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Biomedical subjects

F Maestú

Publications and source records attributed to F Maestú.

At least 19 recordsLinked to original sources

Effects of cholinergic drugs and cognitive training on dementia: 2-year follow-up.

Several studies have shown that pharmacological and cognitive treatments for Alzheimers's disease improve cognitive function for short periods, but fewer studies have evaluated the efficacy of those treatments for longer (2-year) periods. An initial sample of 68 subjects with mild Alzheimer's disease underwent clinical and cognitive evaluation. After evaluation, subjects were assigned to four different groups and participated in a 2-year follow-up study. Group 1 (n = 14) received combined drug and cognitive stimulation, group 2 (n = 20) received only drug treatment, group 3 (n = 14) received only cognitive stimulation, and group 4 (n = 30) received no treatment at all. Results confirmed previous investigation, cognitive and combined stimulation improved patients' performance throughout the 1st year; however, all groups deteriorated gradually throughout the 2nd year of treatment. According to this evidence, it can be concluded that we cannot stop cognitive deterioration after 2 years of treatment, although deterioration is greater and its progress faster in patients not receiving any treatment at all.

Aged↗

[A comparative study of pragmatic language disorders and autism spectrum disorders using magnetoencephalography].

INTRODUCTION: Pragmatics refers to the social use of language; its precursors are already present during the process of maturing, during the preverbal stage, and become manifest when the child starts to point and to share his or her attention with another person. In cases of specific language impairment (SLI) and autism spectrum disorders (ASD) it can be altered to varying degrees. PATIENTS AND METHODS: Due to the difficulties involved in diagnosis from a clinical point of view, we carried out a study by means of magnetoencephalography (MEG) on a series of 11 patients who had SLI and another series of 9 patients with ASD, in order to determine whether MEG is capable of distinguishing these diagnoses. RESULTS: Patients with SLI displayed pathological activity in the frontal and middle temporal regions of both hemispheres. Patients with ASD showed pathological activity in the perisylvian area. Expressive-receptive SLI with pragmatic language disorder showed pathological activity that was similar to that seen in autism. CONCLUSION: MEG can be used to distinguish between SLI and ASD by studying the epileptiform activity that occurs in pervasive developmental disorders. MEG helps us to understand the continuum that exists between SLI or expressive-receptive SLI and autism.

Autistic Disorder↗

Paroxysmal MEG activity in obsessive compulsive patients without SSRIs therapy.

We describe a fronto-temporal paroxysmal rhythmic activity registered by magnetoencephalography (MEG) in two patients with obsessive compulsive disorder (OCD) without SSRIs treatment. The localization of the activity involves cingulate cortex and frontal areas. We think that these MEG findings are related to the disease itself, rather than representing pharmacological SSRIs effect.

Adolescent↗

Evidence of biochemical and biomagnetic interactions in Alzheimer's disease: an MEG and MR spectroscopy study.

BACKGROUND: Several neuroimaging studies have shown reliable differences between Alzheimer's disease (AD) patients and age-matched controls. However, few studies have demonstrated the interactions between neuroimaging methods for the diagnoses of AD. OBJECTIVE: In this study, we try to elucidate the complementary nature of magnetoencephalography (MEG) and magnetic resonance spectroscopy (MRS) examinations in the assessmentof AD. METHODS: Ten patients fulfilling the NINCDS-ADRDA criteria of probable AD, and 10 elderly individuals with no history of neurological or psychiatric illness serving as age-matched controls participated in the study. All patients and controls received an MRS, MEG and neuropsychological assessment. MEG data were obtained in the context of a working memory task, previously utilized in a similar sample of patients. RESULTS: The AD group showed a reduced number of activity sources over left temporoparietal areas during the late portion of the evoked magnetic field (between 400-800 ms), as well as a bilateral temporoparietal increase in creatine and myoinositol concentrations, and in the myoinositol/N-acetyl-aspartate ratio. The combination of the variables 'number of dipoles during the late portion of the evoked magnetic field' and 'myoinositol/N-acetyl-aspartate ratio' accounted for 65% of the variance of the Mini Mental State Examination scores. CONCLUSIONS: These results highlight the importance of assessing the complex brain pathology underlying AD by utilizing multiple brain examination modalities in a coordinate approach.

Aged↗

Medial temporal lobe neuromagnetic hypoactivation and risk for developing cognitive decline in elderly population: a 2-year follow-up study.

