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Neural Plasticity
Volume 2019, Article ID 1678984, 17 pages
Research Article

Early Brain Damage Affects Body Schema and Person Perception Abilities in Children and Adolescents with Spastic Diplegia

1Scientific Institute, IRCCS E. Medea, Neuropsychiatry and Neurorehabilitation Unit, Bosisio Parini, Lecco, Italy
2Scientific Institute, IRCCS E. Medea, 0-3 Centre for the At-Risk Infant, Bosisio Parini, Lecco, Italy
3Scientific Institute, IRCCS E. Medea, Specialist Functional Rehabilitation Unit, Bosisio Parini, Lecco, Italy
4Laboratory of Cognitive Neuroscience, Department of Languages and Literatures, Communication, Education and Society, University of Udine, Italy

Correspondence should be addressed to Niccolò Butti; ti.ailgimafartsonal@ittub.oloccin

Received 29 March 2019; Accepted 24 July 2019; Published 18 August 2019

Academic Editor: Alfredo Berardelli

Copyright © 2019 Niccolò Butti 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.


Early brain damage leading to cerebral palsy is associated to core motor impairments and also affects cognitive and social abilities. In particular, previous studies have documented specific alterations of perceptual body processing and motor cognition that are associated to unilateral motor deficits in hemiplegic patients. However, little is known about spastic diplegia (SpD), which is characterized by motorial deficits involving both sides of the body and is often associated to visuospatial, attentional, and social perception impairments. Here, we compared the performance of a sample of 30 children and adolescents with SpD (aged 7-18 years) and of a group of age-matched controls with typical development (TD) at two different tasks tapping on body representations. In the first task, we tested visual and motor imagery abilities as assessed, respectively, by the object-based mental rotation of letters and by the first-person transformations for whole-body stimuli. In the second task, we administered an inversion effect/composite illusion task to evaluate the use of configural/holistic processing of others’ body. Additionally, we assessed social perception abilities in the SpD sample using the NEPSY-II battery. In line with previously reported visuospatial deficits, a general mental imagery impairment was found in SpD patients when they were engaged in both object-centered and first-person mental transformations. Nevertheless, a specific deficit in operating an own-body transformation emerged. As concerns body perception, while more basic configural processing (i.e., inversion effect) was spared, no evidence for holistic (i.e., composite illusion) body processing was found in the SpD group. NEPSY-II assessment revealed that SpD children were impaired in both the theory of mind and affect recognition subtests. Overall, these findings suggested that early brain lesions and biased embodied experience could affect higher-level motor cognition and perceptual body processing, thus pointing to a strict link between motor deficits, body schema alterations, and person processing difficulties.