Nuestros investigadores

Mario Riverol Fernández

Clínica Universidad de Navarra. Clínica Universidad de Navarra
Líneas de investigación
Alzheimer, Demencia, Deterioro cognitivo, Enferemedades neurodegenerativas
Índice H
11, (WoS, 24/01/2018)

Publicaciones científicas más recientes (desde 2010)

Autores: Guillen Valderrama, Edgar Fernando; Rosales Castillo, Juan Jose; Lisei, D.; et al.
ISSN 2281-5872  Vol. 8  2020  págs. 127 - 140
Purpose We aim to present and critically evaluate the use of FDG-PET in the differential diagnosis between dementing conditions including Alzheimer disease (AD), frontotemporal dementia (FTD) and its variants, vascular dementia (VaD) and pseudodepressive dementia. Methods This review is based on the available consensus recommendations for the use of FDG-PET and current clinical diagnostic criteria. In addition, we updated these reviews with relevant publications in the field after conducting a literature search during the last 5 years through predefined keyword strings relating to the specific terms related to the diseases covered in this review and a common part ('FDG-PET'). Results Neurodegenerative disease are complex groups of several forms of dementia and their clinical diagnostic criteria are progressively incorporating imaging biomarkers as a supporting tool. The role of FDG-PET is currently increasing as part of the clinical practice supporting the clinical diagnosis of AD (at both mild cognitive impairment-MCI-and early dementia stages), FTD and its variants, as well as VaD and pseudodepressive dementia. The pattern of AD is well defined and its negative predicted value may help the differential diagnosis when comorbidities like vascular disease or depression are present. However, the formal evidence supporting the use of FDG-PET is reasonable for MCI due to AD, and the differential diagnosis between FTD and AD, but lacking for the remaining clinical uses. Interestingly, the evidence provided during the last years reinforces these recommendations and gives additional clues about the usefulness of semiquantitative methods in addition to visual reading. Conclusion The large experience accumulated using FDG-PET for the differential diagnosis of the main conditions with dementia has been translated into more formal evidence to support its clinical use. Although FDG-PET form currently part of the clinical practice in many countries, there is still a lack of studies using standardized analysis that confirm specific patterns at individual level.
Autores: Galiano, A.; Mengual Poza, Elisa; García de Eulate Ruiz, María Reyes; et al.
ISSN 1931-7557  Vol. 14  Nº 2  2020  págs. 436 - 450
Aging leads to cerebral perfusion and functional connectivity changes that have been assessed using various neuroimaging techniques. In addition, a link between these two parameters has been demonstrated in healthy young adults. In this work, we employed arterial spin labeling (ASL) fMRI to measure global and voxel-wise differences in cerebral blood flow (CBF) and intrinsic connectivity contrast (ICC) in the resting state in a group of cognitively normal elderly subjects and a group of cognitively normal young subjects, in order to assess the effects of aging on CBF-ICC coupling, which had not been previously evaluated. Our results showed age-related global and regional CBF decreases in prefrontal mesial areas, lateral frontal regions, insular cortex, lateral parietal areas, precuneus and occipital regions. Subcortically, perfusion was reduced in the medial thalamus and caudate nucleus. ICC was also found reduced with age in prefrontal cortical areas and insular cortex, affecting key nodes of the default mode and salience networks. Areas of ICC and CBF decrease partially overlapped, however, the CBF reduction was more extensive and encompassed more areas. This dissociation was accompanied by a decrease in CBF-ICC coupling. These results suggest that aging leads to a disruption in the relationship between CBF and intrinsic functional connectivity that could be due to neurovascular dysregulation.
Autores: Frederiksen, K. S., (Autor de correspondencia); Nielsen, T. R. ; Appollonio, I. ; et al.
ISSN 0885-6230  Vol. 36  Nº 2  2020  págs. 324 - 333
Objectives Mild cognitive impairment (MCI) is associated with an increased risk of further cognitive decline, partly depending on demographics and biomarker status. The aim of the present study was to survey the clinical practices of physicians in terms of biomarker counseling, management, and follow-up in European expert centers diagnosing patients with MCI. Methods An online email survey was distributed to physicians affiliated with European Alzheimer's disease Consortium centers (Northern Europe: 10 centers; Eastern and Central Europe: 9 centers; and Southern Europe: 15 centers) with questions on attitudes toward biomarkers and biomarker counseling in MCI and dementia. This included postbiomarker counseling and the process of diagnostic disclosure of MCI, as well as treatment and follow-up in MCI. Results The response rate for the survey was 80.9% (34 of 42 centers) across 20 countries. A large majority of physicians had access to biomarkers and found them useful. Pre- and postbiomarker counseling varied across centers, as did practices for referral to support groups and advice on preventive strategies. Less than half reported discussing driving and advance care planning with patients with MCI. Conclusions The variability in clinical practices across centers calls for better biomarker counseling and better training to improve communication skills. Future initiatives should address the importance of communicating preventive strategies and advance planning.
Autores: Moreno Ajona, David; Prieto Azcárate, Elena; Grisanti Vollbracht, Fabiana Lucrecia; et al.
ISSN 2075-4418  Vol. 10  Nº 6  2020  págs. 356
Brain positron emission tomography imaging with 18Fluorine-fluorodeoxyglucose (FDG-PET) has demonstrated utility in suspected autoimmune encephalitis. Visual and/or assisted image reading is not well established to evaluate hypometabolism/hypermetabolism. We retrospectively evaluated patients with autoimmune encephalitis between 2003 and 2018. Patients underwent EEG, brain magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) sampling and autoantibodies testing. Individual FDG-PET images were evaluated by standard visual reading and assisted by voxel-based analyses, compared to a normal database. For the latter, three different methods were performed: two based on statistical surface projections (Siemens syngo.via Database Comparison, and 3D-SSP Neurostat) and one based on statistical parametric mapping (SPM12). Hypometabolic and hypermetabolic findings were grouped to identify specific patterns. We found six cases with definite diagnosis of autoimmune encephalitis. Two cases had anti-LGI1, one had anti-NMDA-R and two anti-CASPR2 antibodies, and one was seronegative.F-18-FDG-PET metabolic abnormalities were present in all cases, regardless of the method of analysis. Medial-temporal and extra-limbic hypermetabolism were more clearly depicted by voxel-based analyses. We found autoantibody-specific patterns in line with the literature. Statistical surface projection (SSP) methods (Neurostat and syngo.via Database Comparison) were more sensitive and localized larger hypermetabolic areas. As it may lead to comparable and accurate results, visual analysis of FDG-PET studies for the diagnosis of autoimmune encephalitis benefits from voxel-based analysis, beyond the approach based on MRI, CSF sample and EEG.
Autores: Navarta-Sanchez, M. V. ; Ambrosio Gutierrez, Leire (Autor de correspondencia); Portillo, M. C.; et al.