Cognition declines as a function of age. However, some elders could develop more severe status such as mild cognitive impairment (MCI). The aim of this study was the early detection of neurophysiological patterns of brain activity that may predict the possibility of certain subjects to develop MCI. Brain magnetic activity was recorded from 15 healthy subjects during a memory task by means of magnetoencephalography. None of the participants could be considered as MCI at the time of the first clinical evaluation. After 2-year follow-up, five subjects developed MCI and 10 maintained their cognitive status across time. The subjects who developed cognitive decline showed a lower number of activity sources in the left medial temporal lobe between 400 and 800 ms after stimulus onset, as compared to the non-cognitive decline group. These findings may help with the early identification of elderly subjects at high risk of cognitive decline, allowing the possibility of neuropsychological or pharmaceutical treatment that delay or prevent the progression of the cognitive impairment.

Age Factors↗

[Specific language disorders: their diagnosis, classification and study using magnetoencephalography].

INTRODUCTION: Specific language disorder (SLD) is defined as a disorder in which language is slow and retarded with respect to the patient's chronological age, and which is not related to a sensory-auditory or motor deficit or to a pervasive development disorder; in other words, structural and functional neurological developmental disorders must be excluded. After many studies and attempts to reach an agreement, specific language disorders have been broadly classified into two groups: specific expressive language disorder and specific receptive-expressive language disorder. AIMS: Our objective was to study SLD using magnetoencephalography (MEG) in order to look for epileptiform manifestations in precise language areas. PATIENTS AND METHODS: We studied a sample made up of 11 patients with SLD, one of whom had Landau-Kleffner syndrome and one with cryptogenic-type SLD. The criteria used were age-dependent autism exclusion tests and specific language tests for SLD. The MSI technique was carried out on all the patients, by magnetic resonance and MEG. RESULTS: A characteristic pattern is obtained for SLD in the form of irregular spike and polyspike-wave discharges in bilateral frontal channels. The dipoles were situated mainly in the left perisylvian areas. CONCLUSIONS: The study of specific language disorders using MEG enables us to identify the SLD included in a proposed classification as primary-type specific language disorder, cryptogenic-type specific language disorder and secondary-type type specific language disorder, like Landau-Kleffner syndrome.

Language Disorders↗

[Recent contributions from magnetoencephalography to the neurobiology of attention-deficit/hyperactivity disorder].

INTRODUCTION AND DEVELOPMENT: Current theories postulate that the core cognitive deficit in attention-deficit/hyperactivity disorder (ADHD) is an executive dysfunction. Neuroimaging studies on the whole have provided both anatomical and functional evidence supporting the fronto-striatal dysfunction hypothesis in ADHD. However, recent neuroimaging studies have found anatomical and functional impairments in posterior cortical regions, such as the inferior parietal and posterior temporal cortices, which have been related to a deficit in selective attention. Event related potential (ERP) studies show that ADHD children have an impairment in early components (within the first 200 ms of processing), such as P1 or N1, both of which are sensitive to selective attention effects. These findings cast doubt regarding the fronto-striatal/executive dysfunction as the core deficit in ADHD. CONCLUSIONS: One of the main objectives of ADHD research is the search for its core cognitive deficit and the neural networks underlying it, because it has important repercussions over ADHD diagnosis and treatment. High temporal resolution techniques, such as ERP or magnetoencephalography may be particularly useful in distinguishing the precise moment of cognitive processing during which the brain activity of children with ADHD begins to be impaired. As a consequence, this may help to elucidate the core cognitive deficit in ADHD.

Attention Deficit Disorder with Hyperactivity↗

Effects of cholinergic drugs and cognitive training on dementia.

A study was performed on patients with Alzheimer's disease (AD) in order to evaluate the efficacy of a combined treatment (donepezil plus cognitive training) in both cognitive processes and affective states. Eighty-six subjects, 25 men and 61 women, with an average age of 75.58 years, were studied. Almost all the subjects had a basic educational level. Donezepil was administered at a dose of 10 mg daily along with cognitive treatment involving images of everyday life and reminiscent music; the sessions took place on Monday to Friday and lasted three quarters of an hour. The study lasted 12 months. Subjects underwent test-retest with the following tests: Mini-Mental State Examination (MMSE), the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog); the Geriatric Depression Scale (GDS) and the overall deterioration scale (FAST). The results showed that subjects receiving the combined treatment had a better response than those who did not receive any cognitive training. These subjects' MMSE score decreased by 3.24 on average. The affective symptomatology of those receiving only drug treatment improved whereas the cognitive processes did not.

Aged↗

Profiles of brain magnetic activity during a memory task in patients with Alzheimer's disease and in non-demented elderly subjects, with or without depression.

The presence of depression is common among the elderly and it often complicates the early diagnosis of Alzheimer's disease (AD). In this study, we searched for brain activity measures that characterise AD. We compared brain magnetic activity profiles during a memory task, obtained from patients with AD, elderly patients with late onset depression, and age matched volunteers without history of neurological or psychiatric disease. AD patients showed significantly reduced activity in left temporal lobe regions during late portions of the event related magnetic response (400 ms or later after stimulus onset), compared with both groups of patients who did not present with serious cognitive decline. This finding highlights the potential usefulness of MEG protocols supporting the differential diagnosis of AD and major depression related cognitive decline in the elderly.

