpaired participants a reversed bias ("pseudoneglect") has been consistently reported. In a study with healthy subjects, suggested the existence of partially independent mechanisms involved in word and line bisection, not only linguistic but also visuo-perceptual. Furthermore, both lexical and syntactic factors are shown to modulate the reading performance in patients with neglect dyslexia . A series of studies involving USN patients were conducted in order to investigate the spatial and linguistic encoding of orthographic material through a bisection task. In Study I, right-brain damaged patients with USN, right-brain damaged patients without USN, and matched controls were asked to manually bisect words (5-10-13 letters) and lines of comparable length (Exp. 1), and words with final sequences differing on the prediction made concerning how the word should have been read (stressed on the penultimate or antepenultimate syllable; Exp. 2). Study II required the bisection of words and lines of different lengths, radially oriented. In Study III, patients were asked to bisect affirmative and interrogative sentences varying on the syntactic structure, compared to letter strings and lines (Exp. 1), and sentences in which lexical and syntactic alterations were introduced (Exp.2). Data from Study I demonstrated that most USN patients show a rightward deviation similar for words and lines, with the bias increasing with stimulus length. However, in individual patients USN can affect the bisection of lines and orthographic material with various degrees of severity, demonstrating that at least partially independent mechanisms interact during bisection . Furthermore, the ortho-phonological information contained in the final part of a word could act as a cue, modulating the bisection error in patients and healthy subjects. In Study II, radial words are re-oriented during bisection, reaching their canonical orientation. Finally, the linguistic nature of the stimulus induces facilitation in USN patients, who show a reduced error deviation in case of sentences with respect to letter strings and lines (Study III), even when lexical and syntactic alterations were introduced. In conclusion, visuo-perceptual and linguistic information (both lexical and possibly syntactic) modulates the allocation of attention in word and sentence bisection.
Brain Sciences, 2021
Acquired Neglect Dyslexia is often associated with right-hemisphere brain damage and is mainly ch... more 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 ...
Neurocase, 2020
Patients with pure alexia have major difficulties in reading aloud. However, they often perform a... more Patients with pure alexia have major difficulties in reading aloud. However, they often perform above chance level in reading tasks that do not require overt articulation of the target word -like lexical decision or semantic judgment -a phenomenon usually known as "implicit reading." There is no agreement in the literature on whether implicit reading should be attributed to relative sparing of some left hemisphere (LH) reading centers or rather to signs of compensatory endeavors by the right hemisphere (RH). We report the case of an 81-year-old patient (AA) with pure alexia due to a lesion involving the left occipital lobe and the temporal infero-mesial areas, as well as the posterior callosal pathways. Although AA's reading was severely impaired and proceeded letter by letter, she showed an above-chance-level performance for frequent concrete words in a tachistoscopic lexical decision task. A structural disconnectome analysis revealed that AA's lesion not only affected the left occipital cortex and the splenium: it also disconnected white-matter tracts meant to connect the visual word-form system to decision-related frontal areas within the LH. We suggest that the RH, rather than the LH, may be responsible for patient AA's implicit reading.
Journal of Clinical and Experimental Neuropsychology, 2020
Objective: Personal neglect (PN) refers to a form of hemi-inattention toward the contralesional b... more Objective: Personal neglect (PN) refers to a form of hemi-inattention toward the contralesional body space and it usually occurs following a right brain lesion. Recent studies suggest that PN indicates a disorder of body representation. Specifically, patients with PN show difficulties in identifying differences between left and right hands and have an altered visuospatial body map, which is associated with disrupted mental body representations. However, the metric representation of the body, and in particular the hands, has not been systematically addressed in patients showing this form of neglect. In the present study, we have investigated this representation by testing the perceived hands' width of 11 hemiplegic patients with right hemisphere cerebral lesions (5 with PN) and 12 healthy controls on a judgment of passability task. Patients and controls were asked to imagine inserting their hand (left and right) through a series of vertical apertures of different sizes and to judge whether their hand could fit through. Due to the heterogeneity of the data, both parametric and non-parametric approaches were used. Furthermore, additional single-case analyses were conducted by using Crawford and Howell's (1998) method. Results: Study findings showed that patients with PN showed a significant underestimation of the left hand compared with their right hand. In contrast, whilst the right hand was equally distorted in both patients' groups, the hemiplegic patients with no evidence of PN tended to perceive the affected hand as larger than their ipsilesional one. In line with the literature, our findings confirm an underlying distorted body representation following right brain damage. However, for the first time, we report both a quantitative and qualitative difference in impact of hemiplegia and PN on body representation of the contralesional body space.