ISSN 0309-2402  Vol. 76  Nº 10  2020  págs. 2719 - 2732
Aim To evaluate the effects of a psychoeducational intervention compared with an education programme to strengthen quality of life, psychosocial adjustment, and coping in people with Parkinson's disease and their informal caregivers. Design A quasi-experimental study was performed with repeated measures at baseline, after the intervention and 6 months post-intervention. Methods The study was carried out at seven primary care centres from 2015-2017. A total of 140 people with Parkinson's and 127 informal caregivers were allocated to the experimental and the control groups. The experimental group received a 9-week psychoeducational intervention, whereas the control group received a 5-week education programme. Repeated measures ANOVA were used to test differences in quality of life, psychosocial adjustment, and coping between the experimental and control groups and over time. Results Patients and informal caregivers in both the experimental and control groups showed significantly better psychosocial adjustment at the post-intervention measurement compared with baseline data. We also found significantly greater quality of life in patients and coping skills in caregivers after the end of the interventions in the experimental and control groups. Nevertheless, no significant differences were identified on the outcomes at the 6-month post-intervention measurement. Conclusion The effect of the psychoeducational intervention was not different from the effect of the education programme. The strategies applied in both interventions followed a group approach led by a multidisciplinary team covering information about PD, healthy lifestyles, and social resources. They might be easily sustained in Primary Care to improve care for people with Parkinson's and informal caregivers.
Autores: Martí Andrés, Gloria María; Van Bommel, L.; Meles, S.; et al.
ISSN 0885-3185  Vol. 35  2020  págs. S116 - S116
Autores: Ambrosio Gutierrez, Leire; Portillo Vega, María Carmen; Martín Lanas, Raquel; et al.
ISSN 0885-3185  Vol. 35  Nº S1  2020  págs. S575 - S576
Autores: Martí Andrés, Gloria María; Perovnik, M. ; Rebec, E.; et al.
ISSN 0885-3185  Vol. 35  2020  págs. S114 - S116
Autores: Navarta Sánchez, María Victoria (Autor de correspondencia); Riverol Fernández, Mario; Ursúa, M. E.; et al.
ISSN 2013-5246  Vol. 49  Nº January - June 2019  2019  págs. 16 - 22
Introduction: Psychosocial adjustment affects the quality of life of patients with Parkinson's disease (PD) and his/her family/carers. However, this is not usually addressed in clinical practice. Objective: To evaluate coping skills, psychosocial adjustment and quality of life of patients with PD and their family/carers from a quasiexperiment at baseline time. Method: Quasi-experimental study carried out in Primary Care centres to evaluate the impact of a psychoeducational intervention in contrast with an informative intervention. The sample comprised 80 patients with PD and 80 family carers, divided into a control group and an experimental group. The psychosocial adjustment scale PAIS-SR, the coping scale Brief COPE and the quality of life scales PDQ-39 and SQLC were used in the data collection. The analysis of sociodemographic data and Student's t tests was performed using SPSS 23.0. Results: The patients and family/carers from the control group and the experimental group noticed a mild impairment in their quality of life and some difficulties in their psychosocial adjustment to illness. Both groups used coping skills with a medium-low frequency. Acceptance was the most used coping skill by patients and family/carers. No statistically significant differences were found between the control group and the experimental group. Conclusions: We observed that the quality of life and psychosocial adjustment to their illness was impacted in patients with PD and their family/carers, which could be addressed with psychoeducational interventions focused on developing their coping skills
Autores: Portillo, M. C., (Autor de correspondencia); Ambrosio Gutierrez, Leire; Martín Lanas, Raquel; et al.
ISSN 2054-1058  Vol. 6  Nº 3  2019  págs. 1262 - 1268
Aim To report the cross-cultural adaptation and pilot study of the ongoing validation of the Spanish version of the Psychosocial Adjustment to Illness Scale with carers of people with Parkinson's disease. Design Cross-cultural adaptation and pilot study with a cross-sectional validation design of the Spanish version of the Psychosocial Adjustment to Illness Scale - Carers. Methods Twenty-one carers of people with Parkinson's disease from a Primary Care practice in Spain were recruited and completed the PAIS-Carers, the SF-36 Health Survey, the Brief COPE Inventory and an assessment form. SPSS 23.0 was used to determine viability/acceptability and preliminary aspects of internal consistency of the instrument. Results Five of the seven domains presented floor effect (71.42%), and only one presented ceiling effect (14.28%). The internal consistency of the scale and domains showed acceptable values (over 0.7). The content validity of the Spanish version seemed satisfactory with positive comments in general from participants.
Autores: Pascual, B., (Autor de correspondencia); de Bot, S. T. ; Daniels, M. R.; et al.
ISSN 0195-6108  Vol. 40  Nº 1  2019  págs. 199 - 203
BACKGROUND AND PURPOSE: The "ears of the lynx" MR imaging sign has been described in case reports of hereditary spastic paraplegia with a thin corpus callosum, mostly associated with mutations in the spatacsin vesicle trafficking associated gene, causing Spastic Paraplegia type 11 (SPG11). This sign corresponds to long T1 and T2 values in the forceps minor of the corpus callosum, which appears hyperintense on FLAIR and hypointense on T1-weighted images. Our purpose was to determine the sensitivity and specificity of the ears of the lynx MR imaging sign for genetic cases compared with common potential mimics. MATERIALS AND METHODS: Four independent raters, blinded to the diagnosis, determined whether the ears of the lynx sign was present in each of a set of 204 single anonymized FLAIR and T1-weighted MR images from 34 patients with causal mutations associated with SPG11 or Spastic Paraplegia type 15 (SPG15). 34 healthy controls, and 34 patients with multiple sclerosis. RESULTS: The interrater reliability for FLAIR images was substantial (Cohen kappa, 0.66-0.77). For these images, the sensitivity of the ears of the lynx sign across raters ranged from 78.8 to 97.0 and the specificity ranged from 90.9 to 100. The accuracy of the sign, measured by area under the receiver operating characteristic curve, ranged from very good (87.1) to excellent (93.9). CONCLUSIONS: The ears of the lynx sign on FLAIR MR imaging is highly specific for the most common genetic subtypes of hereditary spastic paraplegia with a thin corpus callosum. When this sign is present, there is a high likelihood of a genetic mutation, particularly associated with SPG11 or SPG15, even in the absence of a family history.
Autores: Chincarini, A., (Autor de correspondencia); Peira, E.; Morbelli, S.; et al.
ISSN 2213-1582  Vol. 23  2019 
Background: amyloid-PET reading has been classically implemented as a binary assessment, although the clinical experience has shown that the number of borderline cases is non negligible not only in epidemiological studies of asymptomatic subjects but also in naturalistic groups of symptomatic patients attending memory clinics. In this work we develop a model to compare and integrate visual reading with two independent semi-quantification methods in order to obtain a tracer-independent multi-parametric evaluation. Methods: We retrospectively enrolled three cohorts of cognitively impaired patients submitted to F-18-florbetaben (53 subjects), F-18-flutemetamol (62 subjects), F-18-florbetapir (60 subjects) PET/CT respectively, in 6 European centres belonging to the EADC. The 175 scans were visually classified as positive/negative following approved criteria and further classified with a 5-step grading as negative, mild negative, borderline, mild positive, positive by 5 independent readers, blind to clinical data. Scan quality was also visually assessed and recorded. Semi-quantification was based on two quantifiers: the standardized uptake value (SUVr) and the ELBA method. We used a sigmoid model to relate the grading with the quantifiers. We measured the readers accord and inconsistencies in the visual assessment as well as the relationship between discrepancies on the grading and semi-quantifications. Conclusion: It is possible to construct a map between different tracers and different quantification methods without resorting to ad-hoc acquired cases. We used a 5-level visual scale which, together with a mathematical model, delivered cut-offs and transition regions on tracers that are (largely) independent from the population. All fluorinated tracers appeared to have the same contrast and discrimination ability with respect to the negative-to-positive grading. We validated the integration of both visual reading and different quantifiers in a more robust framework thus bridging the gap between a binary and a user-independent continuous scale.
