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1.
Arq Neuropsiquiatr ; 80(2): 137-144, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-35352753

RESUMEN

BACKGROUND: Spinocerebellar ataxias (SCAs) are a group of neurodegenerative diseases characterized by deterioration of balance and functionality that tends to follow disease progression. There is no established link between formal clinical markers for severity and functional/balance scores that could guide rehabilitation teams. OBJECTIVE: To evaluate the relationship between functional scales and ataxia severity in order to identify cutoff landmarks for functional loss and estimate the mean SARA (Scale for Assessment and Rating of Ataxia) score for the risk ratings for falls on the BBS (Berg Balance Scale). METHODS: Consecutive patients with a molecular diagnosis of SCA (total 89: 31 with SCA2 and 58 with SCA3) were assessed for functionality FIM-ADL (Functional Independence Measure-activities of daily living and Lawton-IADL (instrumental activities of daily living), balance (BBS) and disease severity (SARA). RESULTS: The main disability cutoff landmarks were that the need for supervision for FIM-ADL starts with 12 points on SARA and the need for supervision for Lawton-IADL starts with 14 points on SARA. The first items to require assistance were "expression" and "shopping", respectively. At 20 points on SARA, patients were dependent on all FIM and Lawton items. The item with the greatest impact on distinguishing dependents from independents was "means of transport" in Lawton-IADL and the domain "locomotion" in FIM-ADL. The mean SARA score for patients classified as low risk in the BBS was 9.9 points, and it was 17.4 for medium risk and 25.2 for high risk. CONCLUSIONS: Analysis on the correlation between the severity of ataxia and functional scales can form an important guide for understanding the progression of functional dependence among individuals with SCAs.


Asunto(s)
Actividades Cotidianas , Ataxias Espinocerebelosas , Humanos , Índice de Severidad de la Enfermedad
2.
Parkinsons Dis ; 2022: 1746540, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35300121

RESUMEN

Introduction: Brain SPECT with 99mTc-TRODAT-1 (SPECT-TRODAT) may be a useful tool in the differential diagnosis of Parkinsonism. Objective: To compare results of SPECT-TRODAT with clinical findings in patients with Parkinsonism. Methods: We evaluated 153 outpatients. SPECT-TRODAT results were visually analyzed into normal, abnormal, symmetric, and asymmetric, and according to the degree of impairment into mild, moderate, marked, and severe (1-4). Results: A direct relationship was found between motor scores severity (MDS-UPDRS-III) and SPECT-TRODAT-reduced binding in general, in the group of patients with synucleinopathies (rho = 0.258, p=0.005), especially in patients with Parkinson's disease (rho = 0.204, p=0.049). Changes in SPECT-TRODAT had high correspondence with symmetry in all Parkinsonism. When comparing groups to the correspondence predominantly bilateral or unilateral impairment in SPECT, there was a difference between patients with SNP (p=0.041) and between this group and patients with secondary Parkinsonism (SP) (p < 0.0001). It was handy in differentiating drug-induced Parkinsonism from synucleinopathies. In the group of drug-induced Parkinsonism, younger people were the ones who showed the most significant reductions in radiotracer uptake. In this group, nonmotor signs resulted in examinations with more significant reductions in radiotracer uptake. When the scans without alterations and those that did not correspond to the symmetry were considered negative, SPECT-TRODAT's accuracy and specificity to differentiate PD from other forms of Parkinsonism were low. There was an inverse correlation between the severity of the SPECT-TRODAT result and the absence of nonmotor signs in patients with drug-induced Parkinsonism. Conclusion: The authors concluded that the SPECT with 99mTc-TRODAT-1 was mainly useful in differentiating between synucleinopathies and secondary Parkinsonism.