Age of Onset↗

Do cognitive patterns of brain magnetic activity correlate with hippocampal atrophy in Alzheimer's disease?

BACKGROUND: Many reports support the clinical validity of volumetric MRI measurements in Alzheimer's disease. OBJECTIVE: To integrate functional brain imaging data derived from magnetoencephalography (MEG) and volumetric data in patients with Alzheimer's disease and in age matched controls. METHODS: MEG data were obtained in the context of a probe-letter memory task. Volumetric measurements were obtained for lateral and mesial temporal lobe regions. RESULTS: As expected, Alzheimer's disease patients showed greater hippocampal atrophy than controls bilaterally. MEG derived indices of the degree of activation in left parietal and temporal lobe areas, occurring after 400 ms from stimulus onset, correlated significantly with the relative volume of lateral and mesial temporal regions. In addition, the size of the right hippocampus accounted for a significant portion of the variance in cognitive scores independently of brain activity measures. CONCLUSIONS: These data support the view that there is a relation between hippocampal atrophy and the degree of neurophysiological activity in the left temporal lobe.

Aged↗

[Neuromagnetic correlates of dyslexia].

Dyslexia was first described over a century ago and since then many theories have been put forward to explain it, but we still do not have one single unified theory that explains the problem. Furthermore, over the years a great deal of research work has also been carried out that relates dyslexia with disorders in different brain structures, and yet we still do not have a clear idea of exactly which neurophysiological mechanisms are involved. It has been claimed, however, that the disorder may be caused by specific deficits in the left frontotemporal region or atypical asymmetries in the left perisylvian regions. Lastly, neuroimaging techniques, such as functional magnetic resonance or mapping of the electrical activity in the brain, have helped to further studies into dyslexia over the last decade. Recently, the introduction of magnetoencephalography in the study of the brain has opened up a whole new range of possibilities that will allow most of the controversial points raised by research into dyslexia using neuroimaging techniques to be resolved empirically.

Child↗

[The neuromagnetic correlates of language].

Studies of language using different functional neuroimaging techniques have shown the cortical structures to be involved in the functions of language, both in control subjects and in patients with different neurological pathologies who are to undergo brain surgery. Magnetoencephalography (MEG) is a totally non-invasive technique that measures the magnetic fields generated by the flow of intracellular current produced in the dendrites of the pyramidal neurones. MEG also offers the possibility of lateralizing language, so enabling us to know which areas of language lie within the dominant hemisphere and to establish the temporal patterns that reveal the organisation, either in sequence or in parallel, of the different areas that are activated. This will provide us with a deeper understanding of the physiological foundations upholding both language and other cognitive processes.

Adult↗

[Clinical features of epilepsy in autism spectrum disorders].

Autism is a rare disease, but is currently in vogue. An incidence of 1/1,000 has been estimated for early childhood autism, but in autism spectrum the incidence can reach 30/1,000. The clinical characteristics of autism are cognitive language disorders, lack of social interaction, obsessive behaviours with stereotypic movements and epilepsy. For some authors it is an associated symptom while for others it is a cardinal symptom of the disease. Epilepsy in autism, as an association, was reported as early as 1944 by Leo Kanner, in describing his initial work involving 11 cases and how one of them suffered from epilepsy. In 1960, the prevalence of epilepsy among autistic patients was evaluated and found to be much higher than in the normal population. The figures differ from author to author, but really they depend on age: the higher the age, the greater the prevalence of epilepsy. It was in fact this detail that drew our attention to this issue, and triggered the first questions in our research into autism and epilepsy. The series vary from 4 to 86%, depending on the methodology used to confirm the epilepsy. In our casuistics, between the ages of 1 and 18 years, 20% of these children with autism spectrum disorders suffer some kind of epileptic seizures, and 80% suffer what other researchers call subclinical seizures . In this paper, the symptomatology of the most important subclinical seizures that have been observed in these children is presented; the diseases associated with autism are commented on; the concept of primary and secondary autism is discussed; we explain why seizures occur in autism and their consequences as a neurodevelopmental disorder, and we put forward an interesting hypothesis within our general theory of autism. We also comment on the importance that the use of functional magnetic images in the study of autism has in our research.

Adolescent↗

[Savant or idiot savant syndrome].

