Nuestros investigadores

Publicaciones científicas más recientes (desde 2010)

Autores: Viedma-Guiard, E.; Aguero, P.; Crespo-Araico, L.; et al.
Revista: NEUROLOGIA
ISSN 1578-1968  Vol. 33  Nº 2  2018  págs. 107-111
Implementing an e-mail-based consultation system is feasible in MD units. It facilitates both communication between neurologists and patients and continued care in the primary care setting.
Autores: Garcia-Ruiz, P. J.; Sanz-Cartagena, P., (Autor de correspondencia); Martinez-Castrillo, J. C.; et al.
Revista: REVISTA DE NEUROLOGIA
ISSN 0210-0010  Vol. 66  Nº 5  2018  págs. 163 - 172
Introduction. Botulinum toxin type A (BTA) is a bacterial endotoxin, whose therapeutic use has had a dramatic impact on different neurological disorders, such as dystonia and spasticity. Aim. To analyze and summarize different questions about the use of BTA in our clinical practice. Development. A group of experts in neurology developed a list of topics related with the use of BTA. Two groups were considered: neuropharmacology and dystonia. A literature search at PubMed, mainly for English language articles published up to June 2016 was performed. The manuscript was structured as a questionnaire that includes those questions that, according to the panel opinion, could generate more controversy or doubt. The initial draft was reviewed by the expert panel members to allow modifications, and after subsequent revisions for achieving the highest degree of consensus, the final text was then validated. Different questions about diverse aspects of neuropharmacology, such as mechanism of action, bioequivalence of the different preparations, immunogenicity, etc. were included. Regarding dystonia, the document included questions about methods of evaluation, cervical dystonia, blepharospasm, etc. Conclusion. This review does not pretend to be a guide, but rather a tool for continuous training of residents and specialists in neurology, about different specific areas of the management of BTA.
Autores: Skorvanek, Matej; Martinez-Martin, Pablo; Kovacs, Norbert; et al.
Revista: MOVEMENT DISORDERS CLINICAL PRACTICE
ISSN 2330-1619  Vol. 4  Nº 4  2017  págs. 536-544
MDS¿UPDRS scores for all 4 parts increase significantly with every HY stage and also with 5¿year increments of disease duration in the first 15 years of the disease.
Autores: Athauda, Dilan; Maclagan, Kate; Skene, Simon S.; et al.
Revista: LANCET
ISSN 1474-547X  Vol. 390  Nº 10103  2017  págs. 1664-1675
Exenatide had positive effects on practically defined off-medication motor scores in Parkinson's disease, which were sustained beyond the period of exposure. Whether exenatide affects the underlying disease pathophysiology or simply induces long-lasting symptomatic effects is uncertain. Exenatide represents a major new avenue for investigation in Parkinson's disease, and effects on everyday symptoms should be examined in longer-term trials.
Autores: Athauda, Dilan; Georgiev, Dejan; Avilés, Iciar; et al.
Revista: MOVEMENT DISORDERS CLINICAL PRACTICE
ISSN 2330-1619  Vol. 4  Nº 1  2017  págs. 105-110
This is the site of the active contacts delivering the most effective stimulation in the current patients. The efficacy of thalamic¿subthalamic DBS despite the absence of any change in leg tremor, together with the evidence of coupled oscillatory activity in the ViM, suggests that cerebellar input to the thalamus (ViM) may be part of this feedback loop. Although the observation period in these reported cases was short, based on these and previous cases, further long¿term data from controlled clinical trials are needed to examine the efficacy of this approach in OT.
Autores: Villadoniga, Marta; San Millan, Arantza; Cabanes-Martinez, Lidia; et al.
Revista: REVISTA DE NEUROLOGIA
ISSN 1576-6578  Vol. 63  Nº 3  2016  págs. 97-102
La cuantificación mediante análisis objetivo de las variables cinéticas y cinemáticas en los pacientes con EP puede emplearse como herramienta para establecer la influencia de las distintas alternativas terapéuticas en el trastorno de la marcha.
Autores: Scott, Robert A.; Freitag, Daniel F.; Li, Li; et al.
Revista: SCIENCE TRANSLATIONAL MEDICINE
ISSN 1946-6242  Vol. 8  Nº 341  2016  págs. 341ra76.
