Papers by Marcelo Berthier
Develop Med Child Neurol, 2007
We describe the coexistence of Asperger and Tourette syndromes (AS and TS) caused by discrete hyp... more We describe the coexistence of Asperger and Tourette syndromes (AS and TS) caused by discrete hypoxic-ischaemic necrosis of the midbrain, infrathalamic and thalamic nuclei, and striatum in an adolescent male with positive family history for tics and obsessive-compulsive disorder. Behavioural ratings, cognitive tests, and volumetric measurements of the basal ganglia were performed in the patient and five other individuals with AS-TS unassociated with MRI lesions. Cognitive deficits in attentional, executive, and visual-spatial domains were found both in the patient and control AS-TS group, though deficits were more severe in the former. MRI showed reduction of the left basal ganglia volume compared with the right in the patient, whereas the control group showed reduction of right basal ganglia volume compared with the left. It is suggested that individuals with a genetic predisposition to TS may develop AS and TS after involvement of midbrain and related components of basal gangliathalamocortical circuits normally implicated in the integration of emotional, cognitive, and motor functions.
Cognitive and Behavioral Neurology, Dec 31, 2000
The goal of this study was to evaluate behavior and cognition in a consecutive series of patients... more The goal of this study was to evaluate behavior and cognition in a consecutive series of patients who developed obsessive-compulsive disorder (OCD) after suffering a traumatic brain injury (TBI). Background: Because OCD is a rare sequelae of TBI, the phenomenology of obsessions and compulsions, the comorbid psychiatric disorders, the performance on cognitive tests, and the neural correlates have not been well characterized. Methods: Ten adult patients who met DSM-IV diagnostic criteria for OCD after suffering either mild (6 cases), moderate (2 cases), or severe (2 cases) TBI were studied using structured psychiatric rating scales (i.e., Yale-Brown Obsessive Compulsive Scale), cognitive tests, and magnetic resonance imaging (MRI). Results: Global severity of OCD ranged from moderate to severe, and all patients had multiple obsessions and compulsions. There was a high frequency of aggressive, contamination, need for symmetry/exactness, somatic, and sexual obsessions as well as cleaning/washing, checking, and repeating compulsions. Unusual features such as obsessional slowness (3 cases) and compulsive exercising (3 cases) were also documented. Comorbid psychiatric diagnoses were common and included posttraumatic stress disorder, anxiety with panic attacks, depression, and intermittent explosive disorder. Compared with 10 age-matched normal controls, the OCD group had poor performance on tests of general intelligence, attention, learning, memory, wordretrieval, and executive functions; these cognitive deficits were more pervasive among patients displaying obsessional slowness. All OCD patients with mild TBI had normal MRI scans, whereas focal contusions in the frontotemporal cortices, subcortical structures (caudate nucleus), or both were found in OCD patients with moderate and severe TBI. Conclusions: Posttraumatic OCD has a relatively specific pattern of symptoms even in patients with mild TBI and is associated with a variety of other psychiatric disorders, particularly non-OCD anxiety. The patterns of cognitive deficits and MRI findings suggest dysfunction of frontal-subcortical circuits. (NNBN 2001;14:23-31)
Frontiers in Human Neuroscience
Knowledge on the patterns of repetition amongst individuals who develop language deficits in asso... more Knowledge on the patterns of repetition amongst individuals who develop language deficits in association with right hemisphere lesions (crossed aphasia) is very limited. Available data indicate that repetition in some crossed aphasics experiencing phonological processing deficits is not heavily influenced by lexical-semantic variables (lexicality, imageability, and frequency) as is regularly reported in phonologically-impaired cases with left hemisphere damage. Moreover, in view of the fact that crossed aphasia is rare, information on the role of right cortical areas and white matter tracts underpinning language repetition deficits is scarce. In this study, repetition performance was assessed in two patients with crossed conduction aphasia and striatal/capsular vascular lesions encompassing the right arcuate fasciculus (AF) and inferior frontal-occipital fasciculus (IFOF), the temporal stem and the white matter underneath the supramarginal gyrus. Both patients showed lexicality effe...