Autores: Martínez Valbuena, Iván; Valentí Azcárate, Rafael; Amat-Villegas, I.; et al.
ISSN 0364-5134  Vol. 86  Nº 4  2019  págs. 539 - 551
Objective Alzheimer disease (AD) is the leading cause of dementia, and although its etiology remains unclear, it seems that type 2 diabetes mellitus (T2DM) and other prediabetic states of insulin resistance could contribute to the appearance of sporadic AD. As such, we have assessed whether tau and beta-amyloid (A beta) deposits might be present in pancreatic tissue of subjects with AD, and whether amylin, an amyloidogenic protein deposited in the pancreas of T2DM patients, might accumulate in the brain of AD patients. Methods We studied pancreatic and brain tissue from 48 individuals with no neuropathological alterations and from 87 subjects diagnosed with AD. We examined A beta and tau accumulation in the pancreas as well as that of amylin in the brain. Moreover, we performed proximity ligation assays to ascertain whether tau and/or A beta interact with amylin in either the pancreas or brain of these subjects. Results Cytoplasmic tau and A beta protein deposits were detected in pancreatic beta cells of subjects with AD as well as in subjects with a normal neuropathological examination but with a history of T2DM and in a small cohort of control subjects without T2DM. Furthermore, we found amylin deposits in the brain of these subjects, providing histological evidence that amylin can interact with A beta and tau in both the pancreas and hippocampus. Interpretation The presence of both tau and A beta inclusions in pancreatic beta cells, and of amylin deposits in the brain, provides new evidence of a potential overlap in the mechanisms underlying the pathogenesis of T2DM and AD. ANN NEUROL 2019
Autores: Navarta Sánchez, María Victoria; Ursua, M. E.; Riverol Fernández, Mario; et al.
ISSN 1471-2296  Vol. 19  Nº 45  2018 
Parkinson's disease progressively limits patients at different levels and as a result family members play a key role in their care. However, studies show lack of an integrative approach in Primary Care to respond to the difficulties and psychosocial changes experienced by them. The aim of this study is to evaluate the effects of a multidisciplinary psychoeducational intervention focusing on improving coping skills, the psychosocial adjustment to Parkinson's disease and the quality of life in patients and family carers in a Primary Care setting. Methods: This quasi-experimental study with control group and mixed methods was designed to evaluate a multidisciplinary psychoeducational intervention. Based on the study power calculations, 100 people with Parkinson's disease and 100 family carers will be recruited and assigned to two groups. The intervention group will receive the ReNACE psychoeducational intervention. The control group will be given a general educational programme. The study will be carried out in six community-based health centres. The results obtained from the two groups will be collected for evaluation at three time points: at baseline, immediately after the intervention and at 6 months post-intervention. The results will be measured with these instruments: the Quality of Life Scale PDQ-39 for patients and the Scale of Quality of Life of Care-givers SQLC for family carers, and for all participants the Psychosocial Adjustment to Illness scale and the Brief COPE Inventory. Focus groups will be organised with some patients and family carers who will have received the ReNACE psychoeducational intervention and also with the healthcare professionals involved in its development. Discussion: An important gap exists in the knowledge and application of interventions with a psychosocial approach for people with PD and family carers as a whole. This study will promote this comprehensive approach in Primary Care, which will clearly contribute in the existing knowledge and could reduce the burden of PD for patients and family carers, and also in other long-term conditions.
Autores: Arbizu Lostao, Javier (Autor de correspondencia); Giuliani, A.; Gállego Pérez de Larraya, Jaime; et al.
ISSN 1824-4785  Vol. 61  Nº 4  2017  págs. 386 - 404
PET using F-18-2-fluoro-2-deoxy-D-glucose (FDG-PET) has been gradually introduced in the diagnostic clinical criteria of the most prevalent neurodegenerative diseases. Moreover, an increasing amount of literature has shown that the information provided by FDG-PET enhances the sensitivity of standard imaging biomarkers in less frequent disorders in which an early differential diagnosis can be of paramount relevance for patient management and outcome. Therefore emerging uses of FDG-PET may be important in prion diseases, autoimmune encephalitis (AE) and amyotrophic lateral sclerosis. Interestingly, FDG-PET findings can also be observed in the early phases of these conditions, even in the presence of normal magnetic resonance imaging scans. Thalamic hypometabolism is a common finding in sporadic Creutzfeldt-Jacob disease and fatal familiar insomnia patients, with further cortical synaptic dysfunction in the former. Limbic and extra-limbic metabolic abnormalities (more often hypermetabolism) can be observed in AE, although specific patterns may be seen within different syndromes associated with antibodies that target neuronal surface or synaptic antigens. FDG-PET shows its usefulness by discriminating patients with amyotrophic lateral sclerosis associated to upper motor neuron onset that evolve to frontotemporal dementia. Besides visual and voxel based image analysis, multivariate analysis as interregional correlation analysis and independent/principal component analysis have been successfully implemented to PET images increasing the accuracy of the discrimination of neurodegenerative diseases. The clinical presentation and current diagnostic criteria of these neurologic disorders as well as the emerging usefulness of FDG-PET in the diagnostic workup are presented and discussed in this review.
Autores: Navarta Sánchez, María Victoria; Caparrós, N.; Riverol Fernández, Mario; et al.
ISSN 0309-2402  Vol. 73  Nº 11  2017  págs. 2609 - 2621
AIMS: The aim of this study were: (1) To explore the meaning that coping with Parkinson's disease has for patients and family carers; (2) To suggest the components of an intervention focused on enhancing their coping with the disease. BACKGROUND: Adapting to Parkinson's disease involves going through many difficult changes; however, it may improve quality of life in patients and family carers. One of the key aspects for facilitating the psychosocial adjustment to Parkinson's disease is the strengthening of coping skills. DESIGN: A sequential explanatory mixed methods study was carried out. Findings from the qualitative phase are presented. METHODS: Data were collected in May 2014 through three focus groups: one of people with Parkinson's disease (n = 9), one of family carers (n = 7) and one of healthcare professionals (n = 5). All focus groups were digitally recorded and transcribed verbatim and content analysis was independently carried out by two researchers. FINDINGS: The participants coincided in highlighting that coping with Parkinson's disease helped the patient and the family carer in their search for balance; and it implied a transformation in their lives. To aid the process of coping with Parkinson's disease, a multifaceted intervention is proposed. CONCLUSION: Coping with Parkinson's disease is a complex process for both patients and family carers and it should therefore be considered a standard service in healthcare policies aimed at this group.
