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Biomedical subjects

C García-Sánchez

Publications and source records attributed to C García-Sánchez.

At least 19 recordsLinked to original sources

Lack of prefrontal repetitive transcranial magnetic stimulation effects in time production processing.

The aim of the present study was to determine the effects of high frequency repetitive transcranial magnetic stimulation (rTMS) over different neuroanatomical areas [left and right doroslateral prefrontal cortex (DLPFC) and right cerebellar hemisphere] on time production task. The study was performed in 16 healthy right-handed men with a cross-over, within subject repeated measures design. There were four rTMS conditions: baseline without stimulation, high frequency rTMS over right, left DLPFC and over right cerebellum. The volunteers were asked to produce a 3-min interval by internal counting. The rTMS was applied during the task. No significantly differences were observed in absolute error scores in time estimation task with any rTMS condition. This preliminary study does not support the role of the prefrontal lobe in time production processes.

Adult↗

Effects of repetitive transcranial magnetic stimulation on memory subtypes: a controlled study.

Repetitive transcranial magnetic stimulation (rTMS) of human cortex may disrupt or facilitate cortical activity. The aim of the present study was to investigate the consequences of rTMS applied over different cortical areas during various memory tasks, measuring immediate, working and episodic verbal memory. The study was performed in 16 right-handed healthy men. A double-blind, cross-over, within-subject repeated measures design was used. There were five rTMS conditions: baseline without stimulation, high frequency (HF) rTMS over right and left dorsolateral prefrontal cortex (DLPFC) and over right cerebellum, and low frequency (LF) parameters over left DLPFC. Digits forwards and backwards and letter-number sequencing of the Wechsler Adults Intelligence Scale (WAIS) were used to assess immediate and working verbal memory, and logical memory of the Rivermead Behavioural Memory Test was used to assess episodic memory encoding. An analysis of variance (ANOVA) for repeated measures in the scores of each memory task according to rTMS conditions was used. Significantly lower scores in the number of memory units of the episodic memory task were observed when rTMS high frequency parameters were applied over left DLPFC (P=0.009). No significant differences were found in the other memory subtype tasks analysed during the different rTMS conditions. These findings provide evidence for the significant role of the left DLPFC in episodic verbal memory processes.

Adult↗

[Cognitive and functional decline in the stage previous to the diagnosis of Alzheimers disease].

INTRODUCTION: The decline in the phase prior to diagnosis of Alzheimers disease (AD) is not well known, although this knowledge is necessary to evaluate the efficiency of new drugs that can influence in disease course prior to diagnosis. OBJECTIVE: To contribute to better knowledge of the decline prior to diagnosis, we have investigated the cognitive and functional deterioration for 2-3 years before the probable AD diagnosis was established. PATIENTS AND METHODS: We compared results obtained by 17 control subjects and 27 patients at the time of diagnosis of a probable AD with results obtained 2-3 years before (interval of 27.7 4 months). We compared memory functions (logical, recognition, learning and autobiographical memory), naming, visual and visuospatial gnosis, visuoconstructive praxis, verbal fluency and the Mini-Mental State Examination (MMSE), Informant Questionnaire and Blessed's Scale scores. RESULTS: Performance of control subjects did not change. AD patients showed a significant decline in scores, except for verbal fluency. In order of importance, cognitive decline was more marked in scores of learning memory, visuospatial gnosis, autobiographical memory and visuoconstructive praxis. CONCLUSIONS: Decline prior to diagnosis of AD is characterized by an important learning memory impairment. Deterioration of visuospatial gnosis and visuoconstructive praxis is greater than deterioration of MMSE and Informant Questionnaire scores.

Aged↗

Long-term effects of bilateral frontal brain lesion: 60 years after injury with an iron bar.