We then tested the association of those variants with disease outcomes, including coronary heart disease, to predict cardiovascular safety of these agents. A low-frequency missense variant (Ala316Thr; rs10305492) in the gene encoding glucagon-like peptide-1 receptor (GLP1R), the target of GLP1R agonists, was associated with lower fasting glucose and T2D risk, consistent with GLP1R agonist therapies. The minor allele was also associated with protection against heart disease, thus providing evidence that GLP1R agonists are not likely to be associated with an unacceptable increase in cardiovascular risk. Our results provide an encouraging signal that these agents may be associated with benefit, a question currently being addressed in randomized controlled trials. Genetic variants associated with metabolic traits and multiple disease outcomes can be used to validate therapeutic targets at an early stage in the drug development process.
Autores: Tripoliti, Elina; Limousin, Patricia; Foltynie, Tom; et al.
Revista: MOVEMENT DISORDERS
ISSN 1531-8257  Vol. 29  Nº 4  2014  págs. 532-538
. They were assessed before and at 1 year after surgery using the Assessment of Intelligibility for the Dysarthric Speech, the perceptual scale from Darley et al., and the UPDRS-III. Speech intelligibility deteriorated on average by 14.4% (P = 0.0006) after 1 year of STN-DBS when off-medication and by 12.3% (P = 0.001) when on-medication. The effect on speech was not linked to age at surgery, unlike the effect on motor outcome. The most significant predictive factors for deterioration of speech intelligibility when patients were off-medication/on-stimulation were lower preoperative speech intelligibility on-medication, longer disease duration, and medially placed left hemisphere active electrode contact. Speech change after STN-DBS is variable and multifactorial. Consistent preoperative speech evaluation would help inform patients about the possible effects of surgery. Appropriate consideration of speech deficits might assist surgical targeting, particularly of the left electrode.
Autores: Avilés, Iciar; Kefalopoulou, Zinovia; Tripoliti, Elina; et al.
Revista: JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
ISSN 1468-330X  Vol. 85  Nº 12  2014  págs. 1419-1425
Our data confirm that STN-DBS, using an MRI-guided/MRI-verified technique, remains an effective treatment for motor 'off' symptoms of PD in the long term with low morbidity.
Autores: Avilés, Iciar; Dickson, John; Kefalopoulou, Zinovia; et al.
Revista: JOURNAL OF PARKINSONS DISEASE
ISSN 1877-718X  Vol. 4  Nº 3  2014  págs. 337-344
While these data must still not be interpreted as evidence of neuroprotection, they nevertheless provide strong encouragement for the further study of this drug as a potential disease modifying agent in Parkinson's disease.
Autores: Foltynie, Thomas; Avilés, Iciar;
Revista: ALZHEIMERS & DEMENTIA
ISSN 1552-5279  Vol. 10  2014  págs. S38-S46
Although data must be interpreted with caution, given the strong possibility of placebo effects, the clinical evaluation of these patients supports additional investment into double-blind trials of the GLP-1 agonists in PD.
Autores: Djamshidian, Atbin; O'Sullivan, Sean S.; Lawrence, Andrew D.; et al.
Revista: JOURNAL OF PSYCHOPHARMACOLOGY
ISSN 1461-7285  Vol. 28  Nº 12  2014  págs. 1149-1154
Impulsive choice and poor information sampling have been found to be key behavioural mechanisms linked to impulse control disorders (ICDs) in Parkinson's disease (PD). Perceptual decision-making is intimately related to information sampling. Therefore, we wanted to determine whether dopaminergic medication or ICDs influence perceptual decision-making in PD. All participants performed two tasks. One was a simple reaction time task, where subjects needed to respond as quickly as possible. The second was a perceptual decision-making task, in which participants had to estimate whether a stimulus contained either more red or more blue pixels. We tested three groups of patients, one treated with levodopa monotherapy, one additionally treated with dopamine agonists, and a third group had ICDs. Results were compared to healthy controls. We found that all patients made more errors than controls. Further, patients with ICDs responded fastest on the reaction time task and also in incorrect trials on the perceptual decision-making task. Similarly, patients with dopamine agonists responded faster than those on levodopa monotherapy and controls. Our results demonstrate that all patients have deficits in perceptual decision-making. However, patients treated with dopamine agonists closely resembled patients with ICDs.
Autores: Djamshidian, Atbin; O'Sullivan, Sean S.; Tomassini, Alessandro; et al.