The International Journal of Psychiatry in Medicine
The aim of this study is to know the prevalence of anxiety and depression in caregivers of patien... more The aim of this study is to know the prevalence of anxiety and depression in caregivers of patients with Alzheimer's disease (AD) and assess the association of caregiver burden (CB) with characteristics of both patients and caregivers. Sociodemographic and clinical variables have been obtained (patients: age, gender, marital status, years of education, duration and severity of dementia, psychiatric disorders, previous history, and use of psychoactive and antidementia drugs; caregivers: age, gender, relationship with patient, and marital status). Cognition was assessed with Mini Mental State Examination (MMSE); severity of dementia was assessed with Global Deterioration Scale (GDS); caregiver burden was assessed with Hamilton Depression Rating Scale (HDRS), State-Trait Anxiety Inventory (STAI), and the number of hours of attention to the basic activities of daily-living (H-BADL). More than 50% of caregivers have shown high anxiety and depression scores. Patients with longer durat...
Neuropsychiatry, neuropsychology, and behavioral neurology, 2001
The goal of this study was to evaluate behavior and cognition in a consecutive series of patients... more The goal of this study was to evaluate behavior and cognition in a consecutive series of patients who developed obsessive-compulsive disorder (OCD) after suffering a traumatic brain injury (TBI). Because OCD is a rare sequelae of TBI, the phenomenology of obsessions and compulsions, the comorbid psychiatric disorders, the performance on cognitive tests, and the neural correlates have not been well characterized. Ten adult patients who met DSM-IV diagnostic criteria for OCD after suffering either mild (6 cases), moderate (2 cases), or severe (2 cases) TBI were studied using structured psychiatric rating scales (i.e., Yale-Brown Obsessive Compulsive Scale), cognitive tests, and magnetic resonance imaging (MRI). Global severity of OCD ranged from moderate to severe, and all patients had multiple obsessions and compulsions. There was a high frequency of aggressive, contamination, need for symmetry/exactness, somatic, and sexual obsessions as well as cleaning/washing, checking, and repea...
The Journal of neuropsychiatry and clinical neurosciences, 1989
Soon after treatment of a right basotemporal vascular malformation using an embolization procedur... more Soon after treatment of a right basotemporal vascular malformation using an embolization procedure, a 25-year-old patient developed an acute episode of mania. Two months later the patient was still manic, and a second embolization was scheduled. Before it was conducted, a Wada test was carried out to determine speech dominance. No changes in manic symptoms were observed after amytal injections into the left middle cerebral, right frontopolar, or right middle cerebral arteries. This finding suggests that secondary mania may not be the result of "release" of the left hemisphere following a right hemisphere lesion but instead may be related to specific disturbances within the right hemisphere.
Medicine - Programa de Formación Médica Continuada Acreditado, 2011
Medicine. 2011;10(74):5035-41 5035
... 207 Autonomous University of Barcelona Beatriz Asenio MD PhD, Jesus Aparicio MD Diego Lara MD... more ... 207 Autonomous University of Barcelona Beatriz Asenio MD PhD, Jesus Aparicio MD Diego Lara MD LT bcanner (,enter Malaga, 'pain *C0rrespondei1ce Io first author at Departamento dc Med icina v Dermatologizi Facultzid dc Medicina, U niversidad de ... 1986; °Bech et al. ...
American Journal of Psychiatry, 1998
TO THE EDITOR: The combination of fluoxetine and valproic acid is frequently used for psychiatric... more TO THE EDITOR: The combination of fluoxetine and valproic acid is frequently used for psychiatric patients (i.e., those with bipolar depression). However, there is a growing recognition that the inhibitory effect of fluoxetine on cytochrome P450 may lead to serious adverse reactions (1). We report a drug interaction between fluoxetine and valproic acid.
