Examinando por Autor "Tijero Merino, Beatriz"
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Ítem Brain degeneration in synucleinopathies based on analysis of cognition and other nonmotor features: a multimodal imaging study(MDPI, 2023-02-15) Lucas Jiménez, Olaia; Ibarretxe Bilbao, Naroa; Diez, Ibai; Peña Lasa, Javier ; Tijero Merino, Beatriz; Galdos Iztueta, Marta; Murueta-Goyena Larrañaga, Ane; Pino, Rocío del; Acera Gil, María Ángeles ; Gómez Esteban, Juan Carlos; Gabilondo Cuellar, Iñigo; Ojeda del Pozo, NataliaBackground: We aimed to characterize subtypes of synucleinopathies using a clustering approach based on cognitive and other nonmotor data and to explore structural and functional magnetic resonance imaging (MRI) brain differences between identified clusters. Methods: Sixty-two patients (n = 6 E46K-SNCA, n = 8 dementia with Lewy bodies (DLB) and n = 48 idiopathic Parkinson’s disease (PD)) and 37 normal controls underwent nonmotor evaluation with extensive cognitive assessment. Hierarchical cluster analysis (HCA) was performed on patients’ samples based on nonmotor variables. T1, diffusion-weighted, and resting-state functional MRI data were acquired. Whole-brain comparisons were performed. Results: HCA revealed two subtypes, the mild subtype (n = 29) and the severe subtype (n = 33). The mild subtype patients were slightly impaired in some nonmotor domains (fatigue, depression, olfaction, and orthostatic hypotension) with no detectable cognitive impairment; the severe subtype patients (PD patients, all DLB, and the symptomatic E46K-SNCA carriers) were severely impaired in motor and nonmotor domains with marked cognitive, visual and bradykinesia alterations. Multimodal MRI analyses suggested that the severe subtype exhibits widespread brain alterations in both structure and function, whereas the mild subtype shows relatively mild disruptions in occipital brain structure and function. Conclusions: These findings support the potential value of incorporating an extensive nonmotor evaluation to characterize specific clinical patterns and brain degeneration patterns of synucleinopathies.Ítem Dysautonomia and small fiber neuropathy in post-COVID condition and Chronic Fatigue Syndrome(BioMed Central Ltd, 2023-11-15) Azcue, N.; Pino, Rocío del; Acera, M.; Fernández Valle, Tamara ; Ayo Mentxakatorre, Naia; Pérez Concha, Tomás; Murueta-Goyena Larrañaga, Ane; Lafuente, Jose Vicente; Prada, A.; López de Munain Arregui, Adolfo ; Ruiz Irastorza, Guillermo; Martín Iglesias, Daniel; Ribacoba Bajo, Laureano; Gabilondo, Iñigo; Gómez Esteban, Juan Carlos; Tijero Merino, BeatrizBackground: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) and post-COVID condition can present similarities such as fatigue, brain fog, autonomic and neuropathic symptoms. Methods: The study included 87 patients with post-COVID condition, 50 patients with ME/CFS, and 50 healthy controls (HC). The hemodynamic autonomic function was evaluated using the deep breathing technique, Valsalva maneuver, and Tilt test. The presence of autonomic and sensory small fiber neuropathy (SFN) was assessed with the Sudoscan and with heat and cold evoked potentials, respectively. Finally, a complete neuropsychological evaluation was performed. The objective of this study was to analyze and compare the autonomic and neuropathic symptoms in post-COVID condition with ME/CFS, and HC, as well as, analyze the relationship of these symptoms with cognition and fatigue. Results: Statistically significant differences were found between groups in heart rate using the Kruskal–Wallis test (H), with ME/CFS group presenting the highest (H = 18.3; p ≤.001). The Postural Orthostatic Tachycardia Syndrome (POTS), and pathological values in palms on the Sudoscan were found in 31% and 34% of ME/CFS, and 13.8% and 19.5% of post-COVID patients, respectively. Concerning evoked potentials, statistically significant differences were found in response latency to heat stimuli between groups (H = 23.6; p ≤.01). Latency was highest in ME/CFS, and lowest in HC. Regarding cognition, lower parasympathetic activation was associated with worse cognitive performance. Conclusions: Both syndromes were characterized by inappropriate tachycardia at rest, with a high percentage of patients with POTS. The prolonged latencies for heat stimuli suggested damage to unmyelinated fibers. The higher proportion of patients with pathological results for upper extremities on the Sudoscan suggested a non-length-dependent SFN.