Tower of London test: a comparison between conventional statistic approach and modelling based on artificial neural network in differentiating fronto-temporal dementia from Alzheimer's disease

The early differentiation of Alzheimer's disease (AD) from frontotemporal dementia (FTD) may be difficult. The Tower of London (ToL), thought to assess executive functions such as planning and visuo-spatial working memory, could help in this purpose. Twentytwo Dementia Centers consecutively recruited patients with early FTD or AD. ToL performances of these groups were analyzed using both the conventional statistical approaches and the Artificial Neural Networks (ANNs) modelling. Ninety-four non aphasic FTD and 160 AD patients were recruited. ToL Accuracy Score (AS) significantly (p < 0.05) differentiated FTD from AD patients. However, the discriminant validity of AS checked by ROC curve analysis, yielded no significant results in terms of sensitivity and specificity (AUC 0.63). The performances of the 12 Success Subscores (SS) together with age, gender and schooling years were entered into advanced ANNs developed by Semeion Institute. The best ANNs were selected and submitted to ROC curves. The non-linear model was able to discriminate FTD from AD with an average AUC for 7 independent trials of 0.82. The use of hidden information contained in the different items of ToL and the non linear processing of the data through ANNs allows a high discrimination between FTD and AD in individual patients.     

Does how I look at what you're doing depend on what I'm doing?

Previous studies showed that people proactively gaze at the target of another's action by taking advantage of their own motor representation of that action. But just how selectively is one's own motor representation implicated in another's action processing? If people observe another's action while performing a compatible or an incompatible action themselves, will this impact on their gaze behaviour? We recorded proactive eye movements while participants observed an actor grasping small or large objects. The participants' right hand either freely rested on the table or held with a suitable grip a large or a small object, respectively. Proactivity of gaze behaviour significantly decreased when participants observed the actor reaching her target with a grip that was incompatible with respect to that used by them to hold the object in their own hand. This indicates that effective observation of action may depend on what one is actually doing, being actions observed best when the suitable motor representations may be readily recruited.     

The Interaction Between Culture, Health and Psychological Well-Being: Data Mining from the Italian Culture and Well-Being Project

The purpose of this study is to understand the impact of health status and cultural participation upon psychological well-being, with special attention to the interaction between patterns of cultural access and other factors known to affect psychological well-being. Data for this report were collected from a sample of 1,500 Italian citizens. A multi-step random sampling method was adopted to draw a large representative sample from the Italian population. Subjects underwent a standard questionnaire for psychological well-being [the Italian short form of the Psychological General Well Being Index (PGWBI)], and a questionnaire related to the frequency of participation to 15 different kinds of cultural activities during the previous year. The results show that, among the various potential factors considered, cultural access unexpectedly rankes as the second most important determinant of psychological well-being, immediately after the absence or presence of diseases, and outperforming factors such as job, age, income, civil status, education, place of living and other important factors. According to a semantic map generated by a powerful data mining algorithm, it turns out that different factors (among which cultural access and health status in particular) may be viewed as concurrent elements of a complex multi-causal scheme that seems to play a primary role in determining psychological distress or well-being. In particular, distress seems to be tightly connected with: living in the Southern part of Italy, average income level, living in semi-urban and urban areas, age group 46–60, presence of more than two concomitant diseases and a low level of cultural access. Well being, on the other hand, is tightly connected with: male gender, high cultural access, and absence of diseases. Some of these associations are confirmed by Principal Component Analysis.     

Out of your hand's reach, out of my eyes' reach

When witnessing another's action, people recruit the same motor resources that enable them to efficiently perform that action, thus gazing at its target well before the agent's hand. But just to what extent does this recruitment help people in grabbing another's action target? If the latter seems to be out of the agent's reach, will this impact on people's gaze behaviour? We recorded proactive eye movements while participants witnessed someone else trying to reach for and grasp objects located either within or outside his reach. Proactivity of gaze was impaired when the targets were just out of the agent's reach. This effect is likely to be due to an interpersonal bodily space representation that allows one to map another's reaching space, thus prompting proactive eye movements towards the target just in case the agent is in the position to act upon it.     

The subjective duration of audiovisual looming and receding stimuli

Looming visual stimuli (log-increasing in proximal size over time) and auditory stimuli (of increasing sound intensity over time) have been shown to be perceived as longer than receding visual and auditory stimuli (i.e., looming stimuli reversed in time). Here, we investigated whether such asymmetry in subjective duration also occurs for audiovisual looming and receding stimuli, as well as for stationary stimuli (i.e., stimuli that do not change in size and/or intensity over time). Our results showed a great temporal asymmetry in audition but a null asymmetry in vision. In contrast, the asymmetry in audiovision was moderate, suggesting that multisensory percepts arise from the integration of unimodal percepts in a maximum-likelihood fashion.     

The effectiveness of reward and punishment contingencies on response inhibition

The relative effectiveness of reward and punishment on the development of response inhibition was evaluated developmentally. Forty kindergarten and forty second-graders received response inhibition training with half of each group rewarded for inhibiting and half punished for not inhibiting. Reward involved the presentation of positive reinforcers, whereas punishment involved their removal. Punishment produced more inhibition at both age levels than did reward. Transfer of inhibition training was evaluated in two tasks. Transfer effects were observed only on one of the two tasks. Reinforcement contingencies and age did not differentially influence the magnitude of transfer.     

Persistent Vegetative State: A Presumption to Treat

The article briefly analyzes the concept of a person, arguing that personhood does not coincide with the actual enjoyment of certain intellectual capacities, but is coextensive with the embodiment of a human individual. Since in PVS patients we can observe a human individual functioning as a whole, we must conclude that these patients are still human persons, even if in a condition of extreme impairment. It is then argued that some forms of minimal treatment may not be futile for these patients; they may constitute a form of respect for their human dignity and benefit these patients, even if they are not aware of that. Moreover, it is important to consider the symbolic significance of care: while many believe that PVS is a kind of imprisonment, for others providing food and fluids is the only way to testify our proximity to these persons. The best policy would be to provide, as a general rule, artificial nutrition and hydration to PVS patients: this treatment could be withdrawn, after a period of observation and reflection by the family and proxies, on the basis of the proxies' objection to the continuation or of the patient's advance directives specifically referring to this situation.     

Role-Reversal: A Somewhat Neglected Mirror of Heritages of the Past

Within a clinical–theoretical framework focused on transference–countertransference dynamics, the authors reflect on role-reversal and on the reasons it has been neglected for a long time in literature. This primitive inter- and intra-psychic process, often at the forefront in our practice, will be discussed in its principal aspects (patient's unconscious identification with parents’ psychic culture and concomitant dissociation of the infant part of the self), signaling how the enactment can be an inevitable element which, putting into play the past dissociated object relationships, becomes a source of mutative understanding.