Le Neuroscienze tra spiegazione della vita e cura della mente, Padova 8 - 10 maggio 2012

1. Neuropsychology of Free Will
Giuseppe Sartori
Università di Padova
With
Francesca Gnoato – Padova
Francesco Tomaiuolo – Volterra
Mario De Caro – Roma
Massimo Marraffa ‐ Roma
mercoledì 9 maggio 2012

2. Model building and neuropsychology
• From breakdown of cogniHon to cogniHve
organisaHon
• PaHents with neuropsychological syndromes
are used to model cogniHon
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3. Sense of Agency – Sense of Ownership
• SoA ‐ Sense of Agency ‐ I am the iniHator of my
act
• SoO – Sense of Ownership – My arm belongs
to me
• IntenHonal acHon – acHon with a clear purpose
rather than with a random behaviour (e.g.
ballism)
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4. Syndromes with impaired awareness of
body
• Somatoparaphrenia: impaired sense of ownership, loss of
recogniHon of a limb, damage to right hemisphere
• Alien hand: with closed eyes, they can not recognize theirs own hand o
finger grabbed by the other hand. Damage to the corpus callosum
• Autotopoagnosia: the paHents are unable to localize body part of
themselves. Damage to leS parietal lobe.
• Hemiasomatognosia: neglect of the contralesional hemisoma,
damage to right hemisphere.
• Digital agnosia: impaired idenHficaHon and denominaHon of fingers.
Damage to right parietal lobe.
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5. Syndromes with impaired awareness of
disability
• Anosognosia: the paHents are unaware of the existence of his or her
disability
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6. Major syndromes of intenHonal acHon
• Anarchic hand syndrome: impaired control of the
movements of one hand, that has the capability of acHng
autonomously and it is indipendent of their voluntary control. The
anarchic hand interferes with the acHviHes of the other hand. Damage
to the Corpus Callosum.
• Apraxia: difficulty with acHons requiring planning. AutomaHc ‐
voluntary dissociaHon. Damage to leS hemisphere.
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7. mercoledì 9 maggio 2012

8. Anarchic Hand
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9. Anarchic Hand
• Usually short‐living syndrome
• Usually lesion to the corpus callosum even if
other lesion sites have been reported.
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10. Case study
• Female 68
• Pharmacist
• Ischemia in the territoty of the AcA
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11. Anarchich Hand
‐ 10 days post‐onset CT
scan
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12. Anarchic Hand
CT scan obtained 6
months aSer stroke,
confirmed the
callosal damage and
the lesions of most
of the superior
frontal gyrus and
part of the
underlying cigulate
cortex of the right
hemisphere.
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13. Anarchic hand
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14. QualitaHve clinical features
• SoO – always present
• Bimanual tasks – in dressing the anarchic hand
is collaboraHve
• TacHle sensiHvity and pain in the anarchich
hand – present
• PropriocepHon – present
• Examples of anarchic behaviours: when eaHng
takes the bread, strangling, etc.
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15. Anarchic hand shows dissociaHons
• Between SoA (absent) and SoO (present)
• Between intenHonal, purposeful and behaviour
(present) and voliHon (absent)
• Unwanted behaviour is usually naughty rather
than neutral
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16. Theory of voliHon
• Naive theory of voliHon claims that SoA, SoO
and purposeful behaviour are a unique
cogniHve condiHon
• Neuropsychology of anarchic hand shows that
SoA may be dissociated from SoO in a
purposeful unwanted motor acHon
mercoledì 9 maggio 2012