Satisfacción con la vida en relación con la funcionalidad de las personas mayores activas / Satisfaction with life related to functionality in active elderly people

Introducción. Estudiar la relación entre variables objetivas de funcionalidad y grado de satisfacción con la vida en personas mayores con un estilo de vida activo. Material y métodos. Estudio con 340 personas mayores con edades comprendidas entre los 60-85 años. Todas ellas presentan un estilo de vida activo. Pruebas aplicadas: Escala de Satisfacción con la Vida, Test Conductual de Memoria Rivermead, Cuestionario de Fallos de Memoria de la Vida Diaria, Escala Geriátrica de Depresión, subescala de apoyo social del OARS, subescala de la dimensión física del COOP-WONCA, escala de valoración jerárquica para la autonomía de Siu y Reuben. Resultados. Análisis estadísticos con las correlaciones de Pearson (p < 0,05 y p < 0,001) entre las variables objetivas de funcionalidad y el nivel de satisfacción con la vida. Los resultados globales muestran que hay correlación negativa, es decir, paradoja del bienestar entre los criterios objetivos nivel de estudios, nivel de memoria y autonomía y el criterio subjetivo del nivel de satisfacción vital. Conclusión. Se hacen necesarias propuestas de intervención en actividad física entre las personas más mayores, ya que la reducción de la movilidad podría ser el desencadenante de un modelo de vida patológico (AU)

Introduction. To study the relation ship between the objective variables of functionality and degree of life satisfaction in elderly people with an active lifestyle. Material and Methods. The study took place using as ample of 340 elderly people, aged 60-85, who were allleading an active life. The tests applied were: Satisfaction with Life Scale, Rivermead Behavioral Memory Test, Memory Failures Everyday, Geriatric Depression Scale, OARS social support subscale, COOP-WONCA physical dimension subscale and Siu and Reuben hierarchical scale for self-sufficiency. Results. Statistical analyses were made using Pearson's correlations, with a significance level of p < 0.05 and p < 0.001 between the objective variables and satisfaction with life level. The overall results show a negative correlation, that is, a paradox of well-being between the objective criteria of level of studies, memory level and self-sufficiency and the objective criterion of the level of life satisfaction. Conclusion. Proposals for intervention in elderly people's physical activity are needed, since reduced mobility could lead to a pathological pattern of life (AU)

[Cognition and neural networks, a new perspective based on functional neuroimaging]. / Cognición y redes neurales, una nueva perspectiva desde la neuroimagen funcional.

AIM: We went through a critical review of the current status of neuroimaging studies of cognition. Thus, we argue why the use of a neuronal network perspective could led us to a better understanding of cognition than a localizationism perspective. METHOD: The question about how cognitive functions are organized in the brain, comes from the very early lesions studies. Electrocortical stimulation and the intracorotid amytal procedure collaborate together with lesions studies to increase the knowledge about the organization of cognitive functions in the brain. Functional neuroimaging could help to this issue answering the following questions: where, when and how the activity is produced in the brain. Many of the functional neuroimaging studies have addressed the question of where the activity is located, but very few has been concentrated into describe the spatio temporal profiles of brain activity, and then how the neural networks which support cognition are organized. Taking into account just one of this perspectives (where or when) we could achieve a reductionism view of the problem. CONCLUSIONS: Executive function, memory or language are more distributed than located in just one area, even the different subprocesses that are included in each of this functions are supported by a network rather than a particular area. We analyze the current available functional neuroimaging techniques under this view and its possibilities to describe the neural networks which support cognition.

[Neuromagnetic correlates of dyslexia]. / Correlatos neuromagnéticos de la dislexia.

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.

[The neuromagnetic correlates of language]. / Correlatos neuromagnéticos del lenguaje.

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.

[Clinical features of epilepsy in autism spectrum disorders]. / Clínica de la epilepsia en los trastornos del espectro autista.

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.

[Savant or idiot savant syndrome]. / El síndrome de savant o idiot savant.

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.

[Magnetoencephalographic study in patients with cognitive impairment]. / Estudio magnetoencefalográfico en pacientes con deterioro cognitivo.

