J M Gobernado

Hospital Universitario Ramón y Cajal, Madrid, Madrid, Spain

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Publications (51)149.27 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: To elaborate a brief but efficient neuropsychological assessment of frontotemporal dementia (FTD), selecting the most specific and sensitive cognitive and behavioural items for distinguish between AD and FTD in the earlier dementia stages. Retrospective study with three groups, 35 patients with FTD, 46 with AD and 36 normal subjects, were administered the MMSE, FAB, Tower of London and Stoop's test along with a 98 items behavioural and cognitive questionnaire. The most sensitive items were selected and validated internally for diagnosis by lineal discriminant analysis. From the 98 items in the questionnaire, 29 showed significant discriminatory power. Non-cognitive symptoms with higher odd-ratio for FTD compared to AD were impairment in social behaviour (disinhibition, aggressiveness), loss of insight and inappropriate acts. Language disorders, such as echolalia, verbal apraxia or aggramatism, dominate in the cognitive profile of FTD. FAB was confirmed as the best cognitive instrument to differentiate FTD and AD. A linear discriminant function with the combination of the FAB score and the items from our questionnaire with higher OR for FTD accurately classified 97% of individuals. The neuropsychological tests allow the differentiation between FTD and AD. The combination of FAB test with the assessment of key behavioural and cognitive symptoms appears helpful in this distinction.
    Clinical neurology and neurosurgery 04/2009; 111(3):251-5. DOI:10.1016/j.clineuro.2008.10.012 · 1.13 Impact Factor
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    ABSTRACT: We have studied the relationship between the histocompatibility class I and II antigens and Sneddon's syndrome (SS) in a Spanish patient with SS and her relatives (13 available members of an extensive 3-generation pedigree with diverse autoimmune hypercoagulation abnormalities). The patient and her father were diagnosed with a primary antiphospholipid antibody syndrome and were HLA-A30-B13-Bw6. In addition, a HLA-Bw6-DQ1 association was present in all the members of this kindred. These data suggest that the combination of the histocompatibility class I and II antigens in this family may be a marker for predisposition to SS.
    Human Immunology 02/2007; 68(1):26-9. DOI:10.1016/j.humimm.2006.10.015 · 2.14 Impact Factor
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    ABSTRACT: There are no studies on event-related cognitive potentials in frontotemporal dementia (FTD). In order to evaluate the aptitude and usefulness of the event-related P300 potential in this disease, we prospectively examined 60 cases: 11 patients with FTD diagnosed according to the Lund and Manchester criteria and Neary consensus criteria, 33 patients with a probable Alzheimer's disease diagnosis following NINCDS-ADRDA criteria, and 16 normal controls. P300 latency, amplitude and reaction time were recorded using an auditory oddball paradigm. In this sample, P300 potential could be reliably performed by 10/11 FTD patients, notwithstanding their language or executive function deficiencies. The FTD group P300 mean latency was midway between the normal controls and the Alzheimer's disease group (ANOVA F(2, 74199) = 16.5; p = 0.00003). The latency range of the FTD patients were within normal values (average plus 1.96 standard deviation of the values of the control group), except for one case with a latency of 448 ms. Post hoc Newman-Keuls analysis showed that the P300 latencies of the control and FTD groups did not differ significantly (p = 0.15) and that the Alzheimer's disease group had a delayed P300 latency that differed significantly from that of the FTD (p = 0.002) and control group (p = 0.0002). However, there was overlapping in P300 latency values of the three groups. Despite these differences in latencies, the reaction time was significantly increased in the FTD and the Alzheimer's disease groups. These findings indicate that the P300 potential is less affected in patients with FTD than those with Alzheimer's disease. This fact could aid in FTD diagnosis, differential diagnosis with Alzheimer's disease and possibly its clinical management.
