{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T08:06:33Z","timestamp":1783411593655,"version":"3.54.6"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T00:00:00Z","timestamp":1707868800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T00:00:00Z","timestamp":1707868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003407","name":"Ministero dell\u2019Istruzione, dell\u2019Universit\u00e0 e della Ricerca","doi-asserted-by":"publisher","award":["PRIN 2020"],"award-info":[{"award-number":["PRIN 2020"]}],"id":[{"id":"10.13039\/501100003407","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007109","name":"Universit\u00e0 degli Studi di Ferrara","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007109","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurol Sci"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Usually, positive neurological symptoms are considered as the consequence of a mere, afinalistic and abnormal increase in function of specific brain areas. However, according to the Theory of Active Inference, which argues that action and perception constitute a loop that updates expectations according to a Bayesian model, the brain is rather an explorer that formulates hypotheses and tests them to assess the correspondence between internal models and reality. Moreover, the cerebral cortex is characterised by a continuous \u201cconflict\u201d between different brain areas, which constantly attempt to expand in order to acquire more of the limited available computational resources, by means of their dopamine-induced neuroplasticity. Thus, it has recently been suggested that dreams, during rapid eye movement sleep (REMS), protect visual brain areas (deprived of their stimuli during rest) from being conquered by other normally stimulated ones. It is therefore conceivable that positive symptoms also have a functional importance for the brain. We evaluate supporting literature data of a \u2018defensive\u2019 role of positive symptoms and the relevance of dopamine-induced neuroplasticity in the context of neurodegenerative and psychiatric diseases. Furthermore, the possible functional significance of idiopathic REMS-related behavioural disorder as well as phantom limb syndrome is examined. We suggest that positive neurological symptoms are not merely a passive expression of a damage, but active efforts, related to dopamine-induced plasticity, to maintain a correct relationship between the external world and its brain representation, thus preventing healthy cortical areas from ousting injured ones.<\/jats:p>","DOI":"10.1007\/s10072-024-07395-x","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T09:02:21Z","timestamp":1707901341000},"page":"2347-2351","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["A new perspective on positive symptoms: expression of damage or self-defence mechanism of the brain?"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1555-6418","authenticated-orcid":false,"given":"Annibale","family":"Antonioni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela Maria","family":"Raho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariachiara","family":"Sensi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Di Lorenzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciano","family":"Fadiga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Koch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,14]]},"reference":[{"key":"7395_CR1","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780190905385.001.0001","volume-title":"The brain from inside out","author":"G Buzs\u00e1ki","year":"2019","unstructured":"Buzs\u00e1ki G (2019) The brain from inside out. Oxford University Press"},{"issue":"1","key":"7395_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1162\/NECO_a_00912","volume":"29","author":"K Friston","year":"2017","unstructured":"Friston K, FitzGerald T, Rigoli F, Schwartenbeck P, Pezzulo G (2017) Active inference: a process theory. Neural Comput 29(1):1\u201349. https:\/\/doi.org\/10.1162\/NECO_a_00912","journal-title":"Neural Comput"},{"issue":"6","key":"7395_CR3","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1016\/S1474-4422(21)00422-1","volume":"21","author":"M Hallett","year":"2022","unstructured":"Hallett M, Aybek S, Dworetzky BA, McWhirter L, Staab JP, Stone J (2022) Functional neurological disorder: new subtypes and shared mechanisms. Lancet Neurol 21(6):537\u2013550. https:\/\/doi.org\/10.1016\/S1474-4422(21)00422-1","journal-title":"Lancet Neurol"},{"issue":"Pt 11","key":"7395_CR4","doi-asserted-by":"publisher","first-page":"3495","DOI":"10.1093\/brain\/aws129","volume":"135","author":"MJ Edwards","year":"2012","unstructured":"Edwards MJ, Adams RA, Brown H, Pare\u00e9s I, Friston KJ (2012) A Bayesian account of \u2018hysteria.