J Pablo Lara

Publications (4)17.27 Total impact

• Article: Atypical conduction aphasia and the right hemisphere: Cross-hemispheric plasticity of phonology in a developmentally dyslexic and dysgraphic patient with early left frontal damage.

  Marcelo L Berthier, Guadalupe Dávila, Natalia García-Casares, Cristina Green, Rocío Juárez, Rafael Ruiz-Cruces, J Pablo Lara, M A Barbancho
  [show abstract] [hide abstract]
  ABSTRACT: We report the rare case of a patient, JNR, with history of mixed handedness, developmental dyslexia, dysgraphia, and attentional deficits associated with a Klippel-Trenaunay syndrome and a small subcortical frontal lesion involving the left arcuate fasciculus. In adulthood, he suffered a large right perisylvian stroke and developed atypical conduction aphasia with deficits in input and output phonological processing and poor auditory-verbal short-term memory. Lexical-semantic processing for single words was intact, but he was unable to access meaning in sentence comprehension and repetition. Reading and writing deficits worsened after the stroke and he presented a combination of developmental and acquired dysgraphia and dyslexia with mixed lexical and phonological processing deficits. This case suggest that a small lesion sustained prenatally or early in life could induce a selective rightward shift of phonology sparing the standard left hemisphere lateralisation of lexical-semantic functions.
  Neurocase 01/2011; 17(2):93-111. · 1.11 Impact Factor
• Article: Structural abnormalities in the substantia nigra and neighbouring nuclei in Tourette's syndrome.

  Guadalupe Dávila, Marcelo L Berthier, Jaime Kulisevsky, Beatriz Asenjo, Jorge Gómez, J Pablo Lara, Salud Jurado Chacón, Víctor M Campos
  [show abstract] [hide abstract]
  ABSTRACT: Although midbrain nuclei (substantia nigra, ventral tegmental area, and periaqueductal grey) are considered candidate loci of pathology in Tourette's syndrome (TS), few imaging studies have examined midbrain structure. The objective of this study was to evaluate the presence of subtle structural abnormalities in the midbrain of patients with TS. High-field magnetic resonance imaging (MRI) (1.5- and 3-T) was used in 23 patients with TS and in 20 age- and sex-matched normal control subjects. Tics symptoms were rated using the Yale Global Tic Severity Scale and comorbid neuropsychiatric disorders were evaluated with standardised psychiatric rating scales. MRI scans revealed subtle structural abnormalities consistent with expanded perivascular spaces (EPVS) in the substantia nigra (compacta and reticulata) and neighbouring nuclei in 6 (26%) patients with TS, but in none of the normal control subjects (P = 0.045). Stereotyped movements were more frequent (P = 0.017) amongst TS patients with midbrain EPVS than in TS patients with normal MRI. Parkinsonism, posttraumatic stress disorder and autistic spectrum disorders exclusively occurred in TS patients with midbrain EPVS. There were no significant between-group differences in other comorbid neuropsychiatric disorders and in tics. Although EPVS are generally viewed as incidental findings, our results suggest that when EPVS are located in the midbrain they may be symptomatic. These abnormalities would reduce the actual number of neurons in specific midbrain nuclei (e.g., substantia nigra) and disrupt their connectivity with limbic, associative, and motor circuits.
  Acta Neurovegetativa 04/2010; 117(4):481-8. · 2.73 Impact Factor
• Article: Memantine and constraint-induced aphasia therapy in chronic poststroke aphasia.

  Marcelo L Berthier, Cristina Green, J Pablo Lara, Carolina Higueras, Miguel A Barbancho, Guadalupe Dávila, Friedemann Pulvermüller
  [show abstract] [hide abstract]
  ABSTRACT: We conducted a randomized, double-blind, placebo-controlled, parallel-group study of both memantine and constraint-induced aphasia therapy (CIAT) on chronic poststroke aphasia followed by an open-label extension phase. Patients were randomized to memantine (20 mg/day) or placebo alone during 16 weeks, followed by combined drug treatment with CIAT (weeks 16-18), drug treatment alone (weeks 18-20), and washout (weeks 20-24), and finally, an open-label extension phase of memantine (weeks 24-48). After baseline evaluations, clinical assessments were done at two end points (weeks 16 and 18), and at weeks 20, 24, and 48. Outcome measures were changes in the Western Aphasia Battery-Aphasia Quotient and the Communicative Activity Log. Twenty-eight patients were included, and 27 completed both treatment phases. The memantine group showed significantly better improvement on Western Aphasia Battery-Aphasia Quotient compared with the placebo group while the drug was taken (week 16, p = 0.002; week 18, p = 0.0001; week 20, p = 0.005) and at the washout assessment (p = 0.041). A significant increase in Communicative Activity Log was found in favor of memantine-CIAT relative to placebo-CIAT (week 18, p = 0.040). CIAT treatment led to significant improvement in both groups (p = 0.001), which was even greater under additional memantine treatment (p = 0.038). Beneficial effects of memantine were maintained in the long-term follow-up evaluation, and patients who switched to memantine from placebo experienced a benefit (p = 0.02). Both memantine and CIAT alone improved aphasia severity, but best outcomes were achieved combining memantine with CIAT. Beneficial effects of memantine and CIAT persisted on long-term follow-up.
  Annals of Neurology 06/2009; 65(5):577-85. · 11.09 Impact Factor
• Article: Late-life reactivation of obsessive-compulsive disorder associated with lesions in prefrontal-subcortical circuits.

  Christine Salinas, Guadalupe Dávila, Marcelo L Berthier, Cristina Green, J Pablo Lara
  [show abstract] [hide abstract]
  ABSTRACT: The authors describe the reactivation of obsessive-compulsive disorder (OCD) in three patients with lesions in the prefronto-subcortical circuits after decades of being asymptomatic. The patients also reported the emergence of new OCD symptoms and motor/phonic tics as well as mental rituals thematically related to the negative experience of suffering cognitive and motor deficits.
  The Journal of neuropsychiatry and clinical neurosciences 01/2009; 21(3):332-4. · 2.34 Impact Factor