Error-based training and emergent awareness in anosognosia for hemiplegia.

Residual forms of awareness have recently been demonstrated in subjects affected by anosognosia for hemiplegia, but their potential effects in recovery of awareness remain to date unexplored. Emergent awareness refers to a specific facet of motor unawareness in which anosognosic subjects recognise their motor deficits only when they have been requested to perform an action and they realise their errors. Four participants in the chronic phase after a stroke with anosognosia for hemiplegia were recruited. They took part in an "error-full" or "analysis of error-based" rehabilitative training programme. They were asked to attempt to execute specific actions, analyse their own strategies and errors and discuss the reasons for their failures. Pre- and post-training and follow-up assessments showed that motor unawareness improved in all four patients. These results indicate that unsuccessful action attempts with concomitant error analysis may facilitate the recovery of emergent awareness and, sometimes, of more general aspects of awareness.

Visual body recognition in a prosopagnosic patient.

Conspicuous deficits in face recognition characterize prosopagnosia. Information on whether agnosic deficits may extend to non-facial body parts is lacking. Here we report the neuropsychological description of FM, a patient affected by a complete deficit in face recognition in the presence of mild clinical signs of visual object agnosia. His deficit involves both overt and covert recognition of faces (i.e. recognition of familiar faces, but also categorization of faces for gender or age) as well as the visual mental imagery of faces. By means of a series of matching-to-sample tasks we investigated: (i) a possible association between prosopagnosia and disorders in visual body perception; (ii) the effect of the emotional content of stimuli on the visual discrimination of faces, bodies and objects; (iii) the existence of a dissociation between identity recognition and the emotional discrimination of faces and bodies. Our results document, for the first time, the co-occurrence of body agnosia, i.e. the visual inability to discriminate body forms and body actions, and prosopagnosia. Moreover, the results show better performance in the discrimination of emotional face and body expressions with respect to body identity and neutral actions. Since FM's lesions involve bilateral fusiform areas, it is unlikely that the amygdala-temporal projections explain the relative sparing of emotion discrimination performance. Indeed, the emotional content of the stimuli did not improve the discrimination of their identity. The results hint at the existence of two segregated brain networks involved in identity and emotional discrimination that are at least partially shared by face and body processing.

Laparoscopic ovarian biopsy in hypergonadotropic amenorrhea.

After reviewing the different etiopathogenetic hypotheses of hypergonadotropic amenorrhea, the AA. describe six clinical cases, four of which classifiable as early menopause and two as syndrome of resistant ovary. The basic role of laparoscopic ovarian biopsy in the attainment of a correct diagnosis is emphasized. Prognosis in terms of fertility is related to the residual follicular endowment which, even when extremely low, justifies a stimulating treatment, as demonstrated in the case reported in detail.

Line bisection and cognitive plasticity of unilateral neglect of space.

Patients with neglect of the left half of space were asked to bisect lines of different lengths. The leftmost points of the represented lines, determined on the basis of the midpoints set by the patients on the objective lines, were the dependent variable. It was thus possible to recognize diverse patterns of behavior which were conceivably averaged away in earlier investigations. In discussing the results, the question is raised of whether unilateral neglect of space may be altered by cognitive processes.

A comparison of hysterosalpingography and laparoscopy in the investigation of infertility.

From 1974-1980, 85 patients were investigated with both hysterosalpingography (HSG) and laparoscopy. Discordant diagnosis of adhesions made the largest group of disagreements. The causes of such and other discrepancies are discussed. The Authors conclude that laparoscopy is necessary to establish a conclusive assessment of the tubal factor and must be performed before HSG. The radiologic investigation still has its place to demonstrate lesions of endosalpinx before microsurgery.