\u2019 Brain 135(Pt 11):3495\u20133512. https:\/\/doi.org\/10.1093\/brain\/aws129","journal-title":"Brain"},{"issue":"15","key":"7395_CR5","doi-asserted-by":"publisher","first-page":"632853","DOI":"10.3389\/fnins.2021.632853","volume":"21","author":"DM Eagleman","year":"2021","unstructured":"Eagleman DM, Vaughn DA (2021) The defensive activation theory: REM sleep as a mechanism to prevent takeover of the visual cortex. Front Neurosci 21(15):632853. https:\/\/doi.org\/10.3389\/fnins.2021.632853","journal-title":"Front Neurosci"},{"issue":"2","key":"7395_CR6","doi-asserted-by":"publisher","first-page":"1633","DOI":"10.1152\/jn.00806.2006","volume":"97","author":"LB Merabet","year":"2007","unstructured":"Merabet LB, Swisher JD, McMains SA, Halko MA, Amedi A, Pascual-Leone A, Somers DC (2007) Combined activation and deactivation of visual cortex during tactile sensory processing. J Neurophysiol 97(2):1633\u20131641. https:\/\/doi.org\/10.1152\/jn.00806.2006","journal-title":"J Neurophysiol"},{"issue":"5","key":"7395_CR7","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1136\/jnnp-2019-322702","volume":"91","author":"J O\u2019Brien","year":"2020","unstructured":"O\u2019Brien J, Taylor JP, Ballard C, Barker RA, Bradley C, Burns A, Collerton D, Dave S, Dudley R, Francis P, Gibbons A, Harris K, Lawrence V, Leroi I, McKeith I, Michaelides M, Naik C, O\u2019Callaghan C, Olsen K, Onofrj M, Pinto R, Russell G, Swann P, Thomas A, Urwyler P, Weil RS, Ffytche D (2020) Visual hallucinations in neurological and ophthalmological disease: pathophysiology and management. J Neurol Neurosurg Psychiatry 91(5):512\u2013519. https:\/\/doi.org\/10.1136\/jnnp-2019-322702","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"4","key":"7395_CR8","doi-asserted-by":"publisher","first-page":"735","DOI":"10.3390\/cells10040735","volume":"10","author":"L Speranza","year":"2021","unstructured":"Speranza L, di Porzio U, Viggiano D, de Donato A, Volpicelli F (2021) Dopamine: the neuromodulator of long-term synaptic plasticity, reward and movement control. Cells 10(4):735. https:\/\/doi.org\/10.3390\/cells10040735","journal-title":"Cells"},{"issue":"Suppl 2","key":"7395_CR9","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1111\/j.1468-1331.2008.02214.x","volume":"15","author":"JC M\u00f6ller","year":"2008","unstructured":"M\u00f6ller JC, Eggert KM, Unger M, Odin P, Chaudhuri KR, Oertel WH (2008) Clinical risk-benefit assessment of dopamine agonists. Eur J Neurol 15(Suppl 2):15\u201323. https:\/\/doi.org\/10.1111\/j.1468-1331.2008.02214.x","journal-title":"Eur J Neurol"},{"issue":"5","key":"7395_CR10","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1007\/s00359-014-0906-2","volume":"200","author":"E Popova","year":"2014","unstructured":"Popova E (2014) Role of dopamine in distal retina. J Comp Physiol A Neuroethol Sens Neural Behav Physiol 200(5):333\u2013358. https:\/\/doi.org\/10.1007\/s00359-014-0906-2","journal-title":"J Comp Physiol A Neuroethol Sens Neural Behav Physiol"},{"issue":"286","key":"7395_CR11","doi-asserted-by":"publisher","first-page":"112906","DOI":"10.1016\/j.psychres.2020.112906","volume":"1","author":"C Zhuo","year":"2020","unstructured":"Zhuo C, Ji F, Xiao B, Lin X, Chen C, Jiang D, Ma X, Li R, Liu S, Xu Y, Wang W (2020) Antipsychotic agent-induced deterioration of the visual system in first-episode untreated patients with schizophrenia maybe self-limited: findings from a secondary small sample follow-up study based on a pilot follow-up study. Psychiatry Res 1(286):112906. https:\/\/doi.org\/10.1016\/j.psychres.2020.112906","journal-title":"Psychiatry Res"},{"key":"7395_CR12","doi-asserted-by":"publisher","first-page":"1010","DOI":"10.3389\/fnhum.2014.01010","volume":"8","author":"M Ribolsi","year":"2014","unstructured":"Ribolsi M, Daskalakis ZJ, Siracusano A, Koch G (2014) Abnormal asymmetry of brain connectivity in schizophrenia. Front Hum Neurosci 8:1010. https:\/\/doi.org\/10.3389\/fnhum.2014.01010","journal-title":"Front Hum Neurosci"},{"issue":"6","key":"7395_CR13","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1038\/nrneurol.2009.62","volume":"5","author":"NJ Diederich","year":"2009","unstructured":"Diederich NJ, F\u00e9nelon G, Stebbins G, Goetz CG (2009) Hallucinations in Parkinson disease. Nat Rev Neurol 5(6):331\u2013342. https:\/\/doi.org\/10.1038\/nrneurol.2009.62","journal-title":"Nat Rev Neurol"},{"issue":"2","key":"7395_CR14","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1007\/s00415-019-09583-8","volume":"267","author":"E Matar","year":"2020","unstructured":"Matar E, Ehgoetz Martens KA, Halliday GM, Lewis SJG (2020) Clinical features of Lewy body dementia: insights into diagnosis and pathophysiology. J Neurol 267(2):380\u2013389. https:\/\/doi.org\/10.1007\/s00415-019-09583-8","journal-title":"J Neurol"},{"issue":"1","key":"7395_CR15","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1186\/s40478-023-01575-0","volume":"11","author":"D