3.
Arq. neuropsiquiatr ; 80(2): 137-144, Feb. 2022. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1364372

RESUMEN

ABSTRACT Background: Spinocerebellar ataxias (SCAs) are a group of neurodegenerative diseases characterized by deterioration of balance and functionality that tends to follow disease progression. There is no established link between formal clinical markers for severity and functional/balance scores that could guide rehabilitation teams. Objective: To evaluate the relationship between functional scales and ataxia severity in order to identify cutoff landmarks for functional loss and estimate the mean SARA (Scale for Assessment and Rating of Ataxia) score for the risk ratings for falls on the BBS (Berg Balance Scale). Methods: Consecutive patients with a molecular diagnosis of SCA (total 89: 31 with SCA2 and 58 with SCA3) were assessed for functionality FIM-ADL (Functional Independence Measure-activities of daily living and Lawton-IADL (instrumental activities of daily living), balance (BBS) and disease severity (SARA). Results: The main disability cutoff landmarks were that the need for supervision for FIM-ADL starts with 12 points on SARA and the need for supervision for Lawton-IADL starts with 14 points on SARA. The first items to require assistance were "expression" and "shopping", respectively. At 20 points on SARA, patients were dependent on all FIM and Lawton items. The item with the greatest impact on distinguishing dependents from independents was "means of transport" in Lawton-IADL and the domain "locomotion" in FIM-ADL. The mean SARA score for patients classified as low risk in the BBS was 9.9 points, and it was 17.4 for medium risk and 25.2 for high risk. Conclusions: Analysis on the correlation between the severity of ataxia and functional scales can form an important guide for understanding the progression of functional dependence among individuals with SCAs.


RESUMO Antecedentes: As ataxias espinocerebelares (SCA) são um grupo de doenças neurodegenerativas caracterizadas pela deterioração do equilíbrio e da funcionalidade, que tende a acompanhar a progressão da doença. Não existe uma ligação estabelecida entre os marcadores clínicos formais de gravidade e escores funcionais e de equilíbrio que possam orientar as equipes de reabilitação. Objetivo: Avaliar a relação entre escalas funcionais e de gravidade da ataxia, buscando identificar pontos de corte para a perda funcional relacionados aos escores de gravidade e aos patamares de Risco de Quedas. Métodos: Uma amostra consecutiva de 89 pacientes com diagnóstico molecular de SCA (31-SCA2 e 58-SCA3) foram avaliados para funcionalidade MIF-AVDs (Medida de independência funcional-Atividades da vida diária) e Lawton-AIVDs (Atividades instrumentais da vida diária), equilíbrio (EEB-escala de Equilíbrio de Berg), e gravidade da ataxia (SARA-escala para avaliação e graduação de ataxia). Resultados: Os principais pontos de corte de deficiência foram: com 12 pontos no SARA começa a necessidade de supervisão para MIF-AVDs e com 14 pontos no SARA começa a necessidade de supervisão para Lawton-AIVDs. Os primeiros itens a necessitar de assistência foram "expressão" e "compras", respectivamente. Com 20 pontos no SARA os pacientes eram dependentes em todos os itens MIF/LAWTON. O item com maior impacto na discriminação entre dependentes e independentes foi "meio de transporte" na Lawton e o domínio "locomoção" na MIF. O escore médio no SARA foi de 9,9 pontos para pacientes classificados com baixo risco na EEB, 17,4 para médio risco e 25,2 para alto risco. Conclusões: A análise da correlação entre a gravidade da ataxia e as escalas funcionais pode ser um importante guia no entendimento da progressão da dependência funcional em indivíduos com SCA.

4.
Acta Neurol Scand ; 145(2): 193-199, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34542909

RESUMEN

OBJECTIVES: To determine the effectiveness of botulinum toxin in a sample of patients diagnosed with greater occipital nerve neuralgia. MATERIAL AND METHODS: Twenty-nine patients (28 females, 1 male) were treated for greater occipital nerve neuralgia with onabotulinum toxin type A; the Visual Analog Pain Scale was used to determine pain severity at treatment and again 12 weeks after application. RESULTS: Average doses of onabotulinum toxin type A of 18.66±6.44 U per nerve and 35.96±12.89 U per patient were utilized. Average pain severity among the sample was 9.81±0.89 prior to botulinum toxin application and 3.68±2.31 points (p<0.0001) twelve weeks after application. Pain frequency decreased from 29.93±0.37 to 12.17±11.05 days with pain per month (p<0.0001). Six patients reported absence of pain after application (p=0.023). Dose did not correlate with the degree of clinical response observed, and no side effects were reported. CONCLUSION: Our findings suggest onabotulinum toxin type A is a safe and effective treatment alternative for patients suffering from refractory greater occipital nerve neuralgia.


