Marcello Gallucci

Intraoperative subcortical language tract mapping guides surgical removal of gliomas involving speech areas

OBJECTIVESubcortical stimulation can be used to identify functional language tracts during resection of gliomas located close to or within language areas or pathways. The objective of the present study was to investigate the feasibility of the routine use of subcortical stimulation for identification of language tracts in a large series of patients with gliomas and to determine the influence that subcortical language tract identification exerted on the extent of surgery and on the appearance of immediate and definitive postoperative deficits. METHODSSubcortical stimulation for language tract identification was systematically used during surgical removal of 88 gliomas (44 high-grade and 44 low-grade gliomas) involving language pathways. Procedures were performed during asleep/awake craniotomy. Subcortical stimulation was continuously alternated with surgical resection in a back-and-forth fashion. Language performances were tested by neuropsychological language evaluation preoperatively and at 3, 30, and 90 days after surgery. RESULTSLanguage tracts were identified in 59% of patients, with differences according to tumor location but not according to histological grade. Language tract identification influenced the ability to reach a complete tumor removal in low-grade gliomas, in which tracts were documented inside the peripheral mass of the tumor. Identification of language tracts was associated with a higher occurrence of transient postoperative deficits (67.3% of cases), but a low occurrence of definitive morbidity (2.3% of cases). A pattern of typical language disturbances related to the phonological and semantic system can be identified according to tumor location, with preservation being important for the maintenance of language integrity. CONCLUSIONOur study supports the routine use of subcortical stimulation for language tract identification as a reliable tool for guiding surgical removal of gliomas in or in close proximity to language areas or pathways.

When people fall from grace: reconsidering the role of envy in Schadenfreude.

Previous research yielded conflicting results concerning the role of envy in predicting Schadenfreude (pleasure at anothers misfortune). Some studies showed that envy predicts Schadenfreude, whereas others did not. Results of the present research reconcile these opposing findings, by showing that envy is a predictor of Schadenfreude when the target is similar to the observer in terms of gender. These results suggest that envy predicts Schadenfreude when people are confronted with the misfortune of a relevant social comparison other.

Rehabilitating patients with left spatial neglect by prism exposure during a visuomotor activity

OBJECTIVE Adaptation to prisms displacing the visual scene rightward is a therapeutic tool for left unilateral spatial neglect (USN). We aimed at comparing the effects of the classic adaptation procedure (repeated pointing toward visual targets, control treatment, C), with those of a novel adaptation method, involving ecological visuomotor activities (experimental treatment, E). METHOD In 10 right-brain-damaged USN patients, each treatment was given for 1 week, with a crossover design, for a total of 20 sessions, twice per day. USN was assessed by cancellation, reading, and drawing tasks, and by a standardized scale. Neurological severity was assessed by the National Institutes of Health (NIH) stroke scale (Brott et al., 1989), disability by the Functional Independence Measure (FIM) scale. RESULTS The 2-week treatments (EC, CE) were equally effective, improving both USN, confirming previous reports (Frassinetti, Angeli, Meneghello, Avanzi, & Làdavas, 2002) and, importantly, disability. The improvement was independent of baseline performance, duration of disease, and neurological severity. Recovery took place after the first week, continued in the second week, and was stable at the follow-up of 3 months. The improvement of USN, measured by cancellation performance, and, in part, that of disability, measured through the FIM scale, were mediated by the size of the leftward aftereffects, suggesting a causal relationship between prism exposure and recovery. The E protocol was better tolerated. CONCLUSIONS Daily life visuomotor activities, associated with prism exposure, are a useful tool for rehabilitating USN patients. This new treatment may widen the compliance with prism exposure treatments and their feasibility within home-based programs.

Role of diffusion tensor magnetic resonance tractography in predicting the extent of resection in glioma surgery

Diffusion tensor imaging (DTI) tractography enables the in vivo visualization of the course of white matter tracts inside or around a tumor, and it provides the surgeon with important information in resection planning. This study is aimed at assessing the ability of preoperative DTI tractography in predicting the extent of the resection achievable in surgical removal of gliomas. Patients with low-grade gliomas (LGGs; 46) and high-grade gliomas (HGGs; 27) were studied using a 3T scanner according to a protocol including a morphological study (T2, fluid-attenuated inversion-recovery, T1 sequences) and DTI acquisitions (b = 1000 s/mm(2), 32 gradient directions). Preoperative tractography was performed off-line on the basis of a streamline algorithm, by reconstructing the inferior fronto-occipital (IFO), the superior longitudinal fascicle (SLF), and the corticospinal tract (CST). For each patient, the relationship between each bundle reconstructed and the lesion was analyzed. Initial and residual tumor volumes were measured on preoperative and postoperative 3D fluid-attenuated inversion-recovery images for LGGs and postcontrast T1-weighted scans for HGGs. The presence of intact fascicles was predictive of a better surgical outcome, because these cases showed a higher probability of total resection than did subtotal and partial resection. The presence of infiltrated or displaced CST or infiltrated IFO was predictive of a lower probability of total resection, especially for tumors with preoperative volume <100 cm(3). DTI tractography can thus be considered to be a promising tool for estimating preoperatively the degree of radicality to be reached by surgical resection. This information will aid clinicians in identifying patients who will mostly benefit from surgery.