Savant syndrome is currently still very mysterious, yet, thanks to the progress made in neuroimaging studies and especially MSI (Magnetic Source Imaging) techniques, a little more is now known about it. The theory, formulated many years ago, about damage to the left hemisphere of the brain has been supported by functional neuroimaging. Its relation to developmental disorders or to autism spectrum disorders is far more justified today and can be explained on the basis of its neuropathology. We present a study based on a review of the scientific literature concerning the syndrome, from the first time it was described back in 1789 by Benjamin Rush up to the present day. We comment on its epidemiology and positive clinical manifestations, involving brilliant artistic talent and dazzling memory, but also the negative aspects suffered by these autistic patients. The most important theories are discussed together with the clinical coincidence with frontotemporal dementia and the responsibility of the right hemisphere when there are alterations in the contralateral hemisphere. The latest contributions made by Positron Emission Tomography and magnetoencephalography will be discussed and a mini-video of a personal case will be projected.

Art↗

Spatio-temporal patterns of brain magnetic activity during a memory task in Alzheimer's disease.

The brain magnetic activity patterns in a high load probe-letter (targets and distractors) memory task were examined in patients with Alzheimers's disease (AD) and elderly controls. Control subjects showed a higher number of activity sources over the temporal and parietal cortex between 400 and 700 ms after stimulus onset. However, AD patients showed a higher number of sources over the frontal motor areas, including Broca's and the insula. The number of activity sources on the left parietal areas in response to the target stimuli predicted the AD score oncognitive (MMSE, CAMCOG) and functional staging (FAST) scales. These results suggest that a high information load reveals a deficient functioning of phonological store and reduced task-related activity in temporal and parietal areas, manifesting in a rapid information trace decay. The increased levels of activity in motor areas may reflect a compensatory strategy in an attempt to facilitate rehearsal speed.

Aged↗

Neural processing to visual stimuli in a three-choice reaction-time task.

Some authors have suggested that certain components of the event-related potentials (ERPs) reflect underlying stages in the discrimination process. Previous studies have shown that in an auditive three-choice reaction-time task the discrimination is accomplished as a two-stage process, with the more frequently occurring stimulus discriminated at an earlier point than the rarer stimulus and the subjects could be classified as fast and slow responders in function of their response to the most frequent of the three tones. We continuously recorded the electrocerebral activity (EEG) from the scalp and the electromyographic activity (EMG) from the responding muscles in a visual three-choice reaction-time task in 10 strictly right-handed subjects. EEG and EMG responses were subsequently analyzed off-line by aligning them by the onset of either the stimulus (stimulus-synchronized) or the response (response-synchronized). The results suggest that processes of visual stimuli evaluation and response execution are continuously integrated. The discrimination and response systems to visual stimuli is accomplished as a three-stage process, one to frequent tone, another for rare 1, and the last for rare 2. The subjects were classified as fast and slow responders in function of their response to the most frequent of the three tones.

Adult↗

Neuropathological findings in a patient with epilepsy and the Parry-Romberg syndrome.

PURPOSE: The Parry-Romberg syndrome is an unusual disorder frequently associated with epilepsy. The origin of this disease, and the cause of epilepsy, are unknown. This study is the first reported case of the Parry-Romberg syndrome, with intractable temporal lobe epilepsy, in which detailed microanatomic analyses have been performed on resected brain tissue obtained after surgical intervention. METHODS: Standard histopathologic methods and correlative light and electron microscopy, combined with immunocytochemical techniques, were used to study in detail the synaptic microorganization of the resected hippocampal formation. RESULTS: After surgery, the patient was seizure free (follow-up period of 4 years and 7 months). The resected temporal lobe showed a variety of dramatic microanatomic alterations (small groups of ectopic cells, neuronal loss, gliosis, and activated microglial cells) in mesial structures, including the entorhinal cortex, subiculum, and dentate gyrus. At the electron-microscopic level, we found that in the dentate gyrus, the number of synapses in the cell-sparse region adjacent to the ectopic mass of neurons was almost twice that found in the molecular and polymorph cell layers, indicating the intrusion of neuritic processes and synapse formation. In addition, the symmetrical axosomatic synapses characteristically found on granule cells, which are likely derived from gamma-aminobutyric acid (GABA)ergic inhibitory basket cells, were not observed. CONCLUSION: The complete seizure relief after surgery suggests that the pacemaker region(s) of seizure activity were within the resected tissue. However, we do not know which of the multiple neuropathologic findings reported here were the primary cause of seizure activity. Nevertheless, the changes found in the dentate gyrus circuitry appear to be among the most important alterations that would lead to epilepsy.

Adult↗

Expectancy and response strategy in a three-choice visual task.

We investigated the relationship between sensorial discrimination and motor response by means of movement-related potentials, in a task where subjects had to discriminate between 3 stimuli presented visually in a random way. The results indicate that subjects anticipate the response to each type of stimulus by following a probabilistic criterion in the absence of a warning stimulus. This criterion entails an erroneous lateralization of cerebral activation and a significant increase in reaction time, despite the reduction of errors.

Adult↗