In 1861, the French surgeon, Pierre Paul Broca, described two patients who had lost the ability to speak after injury to the posterior inferior frontal gyrus of the brain. Since that time, an infinite number of clinical and functional imaging studies have relied on this brain-behaviour relationship as their anchor for the localization of speech functions. Clinical studies of Broca's aphasia often assume that the deficits in these patients are due entirely to dysfunction in Broca's area, thereby attributing all aspects of the disorder to this one brain region. Moreover, functional imaging studies often rely on activation in Broca's area as verification that tasks have successfully tapped speech centres. Despite these strong assumptions, the range of locations ascribed to Broca's area varies broadly across studies. In addition, recent findings with language-impaired patients have suggested that other regions also play a role in speech production, some of which are medial to the area originally described by Broca on the lateral surface of the brain. Given the historical significance of Broca's original patients and the increasing reliance on Broca's area as a major speech centre, we thought it important to re-inspect these brains to determine the precise location of their lesions as well as other possible areas of damage. Here we describe the results of high resolution magnetic resonance imaging of the preserved brains of Broca's two historic patients. We found that both patients' lesions extended significantly into medial regions of the brain, in addition to the surface lesions observed by Broca. Results also indicate inconsistencies between the area originally identified by Broca and what is now called Broca's area, a finding with significant ramifications for both lesion and functional neuroimaging studies of this well-known brain area.
Recent developments worldwide in medical curricula have often led to major cuts in the teaching of human anatomy. Indeed, it is perceived by some that gross (topographical) anatomy has an exaggerated importance in the initial training of doctors. The value of anatomy consequently has frequently been considerably diminished within medical curricula that have reduced factual content. To date, however, there have been no objective studies into the perceived relevance of anatomy to clinical medicine that have aimed to quantify the attitudes of medical students. On the basis of responses to an attitude analysis questionnaire devised according to the precepts of Thurstone and Chave (The Measurement of Attitude: A Psychophysical Method and Some Experiments with a Scale for Measuring Attitude Toward the Church. Chicago, IL: University of Chicago Press, 1951), we investigated the perception of medical students at Cardiff and Paris towards the importance of gross anatomy to clinical medicine. This was undertaken during the early stages of their studies (when they were newly-admitted to university and were about to commence anatomy courses), immediately after finishing their anatomy courses, and later in the final year of medical studies. The results suggest that, even where there might be geopolitical and cultural backgrounds, students at all stages of their medical course share with professional anatomists the view that anatomy is a very important subject for their clinical studies. Thus, contrary to the unquantified beliefs of those who are sceptical about the purpose and value of anatomy in an undergraduate medical curriculum, the students themselves do not appear to share such beliefs.
Objectives. -The goal of this paper is to present the validation process of the French BFI (BFI-Fr) on a large student sample to verify psychometric properties, including factor structure and internal reliability and to show that the scales possess the necessary convergent and discriminant validity with the NEO-PI-R. Study 1: internal consistency and intercultural comparisonMaterials and method. -2 499 students were included (women 69%; mean age 20.2 years old, SD=2.21, between 15 and 46 years). The 45 items of the BFI-Fr were filled out anonymously by the students at the university.Results and discussion. -A factorial analysis using principal components was performed on the student answers (raw data) and resulted in a five-factor varimax- Normality of the distribution factors was verified before comparing the scores of French students with those of American and Spanish students. Mean scores and standard deviations were very similar in the three countries. As in previous research, gender differences in personality were found: females had higher scores (p <.001) for N, A, and C Study 2: convergent and discriminant validation with the NEO-PI-RThe goal of study 2 was to compare the BFI-Fr with the NEO-PI-R. General discussion and conclusion. -All three studies demonstrate that the BFI-Fr is a valid, powerful yet very efficient tool, as are the original English version and the other translations. The much longer NEO-PI-R remains the instrument of choice. Psychiatrists, psychologists, and researchers can now make use of another inventory in French to measure the Big Five which has the advantages of being simple, robust, reliable, and economical (5 to 10 minutes to complete).