Autores: García de Eulate Ruiz, María Reyes; Goñi, I.; Galiano, A.; et al.
ISSN 1387-2877  Vol. 58  Nº 2  2017  págs. 585 - 595
There is increasing evidence of a vascular contribution to Alzheimer's disease (AD). In some cases, prior work suggests that chronic brain hypoperfusion could play a prime pathogenic role contributing to the accumulation of amyloid-ß,while other studies favor the hypothesis that vascular dysfunction and amyloid pathology are independent, although synergistic, mechanisms contributing to cognitive impairment. Vascular dysfunction can be evaluated by assessing cerebral blood flow impairment. Phase contrast velocity mapping by MRI offers a non-invasive means of quantifying the total inflow of blood to the brain. This quantitative parameter could be a sensitive indicator of vascular disease at early stages of AD. In this work, phase contrast MRI was used to evaluate cerebral hemodynamics in patients with subjective memory complaints, amnestic mild cognitive impairment, and mild to moderate AD, and compare them with control subjects. Results showed that blood flow and velocity were decreased in the patients with cognitive dysfunction and the decrease correlated with the degree of cognitive impairment as assessed by means of neuropsychological tests. Total cerebral blood flow measurements were clearly reduced in AD patients, but more importantly appeared to be sensitive enough to distinguish between healthy subjects and those with mild cognitive impairment. A quantitative measurement of total brain blood flow could potentially predict vascular dysfunction and compromised brain perfu
Autores: Navarta Sánchez, María Victoria; Caparrós Civera, María Neus; Sesma, M. E. U. ; et al.
ISSN 0212-6567  Vol. 49  Nº 4  2017  págs. 214 - 223
Objective: To explore the main psychosocial aspects which have influence on the coping with the disease in patients with Parkinson's disease (PD) and their family carers. Design: An exploratory qualitative study which constitutes the second phase of a mixed methods project. Setting: Multicenter study carried out in Navarre in 2014 in collaboration with Primary Care of Navarre Service of Health-Osasunbidea, Clinica Universidad de Navarra and Navarre Association of Parkinson's patients. Participants: A total of 21 participants: 9 people with PD, 7 family carers and 5 healthcare professionals. Method: Participants were selected through purposive sampling. Focus groups were conducted until a suitable saturation data was achieved. Transcriptions were analysed by 2 researchers through a content analysis. Results: Three aspects that affected how patients and family carers coped with PD were identified: features of the clinical practice; family environment, and disease's acceptance. Taking account of these findings, some strategies which could foster these aspects from primary healthcare are suggested in order to improve the adjustment to the disease in patients and family carers. Conclusions: The healthcare in people with PD should have an integral approach that tackle the symptoms control in patients and also deal with psychosocial aspects that influence on the coping with the disease, in patients and family carers. (C) 2016 Elsevier Espana, S.L.U.
Autores: Navarta Sánchez, María Victoria; Senosiáin García, Juana María; Riverol Fernández, Mario; et al.
ISSN 0962-9343  Vol. 25  Nº 8  2016  págs. 1959-1968
Multidisciplinary interventions aimed at improving PD patients' QoL may have more effective outcomes if education about coping skills, and how these can help towards a positive psychosocial adjustment to illness, were included, and targeted not only at patients, but also at informal caregivers.
Autores: Arbizu Lostao, Javier; Danilenko, A.; Guillen Valderrama, Edgar Fernando; et al.
ISSN 1619-7070  Vol. 43  Nº Supl.1  2016  págs. S118 - S118
Autores: Treviño Peinado, Cristina de los Angeles; Arbizu Lostao, Javier; Irimia Sieira, Pablo; et al.
ISSN 0363-9762  Vol. 40  Nº 9  2015  págs. e441-43
A 70-year-old woman with a history of autoimmune hepatitis and renal cell carcinoma presented with subacute cognitive impairment. A brain MRI revealed mild leukoaraiosis, whereas brain F-FDG PET/CT showed diffuse cerebral hypometabolism that resembled some of the patterns described in limbic encephalitis and neurodegenerative diseases. With the suspicion of autoimmune encephalitis, the patient received immunotherapy with dramatic improvement of cognitive function and metabolic normalization at the 2-month follow-up on brain F-FDG PET/CT. Our results demonstrate that brain F-FDG PET/CT might be a useful tool in the assessment of patients with autoimmune encephalitis.
Autores: McDade, E; Boot, B; Riverol Fernández, Mario; et al.
ISSN 2163-0402  Vol. 5  Nº 3  2015  págs. 263-266
Autores: Carmona Abellán, María del Mar; Luquin Piudo, María Rosario Isabel; Lamet Gil, María Isabel; et al.
ISSN 1137-6627  Vol. 38  Nº 1  2015  págs. 79-92
La degeneración lobar frontotemporal engloba tres síndromes diferentes, que comparten características clínicas y patológicas comunes, dificultando así su diagnóstico en estadios iniciales. Se incluyen en este grupo las tres variantes de la demencia frontotemporal, el síndrome corticobasal y el síndrome de parálisis supranuclear progresiva. Se ha llevado a cabo una revisión del perfil neuropsicológico de cada uno de los síndromes, que permita clarificar las características fundamentales que los definen y ayudar a diferenciarlos de otras demencias.Se ha hecho una revisión de los diferentes trabajos publicados en la literatura al respecto, describiendo las características clínicas, patológicas y los hallazgos de imagen fundamentales de cada entidad para describir de manera exhaustiva los hallazgos en los diferentes dominios neuropsicológicos y su progresión. Aunque existe un solapamiento entre los síndromes que conforman la degeneración lobar frontotemporal, la comparación del perfil neuropsicológico de las mismas entre sí y frente a otras demencias permite establecer características propias de su perfil neuropsicológico para llevar a cabo un diagnóstico diferencial.
Autores: Riverol Fernández, Mario; Becker, J; López, O; et al.
ISSN 1387-2877  Vol. 44  Nº 1  2015  págs. 319-328
Cerebral white matter lesions (WMLs) are considered a reflection of cerebral and systemic small vessel disease (SVD), and are associated with reductions in brain volume. Like the brain, the kidney is also sensitive to factors that affect vasculature. Glomerular dysfunction due to renal vascular damage can be measured with different biochemical parameters, such as creatinine or cystatin C, although cystatin C is considered to be more accurate than creatinine in the elderly. The purpose of the study was to determine whether manifestations of SVD in the kidney can predict SVD-based damage to the brain. We examined the relationship between glomerular dysfunction as a measure of SVD on WMLs, gray matter (GM) volume, and cognition in 735 cognitively normal participants from the Cardiovascular Health Study Cognition Study. The multivariate analyses controlled for demographic characteristics, hypertension, heart disease, diabetes, Apolipoprotein 4 allele, C reactive protein, lipids, physical activity, smoking, and body mass index (BMI). Elevated cystatin C levels were associated with lower neuropsychological test scores, the presence of MRI-identified brain infarcts, the severity of WMLs, and GM atrophy five years later. In adjusted models, GM volume was significantly associated with cystatin-C only until BMI and severity of WMLs were added to the model, meaning that the effect of SVD on GM volume is mediated by these two variables. These findings suggest that age-related SVD is a pr
Autores: Riverol Fernández, Mario
ISSN 0304-5412  Vol. 11  Nº 73  2015  págs. 4395-9
The transient loss of consciousness (TLC) is defined as a loss of consciousness abrupt onset, short duration and spontaneous complete recovery. The TLC is a very common cause of medical consultation, especially in the emergency department. Episodes of TLC may be secondary to different entities such as syncope, seizures and functional disorders. In most patients, the TLC is secondary to syncope. However, some studies suggest that up to one in four individuals are wrongly diagnosed as epileptic seizures. This protocol aims to help in the diagnosis of patients with TLC. The various entities that involve TLC will be presented, exploring the elements of the clinical and laboratory tests that may be helpful to reach an accurate diagnosis.