Cold-blooded loneliness: Social exclusion leads to lower skin temperatures

Being ostracized or excluded, even briefly and by strangers, is painful and threatens fundamental needs. Recent work by Zhong and Leonardelli (2008) found that excluded individuals perceive the room as cooler and that they desire warmer drinks. A perspective that many rely on in embodiment is the theoretical idea that people use metaphorical associations to understand social exclusion (see Landau, Meier, & Keefer, 2010). We suggest that people feel colder because they are colder. The results strongly support the idea that more complex metaphorical understandings of social relations are scaffolded onto literal changes in bodily temperature: Being excluded in an online ball tossing game leads to lower finger temperatures (Study 1), while the negative affect typically experienced after such social exclusion is alleviated after holding a cup of warm tea (Study 2). The authors discuss further implications for the interaction between body and social relations specifically, and for basic and cognitive systems in general.

Complement Receptor 3 Ligation of Dendritic Cells Suppresses Their Stimulatory Capacity

To activate T cells effectively, dendritic cells (DCs) must provide three separate signals, MHC-Ag, costimulatory molecules (such as CD80 and CD86), and proinflammatory cytokines (such as IL-12). These three signals are up-regulated in the presence of “danger signals” such as LPS or viral nucleic acids. Evidence suggests that DCs providing only the first two of these signals cannot successfully stimulate T cells. Apoptotic cells have been proposed to suppress DC immunogenicity through the ligation of apoptotic cell receptors. Complement receptor 3 (CR3) and CD36 have been suggested to be important in this process, although the mechanism by which this modulation occurs is still unclear. We demonstrate that ligation of CR3, but not CD36, directs DCs to increase surface MHC and costimulatory molecules, while suppressing inflammatory cytokine release. CR3 modulation of DCs does not require a type I IFN response, does not involve the specific regulation of the MyD88- or Toll/IL-1R domain-containing adaptor-inducing IFN-β-dependent TLR signaling pathways, and occurs even in the absence of danger signals. The functional outcome of this process is poor Ag-specific stimulation of CD4 and CD8 T cells by CR3-ligated DCs both in naive response as well as upon subsequent challenge with normal DCs. We propose that CR3 provides a “nondanger” signal that suppresses the stimulatory capacity of DCs.

A bumpy train ride: A field experiment on insult, honor, and emotional reactions.

The present research examined the relationship between adherence to honor norms and emotional reactions after an insult. Participants were 42 Dutch male train travelers, half of whom were insulted by a confederate who bumped into the participant and made a degrading remark. Compared with insulted participants with a weak adherence to honor norms, insulted participants with a strong adherence to honor norms were (a) more angry, (b) less joyful, (c) less fearful, and (d) less resigned. Moreover, insulted participants with a strong adherence to honor norms perceived more anger in subsequent stimuli than not-insulted participants with a strong adherence to these norms. The present findings support a direct relationship among insult, adherence to honor norms, and emotional reactions.

Individual differences and social norms: the distinction between reciprocators and prosocials

Reciprocity is in this contribution compared with cooperation, hostility, and prosociality, in order to distinguish its peculiar theoretical and empirical characteristics. Two studies are presented. Study 1 (n = 166) is based on the distinction between the mechanism of reciprocity and the consequent behaviour that this mechanism produces. It is shown that participants have a clear implicit theory of the personality traits underlying reciprocal behaviour, and these traits are well differentiated with respect to traits underlying cooperation and hostility. Study 2 (n = 134) is based on the distinction between reciprocity as a goal and reciprocity as a strategy to achieve equality. Results show that individuals with high internalization of the norm of reciprocity allocate payoffs as a function of the valence of others past behaviour, whereas this feature is irrelevant for individuals with high prosocial orientation. Copyright

Measuring clinical outcomes in neuro-oncology. A battery to evaluate low-grade gliomas (LGG)

We describe how a neuropsychological evaluation in patients with brain tumors should be performed, specifically in the case of low-grade gliomas. Neuropsychological examination is crucial before starting any treatment as well as during the follow-up, since it can improve neurosurgery techniques and reveal potential cognitive effects of chemotherapy and radiotherapy, besides planning rehabilitation. We underline that sensitive and wide-ranging tests are required; specific tasks based on the lesion site should be added. Moreover, some tests can provide additional information about the evolution of the tumor. A careful, thorough examination improves quality of life.

Racism and the Empathy for Pain on Our Skin

Empathy is a critical function regulating human social life. In particular, empathy for pain is a source of deep emotional feelings and a strong trigger of pro-social behavior. We investigated the existence of a racial bias in the emotional reaction to other peoples pain and its link with implicit racist biases. Measuring participants’ physiological arousal, we found that Caucasian observers reacted to pain suffered by African people significantly less than to pain of Caucasian people. The reduced reaction to the pain of African individuals was also correlated with the observers’ individual implicit race bias. The role of others’ race in moderating empathic reactions is a crucial clue for understanding to what extent social interactions, and possibly integration, may be influenced by deeply rooted automatic and uncontrollable responses.