INTRODUCTION: In early stages, dementia is a neurodegenerative process with difficult diagnosis. Although well defined clinically, its neurophysiological, neuroradiological and metabolic diagnosis is still unsuccessful. PATIENTS AND METHOD: A MEG study using a 148 channel whole head magnetometer (Magnes 2500 WH) and evaluation by mini mental state examination (MMSE) was performed in 31 subjects. Statistical analyses was made to correlate number of dipoles of slow waves and neuropsychological variables. RESULTS: The 63.3% (21 patients) show slow waves dipoles in temporal lobes (52.3% were bitemporal). Right temporal lobe has 119.5 23.3 dipoles (averaged value), and left temporal lobe has 126.2 19.8 dipoles (averaged value). The 25% (8 patients) shown slow waves dipoles in parietals lobes, 5 of them biparietal. Correlation between MMSE averaged scores and temporal lobe dipoles was r= 0.84. CONCLUSION: MEG results show that slow waves dipoles number in temporal lobes is related with low scores in the mini mental state examination. MEG could be a usefully complementary method in evaluation and following of degree of cognitive impairment in these patients

Clínica de la epilepsia en los trastornos del espectro autista / Clinical features of epilepsy in autism spectrum disorders

El autismo es una enfermedad rara, pero está de moda. Se estima una incidencia de 1/1.000 para el autismo infantil precoz, pero en el espectro autista la incidencia puede llegar a ser de 30/1.000. Las características clínicas del autismo son: trastornos cognitivos del lenguaje, falta de interacción social, comportamientos obsesivos con estereotipias y epilepsia. Para algunos autores es un síntoma asociado, y para otros, un síntoma cardinal de la enfermedad. La epilepsia en el autismo, como asociación, ya la citó en 1943 Leo Kanner, al describir en su trabajo inicial de 11 casos que uno de ellos padecía epilepsia. En 1960 se valoró la prevalencia de la epilepsia en los autistas, mucho mayor que en la población normal. Existen cifras dispares, según los autores, pero en realidad las cifras en aumento dependen de la edad: a mayor edad, mayor prevalencia de epilepsia, dato que nos llamó la atención para interesarnos en el tema, y en el que surgieron las primeras preguntas de nuestra investigación en autismo y epilepsia. Las series varían entre el 4 y el 86 por ciento, dependiendo también de la metodología utilizada para confirmar la epilepsia. En nuestra casuística, entre 1 y 18 años de edad, el 20 por ciento de estos niños con trastorno del espectro autista padece algún tipo de crisis epilépticas, y un 80 por ciento padece lo que otros investigadores denominan `crisis subclínicas'. Se presenta la semiología de las crisis subclínicas más importantes que se han encontrado en estos niños, se comentan las enfermedades asociadas al autismo, se discute el concepto de autismo primario y secundario, se explica el porqué de las crisis en el autismo y sus consecuencias como trastorno neuroevolutivo, y se propone una hipótesis interesante dentro de nuestra teoría general del autismo. Asimismo, se comenta también la importancia que tienen en nuestras investigaciones en magnetoencefalografía en el estudio del autismo (AU)

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 1943 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 magnetoencephalography in the study of autism has in our research (AU)

El síndrome de savant o idiot savant / Savant or idiot savant syndrome

El síndrome de savant es aún, en la actualidad, muy misterioso; pero, gracias a los avances en los estudios con neuro imagen, especialmente con técnicas MSI (del inglés, magnetic source imaging), se sabe más de él. La teoría, formulada hace largo tiempo, sobre los daños del hemisferio cerebral izquierdo, se ha visto respaldada por la neuroimagen funcional. Su relación con los trastornos del desarrollo o trastornos del espectro autista, está hoy mucho más justificada y puede explicarse desde su neuropatología. Se expone un trabajo de revisión del síndrome en cuanto a la literatura científica, desde su primera descripción, en 1789, por Benjamín Rush, hasta la actualidad. Se comenta la epidemiología y sus manifestaciones clínicas positivas, de brillantez artística y de memoria deslumbrante, a la vez que los aspectos negativos que acompañan a estos pacientes autistas. Se discuten las teorías más importantes, así como la coincidencia clínica con la demencia frontotemporal, la responsabilidad del hemisferio derecho cuando hay alteraciones en el hemisferio contralateral, y las nuevas aportaciones mediante la tomografía por emisión de positrones y la magnetoencefalografía (AU)