Autores: Ambrosio Gutierrez, Leire; Senosiáin García, Juana María; Riverol Fernández, Mario; et al.
ISSN 0962-1067  Vol. 24  Nº 17 - 18  2015  págs. 2357 - 2367
Findings generated from this concept analysis can raise awareness of Living with chronic illness so that this process could be assessed in a correct and uniform way in the clinical community and improved when needed.
Autores: Tellechea, P; Pujol, N; Esteve Belloch, Patricia; et al.
ISSN 0213-4853  Vol. 33  Nº 4  2015  págs. 244-253
Early-onset Alzheimer disease (EOAD), which presents in patients younger than 65 years, has frequently been described as having different features from those of late-onset Alzheimer disease (LOAD). This review analyses the most recent studies comparing the clinical presentation and neuropsychological, neuropathological, genetic, and neuroimaging findings of both types in order to determine whether EOAD and LOAD are different entities or distinct forms of the same entity. We observed consistent differences between clinical findings in EOAD and in LOAD. Fundamentally, the onset of EOAD is more likely to be marked by atypical symptoms, and cognitive assessments point to poorer executive and visuospatial functioning and praxis with less marked memory impairment. Alzheimer-type features will be more dense and widespread in neuropathology studies, with structural and functional neuroimaging showing greater and more diffuse atrophy extending to neocortical areas (especially the precuneus). In conclusion, available evidence suggests that EOAD and LOAD are 2 different forms of a single entity. LOAD is likely to be influenced by ageing-related processes.
Autores: Prieto Azcárate, Elena; Domínguez Prado, Inés; Riverol Fernández, Mario; et al.
ISSN 1619-7070  Vol. 42  Nº 10  2015  págs. 1522-9
Patients with a prion disease exhibit a characteristic pattern of brain metabolism presentation in FDG PET imaging. Consequently, in patients with rapidly progressive cognitive impairment, the detection of these patterns in the FDG PET study could orient the diagnosis to a prion disease.
Autores: Sancho Rodriguez, Lidia; Morán Velasco, Verónica; Ribelles Segura, María Jesús; et al.
ISSN 2253-8070  Vol. 34  Nº Supl. 1  2015  págs. 59
La evaluación clínica del PET de amiloide con 18 F-florbetapir no se afecta por el tipo de equipo, aunque los de nueva generación reducen el número de casos dudosos. Para el seguimiento, los estudios deben ser adquiridos en un tiempo de adquisición similar. Estos hallazgos son relevantes para los ensayos de posibles nuevos fármacos anti-amiloid
Autores: Moreno Montañés, Javier; Sabater Gozalvo, Alfonso Luis; GUARNIERI, Adriano; et al.
ISSN 0885-3185  Vol. 1  Nº 3  2014  págs. 247 - 248
Autores: Ortega Cubero, Sara; Pagola Lorz, María Inmaculada; Luquin Piudo, María Rosario Isabel; et al.
ISSN 0213-4853  Vol. 30  Nº 3  2014  págs. 144 - 152
Introducción Las prionopatías representan hasta el 62% de los casos de demencia rápidamente progresiva (DRP) en los que se alcanza un diagnóstico definitivo. La variabilidad de los síntomas y signos iniciales y las diferencias en su evolución dificultan el diagnóstico precoz. Métodos Estudio retrospectivo en el que se incluye a pacientes con prionopatía probable o definitiva, que acudieron a la consulta de Neurología de nuestro centro durante el periodo 1999-2012. Se describen las características clínicas y los resultados de las exploraciones complementarias (proteína 14-3-3, EEG, RM, PET-FDG y análisis genético), con la finalidad de identificar qué marcadores permiten un diagnóstico precoz. Resultados Se describe a 14 pacientes: 6 con enfermedad de Creutzfeldt-Jakob esporádica (ECJe) definitiva, 3 con ECJe probable, 4 con insomnio familiar fatal y uno con la nueva variante de la enfermedad de Creutzfeldt-Jakob. La mediana de edad al diagnóstico fue de 54 años y la mediana de supervivencia de 9,5 meses. El trastorno del ánimo fue el síntoma inicial más frecuente, seguido de inestabilidad de la marcha y deterioro cognitivo. La proteína 14-3-3 fue positiva en el líquido cefalorraquídeo en 7 de 11 pacientes y el EEG mostró signos típicos en 2 de 12 pacientes explorados. El estudio de neuroimagen mostró alteraciones en 13 de los 14 pacientes. Conclusiones Además de la DRP, el trastorno conductual y de la marcha son síntomas iniciales frecuentes en las prionopatías. En nuestra serie, las pruebas complementarias más útiles para apoyar el diagnóstico fueron la RM y la PET-FDG.
Autores: Riverol Fernández, Mario; Ordoñez Camblor, Cristina; Collantes Martínez, María; et al.
ISSN 0969-9961  Vol. 62  2014  págs. 250-259
Much controversy exists concerning the effect of levodopa on striatal dopaminergic markers in Parkinson's disease (PD) and its influence on functional neuroimaging. To deal with this issue we studied the impact of neurotoxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and chronic levodopa administration on striatal (18)F-DOPA uptake (Ki) in an animal model of PD. The levels of several striatal dopaminergic markers and the number of surviving dopaminergic neurons in the substantia nigra (SN) were also assessed. Eleven Macaca fascicularis were included in the study. Eight animals received weekly intravenous injections of MPTP for 7weeks and 3 intact animals served as controls. MPTP-monkeys were divided in two groups. Group I was treated with placebo while Group II received levodopa. Both treatments were maintained for 11months and then followed by a washout period of 6months. (18)F-DOPA positron emission tomography (PET) scans were performed at baseline, after MPTP intoxication, following 11months of treatment, and after a washout period of 1, 3 and 6months. Monkeys were sacrificed 6months after concluding either placebo or levodopa treatment and immediately after the last (18)F-DOPA PET study. Striatal dopamine transporter (DAT) content, tyrosine hydroxylase (TH) content and aromatic l-amino acid decarboxylase (AADC) content were assessed. In Group II (18)F-DOPA PET studies performed at 3 and 6months after interrupting levodopa showed a significantly increased Ki in the anterior putamen as compared to Group I. Levodopa and placebo treated animals exhibited a similar number of surviving dopaminergic cells in the SN. Striatal DAT content was equally reduced in both groups of animals. Animals in Group I exhibited a significant decrease in TH protein content in all the striatal regions assessed. However, in Group II, TH levels were significantly reduced only in the anterior and posterior putamen. Surprisingly, in the levodopa-treated animals the TH levels in the posterior putamen were significantly lower than those in the placebo group. AADC levels in MPTP groups were similar to those of control animals in all striatal areas analyzed. This study shows that chronic levodopa administration to monkeys with partial nigrostriatal degeneration followed by a washout period induces modifications in the functional activity of the dopaminergic nigrostriatal pathway.
