Pierluigi Zoccolotti

Cognitive rehabilitation of the hemineglect disorder in chronic patients with unilateral right brain damage

Thirteen patients with a stabilized hemineglect symptomatology due to right-hemisphere lesions were subjected to a rehabilitation training specifically aimed at reducing the scanning deficit. The training consisted of four procedures (visual-spatial scanning, reading and copying training, copying of line drawings on a dot matrix, and figure description) which lasted 40 sessions. By the end of therapy, the patients as a group showed significant improvements on several standard tests of hemineglect. The results on a Semi-structured Scale for the Functional Evaluation of Hemineglect pointed to the extension of exploratory improvements to situations similar to those of daily life. In contrast, patients improved very slightly on a variety of standard visual-spatial tests, indicating the specificity of training in reducing the scanning defect. Seven patients were examined at a follow-up several months after the end of therapy and appeared stable on both standard and functional tests of neglect.

Left/right and cortical/subcortical dichotomies in the neuropsychological study of human emotions

Abstract Two main dichotomies have been put forth in the study of the anatomical substrates of emotional behaviour. The first, more classical and more firmly established, claims that the basic brain mechanisms for emotions are located in subcortical rather than in cortical structures. The second, more recent and still more hypothetical dichotomy, maintains that the right and the left hemispheres are not equally involved in emotional behaviour and that the right hemisphere plays a critical role in this regard. It is not clear, however, if these two dichotomies are independent or are somehow interconnected. The aim of this article is to discuss some aspects of the neuropsychology of human emotions, taking into account both the cortical/subcortical and the left/right dichotomy. First, we will review some well-established facts and some more recent models and data concerning the role played by cortical and subcortical structures in various aspects of emotional behaviour. Secondly, we will present a short summ...

Effectiveness of neglect rehabilitation in a randomized group study

The effectiveness of neglect rehabilitation training has been studied in two randomly selected groups of right brain-damaged patients. All patients proved heminattentive on a standard battery 2 months or more after the CVA. One group received 2 months of treatment immediately after admission to a clinic, and the other group received only general cognitive stimulation for the same amount of time. At the end of this period a comparison showed significant improvement in the first group, based on a standard test battery and a functional scale. The second group was then given rehabilitation training for neglect for the same amount of time and obtained similar improvement. It is concluded that the rehabilitation program produces significant results, which generalize to situations similar to those of everyday life. The importance of the duration of training on the generalization of learning is briefly discussed with reference to previous negative reports in the literature.

Reading Words and Pseudowords: An Eye Movement Study of Developmental Dyslexia ☆

The pattern of eye movements during reading was studied in 12 developmental dyslexics and in 10 age-matched controls. According to standard reading batteries, dyslexics showed marked reading slowness and prevalently used the sublexical procedure in reading. Eye movements were recorded while they read lists of short and long words or pseudowords. In normal readers, saccade amplitude increased with word length without a concomitant change in the number of saccades; in contrast, the number of saccades increased for long pseudowords. In dyslexics, the eye movement pattern was different. The number of saccades depended on stimulus length for both words and pseudowords while saccade amplitude remained small and constant. The sequential scanning shown by dyslexics for both words and pseudowords appears consistent with the cognitive description of the reading disorder which indicates the preferential use of the sublexical print-to-sound correspondence rules.

Eye movement patterns in linguistic and non-linguistic tasks in developmental surface dyslexia

Ten subjects who could be reliably assessed as surface dyslexics were selected on the basis of a large test battery. Eye movements in non-linguistic and linguistic tasks were studied in these subjects. Stability of fixation on a stationary stimulus was examined. Performance of dyslexics was no different from that of an age-matched control group. Similarly, no difference was observed between the two groups when they were requested to saccade to a rightward or leftward target. On the other hand, while reading short passages, dyslexics showed an altered pattern of eye movements with more frequent and smaller rightward saccades as well as longer fixation times. The reading pattern was analysed by eye tracking. Numerous fixations were used to read a single word in a fragmented way. Longer words showed a higher number of fixations. Overall, it was concluded that surface dyslexia is not associated with oculo-motor dysfunction and the study of eye movements in reading reveals the processing through orthography-to-phonology conversion characteristic of surface dyslexia. The importance is stressed of examining selected groups of subjects in the psychophysiological study of dyslexia.