Asunto(s)
Toxinas Botulínicas Tipo A , Neuralgia , Femenino , Cefalea , Humanos , Masculino , Neuralgia/tratamiento farmacológico , Nervios Espinales , Resultado del Tratamiento
5.
Arq Neuropsiquiatr ; 2021 Dec 17.
Artículo en Inglés | MEDLINE | ID: mdl-34932644

RESUMEN

Even though jazz is a musical style that excels in improvisation and virtuosity, it is not without its share of anecdotes, drama, and downright tragedy, and the biographies of jazz musicians and their demise are fraught with ominous and dire straits. Unsurprisingly, some would develop chronic and fatal diseases. The neurological diseases that afflicted the following six composers and musicians, all of whom are considered jazz legends, are briefly discussed: Charles Mingus, diagnosed with amyotrophic lateral sclerosis; Lester Young and Charlie Parker, both diagnosed with neurosyphilis; Thelonius Monk, who had possible frontotemporal dementia; George Gershwin, who died as a result of brain glioma; and Cole Porter, who developed phantom limb pain following an amputation. The association of lifestyles, with drug abuse, particularly alcohol and heroin, in addition to great sexual promiscuity factors contributed to the development of a series of diseases such as syphilis. In addition, we also described some fatalities such as neurodegenerative diseases and cerebral glioma.

6.
Arq Neuropsiquiatr ; 79(11): 1039-1042, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34816996

RESUMEN

The year of 2021 marks 90 year since the death of the neuroscientist Constantin von Economo, whose research in various areas was extremely relevant for the field of neurology. He described lethargic epidemic encephalitis, published an atlas of the cytoarchitecture of the human cerebral cortex, and conducted multiple studies in neuroanatomy, neurophysiology, and clinical neurology. Von Economo's genius extended into other nonmedical fields such as aeronautics, and he had renowned artistic skills.


Asunto(s)
Encefalitis por Arbovirus , Neurología , Aniversarios y Eventos Especiales , Historia del Siglo XX , Humanos , Masculino , Neuroanatomía , Neurofisiología
10.
Eur Neurol ; 83(6): 636-638, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33176307

RESUMEN

Jean-Martin Charcot, one of the most brilliant neurologists in history, was a man of few words and few gestures. He had an impenetrable and unmovable face and was described as being austere, reserved, and shy. In contrast, in his personal life, he was a softhearted man who loved animals - especially dogs. In this historical note, we sought to look into the past and learn more about Dr. Charcot's personal life - which was robustly impacted by his passion for dogs.


Asunto(s)
Neurólogos/historia , Mascotas/historia , Animales , Perros , Francia , Historia del Siglo XIX , Humanos , Neurología
11.
Eur Neurol ; 83(3): 345-350, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32690851

RESUMEN

In no country has the duel prevailed to such a great extent as in France where the matter of dueling and affairs of honor were of frequent occurrence until the 20th century. The term duel has since been established for any contest between 2 persons or parties, be they sporting, intellectual, political, or in other matters. Despite their worldwide recognition and great scientific production, Pierre Marie and Jules Dejerine became rivals at the end of the 19th century. While Marie defended Charcot's neurological school at Salpêtrière Hospital, Dejerine had his own neurology school to contend. The fierce antagonism between them materialized to the verge of a real death duel in 1892 and later to an intellectual duel in the famous debate about aphasias, held in Paris in 1908.


Asunto(s)
Neurología/historia , Francia , Historia del Siglo XIX , Historia del Siglo XX , Humanos
12.
Arq. neuropsiquiatr ; 78(5): 307-310, May 2020. graf
Artículo en Inglés | LILACS | ID: biblio-1131699

RESUMEN

Abstract Professor Andrew John Lees, from the National Hospital for Neurology and Neurosurgery, a neurological hospital in Queen Square, London, UK, has contributed in a stupendous way to the development of the field of movement disorders in Brazil, with a constant and intense participation in numerous congresses and scientific meetings of this specialty since 1983.


