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Behavioural Neurology
Volume 2014, Article ID 297128, 9 pages
Review Article

Utilization Behavior: What Is Known and What Has to Be Known?

1Vita-Salute San Raffaele University, Via Olgettina, 58, 20132 Milan, Italy
2Department of Nuclear Medicine, San Raffaele Hospital, Via Olgettina, 58, 20132 Milan, Italy
3Department of Experimental Medicine, Second University of Naples, Via Santa Maria di Costantinopoli, 16, 80138 Naples, Italy
4Neurological and Stroke Unit, CTO Hospital, AORN, “Ospedali dei Colli”, Viale Colli Aminei, 21, 80131 Naples, Italy

Received 10 April 2013; Accepted 29 November 2013; Published 9 February 2014

Academic Editor: Argye E. Hillis

Copyright © 2014 Leonardo Iaccarino et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Since the first description by Lhermitte (1983), the utilization behavior (UB) still represents an enigma for behavioral neurology and neuropsychology. Recent findings shed some light on new frameworks for interpreting this interesting phenomenon. Functional neuroanatomical basis is still unclear, although recent advances in neuroimaging techniques have contributed to a better understanding of the syndrome. An important and promising step is given by shifting researcher’s attention from frontoparietal to intrafrontal mechanisms. From a cognitive standpoint, three models have been proposed. However, a comprehensive account for the UB neurobehavioral complexity is still lacking. Aims of this paper are to briefly review the reported cases of utilization behavior (UB) and to describe the putative neurological mechanisms underlying UB. Furthermore, the cognitive models proposed to interpret UB will be summarized. For clinical purposes, features suitable for distinguishing UB from other neurobehavioral symptoms will be briefly described.