Examinando por Autor "Tijero Merino, Beatriz"

Mostrando 1 - 5 de 5
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    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, Natalia
    Background: 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.
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    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 Gil, María Ángeles; 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 Cuellar, Iñigo; Gómez Esteban, Juan Carlos; Tijero Merino, Beatriz
    Background: 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.
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    Dysautonomia in COVID-19 patients: a narrative review on clinical course, diagnostic and therapeutic strategies
    (Frontiers Media S.A., 2022-05-27) Carmona de la Torre, Francisco; Mínguez Olaondo, Ane; López Bravo, Alba; Tijero Merino, Beatriz; Grozeva, Vasselina ; Walcker, Michaela ; Azkune, Harkaitz ; López de Munain Arregui, Adolfo; Alcaide, Ana Belén ; Quiroga Vila, Jorge Augusto ; Pozo, José Luis del ; Gómez Esteban, Juan Carlos
    On March 11, 2020, the World Health Organization sounded the COVID-19 pandemic alarm. While efforts in the first few months focused on reducing the mortality of infected patients, there is increasing data on the effects of long-term infection (Post-COVID-19 condition). Among the different symptoms described after acute infection, those derived from autonomic dysfunction are especially frequent and limiting. To conduct a narrative review synthesizing current evidence of the signs and symptoms of dysautonomia in patients diagnosed with COVID-19, together with a compilation of available treatment guidelines. Autonomic dysfunction associated with SARS-CoV-2 infection occurs at different temporal stages. Some of the proposed pathophysiological mechanisms include direct tissue damage, immune dysregulation, hormonal disturbances, elevated cytokine levels, and persistent low-grade infection. Acute autonomic dysfunction has a direct impact on the mortality risk, given its repercussions on the respiratory, cardiovascular, and neurological systems. Iatrogenic autonomic dysfunction is a side effect caused by the drugs used and/or admission to the intensive care unit. Finally, late dysautonomia occurs in 2.5% of patients with Post-COVID-19 condition. While orthostatic hypotension and neurally-mediated syncope should be considered, postural orthostatic tachycardia syndrome (POTS) appears to be the most common autonomic phenotype among these patients. A review of diagnostic and treatment guidelines focused on each type of dysautonomic condition was done. Symptoms deriving from autonomic dysfunction involvement are common in those affected by COVID-19. These symptoms have a great impact on the quality of life both in the short and medium to long term. A better understanding of the pathophysiological mechanisms of Post-COVID manifestations that affect the autonomic nervous system, and targeted therapeutic management could help reduce the sequelae of COVID-19, especially if we act in the earliest phases of the disease.
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    Parafoveal thinning of inner retina is associated with visual dysfunction in Lewy body diseases
    (John Wiley and Sons Inc., 2019-09-01) Murueta-Goyena Larrañaga, Ane; Pino, Rocío del; Reyero, Paula; Galdos Iztueta, Marta; Arana Larrea, Begoña; Lucas Jiménez, Olaia; Acera Gil, María Ángeles ; Tijero Merino, Beatriz; Ibarretxe Bilbao, Naroa ; Ojeda del Pozo, Natalia ; Peña Lasa, Javier ; Cortés, Jesús; Gómez Esteban, Juan Carlos ; Gabilondo Cuellar, Iñigo
    Background: Retinal optical coherence tomography findings in Lewy body diseases and their implications for visual outcomes remain controversial. We investigated whether region-specific thickness analysis of retinal layers could improve the detection of macular atrophy and unravel its association with visual disability in Parkinson's disease. Methods: Patients with idiopathic Parkinson's disease (n = 63), dementia with Lewy bodies (n = 8), and E46K mutation carriers in the α-synuclein gene (E46K-SNCA) (n = 4) and 34 controls underwent Spectralis optical coherence tomography macular scans and a comprehensive battery of visual function and cognition tests. We computed mean retinal layer thicknesses of both eyes within 1-, 2-, 3-, and 6-mm diameter macular discs and in concentric parafoveal (1- to 2-mm, 2- to 3-mm, 1- to 3-mm) and perifoveal (3- to 6-mm) rings. Group differences in imaging parameters and their relationship with visual outcomes were analyzed. A multivariate logistic model was developed to predict visual impairment from optical coherence tomography measurements in Parkinson's disease, and cutoff values were determined with receiver operating characteristic analysis. Results: When compared with controls, patients with dementia with Lewy bodies had significant thinning of the ganglion cell–inner plexiform layer complex within the central 3-mm disc mainly because of differences in 1- to 3-mm parafoveal thickness. This parameter was strongly correlated in patients, but not in controls, with low contrast visual acuity and visual cognition outcomes (P <.05, False Discovery Rate), achieving 88% of accuracy in predicting visual impairment in Parkinson's disease. Conclusion: Our findings support that parafoveal thinning of ganglion cell–inner plexiform complex is a sensitive and clinically relevant imaging biomarker for Lewy body diseases, specifically for Parkinson's disease. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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    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, Iñigo
    Objective: 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