BACKGROUND: Harlow's report of the case of Phineas P. Gage in 1848 was one of the earliest description of the personality and behavioral changes following frontal lobe damage. Since Harlow's articles, a few more case reports of frontal lobe damage have been published. As standard neuropsychological and neurologic evaluations may reveal subtle defects, case reports have been particularly useful in characterizing the behavioral changes that follow frontal lobe damage. OBJECTIVE: To describe the long-term outcome of an 81-year-old patient who sustained a severe frontal brain lesion 60 years ago caused by the passage of an iron spike through his head. RESULTS: The patient has bilateral damage affecting the orbital and dorsolateral frontal regions. He displays many of the typical frontal behavioral disturbances described in the literature. His conduct is characterized by dependence on others, cheerfulness, planning difficulties, problems establishing realistic goals, lack of drive, and difficulties in initiating, continuing, and finishing activities. Although gross cognitive functioning is intact, neuropsychological deficits are present in the executive functioning, memory, and visuoconstructive domains. CONCLUSIONS: In contrast with the antisocial conduct pattern usually associated with frontal damage in the literature, this case suggests that large frontal lesions can produce behavioral and personality changes that are compatible with stable functioning in family, professional, and social settings. In addition to the localization of the lesion, many other factors should be considered in the long-term prognosis of frontal brain injured patients.

Adult↗

Blood pressure variability and leukoaraiosis amount in cerebral small-vessel disease.

OBJECTIVES: To analyze the correlation between blood pressure (BP) variability and leukoaraiosis (LA) amount in patients with symptomatic cerebral small-vessel disease. MATERIALS AND METHODS: We included 25 hypertensive patients: 13 with Binswanger's disease (BD) and 12 with a first-ever lacunar infarction (LI). Baseline office BP was obtained for 3 consecutive weeks. From a 24-h ambulatory BP monitoring performed 1 week later we obtained average systolic (SBP) and diastolic (DBP) BP for daytime, nighttime and 24-h periods. SBP and DBP variability was defined as the within-subject standard deviation of all readings. A standardized cerebral MR was performed in each patient and an LA score was calculated. RESULTS: No statistically significant correlation was obtained between the LA score and any of the following BP values: 1) Baseline SBP and DBP; 2) 24-h, daytime or nighttime SBP and DBP, and 3) 24-h, daytime or nighttime SBP and DBP variability. CONCLUSION: Increased BP variability is not associated with greater amounts of leukoaraiosis.

Aged↗

Blood pressure variability in Binswanger's disease and isolated lacunar infarction.

UNLABELLED: To determine whether blood pressure (BP) variability is increased in hypertensive patients with Binswanger's disease (BD), we studied two samples of consecutive treated hypertensive patients: (1) 11 with BD (mean age 71.3 +/- 5.2 years); (2) 16 with lacunar infarction (mean age 65.2 +/- 8.3 years) without cognitive impairment. An averaged baseline office BP was obtained for 3 consecutive weeks. Ambulatory BP monitoring was then carried out to obtain the averaged mean systolic (SBP) and diastolic BP, and BP variability was defined as the standard deviation of consecutive BP values. RESULTS: Diurnal SBP variability was significantly increased in the BD group (p = 0.04). However, with the analysis of covariance for age and baseline office BP, the difference was no longer significant (p = 0.17 and p = 0.09, respectively). We conclude that increased BP variability in BD patients is probably due to older age and increased baseline office BP. Increased BP variability may be a risk factor for small-vessel disease, but not for cognitive impairment.

Age Factors↗

Chronic effects of dopaminergic replacement on cognitive function in Parkinson's disease: a two-year follow-up study of previously untreated patients.

