Toward the characterization of a visual form of developmental dyslexia: Reduced visuo-attentional capacity for processing multiple stimuli made of separable features.

Some dyslexics cannot process multiple letters simultaneously. It has been argued that this reduced visuo-attentional (VA) letter span could result from poor reading ability and experience. Here, moving away from reading context, we showed that dyslexic group exhibited slower visual search than normal readers group for "symbols", defined as graphic stimuli made up of separable visual features, but not for filled objects. Slowness in symbol visual search was explained by reduced VA field and atypical ocular behaviour when processing those letter-like stimuli and was associated with reduced VA letter span and impaired elementary visuo-spatial perception. Such a basic visual search deficit can hardly be attributed to poor reading ability and experience. Moreover, because it is specific to letter-like stimuli (i.e., "symbols"), it can specifically hinder reading acquisition. Symbol visual search can easily be tested in the pre-reading phase, opening up prospects for early risk detection and prevention of VA dyslexia.

Feeling without localizing: exploring tactile misperception in a patient with uncommon parietal left brain damage.

Introduction: We report a very unique clinical presentation of a patient who complained, after a left parietal brain damage, about feeling tactile stimulations on his right upper limb without being able to localize them. Methods: Using a single case study approach, we report three experiments relying on several custom-made tasks to explore the different levels of somatosensory information processing, ranging from somato-sensation to somato-representation. Results: Our results showed a preserved ability to localize tactile stimuli applied on the right upper limb when using pointing responses while the ability to localize was less efficient when having to name the stimulated part (akin Numbsense). When the stimuli were applied on more distal locations (i.e., on the hand and on fingers), the number of correct responses decreased significantly independently of the modality of response. Finally, when visually presented with a stimulus delivered on the hand of an examiner in synchrony with the stimulation on the hidden hand of the patient, responses were largely influenced by the visual information available. Altogether, the convergence of these different customized tasks revealed an absence of autotopagnosia for motor responses for the right upper limb, associated with altered abilities to discriminate stimulus applied on distal and restricted/closer zones in the hand. Discussion: The somato-representation of our patient seemed to significantly rely on visual information, leading to striking deficits to localize tactile stimuli when vision and somesthesic afferences are discordant. This case report offers a clinical illustration of pathological imbalance between vision and somesthesia. Implications of these troubles in somato-representation on higher cognitive level processes are discussed.

Enhancing reading accuracy through visual search training using symbols.

Children with reading disorders present with inaccurate and/or delayed printed word identification. Regarding visual-attentional processing, printed words are letter strings, and each letter is a symbol made of separable features. Simultaneous processing of separable features has been evidenced to be specifically impaired in visual search tasks using symbols in poor readers as well as in a patient with superior parietal lobules (SPL) lesion. Additionally, activation in the SPL has been shown to be abnormally low in dyslexic readers displaying a reduced span of letter strings processing. This deficit has been assumed to impair visual-attentional sampling of printed words. An experiment conducted with 21 dyslexic children tested the hypothesis that a training program based on visual symbol search may stimulate the SPL, leading to a potential benefit transferred to reading performance. We designed the VisioCogLetters serious game and introduced it at random for one month (10 min every day) between four monthly reading sessions. No training was provided between the other (control) reading sessions. Reading accuracy increased without any speed-accuracy trade-off specifically in the session after training. Moreover, the percentage of improvement correlated with the individual time spent at home on training. These results show that improved visual search skills on symbols can translate into enhanced reading performance, and pave a new avenue for future rehabilitation tools.

Does nonviolent communication education improve empathy in French medical students?

OBJECTIVES: To evaluate the impact of nonviolent communication (NVC) training on five aspects of medical students' empathy skills using implicit and explicit measures. METHODS: 312 third-year French medical students were randomly allocated to an intervention group (n = 123) or a control group (n = 189). The intervention group received 2.5 days of NVC training. For each group, empathy-related skills were measured implicitly using three cognitive tests (Visuo-Spatial Perspective Taking, Privileged Knowledge, Empathy for Pain evaluation) and explicitly using two self-rating questionnaires (Jefferson Scale of Physician Empathy, Empathy Quotient). Both groups completed tests and questionnaires before (pre-test) and three months after training (post-test). Responses were collected via online software, and data were analyzed using paired linear mixed models and Bayes Factors. RESULTS: We found a significant increase in the Jefferson  Scale of Physician Empathy (JSPE) score between pre- and post-tests in the intervention group compared to the control group (linear mixed models: 0.95 points [0.17, 1.73], t(158) = 2.39, p < 0.05), and an expected gender effect whereby females had higher JSPE scores (1.57 points [0.72, 2.42], t(262) = -3.62, p < 0.001). There was no interaction between these two factors. CONCLUSIONS: Our results show that brief training in nonviolent communication improves subjective empathy three months after training. These results are promising for the long-term effectiveness of NVC training on medical students' empathy and call for the introduction of NVC training in medical school. Further studies should investigate whether longer training will produce larger and longer-lasting benefits.

Sympathy for the underdog: people are inclined to adopt the emotional perspective of powerless (versus powerful) others.

Upon learning of the story of Cinderella, most people spontaneously adopt the emotional perspective of this helpless young woman rather than of her older sisters who oppress her. The present research examines whether this pattern reveals a general human tendency to empathise more with the emotions of individuals with low (versus high) power. Six experiments (N = 878) examined how power influences the focus of people's emotional attributions. Participants were presented with situations in which one character exercised power over another one and had to resolve a referential ambiguity by considering the perspective of one or the other character. Results show that participants largely privileged the emotional states of the low-power character over those of the high-power character. This effect was observed with different types of stimuli (comics and video clips), with high- and low-power roles attributed to pairs of different genders (Experiments 1-4) or same gender (Experiments 5-6). Finally, the tendency persisted - though it was reduced - when participants adopted a less passive role with respect to the characters (Experiment 3) and when power occurred in a less despotic way (Experiment 6). Results are discussed with respect to social attention and sensitivity to fairness.