Revista: JOURNAL OF PARKINSONS DISEASE
ISSN 1877-718X  Vol. 4  Nº 4  2014  págs. 579-583
Our results suggest that dopamine agonist therapy rather than deep brain stimulation is likely responsible for the inability to slow down in high conflict situations in PD. These results further strengthen the need to reduce dopamine agonists in PD patients undergoing functional neurosurgery in order to prevent them making inadvisable decisions
Autores: Blanco, Lisette; Enrique Yuste, Jose; Angeles Carrillo-de Sauvage, Maria; et al.
Revista: NEUROSCIENCE
ISSN 1873-7544  Vol. 247  2013  págs. 351-363
Bar; Barrington nucleus; CRF; DBS; LC; LDTg; MRI; PBS; PD; PFA; PPN; Parkinson¿s disease; TH; VAChT; corticotropin release factor; deep brain stimulation; laterodorsal tegmental nucleus; locus coeruleus; magnetic resonance imaging; micturition centre; paraformaldehyde; pedunculopontine nucleus; phosphate-buffered saline; tyrosine hydroxylase; vesicular acetylcholine transporter
Autores: Djamshidian, Atbin; O'Sullivan, Sean S.; Foltynie, Thomas; et al.
Revista: JOURNAL OF PARKINSONS DISEASE
ISSN 1877-7171  Vol. 3  Nº 2  2013  págs. 139-144
Our results imply that dopamine agonist therapy but not deep brain stimulation leads to "reflection impulsivity" in PD.
Autores: Avilés, Iciar; Dickson, John; Kefalopoulou, Zinovia; et al.
Revista: JOURNAL OF CLINICAL INVESTIGATION
ISSN 1558-8238  Vol. 123  Nº 6  2013  págs. 2730-2736
There is increasing interest in methods to more rapidly and cost-efficiently investigate drugs that are approved for clinical use in the treatment of another condition. Exenatide is a type 2 diabetes treatment that has been shown to have neuroprotective/neurorestorative properties in preclinical models of neurodegeneration. METHODS. As a proof of concept, using a single-blind trial design, we evaluated the progress of 45 patients with moderate Parkinson's disease (PD), randomly assigned to receive subcutaneous exenatide injection for 12 months or to act as controls. Their PD was compared after overnight withdrawal of conventional PD medication using blinded video assessment of the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), together with several nonmotor tests, at baseline, 6 months, and 12 months and after a further 2-month washout period (14 months). RESULTS. Exenatide was well tolerated, although weight loss was common and l-dopa dose failures occurred in a single patient. Single-blinded rating of the exenatide group suggested clinically relevant improvements in PD across motor and cognitive measures compared with the control group. Exenatide-treated patients had a mean improvement at 12 months on the MDS-UPDRS of 2.7 points, compared with mean decline of 2.2 points in control patients (P = 0.037). CONCLUSION. These results demonstrate a potential cost-efficient approach through which preliminary clinical data of possible biological eff
Autores: Miquel, Marie; Spampinato, Umberto; Latxague, Chrystelle; et al.
Revista: PLOS ONE
ISSN 1932-6203  Vol. 8  Nº 11  2013 
This study shows that bilateral DBS of the GPi effectively reduces the severity of drug-resistant hyperkinetic movement disorders such as present in ChAc.
Autores: Hariz, G. -M.; Limousin, P.; Zrinzo, L.; et al.
Revista: ACTA NEUROLOGICA SCANDINAVICA
ISSN 0001-6314  Vol. 128  Nº 4  2013  págs. 281-285
Although STN DBS results in equal degree of motor improvement between women and men, health-related quality of life seems to improve to a greater extent in women.
Autores: Angeli, Aikaterina; Mencacci, Niccolo E.; Duran, Raquel; et al.
Revista: MOVEMENT DISORDERS
ISSN 1531-8257  Vol. 28  Nº 10  2013  págs. 1370-1375
vVariation in the genetic risk(s) of developing Parkinson's disease (PD) undoubtedly contributes to the subsequent phenotypic heterogeneity. Although patients with PD who undergo deep brain stimulation (DBS) are a skewed population, they represent a valuable resource for exploring the relationships between heterogeneous phenotypes and PD genetics. In this series, 94 patients who underwent DBS were screened for mutations in the most common genes associated with PD. The consequent genetic subgroups of patients were compared with respect to phenotype, levodopa (l-dopa), and DBS responsiveness. An unprecedented number (29%) of patients tested positive for at least 1 of the currently known PD genes. Patients with Parkin mutations presented at the youngest age but had many years of disease before needing DBS, whereas glucocerebrosidase (GBA) mutation carriers reached the threshold of needing DBS earlier, and developed earlier cognitive impairment after DBS. DBS cohorts include large numbers of gene positive PD patients and can be clinically instructive in the exploration of genotype-phenotype relationships.