BACKGROUND: The cognitive effects of dopaminergic treatment in Parkinson's disease (PD) are still controversial. OBJECTIVE: To evaluate, in previously untreated patients with PD, whether chronic dopaminergic stimulation produces significant cognitive changes; whether they are sustained beyond the period of a few months; and whether the cognitive status of two motor-comparable groups is differently affected by levodopa and pergolide. DESIGN AND SUBJECTS: Parallel, randomized open study with blind neuropsychologic evaluation of 20 consecutive de novo patients with PD before and 3, 6, 12, 18, and 24 months after monotherapy with levodopa (n = 10) or pergolide (n = 10; 6-month monotherapy; pergolide + levodopa thereafter). RESULTS: Both treatments were associated with a significant improvement in motor scores and in tests assessing learning and long-term verbal and visual memory, visuospatial abilities, and various frontal tasks. While improvement in motor scores persisted, improvement in activities of daily living and in semantic fluency, Luria's rhythm and motor and long-term memory tests was not sustained at the 24-month examination. Further, performance on attentional, short-term memory, and the Stroop tests did not change over the course of the study. CONCLUSIONS: Both treatments were associated with incomplete but long-lasting (18 mos) improvement in many cognitive tasks which declined thereafter, suggesting that dopaminergic replacement is not enough to compensate for all cognitive deficits of PD.

Aged↗

[Progressive aphasia without dementia].

INTRODUCTION: Slowly progressive aphasia without generalized dementia is considered as a degenerative disorder that can be differentiated of others well-known neurodegenerative disorders. CLINICAL CASE: We present a case report of a patient with slowly progressive aphasia, characterized by a progressive anomia and without generalized dementia. The patient was evaluated in the last four years: a neuropsychological assessment, a neurological exploration and structural (MRI) and functional (SPECT) neuroimaging were performed. CONCLUSION: This case is interesting on account of a selective implication of the left temporal hemisphere is showed in the pathogenesis of this disorder.

Anomia↗

Right hemisphere dysfunction in subjects with attention-deficit disorder with and without hyperactivity.

The attention-deficit disorder, with and without hyperactivity, is associated with defective attention, response inhibition and, in attention-deficit disorder with hyperactivity, with motor restlessness. In adults, inattention, defective response inhibition, and impersistence are more commonly seen in right hemisphere lesions. In the present study, we investigate possible right hemisphere dysfunctions in attention-deficit disorder with hyperactivity and attention-deficit disorder without hyperactivity. The right hemisphere performance of 60 teenagers, 16 having attention-deficit disorder with hyperactivity, 9 having attention-deficit disorder without hyperactivity, and 35 controls, selected clinically (DSM-III) and experimentally (through Continuous Performance Test and Paced Auditory Addition Task), with normal IQ was assessed using a wide-ranging battery of visuospatial, visuoperceptive, and visuoconstructive functions (Benton's Line Orientation, Benton's Visual Retention, Raven's Progressive Matrices, Wechsler Adult Intelligence Scale [WAIS] Block-Design, Rey's Complex Figure). Teenagers with attention-deficit disorder with and without hyperactivity performed significantly worse than controls. Greater differences were found between subjects with attention-deficit disorder without hyperactivity and control than between subjects with attention-deficit disorder with hyperactivity and control subjects. Our results seem to be consistent with right-hemisphere dysfunction, especially in subjects with attention-deficit disorder without hyperactivity. Additionally, WAIS Block-Design and Benton's Line Orientation are the visuospatial tests with the highest discriminant power to differentiate between controls, subjects with attention-deficit disorder without hyperactivity, and subjects with attention-deficit disorder with hyperactivity.

Adolescent↗

[Fragile X syndrome and mental retardation].

INTRODUCTION: Fragile-X syndrome is characterized by the presence of a fragile site (gap) on Xq 27.3 and the transcriptional inhibition of a mRNA protein-binding gene called FMR-1. Neuropsychological features include cognitive impairment, attention deficit disorder with and without hyperactivity, and impairment of visuospatial functions, language and frontal executive functions. In the present paper, other cytogenetic and phenotype characteristics, associate disorders, neurological and neuroimaging studies are revised. CLINICAL CASES: We describe two siblings that illustrate the pattern of neurocognitive and behavioural trends of the Fragile X syndrome, and sex differences. DISCUSSION AND CONCLUSIONS: These two cases emphasize the need for performing a cytogenetic diagnostic in patients with mental retardation, of unknown etiology, and with a familiar history of mental retardation.