    Dementia and Geriatric Cognitive Disorders 02/2002; 13(1):27-32. DOI:10.1016/S0197-4580(00)82660-3 · 3.55 Impact Factor
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    ABSTRACT: Antiphospholipid antibodies (lupus anticoagulant and anticardiolipin antibodies) are associated with a variety of clinical situations, including drug-intake, but their relationships with antiepileptic drugs have been scarcely investigated. To determine the prevalence of antiphospholipid antibodies in patients treated with antiepileptic drugs and the associated risk of thrombotic events. We performed the serologic study of thirty-six consecutively prospectively recruited epileptic patients treated with diverse antiepileptic drugs during 44.38 +/- 8.08 months (mean +/- SD) in which antiphospholipid antibodies were determined using cardiolipin and a mixture of phospholipid from rabbit brain as antigen for detection of cardiolipin and lupus anticoagulant by ELISA and in addition lupus anticoagulant was carried out also using coagulometric assays. A clinical evaluation was done in order to determine the presence of thrombotic events in the following five years. Antiphospholipid antibodies were detected in 43% of these patients, in most of them as anticardiolipin antibodies (IgM subtype). The patients did not present thrombotic events during the time of the study. Antiphospholipid antibodies are positive in a high proportion of these patients but thrombosis were not found during the study duration. This may be explained by the fact that the profile of aCL positivity not associated to positive LA observed in these patients does not confer a risk for thrombotic events.
    Neurologia (Barcelona, Spain) 02/2001; 16(1):7-10. · 1.38 Impact Factor
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    ABSTRACT: Lesion of cranial nerves due to vascular damage at pontine level generally associates affectation of near nerve tracts. Isolated fifth nerve palsy due to vascular pontine lesions has been scarcely reported. We present a hypertense 57 year old woman who suffered from sudden paresthesias and hypoesthesia on the three divisions of trigeminal nerve without motor involvement and with preservation of corneal and masseter reflexes. Cranial magnetic resonance showed small dorsolateral pontine infarct over the right fifth cranial nerve entry. Isolated sensitive trigeminal neuropathy is a rare debut form of pontine infarct.
    Neurologia (Barcelona, Spain) 12/2000; 15(9):411-3. · 1.38 Impact Factor
  • M Lousa · J M Gobernado · A Pardo
    Neurologia (Barcelona, Spain) 11/2000; 15(8):361. · 1.38 Impact Factor
  • Manuel Lousa · Jose M. Gobernado · Ana Pardo
    European Journal of Neurology 04/1999; 6(2):255. DOI:10.1111/j.1468-1331.1999.tb00023.x · 4.06 Impact Factor
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    ABSTRACT: More than 40 point mutations (producing different clinical manifestations) have been described in diverse points of the plasma protein transthyretin (TTR). The Met30 is considered the most common mutation, the Tyr77 mutation being the second most prevalent. However, data from patients with this late mutation are scarce, and usually come from isolated case reports or tables. The Tyr77 mutation is not as well characterized as the Met30 mutation, especially with respect to such aspects as prognosis or possible treatment by liver transplantation. We therefore present the clinical and pathological features of an extensive family with the Tyr77 TTR mutation, comprising 12 affected individuals over four generations. Six living individuals were followed over a 10-year period. Retrospective data were obtained with regard to the deceased family members. We found that an initial and sometimes prolonged carpal tunnel syndrome, beginning between the 6th and 7th decades, characterizes the Tyr77 mutation. In most cases this evolved to generalized peripheral nerve involvement, restrictive cardiomyopathy, and intestinal malabsortion. Although survival is usually high, there are progressive cases that should be candidates for liver transplant, before severe impairment has developed.
