García-Molina A, Gonzalo-Fonrodona I
Institut Universitari de Neurorehabilitació Guttmann-UAB, Badalona, España.
Universitat Autònoma de Barcelona, Bellaterra, España.
Rev Neurol. 2023 Apr 1;76(7):235-241. doi: 10.33588/rn.7607.2023062.
During the Spanish Civil War, Justo Gonzalo Rodriguez-Leal visited patient M at the Military Healthcare Hospital in Godella (Valencia). This meeting marked the beginning of a long relationship between the two, which gave Justo Gonzalo the opportunity to study the functional organisation of the brain and to develop an original conception of neurophysiology based on the laws of nervous excitability. The aim of this work is to rediscover patient M and the physiological interpretation of Gonzalo's brain dynamics.
Taking patient M as the cornerstone, Gonzalo postulated that the effect of a cortical lesion depends on its magnitude and position: the magnitude conditions the intensity of the disorder, whereas the position determines the type of disorder. Between 1945 and 1950 he developed these and other hypotheses in depth, based on clinical observations, in his work Dinamica cerebral. La actividad cerebral en funcion de las condiciones dinamicas de la excitabilidad nerviosa (Vol. 1, 1945; Vol. 2, 1950). From 1952 onwards he provided an expanded version of his theory of brain dynamics, basing it not only on physiological concepts, but also on the idea of brain gradients, and introducing the concepts of similarity and allometry of dynamic systems.
For centuries, knowledge about the functional organisation of the brain has been based on single case studies. Patient M is a further example of this tradition that helps to establish the basis of the theory of brain dynamics developed by Justo Gonzalo.
西班牙内战期间,胡斯托·冈萨洛·罗德里格斯 - 莱亚尔在戈代拉(巴伦西亚)的军事医疗医院探望了患者M。这次会面标志着两人长期关系的开始,这使胡斯托·冈萨洛有机会研究大脑的功能组织,并基于神经兴奋性定律发展出一种原创的神经生理学概念。这项工作的目的是重新发现患者M以及冈萨洛对大脑动力学的生理学解释。
以患者M为基石,冈萨洛假定皮质损伤的影响取决于其大小和位置:大小决定紊乱的强度,而位置决定紊乱的类型。1945年至1950年间,他在其著作《大脑动力学。基于神经兴奋性动态条件的大脑活动》(第1卷,1945年;第2卷,1950年)中,基于临床观察深入发展了这些及其他假设。从1952年起,他提供了其大脑动力学理论的扩展版本,不仅基于生理学概念,还基于大脑梯度的概念,并引入了动态系统的相似性和异速生长的概念。
几个世纪以来,关于大脑功能组织的知识一直基于单病例研究。患者M是这一传统的又一实例,有助于奠定胡斯托·冈萨洛所发展的大脑动力学理论的基础。