There is increasingly a call for clinical relevance in the teaching of the biomedical sciences within all health care programs. This presupposes that there is an understanding of what is "core" material within the curriculum. To date, the anatomical sciences have been poorly served by the development of core syllabuses, although there have been commendable attempts to define a core syllabus for gross anatomy in medicine and for some medical specialties. The International Federation of Associations of Anatomists and the European Federation for Experimental Morphology aim to formulate, on an international basis, core syllabuses for all branches of the anatomical sciences. This is being undertaken at the initial stage using Delphi Panels consisting of a team of anatomists, scientists, and clinicians who evaluate syllabus content and accord each element/topic "essential," "important," "acceptable," or "not required" status. Their initial conjectures, published on the International Federation of Associations of Anatomists' website, provide merely a framework to enable anatomical (and other cognate learned) societies and individual anatomists, clinicians, and students to comment upon the syllabuses. This article presents the concepts and methodological approaches underlying the hybrid Delphi process employed. Preliminary findings relating to the development of a neuroanatomy core syllabus are provided to illustrate the methods initially employed by a Delphi Panel. The approach is novel in that it is international in scope, is conceptually democratic, and is developmentally fluid in terms of availability for amendment. The aim is to set internationally recognized standards and thus to provide guidelines concerning anatomical knowledge when engaged in course development.
On the 50th anniversary of Norman Geschwind's seminal paper entitled ‘Disconnexion syndrome in animal and man’, we pay tribute to his ideas by applying contemporary tractography methods to understand white matter disconnection in 3 classic cases that made history in behavioral neurology. We first documented the locus and extent of the brain lesion from the computerized tomography of Phineas Gage's skull and the magnetic resonance images of Louis Victor Leborgne's brain, Broca's first patient, and Henry Gustave Molaison. We then applied the reconstructed lesions to an atlas of white matter connections obtained from diffusion tractography of 129 healthy adults. Our results showed that in all 3 patients, disruption extended to connections projecting to areas distant from the lesion. We confirmed that the damaged tracts link areas that in contemporary neuroscience are considered functionally engaged for tasks related to emotion and decision-making (Gage), language production (Leborgne), and declarative memory (Molaison). Our findings suggest that even historic cases should be reappraised within a disconnection framework whose principles were plainly established by the associationist schools in the last 2 centuries.
The SAH and ATL approaches have similar beneficial effects on seizure control, whereas transcortical SAH tends to minimize cognitive deterioration after surgery. Variation in postsurgical outcome with the class of HS should be investigated further.
There is increasingly a call for clinical relevance in the teaching of biomedical sciences within all health care courses. However, this presupposes that there is a clear understanding of what can be considered core material within the curricula. To date, the anatomical sciences have been relatively poorly served by the development of core syllabuses, particularly for specialized core syllabuses such as neuroanatomy. One of the aims of the International Federation of Associations of Anatomists (IFAA) and of the European Federation for Experimental Morphology (EFEM) is to formulate, on an international scale, core syllabuses for all branches of the anatomical sciences using Delphi Panels consisting of anatomists, scientists, and clinicians to initially evaluate syllabus content. In this article, the findings of a Delphi Panel for neuroanatomy are provided. These findings will subsequently be published on the IFAA website to enable anatomical (and other cognate learned) societies and individual anatomists, clinicians, and students to freely comment upon, and elaborate and amend, the syllabuses. The aim is to set internationally recognized standards and thus to provide guidelines concerning neuroanatomical knowledge when engaged in course development.
Assessment of the personalities of medical students could enable medical educators to formulate strategies for the best development of academic and clinical competencies. In this article, we focus on the experience of students in the anatomy dissecting room. While there have been many attempts to evaluate the emotional responses of medical students to human cadaveric dissection, there has been no investigation into how different personality traits affect the responses. The main hypothesis tested was that there is a relationship between personality traits and attitudes toward the dissection room. For the present study, a group of French medical students (n = 403; mean age 21.3 ± 1.6; 65.3% female) completed a "Big Five" personality inventory and a questionnaire to assess their attitudes in regard to human dissection. The findings are consistent with our hypothesis, in that we found a relationship between reporting anxiety and four of the "Big Five" dimensions (all except openness). The rated level of anxiety was positively correlated with negative affectivity, more strongly at the beginning than at the end of the course. There were significant gender differences in attitudes toward dissection. The findings are discussed in relation to the possibility of preparing students for the dissecting room experience and also in relation to the students' understanding of mortality issues.
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