Autores: Djamshidian, Atbin; O'Sullivan, Sean S.; Sanotsky, Yanosh; et al.
Revista: MOVEMENT DISORDERS
ISSN 1531-8257  Vol. 27  Nº 9  2012  págs. 1137-1145
We found that all patients with PD made more impulsive and irrational choices than the control group. PD patients who had an ICB showed similar behavior to illicit substance abusers, whereas patients without ICBs more closely resembled pathological gamblers. In contrast, we found no difference in working memory performance within the PD groups. However, PD patients without ICBs remembered distractors significantly less than all other patients during working memory tests. We were able to correctly classify 96% of the PD patients with respect to whether or not they had an ICB by analyzing three trials of the 80/20 loss condition of the beads task with a negative prediction value of 92.3%, and we propose that this task may prove to be a powerful screening tool to detect an ICB in PD. Our results also suggest that intact cortical processing and less distractibility in PD patients without ICBs may protect them from developing behavioral addictions.
Autores: Martinez-Fernandez, Raul; Zrinzo, Ludvic; Avilés, Iciar; et al.
Revista: MOVEMENT DISORDERS
ISSN 0885-3185  Vol. 26  Nº 10  2011  págs. 1922-1930
Deep brain stimulation remains an experimental treatment for patients with Gilles de la Tourette syndrome. Currently, a major controversial issue is the choice of brain target that leads to optimal patient outcomes within a presumed network of basal ganglia and cortical pathways involved in tic pathogenesis. This report describes our experience with patients with severe refractory Gilles de la Tourette syndrome treated with globus pallidus internus deep brain stimulation. Five patients were selected for surgery, 2 targeting the posteroventral globus pallidus internus and 2 targeting the anteromedial region. The remaining patient was first targeted on the posterolateral region, but after 18 months the electrodes were relocated in the anteromedial area. Tics were clinically assessed in all patients pre- and postoperatively using the Modified Rush Video protocol and the Yale Global Tic Severity Scale. Obsessive-compulsive behaviors were quantified with the Yale-Brown Obsessive Compulsive Scale. The Gilles de la Tourette Syndrome-Quality of Life Scale was also completed. All patients experienced improvements in tic severity but to variable extents. More convincing improvements were seen in patients with electrodes sited in the anteromedial region of the globus pallidus internus than in those with posterolateral implants. Mean reduction in the Modified Rush Video Rating scale for each group was 54% and 37%, respectively. Our open-label limited experience supports the use of the an
Autores: Avilés, Iciar; Foltynie, Thomas; Panicker, Jalesh; et al.
Revista: ACTA NEUROCHIRURGICA
ISSN 0001-6268  Vol. 153  Nº 12  2011  págs. 2357-2360
Low-frequency deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) has been reported to improve akinesia and gait difficulties in patients with Parkinson's disease (PD). We report on a patient with PD and L: -dopa refractory gait symptoms who developed detrusor over-activity immediately after right PPN DBS. Proximity between caudal PPN and brainstem structures implicated in control of micturition is a possible explanation.
Autores: Foltynie, T.; Zrinzo, L.; Martinez-Torres, I.; et al.
Revista: JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
ISSN 0022-3050  Vol. 82  Nº 4  2011  págs. 358-363
There were no haemorrhagic complications. At a median follow-up period of 12&emsp14;months, there was a mean improvement in the off-medication motor part of the Unified Parkinson's Disease Rating Scale (UPDRS III) of 27.7 points (SD 13.8) equivalent to a mean improvement of 52% (p<0.0001). In addition, there were significant improvements in dyskinesia duration, disability and pain, with a mean reduction in on-medication dyskinesia severity (sum of dyskinesia duration, disability and pain from UPDRS IV) from 3.15 (SD 2.33) pre-operatively, to 1.56 (SD 1.92) post-operatively (p=0.0001). Quality of life improved by a mean of 5.5 points (median 7.9 points, SD 17.3) on the Parkinson's disease Questionnaire 39 summary index. This series confirms that image-guided STN DBS without microelectrode recording can lead to substantial improvements in motor disability of well-selected PD patients with accompanying improvements in quality of life and most importantly, with very low morbidity.