Autores: Mathias Thelen, Mathias Thelen; Razquin Burillo, Cristina; Hernandez, Isabel; et al.
ISSN 0197-4580  Vol. 35  Nº 11  2014  págs. 2657.e13-e19
Frontotemporal dementia (FTD) is a clinically and genetically heterogeneous disorder. Rare TREM2 variants have been recently identified in families affected by FTD-like phenotype. However, genetic studies of the role of rare TREM2 variants in FTD have generated conflicting results possibly because of difficulties on diagnostic accuracy. The aim of the present study was to investigate associations between rare TREM2 variants and specific FTD subtypes (FTD-S). The entire coding sequence of TREM2 was sequenced in FTD-S patients of Spanish (n = 539) and German (n = 63) origin. Genetic association was calculated using Fisher exact test. The minor allele frequency for controls was derived from in-house genotyping data and publicly available databases. Seven previously reported rare coding variants (p.A28V, p.W44X, p.R47H, p.R62H, p.T66M, p.T96K, and p.L211P) and 1 novel missense variant (p.A105T) were identified. The p.R47H variant was found in 4 patients with FTD-S. Two of these patients showed cerebrospinal fluid pattern of amyloid beta, tau, and phosphorylated-tau suggesting underlying Alzheimer's disease (AD) pathology. No association was found between p.R47H and FTD-S. A genetic association was found between p.T96K and FTD-S (p = 0.013, odds ratio = 4.23, 95% Confidence Interval [1.17¿14.77]). All 6 p.T96K patients also carried the TREM2 variant p.L211P, suggesting linkage disequilibrium. The remaining TREM2 variants were found in 1 patient, respectively, and were absent in controls. The present findings provide evidence that p.T96K is associated with FTD-S and that p.L211P may contribute to its pathogenic effect. The data also suggest that p.R47H is associated with an FTD phenotype that is characterized by the presence of underlying AD pathology.
Autores: Raji, CA; Erickson, KI; Lopez, OL; et al.
ISSN 0749-3797  Vol. 47  Nº 4  2014  págs. 444-451
Dietary consumption of baked or broiled fish is related to larger gray matter volumes independent of omega-3 fatty acid content. These findings suggest that a confluence of lifestyle factors influence brain health, adding to the growing body of evidence that prevention strategies for late-life brain health need to begin decades earlier.
Autores: Pagola Lorz, María Inmaculada; Esteve Belloch, Patricia; Palma Carazo, José Alberto; et al.
ISSN 0210-0010  Vol. 58  Nº 6  2014  págs. 241 - 246
Objetivo. Identificar las características clínicas que predicen una respuesta favorable al tratamiento con onabotulinumtoxina A (OnabotA) en pacientes con migraña refractaria. Pacientes y métodos. Estudio retrospectivo de pacientes con migraña refractaria que recibieron al menos dos infiltraciones de OnabotA entre los años 2008 y 2012. Los pacientes fueron divididos en respondedores y no respondedores a OnabotA y se compararon entre ambos grupos, y de forma retrospectiva, una serie de características clínicas consideradas predictoras de respuesta en estudios previos: localización unilateral de la cefalea, presencia de tensión muscular pericraneal, tipo de dolor (implosivo, explosivo u ocular), tiempo de evolución de la migraña (menor o mayor de 10 años) y abuso de medicación analgésica. Resultados. Se incluyeron 39 pacientes (35 mujeres) con una edad media de 46 años. En 18 pacientes (46,2%) se observó una reducción mayor del 50% en el número de días de cefalea/mes (pacientes respondedores). Al analizar las diferentes características de la migraña, se observó que todas ellas fueron igualmente prevalentes en los pacientes respondedores y en los no respondedores (p > 0,05): localización unilateral (66,7% frente a 66,6%, respectivamente), dolor implosivo (27,8% frente a 38,1%), presencia de tensión muscular pericraneal (33,3% frente a 38,1%), tiempo de evolución de la migraña mayor de 10 años (77,8% frente a 69,2%) y presencia de abuso de medicación analgésica (50% frente a 81%), Conclusión. En esta serie de pacientes no se ha identificado ningún rasgo clínico que permita predecir en pacientes con migraña refractaria una respuesta favorable al tratamiento con OnabotA.
Autores: Treviño Peinado, Cristina de los Angeles; Páramo Alfaro, María; García del Barrio, Loreto; et al.
ISSN 0014-2565  Vol. 214  Nº 3  2014  págs. e33
Autores: Zaragoza Salcedo, Amparo; Senosiáin García, Juana María; Riverol Fernández, Mario; et al.
ISSN 1137-6627  Vol. 37  Nº 1  2014  págs. 69-80
Autores: Ortega Cubero, Sara; Luquin Piudo, María Rosario Isabel; Domínguez Prado, Inés; et al.
ISSN 0213-4853  Vol. 28  Nº 5  2013  págs. 299-308
Autores: Arbizu Lostao, Javier; Prieto Azcárate, Elena; Martínez-Lage Álvarez, Pablo María; et al.
ISSN 1619-7070  Vol. 10  Nº 9  2013  págs. 1394 - 1405
To introduce, evaluate and validate a voxel-based analysis method of F-18-FDG PET imaging for determining the probability of Alzheimer's disease (AD) in a particular individual. The subject groups for model derivation comprised 80 healthy subjects (HS), 36 patients with mild cognitive impairment (MCI) who converted to AD dementia within 18 months, 85 non-converter MCI patients who did not convert within 24 months, and 67 AD dementia patients with baseline FDG PET scan were recruited from the AD Neuroimaging Initiative (ADNI) database. Additionally, baseline FDG PET scans from 20 HS, 27 MCI and 21 AD dementia patients from our institutional cohort were included for model validation. The analysis technique was designed on the basis of the AD-related hypometabolic convergence index adapted for our laboratory-specific context (AD-PET index), and combined in a multivariable model with age and gender for AD dementia detection (AD score). A logistic regression analysis of different cortical PET indexes and clinical variables was applied to search for relevant predictive factors to include in the multivariable model for the prediction of MCI conversion to AD dementia (AD-Conv score). The resultant scores were stratified into sixtiles for probabilistic diagnosis. The area under the receiver operating characteristic curve (AUC) for the AD score detecting AD dementia in the ADNI database was 0.879, and the observed probability of AD dementia in the six defined groups ranged from 8 % to 100 % in a monotonic trend. For predicting MCI conversion to AD dementia, only the posterior cingulate index, Mini-Mental State Examination (MMSE) score and apolipoprotein E4 genotype (ApoE4) exhibited significant independent effects in the univariable and multivariable models. When only the latter two clinical variables were included in the model, the AUC was 0.742 (95 % CI 0.646 - 0.838), but this increased to 0.804 (95 % CI 0.714 - 0.894, bootstrap p = 0.027) with the addition of the posterior cingulate index (AD-Conv score). Baseline clinical diagnosis of MCI showed 29.7 % of converters after 18 months. The observed probability of conversion in relation to baseline AD-Conv score was 75 % in the high probability group (sixtile 6), 34 % in the medium probability group (merged sixtiles 4 and 5), 20 % in the low probability group (sixtile 3) and 7.5 % in the very low probability group (merged sixtiles 1 and 2). In the validation population, the AD score reached an AUC of 0.948 (95 % CI 0.625 - 0.969) and the AD-Conv score reached 0.968 (95 % CI 0.908 - 1.000), with AD patients and MCI converters included in the highest probability categories. Posterior cingulate hypometabolism, when combined in a multivariable model with age and gender as well as MMSE score and ApoE4 data, improved the determination of the likelihood of patients with MCI converting to AD dementia compared with clinical variables alone. The probabilistic model described here provides a new tool that may aid in the clinical diagnosis of AD and MCI conversion.