Neurological Sciences, 2020
Tests and batteries used in the evaluation of language impairments are overly complex and often i... more Tests and batteries used in the evaluation of language impairments are overly complex and often ineffective (too difficult) in the assessment of post-stroke patients affected by severe aphasia (global aphasia). The present study reports details on the construction and standardization of a new Italian battery of tasks, specifically designed to assess severe lexical disorders in acquired aphasia (Battery for the Assessment of Severe Acquired Lexical Damage in Italian, BASALDI). The battery is composed of a common set of 64 stimuli (concrete nouns), belonging to both living and non-living categories, and consists of four lexical tasks assessing picture naming, repetition, reading aloud, and oral comprehension. The item selection was based on word frequency, word length, and phonological-articulatory complexity, namely the presence of continuant vs. plosive phones, a variable that may interact with word production in case of severe language damage. Standardization (naming agreement) of a new set of 64 colored images and normative data on Italian healthy subjects pooled across homogenous subgroups for age, gender, and education are reported. Finally, for the four tasks, percentile ranks and z-scores were calculated from a pool of 92 left brain-damaged patients affected by aphasia of different types and severity. The battery allows a fine investigation of lexical disorders, being suitable for diagnostic assessment of mild-to-moderate and severe aphasic lexical deficits, detection of changes over time, and possible dissociations between tasks.
Neurological Sciences, 2020
This article was published with incomplete Table . The Equivalent scores were missing during the ... more This article was published with incomplete Table . The Equivalent scores were missing during the submission. The correct Table is presented here.
Cortex, 2020
Hyperschematia (HS) for extra-personal space is a rare neuropsychological disorder characterized ... more Hyperschematia (HS) for extra-personal space is a rare neuropsychological disorder characterized by leftward overexpansion in drawing, with the addition of more left-sided details, and line extension. It has been described following right cortico-subcortical lesions, and most frequently regards the left side of space but see;. Here, we report on the case of a patient affected by ipsilesional HS after a left hemispheric cerebellar lesion. GG, a 75-year-old graduated right-handed man, was hospitalized for sudden onset of headache, vomiting, and dizziness, following left cerebellar hemorrhagic lesion, mainly involving the middle cerebellar peduncle (Fig. ), with perifocal edema, faint left ponto-mesencephalic hypodensity, and traces of bilateral intraventricular and subarachnoid bleeding. At admission to our rehabilitation hospital, 39 days after the event, the neurological examination revealed slight hyposthenia of the right limbs, without somatosensory deficits, disequilibrium with left-latero and retropulsion and diplopia. A comprehensive neuropsychological assessment detected multi-domain deficits, including long-term
Neuropsychologia, 2020
The human brain has a remarkable capacity to focus processing resources based on the features and... more The human brain has a remarkable capacity to focus processing resources based on the features and the relevance of the task at hand. The two cerebral hemispheres contribute differentially to this capacity, with the left hemisphere linguistic and right hemisphere visuo-spatial abilities each offering unique contributions. For example, previous research has established that healthy participants set the subjective mid-point of written sentences more leftwards of center, compared to unpronounceable letter strings or simple lines. Remarkably, patients with right hemisphere damage exhibiting unilateral spatial neglect also show this pattern, even though, as well known in the literature, they tend toward a rightward-bias for non-linguistic stimuli. This evidence