    Muscle & Nerve 12/1998; 21(11):1478-85. DOI:10.1002/(SICI)1097-4598(199811)21:11<1478::AID-MUS17>3.0.CO;2-X · 2.28 Impact Factor
  • D A de Luis · J Gobernado · J Masjuan
    Revista Clínica Española 07/1998; 198(6):403. · 1.06 Impact Factor
  • M Barón · A Jiménez Escrig · L Orensanz · J M Gobernado
    Neurology 06/1998; 50(5):1516. DOI:10.1212/WNL.50.5.1516 · 8.29 Impact Factor
  • A Jiménez Escrig · M Barón · J M Gobernado
    Revista Clínica Española 10/1997; 197(9):659. · 1.06 Impact Factor
  • M. Lousa · J. M. Gobernado · C. Cervero · F. Perez‐Corral · A. Pardo
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    ABSTRACT: We present the coagulation and serological studies of four patients with Sneddon's syndrome, in which antiphospholipid antibodies (anticardiolipin antibodies and lupus anticoagulant) were determined using cardiolipin and a mixture of phospholipid from rabbit brain as antigen for detection of lupus anticoagulant by ELISA. Our results support a relation between Sneddon's syndrome and lupus anticoagulant (IgG subtype) in all cases. The anticardiolipin antibody test was positive only in two cases (one in low level). All patients could be diagnosed as having primary antiphospholipid antibody syndrome. Antiaggregant treatment was not effective in preventing thrombosis in two cases. Three of four patients received long-term oral anticoagulation therapy, with no recurrence of thrombosis observed for a period of at least 3 years.
    European Journal of Neurology 07/1997; 4(4). DOI:10.1111/j.1468-1331.1997.tb00370.x · 4.06 Impact Factor
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    M Baron · J M Gobernado · J Masjuan · M Lousa
    Journal of Neurology Neurosurgery & Psychiatry 07/1997; 62(6):672. DOI:10.1136/jnnp.62.6.672 · 6.81 Impact Factor
  • Electroencephalography and Clinical Neurophysiology 06/1997; 103(1):102-102. DOI:10.1016/S0013-4694(97)88430-5
  • M Barón · J Heredero · I Prieto · M Lousa · J Masjuán · J M Gobernado
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    ABSTRACT: Spinal subdural empyema (SE) is a rare condition. We describe a young patient with a torathic SE after lumbar epidural anaesthesia. SE was distant from the region of manipulation. Spinal magnetic resonance was the most useful procedure for diagnosis and follow-up. Treatment with intravenous antibiotics and drainage was not enough, and she needed complete surgical excision of the lesion.
    Neurologia (Barcelona, Spain) 06/1997; 12(6):262-4. · 1.38 Impact Factor
  • J Masjuan · M Barón · M Lousa · J M Gobernado
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    ABSTRACT: Pontine infarctions may produce combined motor, sensory, cerebellar, and cranial nerve dysfunction. Midline sensory complaints and facial pain are uncommon. Three patients are described with hypoesthesia and numbness of the midline facial area associated with dysarthria and contralateral hemiparesis due to pontine strokes. MRI demonstrated isolated ipsilateral ischemic infarctions of the ventral pons. Pontine infarctions can produce diverse sensory features. Ipsilateral midfacial sensory defect has been rarely reported. The clinicoanatomic basis for the ipsilateral midfacial sensory defect described is unknown. Involvement of the dorsal trigeminothalamic tract or fiber tracts related to central regions of the face, located in the medial part of the midbrain, could help to explain these data. The symptoms could be due to direct damage or to edema resulting from the infarct. In some patients, midfacial sensory complaints, particularly of the ala nasi, could be an early sign of major pontine deficits and may be important to determine appropriate treatment.
    Stroke 04/1997; 28(3):649-51. DOI:10.1161/01.STR.28.3.649 · 5.72 Impact Factor
  • Muscle & Nerve 01/1996; 18(12):1490-2. DOI:10.1002/mus.880181225 · 2.28 Impact Factor
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    Journal of Neurology Neurosurgery & Psychiatry 08/1995; 59(1):101-2. DOI:10.1136/jnnp.59.1.101 · 6.81 Impact Factor
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    Journal of Neurology Neurosurgery & Psychiatry 05/1995; 58(4):519-20. DOI:10.1136/jnnp.58.4.519 · 6.81 Impact Factor
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    Journal of Neurology Neurosurgery & Psychiatry 04/1995; DOI:10.1136/jnnp.58.4.519-a · 6.81 Impact Factor