Adult↗

[Memory and learning: 'experience' and 'skill' of the brain].

OBJECTIVE: To describe the current typology and different processes involved in memory and learning, as well as adequate tests in the diagnosis of the mnesic disorders. DEVELOPMENT: We reviewed the most recent studies about functional and lesional neuroanatomy of memory and learning and their neurophysiological bases (cellular and biochemical), with special emphasis in studies published in the three last years. We structured a typological classification, we expose the processes involved in short-term and long-term memory, we detailed the mnesic processes of declarative and implicit type, and we expose profiles of amnesias frequent in the clinical neurology and neuropsychology. CONCLUSIONS: Memory is not a diffuse and unitary process in our brain, neither amnesia is an absolute loss of memory. The multidimensional combination of two temporary memories (short- and long-term) and three mnesic processes ('working memory', explicit and implicit memory-learning) increases our capacity to memorize and learn, and it allows us to store the information in distinctive periods, with different mechanisms and covering different necessities. Patients with amnesia exhibit distinctive profiles of mnesic processes affected.

Brain↗

[Attention: a complex cerebral function].

INTRODUCTION: Attention is a brain neurocognitive state of preparing what precedes perception and action, and is a result of cortical and subcortical networks. Attention selectively focuses our consciousness while filtering the constant flow of sensory information, selects competent parallel processing among stimuli and activates brain zones for ordering appropriate responses. DEVELOPMENT: From a neurofunctional point of view this paper reviews and describes attention as a brain function regulated by three interrelated systems: Alertness or arousal providing tonic attention, dependent on the mesencephalic reticular activating system and its connections: posterior attention or attention of perceptive selectivity that depends on zones of the right posterior parietal cortex and its connections; and, anterior attention or supervisory attention that regulates deliberate attention, and supported by zones of the anterior cingulate and lateral prefrontal cortex and the connections of the zones.

Attention↗

[Neuropsychology of left-handedness: current knowledge].

About 10% of the population is left-handed or non-right handed. Its brain organization and cognitive skills could differ in relation to right-handed subjects. Our current knowledge is far of get to know its etiology. The scientific literature is sufficiently wide as interesting to review its main contributions. The experimental studies undertake the last 30 years, but this current revision is centred on studies from the last 10 years. From them it is concluded that in Neuropsychology of the left-handedness there are great disagreements. The investigation needs to distinguish types of left-handedness or non-right-handedness, while it is not demonstrated that there is a single type of left-handedness.

Brain↗

[Dyslexia: actual status of our neurological and neuropsychological knowledge].

Developmental dyslexia is a neurological syndrome of unknown origin. Historical, conceptual, etiological, epidemiological aspects of developmental dyslexia are reviewed in a neuropsychological perspective. This article also reviews the known neuroanatomic, neuropathologic, and diagnostic basis of developmental dyslexia. Dislexic typology, with specific deficits in language, the visual domain or both, is discussed. Developmental dyslexia may be associated with several neuropsychological deficits. Its screening must be cognitively complete and according to accepted diagnostic criteria; a disorder manifested by difficulty in learning to read despite conventional instruction, adequate intelligence, and sociocultural opportunity.

Brain↗

[Attention deficit hyperactivity disorder. Cerebral asymmetry observed on magnetic resonance].

INTRODUCTION: Anatomical and functional neuroimaging data from subjects with Attention Deficit Hyperactivity Disorder (ADHD) have consistently implicated a reversal of cerebral asymmetry and suggested a fronto-striatal dysfunction in this disorder. OBJECTIVE: The aim of this study is to investigate the brain asymmetries in a homogeneous and non-medicated sample of adolescents with ADHD who had been previously studied in our laboratory. PATIENTS AND METHODS: T1-weighted magnetic resonance images were obtained for 11 adolescents with ADHD and 19 control subjects. Frontal and posterior brain regions, caudate nucleus, and ventricular system were quantitatively measured. RESULTS: A reversed pattern of asymmetry for the caudate nucleus (right > left) was found in ADHD when compared to the control group. We also found a reversed pattern of asymmetry for the frontal lobe (right < left) and a smaller right frontal volume (prefrontal specifically) in the ADHD subjects most severely impaired. Right caudate and frontal measures were inversely correlated. CONCLUSIONS: ADHD is associated with fronto-striatal abnormalities, which may be explicable via extant neurodevelopmental theories. Enlargement of the right caudate nucleus may suggest the failure of a process of synaptic 'pruning' by which attentional functions could be improperly transferred from the basal ganglia to frontal regions during development.