suggests that the leftward bias for sentential material is due to linguistic, mainly left-hemisphere mediated processes, which are largely unimpaired in right brain-damaged patients, and intact in heathy participants. To test this hypothesis, we compared sentence bisection performance to that of letter strings and simple lines in left brain-damaged patients (with and without aphasia). If the larger leftward bias in the bisection of sentential material is based on linguistic processes, then the left brain-damaged patients should show a reduction or absence of a leftward bias in sentence bisection. We tested twenty-four left brain-damaged patients (12 with aphasia and 12 without aphasia), and 24 age-matched elderly participants (patients and controls were all righthanded). Participants were asked to bisect 240 stimuli, comprising: (i) affirmative and interrogative clauses, (ii) sentences with lexical and syntactic violations, (iii) letter strings and (iv) simple lines. As predicted, neurologically intact participants showed larger leftward biases in bisecting written readable sentences compared to strings of letters. In contrast, the left hemispheredamaged patients (both with and without aphasia) showed no differences in bisecting sentences and letter strings or lines. These findings indicate that the larger leftward bias exhibited by healthy participants in the bisection of sentences is likely due to ortho-phonological coding taking place implicitly during the bisection task. This ortho-phonological coding is impaired with left brain damagealso in absence of apparent aphasialeading to the left hemispheredamaged patients showing a reduced leftward bias in sentence bisection. These findings support the hypothesis that the leftward bias in the bisection of written sentences is the result of ortho-phonological influences rather than visual-spatial biases.
Physiology & Behavior, 2018
The vestibular system plays a pivotal role in behavioural and physiological aspects of body repre... more The vestibular system plays a pivotal role in behavioural and physiological aspects of body representation. If on the one hand, the stimulation of the vestibular system in healthy subjects provokes body representation distortions, accompanied by a decrease of body temperature, on the other hand, in brain-damaged patients it transiently restores body representation disorders. So far, the physiological counterpart of such behavioural amelioration on patients has never been explored. Here we aimed at investigating body temperature variations following Caloric Vestibular Stimulation (CVS), in a patient affected by somatoparaphrenia who regained the sense of body part ownership after the stimulation. Results showed an increase in body temperature after CVS, which also correlated with the temporary restored sense of limb ownership. Our results support the idea that physiological signals are fundamental to maintain a coherent mental representation of the body.
Clinical Rehabilitation, 2019
Objective: The aim of this study was to investigate the efficacy of mirror therapy on upper-limb ... more Objective: The aim of this study was to investigate the efficacy of mirror therapy on upper-limb recovery in early post-stroke patients. Design: Assessor-blinded randomized controlled trial. Setting: Inpatient rehabilitation clinic. Subjects: A total of 40 patients with upper-limb impairment due to a first-ever ischaemic or haemorrhagic stroke, within four weeks from the cerebrovascular accident. Intervention: The intervention group received mirror therapy, while the control group received sham therapy. During mirror therapy, patients’ sound hand was reflected by a mirror. During sham therapy, an opaque surface replaced the mirror-reflecting surface. Both the mirror therapy and sham therapy groups practised their sound hand with exercises, ranging from the simple elbow flexion–extension to complex tasks (e.g. reaching and grasping). Mirror therapy and sham therapy were added to conventional rehabilitation. Main measures: Primary outcome includes Fugl–Meyer upper extremity scale. Sec...
