Biomedical subjects

M A Jurado

Publications and source records attributed to M A Jurado.

13 recordsLinked to original sources

PubMed2002

Obsessive-compulsive disorder (OCD) patients are impaired in remembering temporal order and in judging their own performance.

Obsessive-compulsive disorder (OCD) has been related to frontostriatal dysfunction, but some inconsistencies between studies and a relative paucity of neuropsychological research still characterizes the study of OCD. We compared 28 patients with OCD and matched healthy controls on two neuropsychological tests sensitive to frontal dysfunction: temporal ordering and a "feeling-of-doing" (FOD) judgment about ordering. The OCD group performed significantly worse than controls in the temporal ordering task despite showing normal recognition memory. Patients were also impaired in "feeling-of-doing" judgments suggesting they have a lack of self-awareness of their performance. Thus, the results of the current study reinforces previous research that indicates that OCD patients fail on tasks that require adequate functioning of the frontal-striatal pathways.

Adolescent↗

PubMed2001

Impairment of incidental memory for frequency in patients with obsessive-compulsive disorder.

The aim of our study was to investigate whether patients with obsessive-compulsive disorder (OCD) have impaired incidental memory for frequency. Fifty-four subjects (27 OCD patients and 27 matched control subjects) performed a task assessing estimation of occurrence of previously heard words. Performance on this task was compared with other intentional verbal memory tasks (recognition, recall and learning of common words). We also correlated memory for frequency with frontal lobe tests (Wisconsin Card Sorting Test, Trail Making Tests A and B, and verbal fluency). Performance on incidental learning of frequency was significantly worse in the OCD group than in control subjects. Other verbal memory measures did not show significant differences. Performance in the frequency task correlated with verbal fluency. Although intentional verbal memories are normal in OCD patients, incidental memory for frequency is impaired, suggesting that prefrontal systems are involved in OCD.

Adolescent↗

PubMed2001

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↗

PubMed2001

Correlation of atrophy measures on MRI with neuropsychological sequelae in children and adolescents with traumatic brain injury.

To examine the relationship between neuropsychological sequelae and atrophy parameters from magnetic resonance imaging (MRI) following paediatric moderate-to-severe traumatic brain injury (TBI), 19 head injured children and adolescents were studied at least 6 years after injury. Three-dimensional MRI scans were obtained. A semi-automatic computerized method was used to estimate ventricular volumes and the corpus callosum area. Tests of intellectual, memory, visuospatial, frontal lobe, and motor speed functioning were administered to all patients and to 19 matched normal control subjects. Patients' performance significantly differed from controls in general intellectual function, visual memory, visuospatial and frontal lobe tests. The corpus callosum area correlated strongly with several measures involving processing speed and visuospatial function. Ventricular enlargement was less related to neuropsychological outcome. In conclusion, quantitative measurement of the corpus callosum on MRI reflects neuropsychological outcome better than ventricular dilation in paediatric patients.

Adolescent↗

PubMed2001

Effectiveness of a learner-centred training programme for primary care physicians in using a patient-centred consultation style.

OBJECTIVE: The aim of the present study was to find out if a training programme adapted to family physicians with several years of clinical experience changes their behaviour when they deal with fibromyalgic patients in the sense of introducing the communication skills that define the 'patient-centred' approach. METHODS: A randomized, and simple blind, educative study was carried out. Twenty full-time family physicians were invited to participate. They were allocated randomly to two groups: an intervention and a control group. A total of 110 patients were recruited from people attending physicians' surgeries for the first time and who complained of generalized pain that finally fulfilled criteria for generalized musculoskeletal chronic pain/fibromyalgia. This was done for an entire year. The intervention group received an 18 hour intensive course. One week after the course, all doctors carried out a video-recorded encounter with a patient who played the part of a typical fibromyalgia clinical case. The interviews were coded by an observer blind to the training status of the participants, using the GATHARES-CP questionnaire. All patients were contacted by telephone during a 1-2-month period by a different interviewer who was 'blinded' to the patient's experimental status. They were asked to respond to three questions that represent the key components of patient-centred style. RESULTS: The average score on the GATHARES-CP questionnaire was 11.3 +/- 0.9 and 9 +/- 2.3, for doctors from the intervention and control groups, respectively (P < 0.01). For 11 items, scores were higher in the intervention group. The patients' answers to all three questions showed statistically significant differences in a positive direction for the trained doctors. CONCLUSIONS: The doctors improved the use of strategies and skills for carrying out patient-centred consultations after they had received an interactive course. The doctors' behaviour appeared to have changed as much in a more experimental situation as in the actual consultations. Moreover, the gain was observed immediately after the intervention was completed, and after having run for a variable period of time up to 1 year.

Adult↗

PubMed2000

Age effects on long-term neuropsychological outcome in paediatric traumatic brain injury.

In order to investigate the relationship between age at injury and long-term neuropsychological impairment, 29 children and adolescents who sustained traumatic brain injury (TBI) were studied at least 6 years post-trauma. Tests of intellectual, memory, visuospatial and frontal lobe functions were administered to patients and 29 normal matched control subjects. Correlations between performance on neuropsychological tests and age showed the following direction: the younger the child when TBI was sustained, the worse the cognitive outcome. After controlling for injury severity, visuospatial functions remained related to age. Patients' performance differed significantly from that of controls in half of the neuropsychological variables analysed. To further investigate the effects of age at injury, the sample was divided in two groups (TBI before and after age of 8) and then compared with their respective controls. Patients damaged earlier presented impaired intellectual and visuospatial functions. The results suggest that neuropsychological sequelae remain after at least 6 years of evolution, and that there is an age at injury effect.