Adolescent↗

[Frontal lobes: the executive brain].

OBJECTIVE: To describe the current basic functional neuroanatomy of the frontal lobes and complex cognitive processes associated with this wide brain zone. DEVELOPMENT: We reviewed recent studies with neurofunctional interest. We structured the frontal zones and the cognitive functions more specifically humans, named 'executive functions'. We classified the frontal syndrome into more specific syndromes; and, we reviewed the fronto-cortical and subcortical connections, which are the basis of the frontal zones and functions. CONCLUSIONS: The frontal lobe is not a single anatomical and functional brain region. Regions and fronto-cortical and subcortical circuits within the frontal lobe are associated with motor functions and cognitive processes highly specialized, which may be differently affected.

Cognition↗

[Sustained attention in the preclinical phase of Alzheimer's disease].

INTRODUCTION: Deterioration of attention in the preclinical phase of dementia of Alzheimer s type (DAT) is not very well known neither available studies are conclusive. OBJECTIVE: We outline if would be possible to identify a deficit of sustained attention in preclinical phase of DAT and if this attentional dysfunction could help to identify those patients, referred by subjective memory complaints (SMC), who will progress in a few years to DAT. PATIENTS AND METHODS: We compared basal exploration in a task of sustained attention (CPT) of 70 patients referred by SMC and followed longitudinally for 2 years. Twenty seven patients developed probable DAT and forty three remained clinically stable. RESULTS: Patients who will be diagnosed 2 years later with DAT performed significantly more poorly than patients who did not develop DAT. Patients who will be diagnosed 2 years later with DAT made a higher number of omission errors and obtained a lower number of correct responses. CONCLUSION: CPT paradigm is a vigilance task that detects deterioration of sustained attention in the preclinical phase of DAT and could be an objective indicator of the cognitive decline in the preclinical phase of Alzheimer s disease.

Activities of Daily Living↗

[Validation of the translation to Catalan and Spanish of cognitive evoked potential N400].

INTRODUCTION: The cognitive evoked potential N400 permits an objective assessment of the verbal semantic processing. It has been suspected to be clinically useful in cognitive abnormalities and a correlation with attentional and memory functions has been found. The present study tries to validate the translation and adaptation of the English paradigm to the Catalan and Spanish languages. METHOD: The study was performed on 16 healthy volunteers with Catalan native language and 16 volunteers with Spanish native language. Three blocks of 50 sentences (4-9 words) were administered using headphones. The last word of 50 % of the sentences was incongruent. The beginning of this word was the trigger for the EEG average. EEG leads used were: Fz, Cz, Pz, C3, C4, T3, T4 with biauricular reference. The measures were amplitude and latency of the potential obtained after the subtraction of the EEG average of congruent and incongruent sentences. A t-test for one sample (the original potential) was applied. RESULTS: Amplitude and latency of the potential obtained by the Catalan and Spanish languages were not result statistically different from the original potential. The major amplitude was obtained in Cz. Mean amplitudes: Catalan language: 5.3 2.3 V (95 % CI for the difference: 0.39 2.12 V); Spanish language: 5.2 2.3 V (95 % CI for the difference: 0.43 2.32 V). CONCLUSIONS: The Catalan and Spanish version of the N400 evoked potential offer the possibility to use an objective instrument for the study of language in neuroscience.

Adult↗