Resumo O professor Andrew Lees, do National Hospital for Neurology and Neurosurgery, Queen Square, Londres, Reino Unido, tem contribuído de maneira estupenda para o desenvolvimento da área dos distúrbios do movimento no Brasil, com uma participação constante e intensa em inúmeros congressos e encontros científicos desta especialidade, desde o ano de 1983.


Asunto(s)
Historia del Siglo XX , Neurología , Neurocirugia , Brasil , Procedimientos Neuroquirúrgicos , Hospitales , Londres
13.
Arq Neuropsiquiatr ; 78(3): 169-175, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32348415

RESUMEN

The chess game comprises different domains of cognitive function, demands great concentration and attention and is present in many cultures as an instrument of literacy, learning and entertainment. Over the years, many effects of the game on the brain have been studied. Seen that, we reviewed the current literature to analyze the influence of chess on cognitive performance, decision-making process, linking to historical neurological and psychiatric disorders as we describe different diseases related to renowned chess players throughout history, discussing the influences of chess on the brain and behavior.


Asunto(s)
Cognición/fisiología , Neurología , Psiquiatría , Encéfalo , Humanos , Recreación
14.
Arq Neuropsiquiatr ; 78(5): 307-310, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32130295

RESUMEN

Professor Andrew John Lees, from the National Hospital for Neurology and Neurosurgery, a neurological hospital in Queen Square, London, UK, has contributed in a stupendous way to the development of the field of movement disorders in Brazil, with a constant and intense participation in numerous congresses and scientific meetings of this specialty since 1983.


Asunto(s)
Neurología , Neurocirugia , Brasil , Historia del Siglo XX , Hospitales , Londres , Procedimientos Neuroquirúrgicos
15.
Arq. neuropsiquiatr ; 78(3): 169-175, Mar. 2020. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1098070

RESUMEN

Abstract The chess game comprises different domains of cognitive function, demands great concentration and attention and is present in many cultures as an instrument of literacy, learning and entertainment. Over the years, many effects of the game on the brain have been studied. Seen that, we reviewed the current literature to analyze the influence of chess on cognitive performance, decision-making process, linking to historical neurological and psychiatric disorders as we describe different diseases related to renowned chess players throughout history, discussing the influences of chess on the brain and behavior.


Resumo O jogo de xadrez compreende diferentes domínios da função cognitiva, exige grande concentração e atenção e está presente em muitas culturas como instrumento de alfabetização, aprendizado e entretenimento. Ao longo dos anos, muitos efeitos do jogo no cérebro foram estudados. Dessa forma, revisamos a literatura atual para analisar a influência do xadrez no desempenho cognitivo, no processo de tomada de decisão, vinculando-a a distúrbios neurológicos e psiquiátricos históricos ao descrevermos diferentes doenças relacionadas a renomados jogadores de xadrez ao longo da história, discutindo as influências do xadrez no cérebro e no comportamento.


Asunto(s)
Humanos , Psiquiatría , Cognición/fisiología , Neurología , Recreación , Encéfalo
16.
Arq Neuropsiquiatr ; 78(2): 96-102, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32022136

RESUMEN

BACKGROUND: Subclinical ventilatory dysfunction is observed in individuals with spinocerebellar ataxias (SCA). No studies have correlated ventilatory dysfunction to clinical and functional decline in SCA2. OBJECTIVE: To evaluate the relationship between the values of peak expiratory flow (PEF), maximum inspiratory pressure (MIP), and presence of respiratory complaints with age, disease duration, age at onset of symptoms, balance scores, independence in basic (ADL) and instrumental (IADL) Activities of Daily Living (ADLs), and severity of ataxia (SARA) in individuals with SCA2. METHODS: Cross-sectional study evaluating age, disease duration, age at onset of symptoms, scores in the Berg Balance Scale and in the SARA, Functional Independence Measure and Lawton's scale, values of PEF and MIP, and the presence of respiratory complaints. RESULTS: The study included 36 individuals with SCA2, with a mean age of 42.5±2.4 years, disease duration of 7.6±8.2 years, age 33.7±11.5 years at onset of symptoms, and 9.9±10.3 points in the SARA scale. The lowest PEF values correlated with the longer disease duration (p=0.021). The lowest values of PEF and MIP correlated with greater balance impairment (p=0.019 and p=0.045, respectively), increased degree of dependence in the ADL (p=0.006 and p=0.050, respectively) and IADL (p=0.003 and p=0.001, respectively) scales, and highest severity of ataxia (p=0.00 and p=0.017, respectively). Respiratory complaints were observed in 12 (33.3%) individuals and were not related to age, disease duration, age at onset of symptoms, balance, independence, ataxia severity, or PEF and MIP values. CONCLUSION: Ventilatory dysfunction, even when asymptomatic, is related to balance impairment, independence, and ataxia severity in individuals with SCA2.