Autores: Palma Carazo, José Alberto; Domínguez Echávarri, Pablo Daniel; Riverol Fernández, Mario
ISSN 0028-3878  Vol. 80  Nº 17  2013  págs. 1620
A 77-year-old woman with multiple myeloma for 5 years presented with obtundation, drowsiness, and disorientation over 15 days. Complete blood count revealed thrombocytopenia (25,000/µL). A brain CT disclosed multiple extraaxial hyperdense foci without bone destruction. Differential diagnosis included tumors (meningiomas, leukemia), subdural hematomas, and intracranial hemorrhages; the lesion's multiplicity and morphology were consistent with intracranial extramedullary hematopoiesis (IEH) (figure). Despite platelet transfusions, she died 2 days later of alveolar hemorrhage. Autopsy confirmed IEH and excluded erythropoiesis, reported in subdural hematomas. The formation of blood cells outside the bone marrow is usually related to anemia or lymphoproliferative disorders and is uncommon in multiple myeloma.(1) IEH can cause seizures, hydrocephalus, or cognitive changes.(2.)
Autores: Irimia Sieira, Pablo; Palma Carazo, José Alberto; Idoate Gastearena, Miguel Ángel; et al.
ISSN 0017-8748  Vol. 53  Nº 6  2013  págs. 994 - 997
Cephalalgia alopecia is a rare and recently described headache syndrome in which recurrent, burning head and neck pain is associated with hair loss from areas of scalp affected by the pain. We here report the case of a 33-year-old woman with continuous unilateral occipital pain and colocalized alopecia, only responsive to onabotulinumtoxin A injections. We hypothesize whether this clinical phenotype may correspond to either cephalalgia alopecia or nummular headache with trophic changes, conditions that might represent 2 manifestations of the same spectrum of disorders.
Autores: Riverol Fernández, Mario; Palma Carazo, José Alberto; Alaña, M; et al.
ISSN 0022-3050  Vol. 83  Nº 2  2012  págs. 235 - 236
Autores: Portillo Vega, María Carmen; Senosiáin García, Juana María; Arantzamendi Solabarrieta, María; et al.
ISSN 2013-5246  Vol. 36  Nº 1  2012  págs. 31 - 38
ICS Introducción: En la bibliografía hay un vacío relacionado con la perspectiva holística del proceso de integración de la enfermedad de Parkinson en las vidas de pacientes y familiares. Objetivo: Explorar el proceso de convivencia con la enfermedad de Parkinson de pacientes y familiares, así como los factores y los mecanismos que lo favorecen o inhiben. Método: El proyecto ReNACE es un proyecto con metodología combinada, multicéntrico y multidisciplinario, de 3 años de duración, que consta de 2 fases (cualitativa y cuantitativa), realizado en la Clínica Universidad de Navarra, un centro de Salud del Servicio Navarro de Salud-Osasunbidea y la Asociación Navarra de Parkinson. Se presentan resultados preliminares de la Fase I Cualitativa. Se han recogido datos con entrevistas semiestructuradas, hojas sociodemográficas y escalas (estadio Parkinson). Se ha realizado un análisis de contenido comparativo (programa NVivo9) y un análisis estadístico (SPSS 15.0). Resultados: Participaron 15 pacientes con enfermedad de Parkinson y 16 familiares. Su mediana y rango intercuartil de edad eran de 73 (65¿76,25) y 65 (59,5¿74) años, respectivamente. En el proceso de adaptación al Parkinson, se destacan dos etapas dinámicas: 1) etapa extraordinaria, y 2) etapa de normalidad. Los principales factores y mecanismos que influían en la convivencia con el Parkinson eran: las estrategias de afrontamiento, el apoyo familiar, las redes personales y sociales, los recursos disponibles, así como la educ
Autores: Dicaudo, C.; Riverol Fernández, Mario; Carril Mundiñano, Iñaki; et al.
Revista: PLOS ONE
ISSN 1932-6203  Vol. 7  Nº 11  2012 
In addition to the medium spiny neurons the mammalian striatum contains a small population of GABAergic interneurons that are immunoreactive for tyrosine hydroxylase (TH), which dramatically increases after lesions to the nigrostriatal pathway and striatal delivery of neurotrophic factors. The regulatory effect of levodopa (L-Dopa) on the number and phenotype of these cells is less well understood. Eleven macaques (Macaca fascicularis) were included. Group I (n = 4) received 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP) and L-Dopa; Group II (n = 4) was treated with MPTP plus vehicle and Group III (n = 3) consist of intact animals (control group). L-Dopa and vehicle were given for 1 year and animals sacrificed 6 months later. Immunohistochemistry against TH was used to identify striatal and nigral dopaminergic cells. Double and triple labeling immunofluorescence was performed to detect the neurochemical characteristics of the striatal TH-ir cells using antibodies against: TH, anti-glutamate decarboxylase (GAD(67)) anti-calretinin (CR) anti-dopa decarboxylase (DDC) and anti-dopamine and cyclic AMP-regulated phosphoprotein (DARPP-32). The greatest density of TH-ir striatal cells was detected in the striatum of the L-Dopa treated monkeys and particularly in its associative territory. None of the striatal TH-ir cell expressed DARPP-32 indicating they are interneurons. The percentages of TH-ir cells that expressed GAD67 and DDC was approximately 50%. Interestingly, we found that in the L-Dopa group the number of TH/CR expressing cells was significantly reduced. We conclude that chronic L-Dopa administration produced a long-lasting increase in the number of TH-ir cells, even after a washout period of 6 months. L-Dopa also modified the phenotype of these cells with a significant reduction of the TH/CR phenotype in favor of an increased number of TH/GAD cells that do not express CR. We suggest that the increased number of striatal TH-ir cells might be involved in the development of aberrant striatal circuits and the appearance of L-Dopa induced dyskinesias.