Take a Seat and Get Into Its Shoes! When Humans Spontaneously Represent Visual Scenes From the Point of View of Inanimate Objects.

Human description of the surrounding world may spontaneously rely on others' perspective, which is a crucial component of social cognition. In five studies, participants were asked to describe the spatial relations between objects in visual scenes including, or not, other agents. In Experiment 1, a substantial proportion of participants used an other-centered perspective in the presence of another agent, replicating classical findings. To our own surprise, we also observed that an even greater number of participants used an other-centered perspective when the human agent was replaced by an armchair. In order to explore this phenomenon, Experiments 2 to 5 compared the respective strength of chair-centered and agent-centered perspectives and/or set them into conflict. A significant proportion of participants spontaneously took the seat's perspective even when it may not be sat on (Experiments 3 and 4) and even when the seat was not referred to (Experiments 4 and 5). Altogether, these findings suggest that perspective taking may spontaneously apply to inanimate objects. These results question whether such tendencies originate from social cognitive skills-as classically assumed-or reveal a nonsocial phenomenon. Future works should specifically test the widely assumed social nature of spontaneous perspective-taking.

What Do Spatial Distortions in Patients' Drawing After Right Brain Damage Teach Us About Space Representation in Art?

The right cerebral hemisphere plays a crucial rule in spatial cognition, spanning from perception of elementary features, such as location, color, line orientation or shape to representation of different spaces (3D space, allocentric, egocentric, face, personal, peri-personal, or imaginal). One important aspect of its contribution concerns the perception of space symmetry and the representation of objects and scenes, with reference to the midline or body axis. This representation results from a balance between spatial attention processes depending from the two hemispheres. Healthy participants tend to show a discrete deviation of the midline plane representation toward the left side, that is likely to result from the predominance of the activity of the right cerebral hemisphere, mainly oriented toward the contralateral side of space. The visuospatial abilities of the right hemisphere, especially for the representation of the midline plane are crucially engaged in painting and drawing processes in artists. Interestingly, the distortions created by painters of the Cubism period, characterized by an asymmetry of objects and body representations, a specific enlargement or reduction of parts of space, or even by complex distortions of 3D space are analogous to those classically reported in right-brain-damaged patients (unilateral spatial neglect, hyperschematia, constructional apraxia). Understanding the pathological mechanisms of these representation disorders provides meaningful information to apprehend visual artist creations and esthetic perception of space.

Adding methylphenidate to prism-adaptation improves outcome in neglect patients. A randomized clinical trial.

Spatial neglect is one of the main predictors of poor functional recovery after stroke. Many therapeutic interventions have been developed to alleviate this condition, but to date the evidence of their effectiveness is still scarce. OBJECTIVE: The purpose of this study was to test whether combining prism adaptation (PA) and methylphenidate (MP) could enhance the recovery of neglect patients at a functional level. METHODS: RITAPRISM is a multicentre, randomized, double-blind, placebo-controlled study comparing PA plus placebo (control) versus PA plus MP. 24 patients were prospectively enrolled (10 in the placebo group and 14 in the MP group). RESULTS: The main result is a long-term functional improvement (on the functional independence measure (FIM) and on Bergego's scale) induced by MP combined with PA. No serious adverse event occurred. CONCLUSIONS: The long-term benefit on activities of daily living (ADL) obtained in this randomized controlled trial set this intervention apart from previous attempts and supports with a high level of evidence the value of combining PA and MP in order to improve the autonomy of neglect patients. Further studies will be needed to clarify the mechanism of this improvement. Although not specifically assessed at this stage, a part of the improvement in ADL might be related to the collateral effect of MP on mood, executive functions or fatigue, and/or the combined effect of PA and MP on motor intentional bias of neglect patients. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that adding MP to PA improves the functional outcome of neglect patients. WHO TRIAL REGISTRATION ID: EUCTR2008-000325-20-FR.

Prisms to Shift Pain Away: Pathophysiological and Therapeutic Exploration of CRPS with Prism Adaptation.

Complex Regional Pain Syndrome (CRPS) is an invalidating chronic condition subsequent to peripheral lesions. There is growing consensus for a central contribution to CRPS. However, the nature of this central body representation disorder is increasingly debated. Although it has been repeatedly argued that CRPS results in motor neglect of the affected side, visual egocentric reference frame was found to be deviated toward the pain, that is, neglect of the healthy side. Accordingly, prism adaptation has been successfully used to normalize this deviation. This study aimed at clarifying whether 7 CRPS patients exhibited neglect as well as exploring the pathophysiological mechanisms of this manifestation and of the therapeutic effects of prism adaptation. Pain and quality of life, egocentric reference frames (visual and proprioceptive straight-ahead), and neglect tests (line bisection, kinematic analyses of motor neglect and motor extinction) were repeatedly assessed prior to, during, and following a one-week intense prism adaptation intervention. First, our results provide no support for visual and motor neglect in CRPS. Second, reference frames for body representations were not systematically deviated. Third, intensive prism adaptation intervention durably ameliorated pain and quality of life. As for spatial neglect, understanding the therapeutic effects of prism adaptation deserves further investigations.