title: Disembodied Mind: Cortical Changes Following Brainstem Injury in Patients with Locked-in Syndrome.
abstract: Locked-in syndrome (LIS) following ventral brainstem damage is the most severe form of motor disability. Patients are completely entrapped in an unresponsive body despite consciousness is preserved. Although the main feature of LIS is this extreme motor impairment, minor non-motor dysfunctions such as motor imagery defects and impaired emotional recognition have been reported suggesting an alteration of embodied cognition, defined as the effects that the body and its performances may have on cognitive domains. We investigated the presence of structural cortical changes in LIS, which may account for the reported cognitive dysfunctions. For this aim, magnetic resonance imaging scans were acquired in 11 patients with LIS (6 males and 5 females; mean age: 52.3±5.2SD years; mean time interval from injury to evaluation: 9±1.2SD months) and 44 healthy control subjects matching patients for age, sex and education. Freesurfer software was used to process data and to estimate cortical volumes in LIS patients as compared to healthy subjects. Results showed a selective cortical volume loss in patients involving the superior frontal gyrus, the pars opercularis and the insular cortex in the left hemisphere, and the superior and medium frontal gyrus, the pars opercularis, the insular cortex, and the superior parietal lobule in the right hemisphere. As these structures are typically associated with the mirror neuron system, which represents the neural substrate for embodied simulation processes, our results provide neuroanatomical support for potential disembodiment in LIS.
authors.affiliation: Neurological Institute, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Pistoia
authors.affiliation: Department of Biomedical, Metabolic and Neurosciences, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Cornia
authors.affiliation: Neuropsychology Laboratory, Department of Psychology, Second University of Naples, Naples, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Conson
authors.affiliation: Coma Science Group, GIGA, University of Liege, Liege, Belgium.
authors.forename: Olivia
authors.initials: O
authors.lastname: Gosseries
authors.affiliation: Neurological Institute, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Carolei
authors.affiliation: Neurological Institute, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Sacco
authors.affiliation: Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging, University Campus Bio-Medico of Rome, Rome, Italy.
authors.forename: Carlo C
authors.initials: CC
authors.lastname: Quattrocchi
authors.affiliation: Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging, University Campus Bio-Medico of Rome, Rome, Italy.
authors.forename: Carlo A
authors.initials: CA
authors.lastname: Mallio
authors.affiliation: Department of Communication and Economy, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Iani
authors.affiliation: Post-Coma Rehabilitation Care Unit, San Raffaele Hospital, Cassino, Italy.
authors.forename: Debora Di
authors.initials: DD
authors.lastname: Mambro
authors.affiliation: Post-Coma Rehabilitation Care Unit, San Raffaele Hospital, Cassino, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Sarà
keywords: Cognition; locked-in syndrome; magnetic Resonance (MR) imaging; ventral brainstem damage