Adolescent↗

PubMed2000

Phonemic and semantic fluencies in traumatic brain injury patients with focal frontal lesions.

The purpose of this study was to investigate the effect of focal frontal lesions, identified by magnetic resonance imaging (MRI), in a group of traumatic brain injured (TBI) patients, in order to clarify the sensitivity of phonemic and semantic fluency tasks as tests of frontal lobe functioning. Thirteen TBI patients were included and matched with a normal control group of 26 subjects. Frontal lobe patients produced significantly fewer words than the control group in the phonemic fluency condition. Semantic performance correlated with lesion size, but phonemic performance did not, corroborating the idea that the two have different brain-based substrates. Although, as a group effect, frontal lesions impaired fluency, not all patients were impaired, even in the presence of large bilateral frontal lesions.

Adolescent↗

PubMed1998

Overestimation and unreliability in "feeling-of-doing" judgements about temporal ordering performance: impaired self-awareness following frontal lobe damage.

"Feeling-of-doing" accuracy in a temporal ordering task in 33 patients with frontal lobe lesions and a matched control group was investigated. The temporal ordering task used word lists that had high, medium, or no semantic interrelatedness. Patients with frontal lobe lesions showed an impairment in temporal ordering across all three word lists. Both groups performed better on the lists with higher semantic interrelatedness. Patients with frontal lobe lesions overestimated their ability to order words accurately. On the less semantically interrelated lists, metamemory judgment in patients with frontal lesions did not correlate with their performance. These results indicate that both temporal order judgment and metacognitive decisions about temporal order judgment are subserved by the prefrontal cortex and further clarifies the role of the frontal lobes in behavioral monitoring.

Adult↗

PubMed1995

The role of prefrontal regions in the Stroop task.

The Stroop is a classical paradigm that presumably involves the inhibition of automatic responses and is frequently used to assess the frontal lobe functions. We investigated the effect of discrete prefrontal lesions in a Stroop task. A sample of 32 patients with frontal lesions were matched with normal controls by sex, age and years of education. Significant differences between patients and controls were found for errors but not for reaction time. Regression analysis showed that the region most related to errors was the right prefrontal lateral cortex. Left lobectomies did not impair the Stroop performance. Our results favour the role of the right prefrontal cortex in sustained attention, and disagree with the conception of the left prefrontal cortex having a role in the inhibition of verbal automatic responses.

Adult↗

PubMed1994

[Neuropsychological signs in frontal and temporal supratentorial neuroepithelial tumors].

We have studied a group of patients with supratentorial neuroepithelial tumors before and after surgical treatment. The main neuropsychological impairments were in verbal memory. After surgery, neuropsychological performance improved in 36.1%, worsened in 13.6% and remained the same in 29.7%. In 21.6%, normal performance had already been observed. The physiology of brain tumors make it difficult to distinguish between frontal and temporal symptoms. However, neuropsychological assessment in useful for maximizing the patient's social adjustment.

Adolescent↗

PubMed1993

[Neuropsychological impairment in closed head injury. Relationship between objective and subjective deficit].

We have studied a group of patients who had suffered severe closed head injury. We have found that the presence of neuropsychological impairment was related with the duration of posttraumatic amnesia. The more frequent complaints were memory deficit, problems of attention and personality changes specially an increase in anxiety and aggressivity levels. All these impairments were confirmed by the neuropsychological assessment. We have found a strong relationship between the memory performance and the subjective complaints. We think that questionnaires exploring subjective complaints are useful in the neuropsychological evaluation of traumatic patients.

Adult↗

PubMedDate not supplied

[Criminal behavior after orbitofrontal lesion].

INTRODUCTION: Orbitofrontal lesions may produce abnormal social conduct, making impossible to live independently and even producing antisocial behaviour. CLINICAL CASES: Two young people with orbitofrontal lesion due to TH1 showed as chronic symptoms (18 months and seven years after injury) comportmental changes similar to antisocial personality disease, including criminal actions. Neuropsychologically the first case showed memory, fluency and secuentiation impairment. The second patient' performance was normal. CONCLUSIONS: Prefrontal lesion may impair self-regulation, producing syndromes that prevent normal every-day life but are no much relevant in neurological and neuropsychological assessments. Orbitofrontal cortex plays an important role in social cognition which is the function that allows complex social behaviour. Because of the complexity of this function, symptoms can worse with the passage of time, thus a long follow-up of these patients is required.

Adult↗

PubMedDate not supplied

[Psychopathy and neuropsychology of the prefrontal cortex].

We review the main experimental works about the relationship between psychopathy and prefrontal cortex. First neuropsychological articles found contradictory results exploring psychopaths who were diagnosed by different criteria and using putative dorsolateral tests. Attentional deficits in psychopaths and relationships between psychopathy and attention disorder with and without hyperactivity have been studied. Distinction between primary and secondary psychopathy has been related to neuropsychological impairment in antisocial disorder. Differentiation between orbital and dorsolateral prefrontal systems should be taken into account in order to study the neuropsychological deficits in psychopathy. It has been pointed that orbitoventral system would be involved in antisocial behaviour. Hence, neuropsychological impairment in psychopaths is expected to be related to orbitofrontal dysfunction.

Antisocial Personality Disorder↗