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 (AU)

Correlatos neuromagnéticos del lenguaje / The neuromagnetic correlates of language

Los estudios del lenguaje con diferentes técnicas de neuroimagen funcional han evidenciado las estructuras corticales implicadas en las funciones del lenguaje, tanto en sujetos controles como en pacientes con diferentes patologías neurológicas que van a someterse a cirugía cerebral. La magnetoencefalografía (MEG) es una técnica realmente no invasiva, que mide los campos magnéticos generados por el flujo de corriente intracelular producido en las dendritas de las neuronas piramidales. La MEG, además de ofrecer la posibilidad de lateralizar el lenguaje, permite conocer cuáles son las áreas del lenguaje dentro de ese hemisferio dominante, así como establecer los patrones temporales que indican la organización secuencial o en paralelo de las diferentes áreas activadas. Ello permitirá un conocimiento más profundo de las bases fisiológicas que sustentan tanto el lenguaje como otros procesos cognitivos (AU)

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 (AU)

Estudio magnetoencefalográfico en pacientes con deterioro cognitivo / Magnetoencephalographic study in patients with cognitive impairment

Introducción. La demencia es un proceso neurodegenerativo de difícil diagnóstico en su fase precoz. Se ha definido bien clínicamente, aunque su diagnóstico neurofisiológico, de neuroimagen y metabólico es todavía insuficiente. Pacientes y métodos. Se realizó registro magnetoencefalográfico (equipo whole-head de 148 canales Magnes 2500 WH) y valoración mediante examen minimental en 31 sujetos. Se realizó análisis estadístico para correlacionar el número de dipolos de ondas lentas con las variables neuropsicológicas. Resultados. En el 63,3 por ciento (21 pacientes) se objetivaron durante el análisis MEG dipolos de ondas lentas en lóbulos temporales, y en un 52,3 por ciento de éstos la localización era bitemporal. La media de los dipolos en lóbulo temporal derecho fue de 119,5 ñ 23,3, y en lóbulo temporal izquierdo de 126,2 ñ 19,8. Un 25 por ciento (ocho pacientes) presentaron dipolos de ondas lentas en lóbulos parietales y en cinco de ellos la localización fue biparietal. La correlación entre las puntuaciones medias del examen minimental y los dipolos en lóbulo temporal fue r= -0,84. Conclusión. Los hallazgos de la MEG indican que el número de dipolos de ondas lentas en lóbulos temporales se relaciona con puntuaciones bajas en el examen minimental. La MEG puede ser un método complementario útil en la evaluación y seguimiento del grado de deterioro cognitivo en estos pacientes (AU)

Introduction. In early stages, dementia is a neurodegenerative process with difficult diagnosis. Although well defined clinically, its neurophysiological, neuroradiological and metabolic diagnosis is still unsuccessful. Patients and method. A MEG study using a 148- channel whole-head magnetometer (Magnes 2500 WH) and evaluation by mini mental state examination (MMSE) was performed in 31 subjects. Statistical analyses was made to correlate number of dipoles of slow waves and neuropsychological variables. Results. The 63.3% (21 patients) show slow waves dipoles in temporal lobes (52.3% were bitemporal). Right temporal lobe has 119.5 ± 23.3 dipoles (averaged value), and left temporal lobe has 126.2 ± 19.8 dipoles (averaged value). The 25% (8 patients) shown slow waves dipoles in parietals lobes, 5 of them biparietal. Correlation between MMSE averaged scores and temporal lobe dipoles was r= -0.84. Conclusion. MEG results show that slow waves dipoles number in temporal lobes is related with low scores in the mini mental state examination. MEG could be a usefully complementary method in evaluation and following of degree of cognitive impairment in these patients (AU)

Epilepsia infantil por descargas rolándicas: diagnóstico mediante magneto encefalografía. Réplica / Reply. Childhood epilepsy caused by rolandic discherges: diagnosis using magnetoencephalography

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[P300 clinical utility in major depression]. / Utilidad clínica de la P300 en pacientes con depresión mayor.