Asunto(s)
Ataxias Espinocerebelosas , Actividades Cotidianas , Adulto , Estudios Transversales , Humanos , Persona de Mediana Edad , Índice de Severidad de la Enfermedad
17.
Arq. neuropsiquiatr ; 78(2): 96-102, Feb. 2020. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1089000

RESUMEN

Abstract Subclinical ventilatory dysfunction is observed in individuals with spinocerebellar ataxias (SCA). No studies have correlated ventilatory dysfunction to clinical and functional decline in SCA2. Objective: To evaluate the relationship between the values of peak expiratory flow (PEF), maximum inspiratory pressure (MIP), and presence of respiratory complaints with age, disease duration, age at onset of symptoms, balance scores, independence in basic (ADL) and instrumental (IADL) Activities of Daily Living (ADLs), and severity of ataxia (SARA) in individuals with SCA2. Methods: Cross-sectional study evaluating age, disease duration, age at onset of symptoms, scores in the Berg Balance Scale and in the SARA, Functional Independence Measure and Lawton's scale, values of PEF and MIP, and the presence of respiratory complaints. Results: The study included 36 individuals with SCA2, with a mean age of 42.5±2.4 years, disease duration of 7.6±8.2 years, age 33.7±11.5 years at onset of symptoms, and 9.9±10.3 points in the SARA scale. The lowest PEF values correlated with the longer disease duration (p=0.021). The lowest values of PEF and MIP correlated with greater balance impairment (p=0.019 and p=0.045, respectively), increased degree of dependence in the ADL (p=0.006 and p=0.050, respectively) and IADL (p=0.003 and p=0.001, respectively) scales, and highest severity of ataxia (p=0.00 and p=0.017, respectively). Respiratory complaints were observed in 12 (33.3%) individuals and were not related to age, disease duration, age at onset of symptoms, balance, independence, ataxia severity, or PEF and MIP values. Conclusion: Ventilatory dysfunction, even when asymptomatic, is related to balance impairment, independence, and ataxia severity in individuals with SCA2.


Resumo Disfunção ventilatória subclínica tem sido observada em indivíduos com ataxias espinocerebelares (SCA). Não existem estudos relacionando disfunção ventilatória ao declínio clínico e funcional na SCA2. Objetivo: Avaliar a relação dos valores de Pico de Fluxo Expiratório (PFE), Pressão Inspiratória Máxima (PIMAX) e presença de queixas respiratórias com idade, tempo de doença, idade de início dos sintomas, escore de equilíbrio, independência para atividades básicas (AVD) e instrumentais (AIVD) de vida diária e gravidade da ataxia (SARA) em indivíduos com SCA2. Métodos: Estudo transversal, considerando: idade, tempo de doença, idade de início dos sintomas, escores nas Escalas SARA, Equilíbrio de Berg, Medida da Independência Funcional e de Lawton, valores de PFE, PIMAX e queixas respiratórias. Resultados: Foram avaliados 36 indivíduos com SCA2 com média de 42,5±2,4) anos de idade, 7,6±8,2 anos de tempo de doença, 33,7±11,5 anos de idade de início dos sintomas e 9,9±10,3 pontos na escala SARA. Os menores valores de PFE estiveram relacionados ao maior tempo de doença (p=0,021). Os menores valores de PFE e PIMAX estiveram relacionados ao maior comprometimento do equilíbrio (p=0,019; p=0,045, respectivamente), maior dependência para ADV (p=0,006; p=0,050, respectivamente) e AIVD (p=0,003; p=0,001, respectivamente) e maior gravidade da ataxia (p=0,006; p=0,017, respectivamente). Foram observadas queixas respiratórias em 12 (33,3%) indivíduos que não estiveram relacionadas à idade, idade de início dos sintomas, tempo de doença, equilíbrio, independência, gravidade da ataxia, ou valores de PFE e PIMAX. Conclusão: A disfunção ventilatória, mesmo quando assintomática, está relacionada ao comprometimento do equilíbrio, à independência e à gravidade da ataxia em indivíduos com SCA2.