Ítem Effect of sex on the progression of non-motor symptoms in Parkinson's disease: a registry-based cohort study(Spanish Society of Neurology, 2025) Murueta-Goyena Larrañaga, Ane; Pino, Rocío del; Carmona Abellán, Mar; Tijero Merino, Beatriz; Ruiz López, Marta; Acera Gil, María Ángeles; Morera Herreras, Teresa; Miguélez Palomo, Cristina; Sáez Atxukarro, Oihane; Fernández Valle, Tamara; Gabilondo Cuellar, Iñigo; Gómez Esteban, Juan CarlosIntroduction: Differences in the trajectory of non-motor symptoms (NMS) between male and female Parkinson's disease (PD) patients over the course of the disease are not well-understood. Methods: PD patients were rated with Non-Motor Symptom Scale (NMSS) at two time points with a median follow-up of 3.8 years (IQR 2.1–5.6 years). Sex, age, disease duration, Unified Parkinson's Disease Rating Scale and doses of PD-related medication were registered. Linear mixed models (LMMs) and multinomial logistic regression (MLR) models were fitted to explore the association of sex with changes in NMSS domains over time. Results: Eighty-seven PD patients (30 females and 57 males) were enrolled. Baseline demographic and clinical characteristics were similar between female and male PD patients. The mean increase in NMS frequency and severity over time was non-significant, as well as the interaction term for disease duration × sex. However, gastrointestinal symptoms worsened in both males and females. According to the minimal detectable change of NMSS, <50% of PD patients experienced changes at follow-up beyond measurement error of the scale. Male sex predicted sexual function worsening (adjusted OR = 10.1, p = 0.038). Also, PD patients with more severe symptoms at baseline had increased odds of improving over time. However, high initial scores in attention/memory and cardiovascular domains also posed individuals at a higher risk of symptom worsening (OR [95% CI] = 1.4 [1.0-1.8], p = 0.034 and OR [95% CI] = 2.1 [1.2-3.7], p = 0.01, respectively). Conclusion: NMS progression over the disease course in PD shows large inter-individual variability without observable effect of sex.Ítem Retinal thickness predicts the risk of cognitive decline in Parkinson disease(John Wiley and Sons Inc, 2021-01) Murueta-Goyena Larrañaga, Ane ; Pino, Rocío del; Galdos Iztueta, Marta; Arana Larrea, Begoña; Acera Gil, María Ángeles ; Carmona Abellán, Mar; Fernández Valle, Tamara ; Tijero Merino, Beatriz ; Lucas Jiménez, Olaia; Ojeda del Pozo, Natalia ; Ibarretxe Bilbao, Naroa ; Peña Lasa, Javier; Cortés, Jesús; Ayala Fernández, Unai; Barrenechea Carrasco, Maitane; Gómez Esteban, Juan Carlos ; Gabilondo Cuellar, IñigoObjective: This study was undertaken to analyze longitudinal changes of retinal thickness and their predictive value as biomarkers of disease progression in idiopathic Parkinson's disease (iPD). Methods: Patients with Lewy body diseases were enrolled and prospectively evaluated at 3 years, including patients with iPD (n = 42), dementia with Lewy bodies (n = 4), E46K-SNCA mutation carriers (n = 4), and controls (n = 17). All participants underwent Spectralis retinal optical coherence tomography and Montreal Cognitive Assessment, and Unified Parkinson's Disease Rating Scale score was obtained in patients. Macular ganglion cell–inner plexiform layer complex (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) thickness reduction rates were estimated with linear mixed models. Risk ratios were calculated to evaluate the association between baseline GCIPL and pRNFL thicknesses and the risk of subsequent cognitive and motor worsening, using clinically meaningful cutoffs. Results: GCIPL thickness in the parafoveal region (1- to 3-mm ring) presented the largest reduction rate. The annualized atrophy rate was 0.63μm in iPD patients and 0.23μm in controls (p < 0.0001). iPD patients with lower parafoveal GCIPL and pRNFL thickness at baseline presented an increased risk of cognitive decline at 3 years (relative risk [RR] = 3.49, 95% confidence interval [CI] = 1.10–11.1, p = 0.03 and RR = 3.28, 95% CI = 1.03–10.45, p = 0.045, respectively). We did not identify significant associations between retinal thickness and motor deterioration. Interpretation: Our results provide evidence of the potential use of optical coherence tomography–measured parafoveal GCIPL thickness to monitor neurodegeneration and to predict the risk of cognitive worsening over time in iPD