October 2018
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The concept of “embodied cognition” considers that the classical Perception-Cognition-Action architecture proposing a sequential flow of processing with clean cuts between all modules is not appropriate to understand the behavioral effect of neurodegenerative disorders and to find innovative therapeutic solutions. In the last decades, the discovery of the mirror neurons (MN) has given a biological substrate to this theoretical perspective: the MN are now thought linking together knowledge about actions and perceptions not only to integrate perception in action planning and execution but also as a neural mechanism supporting a wide range of cognitive functions, e.g. empathy and language. At the same time, it is now clear that in each neurodegenerative disease both cognitive and motor symptoms are represented along a continuum. In the current demographic context, neurodegenerative diseases linked to aging have become a very important social issue. Alzheimer Disease (AD), the most common form of dementia, is a neurodegenerative disease strictly linked to aging. As actually there is no cure, several studies are focusing on prevention. A category which now represents a preferential target of intervention is Mild Cognitive Impairment (MCI), considered as an intermediate stage between normal aging and AD. Even if AD and MCI have been characterized as “cognitive” diseases until now, a link between motor function and the risk of developing AD has been recognized.The main purpose of this research is to investigate the integrity of the MN network in AD, MCI and normal aging. Characterizing the functioning of the MN network in neurodegenerative diseases would be useful to better understand functional mechanisms and their clinical manifestations. It would also allow to capitalize on these kinds of neurons in the rehabilitation of motor and cognitive symptoms.The thesis consists of two parts: the first part includes an extensive bibliographic research intended to describe the scientific frame which justifies such a research.We first reviewed the evidence about the existence of a MN system in monkeys and humans, and its multiple possible roles in humans.We then briefly reviewed the clinical picture of the main neurodegenerative disorders, showing how cognitive and motor symptoms intersect in all of them.Next, we detailed the results of literature searching on neurodegenerative diseases, MN, and embodied cognition, commenting them at the light of this hypothesis.The second part of the thesis describe the experimental procedure which has been performed to evaluate the integrity of the MN network in normal elderly and people with AD and MCI, and its results.Three matched groups of 16 subjects each (normal elderly-NE, amnesic MCI with hippocampal atrophy and AD) were evaluated with a neuropsychological battery centered on functions thought to be linked to the MN system, and a fMRI task specifically created to test MN: that comprised of an observation run, where subjects were shown videos of a right hand grasping different objects, and of a motor run, where subjects observed visual pictures of objects oriented to be grasped with the right hand, and made the corresponding gesture.In NE subjects, the conjunction analysis (comparing fMRI activation during observation and execution), indicated the activation of a bilateral fronto-parietal network in “classical” MN areas, and of the superior temporal gyrus (STG), an area thought to provide the cortical visual input to the MN. The MCI group showed the activation of areas belonging to the same network, however, parietal areas were activated to a lesser extent and the STG was not activated, while the opposite was true for the right Broca’s area. We did not observe any activation of the fronto-parietal network in AD participants (...).