P\u00e9rez-Acu\u00f1a","year":"2023","unstructured":"P\u00e9rez-Acu\u00f1a D, Rhee KH, Shin SJ, Ahn J, Lee JY, Lee SJ (2023) Retina-to-brain spreading of \u03b1-synuclein after intravitreal injection of preformed fibrils. Acta Neuropathol Commun 11(1):83. https:\/\/doi.org\/10.1186\/s40478-023-01575-0","journal-title":"Acta Neuropathol Commun"},{"issue":"1","key":"7395_CR16","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1038\/s41572-018-0016-5","volume":"4","author":"Y Dauvilliers","year":"2018","unstructured":"Dauvilliers Y, Schenck CH, Postuma RB, Iranzo A, Luppi PH, Plazzi G, Montplaisir J, Boeve B (2018) REM sleep behaviour disorder. Nat Rev Dis Primers 4(1):19. https:\/\/doi.org\/10.1038\/s41572-018-0016-5","journal-title":"Nat Rev Dis Primers"},{"key":"7395_CR17","doi-asserted-by":"publisher","first-page":"134360","DOI":"10.1016\/j.neulet.2019.134360","volume":"709","author":"Y Li","year":"2019","unstructured":"Li Y, Zhang H, Mao W, Liu X, Hao S, Zhou Y, Ma J, Gu Z, Chan P (2019) Visual dysfunction in patients with idiopathic rapid eye movement sleep behavior disorder. Neurosci Lett 709:134360. https:\/\/doi.org\/10.1016\/j.neulet.2019.134360","journal-title":"Neurosci Lett"},{"issue":"9","key":"7395_CR18","doi-asserted-by":"publisher","first-page":"1237","DOI":"10.1002\/mds.26285","volume":"30","author":"R Franciotti","year":"2015","unstructured":"Franciotti R, Delli Pizzi S, Perfetti B, Tartaro A, Bonanni L, Thomas A, Weis L, Biundo R, Antonini A, Onofrj M (2015) Default mode network links to visual hallucinations: a comparison between Parkinson\u2019s disease and multiple system atrophy. Mov Disord 30(9):1237\u20131247. https:\/\/doi.org\/10.1002\/mds.26285","journal-title":"Mov Disord"},{"issue":"2","key":"7395_CR19","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1002\/ana.22245","volume":"69","author":"C Scherfler","year":"2011","unstructured":"Scherfler C, Frauscher B, Schocke M, Iranzo A, Gschliesser V, Seppi K, Santamaria J, Tolosa E, H\u00f6gl B, Poewe W, SINBAR (Sleep Innsbruck Barcelona) Group (2011) White and gray matter abnormalities in idiopathic rapid eye movement sleep behavior disorder: a diffusion-tensor imaging and voxel-based morphometry study. Ann Neurol 69(2):400\u20137. https:\/\/doi.org\/10.1002\/ana.22245","journal-title":"Ann Neurol"},{"key":"7395_CR20","doi-asserted-by":"publisher","first-page":"252","DOI":"10.3389\/fnagi.2014.00252","volume":"6","author":"A Martorana","year":"2014","unstructured":"Martorana A, Koch G (2014) Is dopamine involved in Alzheimer\u2019s disease? Front Aging Neurosci 6:252. https:\/\/doi.org\/10.3389\/fnagi.2014.00252","journal-title":"Front Aging Neurosci"},{"issue":"2","key":"7395_CR21","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1177\/0891988715606229","volume":"29","author":"A Su\u00e1rez-Gonz\u00e1lez","year":"2016","unstructured":"Su\u00e1rez-Gonz\u00e1lez A, Crutch SJ, Franco-Mac\u00edas E, Gil-N\u00e9ciga E (2016) Neuropsychiatric symptoms in posterior cortical atrophy and Alzheimer disease. J Geriatr Psychiatry Neurol 29(2):65\u201371. https:\/\/doi.org\/10.1177\/0891988715606229","journal-title":"J Geriatr Psychiatry Neurol"},{"issue":"11","key":"7395_CR22","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1038\/nrn1991","volume":"7","author":"H Flor","year":"2006","unstructured":"Flor H, Nikolajsen L, Staehelin Jensen T (2006) Phantom limb pain: a case of maladaptive CNS plasticity? Nat Rev Neurosci 7(11):873\u2013881. https:\/\/doi.org\/10.1038\/nrn1991","journal-title":"Nat Rev Neurosci"}],"container-title":["Neurological Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-024-07395-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10072-024-07395-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-024-07395-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T04:44:08Z","timestamp":1713242648000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10072-024-07395-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,14]]},"references-count":22,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,5]]}},"alternative-id":["7395"],"URL":"https:\/\/doi.org\/10.1007\/s10072-024-07395-x","relation":{},"ISSN":["1590-1874","1590-3478"],"issn-type":[{"value":"1590-1874","type":"print"},{"value":"1590-3478","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,14]]},"assertion":[{"value":"20 December 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 February 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 February 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors report no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The submitted work is original and has not been considered for submission to other journals. All authors approved the final version.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and Informed consent"}}]}}