Autores: Palma Carazo, José Alberto; Irimia Sieira, Pablo; Fernández Torrón, Roberto; et al.
ISSN 0210-0010  Vol. 54  Nº 12  2012  págs. 705-11
Aim. To analyse our experience in the treatment of refractory chronic migraine, episodic frequent refractory migraine (>= 10 days/month), with onabotulinumtoxin A (OnabotA). Patients and methods. Retrospective analysis of patients with refractory migraine who underwent, at least two sessions of OnabotA pericranial injections following the PREEMPT protocol between 2008 and 2012. The efficacy of OnabotA was evaluated comparing the basal situation with 12-16 weeks after the second session. We analysed the subjective improvement of the patients, number of days with headache, preventive and abortive drugs consumption, and adverse effects. Results. Forty-one patients (37 women, 4 male) were identified. 65.8% patients experienced subjective improvement after OnabotA treatment. 36.58% responded (reduction of > 50% in headache days). Differences between days with headache before the first session (24.5 +/- 7.3), and 12-16 weeks after the second session (17.4 +/- 11.6), as well as the differences between the number of abortive drugs taken before the first session (26.8 +/- 23.1) and 12-16 weeks after the second session (16.7 +/- 19.3), were statistically significant (p < 0.001). Subgroups analysis showed that all differences were significant, except for the reduction of the number of days with headache in patients with episodic frequent refractory migraine. Conclusion. Our work shows that treatment with OnabotA is safe and useful in patients with episodic and chronic refractory migraine, including those patients with medication overuse headache.
Autores: Palma Carazo, José Alberto; Lamet Gil, María Isabel; Riverol Fernández, Mario; et al.
ISSN 0340-5354  Vol. 259  Nº 12  2012  págs. 2755-7
Autores: Fernández Torrón, Roberto; Palma Carazo, José Alberto; Riverol Fernández, Mario; et al.
Revista: Spinal Cord
ISSN 1362-4393  Vol. 50  Nº 8  2012  págs. 636 - 637
Autores: Rajagopalan, P; Jahanshad, N; Stein, JL; et al.
ISSN 1053-8119  Vol. 1  Nº 1  2012  págs. 79-87
A commonly carried C677T polymorphism in a folate-related gene, MTHFR, is associated with higher plasma homocysteine, a well-known mediator of neuronal damage and brain atrophy. As homocysteine promotes brain atrophy, we set out to discover whether people carrying the C677T MTHFR polymorphism which increases homocysteine, might also show systematic differences in brain structure. Using tensor-based morphometry, we tested this association in 359 elderly Caucasian subjects with mild cognitive impairment (MCI) (mean age: 75 ± 7.1 years) scanned with brain MRI and genotyped as part of Alzheimer's Disease Neuroimaging Initiative. We carried out a replication study in an independent, non-overlapping sample of 51 elderly Caucasian subjects with MCI (mean age: 76 ± 5.5 years), scanned with brain MRI and genotyped for MTHFR, as part of the Cardiovascular Health Study. At each voxel in the brain, we tested to see where regional volume differences were associated with carrying one or more MTHFR 'T' alleles. In ADNI subjects, carriers of the MTHFR risk allele had detectable brain volume deficits, in the white matter, of up to 2-8% per risk T allele locally at baseline and showed accelerated brain atrophy of 0.5-1.5% per T allele at 1 year follow-up, after adjusting for age and sex. We replicated these brain volume deficits of up to 5-12% per MTHFR T allele in the independent cohort of CHS subjects. As expected, the associations weakened after controlling for homocysteine levels, which th
Autores: Fernández Torrón, Roberto; Esteve Belloch, Patricia; Palma Carazo, José Alberto; et al.
ISSN 0210-0010  Vol. 55  Nº 4  2012  págs. 253 - 254
Autores: Riverol Fernández, Mario; Fernández Torrón, Roberto
ISSN 0304-5412  Vol. 10  Nº 73  2011  págs. 4937 - 4943
Autores: Becker, JT.; Riverol Fernández, Mario
ISSN 0022-3050  Vol. 82  Nº 5  2011  págs. 475
Autores: López, OL.; McDade, E.; Riverol Fernández, Mario; et al.
ISSN 1350-7540  Vol. 24  Nº 6  2011  págs. 532 -541
Autores: Riverol Fernández, Mario; Slachevsky and Oscar, Andrea; López, L.
ISSN 2041-8000  2011  págs. 15 -19
Autores: Riverol Fernández, Mario; López, OL.
ISSN 1664-2295  Vol. 2  2011  págs.  46
Autores: Samaranch Gusi, Lluís; Lorenzo Ramos, María Elena; Pastor, María A.; et al.
ISSN 1351-5101  Vol. 17  Nº 2  2010  págs. 321 - 325
Autores: Riverol Fernández, Mario
Libro:  Del ensayo a la práctica clínica: Souvenaid Clinical Experience
2015  págs. 130-134
Autores: Riverol Fernández, Mario; López, Oscar
Libro:  The neuropsychology of cortical dementias
2015  págs. 175-198
Autores: Fontes Villalba, Ariadna; Esteve Belloch, Patricia; Carmona Abellán, María del Mar; et al.
Libro:  X Concurso de casos clínicos para Residentes de Neurología 2013
2013  págs. 645-648
Autores: Palma Carazo, José Alberto; Ortega Cubero, Sara; Pagola Lorz, María Inmaculada; et al.
Libro:  IX Concurso de casos clínicos para Residentes de Neurología 2012
2012  págs. 660-71
Autores: Riverol Fernández, Mario; Luquin Piudo, María Rosario Isabel
Libro:  Tratado de Neurología Clínica
2012  págs. 709-732
Autores: Pagola Lorz, María Inmaculada; Carmona Abellán, María del Mar; Esteve Belloch, Patricia; et al.
Libro:  IX Concurso de casos clínicos para Residentes de Neurología 2012
2012  págs. 593-595
Autores: Riverol Fernández, Mario
Libro:  Atlas de neuroimagen en enfermedad de Parkinson (Módulo 1)
2012  págs. 46-56
Autores: Riverol Fernández, Mario
Libro:  En atlas de neuroimagen en enfermedad de Parkinson (Módulo 2 Casos Clínicos)
2012  págs. 49-52
Autores: Arbizu Lostao, Javier; Caicedo Zamudio, Carlos Javier; Gállego Pérez de Larraya, Jaime; et al.
Libro:  Medicina Nuclear en la práctica clínica
2012  págs. 355-378
Autores: Riverol Fernández, Mario
Libro:  Atlas de neuroimagen en enfermedad de Parkinson (Módulo 2 Casos Clínicos)
2012  págs. 46-48
Autores: Barriobero Alonso, Noelia; Treviño Peinado, Cristina de los Angeles; Pagola Lorz, María Inmaculada; et al.
Libro:  IX Concurso de casos clínicos para Residentes de Neurología 2012
2012  págs. 416-418
Autores: Palma Carazo, José Alberto; Fernández Torrón, Roberto; Gasca Salas, Carmen; et al.
Libro:  VII Concurso de casos clínicos para Residentes de Neurología 2009
2010  págs. 76-79