Knowledge on the patterns of repetition amongst individuals who develop language deficits in asso... more Knowledge on the patterns of repetition amongst individuals who develop language deficits in association with right hemisphere lesions (crossed aphasia) is very limited. Available data indicate that repetition in some crossed aphasics experiencing phonological processing deficits is not heavily influenced by lexical-semantic variables (lexicality, imageability, and frequency) as is regularly reported in phonologically-impaired cases with left hemisphere damage. Moreover, in view of the fact that crossed aphasia is rare, information on the role of right cortical areas and white matter tracts underpinning language repetition deficits is scarce. In this study, repetition performance was assessed in two patients with crossed conduction aphasia and striatal/capsular vascular lesions encompassing the right arcuate fasciculus (AF) and inferior frontal-occipital fasciculus (IFOF), the temporal stem and the white matter underneath the supramarginal gyrus. Both patients showed lexicality effects repeating better words than non-words, but manipulation of other lexical-semantic variables exerted less influence on repetition performance. Imageability and frequency effects, production of meaning-based paraphrases during sentence repetition, or better performance on repeating novel sentences than overlearned clichés were hardly ever observed in these two patients. In one patient, diffusion tensor imaging disclosed damage to the right long direct segment of the AF and IFOF with relative sparing of the anterior indirect and posterior segments of the AF, together with fully developed left perisylvian white matter pathways. These findings suggest that striatal/capsular lesions extending into the right AF and IFOF in some individuals with right hemisphere language dominance are associated with atypical repetition patterns which might reflect reduced interactions between phonological and lexical-semantic processes.
Journal of Alzheimer's disease : JAD, 2014
The aim was to assess the neuropsychological performance of a group of middle-aged patients with ... more The aim was to assess the neuropsychological performance of a group of middle-aged patients with well-controlled type 2 diabetes mellitus (T2DM) and to examine whether the neuropsychological deficits correlate with structural and functional brain alterations. We compared 25 subjects with T2DM aged 45-65 years with 25 control participants matched for age, gender, and educational level. The neuropsychological battery was designed to examine executive functions, attention, information processing speed, and verbal memory. Severity of depression was assessed using the Hamilton Depression Rating Scale and cardiovascular risk factors were assessed using the Framingham Cardiovascular Risk Profile Score. The presence of at least one APOEε4 allele was determined. Reduced gray matter density was analyzed using voxel-based morphometry and brain glucose metabolic changes were assessed by 18FDG-PET. T2DM subjects had significantly lower scores than subjects without T2DM in the Trail-making Test B...
Frontiers in Human Neuroscience, 2013
Assessment of brain-damaged subjects presenting with dissociated repetition deficits after select... more Assessment of brain-damaged subjects presenting with dissociated repetition deficits after selective injury to either the left dorsal or ventral auditory pathways can provide further insight on their respective roles in verbal repetition. We evaluated repetition performance and its neural correlates using multimodal imaging (anatomical MRI, DTI, fMRI, and 18 FDG-PET) in a female patient with transcortical motor aphasia (TCMA) and in a male patient with conduction aphasia (CA) who had small contiguous but non-overlapping left perisylvian infarctions. Repetition in the TCMA patient was fully preserved except for a mild impairment in nonwords and digits, whereas the CA patient had impaired repetition of nonwords, digits and word triplet lists. Sentence repetition was impaired, but he repeated novel sentences significantly better than clichés. The TCMA patient had tissue damage and reduced metabolism in the left sensorimotor cortex and insula. DTI showed damage to the left temporo-frontal and parieto-frontal segments of the arcuate fasciculus (AF) and part of the left ventral stream together with well-developed right dorsal and ventral streams, as has been reported in more than one-third of females. The CA patient had tissue damage and reduced metabolic activity in the left temporoparietal cortex with additional metabolic decrements in the left frontal lobe. DTI showed damage to the left temporo-parietal and temporo-frontal segments of the AF, but the ventral stream was spared. The direct segment of the AF in the right hemisphere was also absent with only vestigial remains of the other dorsal subcomponents present, as is often found in males. fMRI during word and nonword repetition revealed bilateral perisylvian activation in the TCMA patient suggesting recruitment of spared segments of the left dorsal stream and right dorsal stream with propagation of signals to temporal lobe structures suggesting a compensatory reallocation of resources via the ventral streams. The CA patient showed a greater activation of these cortical areas than the TCMA patient, but these changes did not result in normal performance. Repetition of word triplet lists activated bilateral perisylvian cortices in both patients, but activation in the CA patient with very poor performance was restricted to small frontal and posterior temporal foci bilaterally. These findings suggest that dissociated repetition deficits in our cases are probably reliant on flexible interactions between left dorsal stream (spared segments, short tracts remains) and left ventral stream and on gender-dimorphic architecture of the right dorsal stream.
Atherosclerosis Supplements, 2011
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Papers by Marcelo Berthier