INTRODUCTION: Event related potentials are an objective parameter reflecting cognitive functions. Among the event related potentials, the P300 component is viewed as a measure of stimulus evaluation time and it can provide a rough estimate of the time required for perceptual processing. Impairment in cognitive processing, psychomotor retardation and abnormally amplitude and longer P300 latency have been found in depressive patients. METHODS: To evaluate the influence of visual and auditory stimuli on the P300 latency we studied 595 patients with major depression. The experimental tasks applied were, first, a series of 300 auditory stimuli: 85% were tones of 1,000 Hz, and 15% were tones of 2,000 Hz, and second, a series of 300 visual stimuli; 85% were black circles on a white background and 15% were black squares on a white background. RESULTS: The results shown an increase of P300 latency in depressive patients during auditory and visual tasks. DISCUSSION: These results are consistent with an impairment in brain function with cortical hypo activity in depressive patients that is associated with cognitive deficit processing. These results determine the clinical utility of P300 in patients with major depression.

Utilidad clínica de la P300 en pacientes con depresión mayor / P300 clinical utility in major depression

Introducción. Los potenciales evocados corticales han demostrado ser un parámetro objetivo que refleja las funciones cognitivas. Entre los potenciales evocados corticales, el componente P300 ha sido considerado una medida de evaluación que puede proporcionarnos el tiempo aproximado del proceso perceptivo. Diferentes estudios han encontrado alteraciones en el procesamiento cognitivo, psicomotor, anormalidades en la amplitud de la P300 y retraso de su latencia en pacientes depresivos. Métodos. Con el fin de evaluar la influencia de la estimulación visual y auditiva en la latencia del componente P300 hemos estudiado 595 pacientes con depresión mayor. Las pruebas experimentales fueron, en primer lugar, una serie de 300 estímulos auditivos de los cuales el 85 por ciento fueron tonos de 1.000 Hz y el 15 por ciento fueron tonos de 2.000 Hz y en segundo lugar una serie de 300 estímulos visuales de los cuales el 85 por ciento fueron círculos negros y el 15 por ciento cuadrados negros situados en el centro de una pantalla en blanco. Resultados. Los resultados demuestran un incremento de la latencia del componente P300 en el grupo de pacientes depresivos tanto durante la estimulación auditiva como durante la visual. Discusión. Estos resultados son consistentes con un deterioro de la función cerebral relacionada con una hipofunción cortical que está asociada a un déficit en el procesamiento cognitivo de este tipo de pacientes. Estos datos permiten determinar la utilidad clínica del componente P300 en pacientes con depresión mayor (AU)

[Rolandic discharges in childhood epilepsy: magnetoencephalographic diagnosis]. / Epilepsia infantil por descargas rolándicas: diagnóstico mediante magnetoencefalografía.

INTRODUCTION: Whole head magnetoencephalography (MEG) systems facilitate simultaneous recording from the entire brain surface and deep structures. Thus MEG may be accepted as a clinically feasible method for the evaluation of epileptic patients not diagnosed with EEG. CLINICAL CASE: A 11 year old female, with tonic generalized seizures since birth. At the present time, seizures consist of initial focal signs followed by fear sensation and both eyes and cephalic deviation to the right, tonic extension of the superior limbs and prolonged apnea. Complementary examinations (EEG, Holter EEG, Video EEG, CT, MRI, SPECT) were normal. MEG study was conclusive, diagnosing sharp waves in the internal face of the left precentral circunvolution. CONCLUSIONS: MEG study s utility in seizures focus localization and pseudo seizures differential diagnosis has been demonstrated.