Length Effect in Word Naming in Reading: Role of Reading Experience and Reading Deficit in Italian Readers

Vocal reaction times (RTs) in naming 3- to 8-letter words were measured in proficient and dyslexic readers (Study 1). In proficient readers, RTs were independent of word length up to 5-letter words, indicating parallel processing. In the 5- to 8-letter range, RTs increased linearly, indicating sequential processing. Reading experience was associated with both faster discrimination of individual elements and parallel processing of increasingly large word parts. In dyslexics, RTs increased linearly with increasing length indicating reliance on sequential decoding. Individual analysis indicated 2 profiles of RTs (Types A and B). In Study 2, the distinction between A and B dyslexics was not associated with the use of different reading procedures. However, a more marked speed deficit characterized Type B dyslexics.

Facilitatory effect of neglect rehabilitation on the recovery of left hemiplegic stroke patients: a cross-over study.

A study of the effect of specific training for visual neglect on the recovery of motor and functional impairment in stroke patients is reported. Two groups of right hemisphere stroke patients with hemispatial neglect and one group without neglect were assessed by means of three functional and neurological scales (Rivermead Mobility Index, Barthel Index, Canadian Neurological Scale). Three evaluations were made at 0, 2 and 4 months from the beginning of physical rehabilitation. During the first 2 months of physical rehabilitation one of the two groups of neglect patients was randomly assigned to specific training for neglect, and the second group to a general cognitive intervention; during the final 2 months of rehabilitation the types of training were switched in the two groups. The non-neglect patients improved steadily during physical rehabilitation. In contrast, the functional recovery of the two neglect groups was time-locked to the period of the specific training for neglect. At the time of admission, the two neglect groups performed at the same level; after 2 months of rehabilitation, the group with neglect training showed higher functional recovery than the group with only general cognitive intervention. When the latter group received neglect training, there was no longer any difference between the two neglect groups. This pattern was present for both of the functional scales used but not for the neurological scale. Motor and functional recovery of stroke patients with neglect seems to be significantly improved by the simultaneous presence of a treatment specifically focused on neglect.

The Wundt-Jastrow illusion in the study of spatial hemi-inattention

A new test to detect unilateral neglect was devised using a modified version of the Wundt-Jastrow area illusion. The test was given to three groups of subjects: left brain damaged (LBD), right brain damaged (RBD) patients and controls. Of RBD patients, 40.4% but no LBD patient or control, showed responses inconsistent with the visual illusion when the determinant features of the illusion pointed to the left visual field. These unexpected responses were highly related to a clinical evaluation of the severity of the hemi-inattention disorder. The sensitivity of this test and of other standard measures of hemi-neglect were compared. The possibility of identifying qualitatively different forms of hemi-neglect was also discussed.

Functional evaluation of hemineglect by means of a semistructured scale: Personal extrapersonal differentiation

Abstract A semistructured scale for the functional evaluation of hemineglect was given to 26 patients who proved hemi-inattentive on standard diagnostic tests. Analysis of the internal composition of the scale indicated a differentiation between trials that require the exploration of external space (for example, dealing cards or serving tea) and trials that require the exploration of ones own body (for example, using a comb or razor). This result is consistent with the hypothesis that neglect fractionates as a function of extrapersonal versus personal space. This distinction was also supported by the performance of a patient examined after the completion of the experimental series. This patient showed a selective failure in personal but not extrapersonal items. A brief analysis of this case and of its implications is presented. It is concluded that the part of the scale relative to personal space represents a useful starting point for the evaluation of a disorder that still has a limited clinical descrip...

Italian developmental dyslexic and proficient readers: Where are the differences?

Italian dyslexic children are characterized by a pervasive reading speed deficit, with relatively preserved accuracy. This pattern has been associated with predominant use of the nonlexical reading procedure. However, there is no evidence of a deficit in the lexical route of Italian dyslexics. We investigated both lexical and nonlexical reading procedures in dyslexic children through two marker effects, namely, the word frequency effect and the effect of contextual grapheme-to-phoneme conversion rules. Although dyslexics were slower and less accurate than controls, they were affected by word frequency, grapheme contextuality, and their interaction in a similar manner as average readers. These results show the use of lexical reading in Italian dyslexics, and refute the claim of a deficit in whole-word processing with consequent over-reliance on the nonlexical route.