Asunto(s)
Humanos , Adulto , Persona de Mediana Edad , Ataxias Espinocerebelosas , Índice de Severidad de la Enfermedad , Actividades Cotidianas , Estudios Transversales
18.
Arq Neuropsiquiatr ; 77(8): 590-593, 2019 09 05.
Artículo en Inglés | MEDLINE | ID: mdl-31508686

RESUMEN

Jean-Martin Charcot (1825-1893), considered the father of modern neurology, had a particular interest in pathology and learned to value anatomical findings. Among his main contributions is the use of the anatomo-clinical method in neurology. Although described as cold and impatient in his interpersonal relations, Charcot had a great affection for animals. He had two dogs in his home, which he called Carlo and Sigurd, and a little monkey, Rosalie. Despite his fascination with neuropathology and anatomo-clinical correlations, Charcot disapproved of studies using animal species other than humans, a seemingly paradoxical attitude. As a result, Charcot's human studies resulted in important advances in neurology as, prior to his research, anatomical observations of animals were extrapolated to humans, leading to conceptual errors.


Asunto(s)
Experimentación Animal/historia , Neurología/historia , Animales , Historia del Siglo XIX , Humanos , Neuroanatomía/historia
19.
Eur Neurol ; 81(5-6): 319-322, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31536978

RESUMEN

David Marsden was one of the most renowned neuroscientists of the twentieth century. His scientific contributions in the specialty of movement disorders are recognized worldwide, particularly in the area of Parkinson's disease and also in hyperkinesias, such as dystonia and myoclonus.


Asunto(s)
Trastornos del Movimiento/historia , Neurología/historia , Historia del Siglo XX , Humanos
20.
Arq. neuropsiquiatr ; 77(8): 590-593, Aug. 2019. graf
Artículo en Inglés | LILACS | ID: biblio-1019470

RESUMEN

ABSTRACT Jean-Martin Charcot (1825-1893), considered the father of modern neurology, had a particular interest in pathology and learned to value anatomical findings. Among his main contributions is the use of the anatomo-clinical method in neurology. Although described as cold and impatient in his interpersonal relations, Charcot had a great affection for animals. He had two dogs in his home, which he called Carlo and Sigurd, and a little monkey, Rosalie. Despite his fascination with neuropathology and anatomo-clinical correlations, Charcot disapproved of studies using animal species other than humans, a seemingly paradoxical attitude. As a result, Charcot's human studies resulted in important advances in neurology as, prior to his research, anatomical observations of animals were extrapolated to humans, leading to conceptual errors.


RESUMO Jean-Martin Charcot (1825-1893), considerado o pai da neurologia moderna, teve sua formação direcionada para a patologia, aprendendo a valorizar achados anatômicos. Entre as principais contribuições de Charcot está o uso do método anatomoclínico aplicado à neurologia. Descrito como frio e impaciente em suas relações interpessoais, Charcot mostrava, no entanto, um grande afeto pelos animais. Ele tinha dois cachorros em sua residência, a quem chamou de Carlo e Sigurd, e uma pequena macaca, Rosalie. Apesar de sua fascinação com a neuropatologia e as correlações anatomoclínicas, Charcot foi contra estudos com outras espécies de animais que não humanos, o que pode parecer um paradoxo. Entretanto, seus estudos trouxeram avanços importantes para a Neurologia, uma vez que, antes de suas descobertas, as observações anatômicas dos animais eram extrapoladas para os humanos, levando a erros conceituais.


Asunto(s)
Humanos , Animales , Historia del Siglo XIX , Experimentación Animal/historia , Neurología/historia , Neuroanatomía/historia
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