A new set of tasks for the assessment of lexical disorders in Italian
Frontiers in Human Neuroscience, 2018
Cortex, 2017
Geschwind Syndrome, a characteristic behavioral syndrome frequently described in patients affecte... more Geschwind Syndrome, a characteristic behavioral syndrome frequently described in patients affected by temporal lobe epilepsy (TLE), consists of the following features: hyperreligiosity, hypergraphia, hyposexuality, and irritability. Here we report the 9-year-clinical course of a case of Geschwind Syndrome that developed as a first and salient clinical expression of right temporal lobe variant of frontotemporal lobar degeneration (FTLD). Only one patient affected by frontotemporal dementia has previously been shown to present with Geschwind Syndrome. MS presented at age 73 with 3 years of personality and behavioral symptoms. Her early symptoms primarily included hyper-religiosity, hypergraphia, and poor emotional regulation (irritability, impulsivity, disinhibition, egocentric behavior). Over nine years, other cognitive functions (word retrieval, memory coding and recall, set-shifting, famous face and building recognition) became affected; however, hyper-religiosity, hypergraphia, and scarce emotional control remained her most prominent deficits. Longitudinal cortical thickness and volumetric analyses revealed early atrophy in the right temporal pole, right amygdala, and right hippocampus, which progressively affected homologous regions in the left hemisphere. The present case describes an unusual clinical picture associated with frontotemporal dementia (FTD), in which the most salient symptoms originated and remained consistent with Geschwind Syndrome.
Topics in Stroke Rehabilitation, 2017
Background: Aphasia is a serious consequence of stroke but aphasics patients have been routinely ... more Background: Aphasia is a serious consequence of stroke but aphasics patients have been routinely excluded from participation in some areas of stroke research. Objective: To assess the role of specific linguistic and non-verbal cognitive abilities on the short-term motor recovery of patients with aphasia due to first-ever stroke to the left hemisphere after an intensive rehabilitation treatment. Methods: 48 post-acute aphasic patients, who underwent physiotherapy and speech language therapy, were enrolled for this retrospective cohort-study. Four types of possible predictive factors were taken into account: clinical variables, functional status, language and non-verbal cognitive abilities. The motor FIM at discharge was used as the main dependent variable. Results: Patients were classified as follows: 6 amnestic, 9 Broca's, 7 Wernicke's, and 26 global aphasics. Motor FIM at admission (p = 0.003) and at discharge (p = 0.042), all linguistic subtests of Aachener AphasieTest (p = 0.001), and non-verbal reasoning abilities (Raven's CPM, p = 0.006) resulted significantly different across different types of aphasia. Post-hoc analyses showed differences only between global aphasia and the other groups. A Multiple Linear Regression shows that admission motor FIM (p = 0.001) and Token test (p = 0.040), adjusted for clinical, language, and non-verbal reasoning variables, resulted as independent predictors of motor FIM scores at discharge, while Raven's CPM resulted close to statistical significance. Conclusions: Motor function at admission resulted as the variable that most affects the motor recovery of post-stroke patients with aphasia after rehabilitation. A linguistic test requiring also non-linguistic abilities, including attention and working memory (i.e. Token test) is an independent predictor as well.
Pseudoneglect in sentence bisection: a comparison between Italian and Chinese
Journal of Cognitive Psychology, 2016
ABSTRACT Both reading habits and cerebral asymmetries may play a role on bisection bias. There ha... more ABSTRACT Both reading habits and cerebral asymmetries may play a role on bisection bias. There has been shown to be more recruitment of the right hemisphere in reading Chinese, compared to Japanese or alphabetic scripts. One therefore would expect that for sentence bisection in Chinese compared to Italian, a stronger allocation of attention to the left, mediated by the right hemisphere, would yield larger leftward bisection errors. In this study, native Chinese and Italian speakers bisected Chinese and Italian sentences, respectively, which varied in linguistic domain (syntactic or semantic coherence, definiteness and heaviness) and in the position of the linguistic manipulation (left, right and absent). The sentences were bisected more leftwards for Chinese than for Italian. Bisection deviations were further modulated by the position of the linguistic manipulation, though only for Chinese. We concluded that visuo-perceptual, linguistic and attentional factors influence sentence bisection, in a different way in Italian and Chinese.
Cortex, 2016
Unilateral spatial neglect (USN) syndrome has been rarely diagnosed in association with a concurr... more Unilateral spatial neglect (USN) syndrome has been rarely diagnosed in association with a concurrent status epilepticus. Some reports described patients affected by seizure-related USN together with additional clinical signs, motor or cognitive (Bussi ere,
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Papers by Laura Veronelli