Epilepsia infantil por descargas rolándicas: diagnóstico mediante magnetoencefalografía / Rolandic discherges in childhood epilepsy: magnetoencephalographic diagnosis

Introducción. El sistema whole-head de magnetoencefalografía (MEG) permite el registro simultáneo de toda la superficie cerebral y de estructuras profundas. Así, la MEG puede aceptarse como un método clínico fiable para la evaluación de pacientes epilépticos no diagnosticados mediante el EEG. Caso clínico. Paciente mujer, de 11 años de edad, con crisis tonicoclónicas generalizadas desde el nacimiento. Actualmente, las crisis se inician con signos focales seguidos de sensación de miedo, desviación ocular y cefálica, extensión tónica de las extremidades superiores y apnea prolongada. Las exploraciones complementarias (EEG, Holter-EEG, vídeo-EEG, TAC, RM y SPECT) fueron normales. El estudio de MEG fue concluyente y diagnosticó ondas agudas en la cara interna de la circunvolución precentral. Conclusión. Se ha demostrado la utilidad del estudio mediante MEG en la localización del foco epiléptico y en el diagnóstico diferencial de pseudocrisis (AU)

Deficit in sensory motor processing in depression and Alzheimer's disease: a study with EMG and event related potentials.

Event related potentials have been examined in depression and Alzheimer disease like clinical utility. To evaluate the influence of visual and auditory stimuli on the P300 latency we studied 12 patients with major depression, 12 patients with Alzheimer disease and 12 normal subjects. The experimental tasks applied was, first a series of 300 auditory stimuli, 255 (85%), with tones of 1,000 Hz, and considered as the frequent stimulus, whereas 45 (15%) were tones of 2,000 Hz and referred as the rare stimulus. A second series of 300 visual stimuli, 255 (85%) that were black circles on a white background, and considered the frequent stimulus (9 cm diameter, 200 ms duration), whereas 45 (15%) were black squares on a white background and referred as the rare stimulus (9 cm diameter, 200 ms duration) in the centre of a computer screen. The results show an increase of P300 latency in depressive and Alzheimer patients during auditory and visual tasks. Differences were found in reaction time to visual or auditory stimuli in Alzheimer disease. These results are consistent with an impairment in brain function in depressive patients that is associated with cortical hypoactivity and deficits in perceptive, auditory or visual, functions, whereas deterioration in Alzheimer's disease is sensorymotor, according to the slowness latency in the reaction time.

Avances en neuroimagen en el trastorno obsesivo-compulsivo / Obsesive-compulsive disorder, new developments with neuroimaging techniques

La investigación con técnicas de neuroimagen sugiere que en el trastorno obsesivo-compulsivo (TOC) existe una disfunción que afectaría al circuito croteza prefrontalganglios de la base y tálamo más que a una única región cerebral. Los primeros estudios con tomografía y resonancia magnética demuestran cambios morfológicos en los ganglios de la base. En la actualidad y con el desarrollo de técnicas más sofisticadas se están comprobando estas alteraciones, en especial las relacionadas con el núcleo caudado. La hipótesis serotoninérgica sigue siendo necesaria pero no suficiente para explicar la patogénesis del TOC. La evidencia sigue centrándose en los ganglios de la base y su relación con el 5-HT/dopamina. Dado que los ganglios de la base reciben una rica inervación de neuronas 5-HT y dopaminérgicas, se ha postulado que el TOC se produciría por una disfunción del circuito orbitofrontal y ganglios de la base. La combinación de pruebas cognitivas y técnicas de neuroimagen permite un mejor estudio de la función cerebral de los pacientes y de los controles cuando son sometidos a estimulación. Además con estas técnicas se puede comprobar la respuesta al tratamiento con independencia de si es de tipo farmacológico o utilizando técnicas cognitivo-conductuales. Pero sin embargo no tenemos datos suficientes para entender los mecanismos anatómicos, fisiológicos y químicos que intervienen en el TOC (AU)

Callosal atrophy and associated electromyographic responses in Alzheimer's disease and aging.

Alzheimer's disease is a degenerative disorder characterised by cerebral atrophy with cortical and subcortical changes. Our objective is to investigate the patterns of atrophic changes in the corpus callosum in patients with Alzheimer's disease and healthy elderly subjects and to clarify the relations of callosal impairment and the presence of associated electromyographic responses. We compare cross-sectional area of the corpus callosum by age, group and associated electromyographic responses, using quantitative magnetic resonance imaging from 47 subjects (twenty four healthy subjects and twenty three Alzheimer's disease patients). The control population was selected by criteria of optimal health; medical, neurological or psychiatric illnesses were excluded. We find that the first anterior and medial-anterior corpus callosum areas show an atrophy in Alzheimer group patients. These sectors show a clear relationship with the presence of associated movements.