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452 results on '"Rodríguez Rojas, Rafael"'

1. Subthalamic Nucleus and Substantia Nigra Automatic Segmentation Using Convolutional Segmentation Transformers (Conv-SeTr)

Author

Nebel, Juan, Pinargote, Franklin E. Magallanes, Peláez, Colon Enrique, Paredes, Francis R. Loayza, Rodriguez-Rojas, Rafael, Kacprzyk, Janusz, Series Editor, Gomide, Fernando, Advisory Editor, Kaynak, Okyay, Advisory Editor, Liu, Derong, Advisory Editor, Pedrycz, Witold, Advisory Editor, Polycarpou, Marios M., Advisory Editor, Rudas, Imre J., Advisory Editor, Wang, Jun, Advisory Editor, Rocha, Alvaro, editor, Adeli, Hojjat, editor, Dzemyda, Gintautas, editor, Moreira, Fernando, editor, and Colla, Valentina, editor

Published
2024
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2. Cerebral metabolic pattern associated with progressive parkinsonism in non-human primates reveals early cortical hypometabolism

Author

Molinet-Dronda, Francisco, Blesa, Javier, del Rey, Natalia López-González, Juri, Carlos, Collantes, María, Pineda-Pardo, Jose A, Trigo-Damas, Inés, Iglesias, Elena, Hernández, Ledia F., Rodríguez-Rojas, Rafael, Gago, Belén, Ecay, Margarita, Prieto, Elena, García-Cabezas, Miguel Á., Cavada, Carmen, Rodríguez-Oroz, María C., Peñuelas, Iván, and Obeso, José A.

Published
2022
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4. Skull Density Ratio as Arm‐Allocation Parameter for a Controlled Focused Ultrasound Trial in Parkinson's Disease

Author

Pineda‐Pardo, José Angel, primary, Martínez‐Fernández, Raul, additional, Natera‐Villalba, Elena, additional, Ruiz‐Yanzi, Agustina, additional, Rodríguez‐Rojas, Rafael, additional, Del Alamo, Marta, additional, Jiménez‐Castellanos, Tamara, additional, Matarazzo, Michele, additional, Gasca‐Salas, Carmen, additional, Rascol, Olivier, additional, and Obeso, José A., additional

Published
2024
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5. Staged Bilateral MRI-Guided Focused Ultrasound Subthalamotomy for Parkinson Disease

Author

Martínez-Fernández, Raúl, primary, Natera-Villalba, Elena, additional, Rodríguez-Rojas, Rafael, additional, del Álamo, Marta, additional, Pineda-Pardo, Jose A., additional, Obeso, Ignacio, additional, Guida, Pasqualina, additional, Jiménez-Castellanos, Tamara, additional, Pérez-Bueno, Diana, additional, Duque, Alicia, additional, Mañez-Miró, Jorge U., additional, Gasca-Salas, Carmen, additional, Matarazzo, Michele, additional, Alonso-Frech, Fernando, additional, and Obeso, Jose A., additional

Published
2024
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6. Skull Density Ratio as Arm-Allocation Parameter for a Controlled Focused Ultrasound Trial in Parkinson’s Disease

Author

Universidad San Pablo-CEU. Facultad de Medicina. Departamento de Ciencias Médicas Clínicas., Grupo: HM Centro Integral de Neurociencia (HM CINAC), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Pineda-Pardo, José A., Obeso Inchausti, José Ángel, Martínez-Fernández, Raúl, Natera Villalba, Elena, Ruiz Yanzi, Agustina, Rodríguez Rojas, Rafael, Álamo, Marta del, Jiménez Castellanos, Tamara, Matarazzo, Michele, Gasca Salas, Carmen, Rasco, Olivier, Universidad San Pablo-CEU. Facultad de Medicina. Departamento de Ciencias Médicas Clínicas., Grupo: HM Centro Integral de Neurociencia (HM CINAC), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Pineda-Pardo, José A., Obeso Inchausti, José Ángel, Martínez-Fernández, Raúl, Natera Villalba, Elena, Ruiz Yanzi, Agustina, Rodríguez Rojas, Rafael, Álamo, Marta del, Jiménez Castellanos, Tamara, Matarazzo, Michele, Gasca Salas, Carmen, and Rasco, Olivier

Abstract

Background: Background MR-guided focused ultrasound (FUS) thermoablation is an established therapy for movement disorders. FUS candidates must meet a predefined threshold of skull density ratio (SDR), a parameter that accounts for the efficiency in reaching ablative temperatures. Randomized sham-controlled trials to provide definitive therapeutic evidence employ pure randomization of subjects into active treatment or control arms. The latter design has several general limitations. Objective: Objective To demonstrate that SDR values are not associated with clinically and demographically relevant variables in patients with Parkinson’s disease (PD). This in turn would allow using SDR as an arm-allocation parameter, separating patients who will receive active FUS treatment and best medical management treatment (BMT). Methods: Methods We studied a cohort of 215 PD patients who were candidates for FUS subthalamotomy to determine if the SDR was correlated with demographic or clinical variables that could introduce bias for group allocation in a controlled trial. Results: Results SDR was unassociated with age, gender, and clinical motor features nor with levodopa daily dose in our cohort of PD patients. A negative association with age was found for the female subgroup. Conclusions: Conclusions Our results show that in a PD population considered for FUS subthalamotomy treatment, the SDR may be a valid group-allocation parameter. This could be considered as the basis for a controlled study comparing FUS subthalamotomy vs BMT.

Published
2024

7. Cognitive Reserve in Parkinson's Disease without Dementia: β‐Amyloid and Metabolic Assessment

Author

Fernández‐Rodríguez, Beatriz, primary, Rodríguez‐Rojas, Rafael, additional, Guida, Pasqualina, additional, Angulo‐Díaz‐Parreño, Santiago, additional, Trompeta, Clara, additional, Mata‐Marín, David, additional, Obeso, Ignacio, additional, Vela, Lydia, additional, Plaza de las Heras, Isabel, additional, Obeso, José A., additional, and Gasca‐Salas, Carmen, additional

Published
2024
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11. Brain hypometabolism in non‐demented microtubule‐associated protein tau H1 carriers with Parkinson's disease

Author

Gasca‐Salas, Carmen, primary, Trompeta, Clara, additional, López‐Aguirre, Miguel, additional, Rodríguez Rojas, Rafael, additional, Clarimon, Jordi, additional, Dols‐Icardo, Oriol, additional, El Bounasri, Shaimaa, additional, Guida, Pasqualina, additional, Mata‐Marín, David, additional, Hernández‐Fernández, Frida, additional, Marras, Connie, additional, García‐Cañamaque, Lina, additional, Plaza de las Heras, Isabel, additional, Obeso, Ignacio, additional, Vela, Lydia, additional, and Fernández‐Rodríguez, Beatriz, additional

Published
2023
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12. Neuroimages in Autism

Author

Rodríguez-Rojas, Rafael, Machado, Calixto, Batista, Karla, Carballo, Maylen, Leisman, Gerry, and Robinson-Agramonte, Maria de los Angeles, editor

Published
2015
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13. BBB opening with focused ultrasound in nonhuman primates and Parkinson’s disease patients: Targeted AAV vector delivery and PET imaging

Author

Blesa, Javier, Pineda-Pardo, José A., Inoue, Ken-ichi, Gasca-Salas, Carmen, Balzano, Tiziano, Del Rey, Natalia López-González, Reinares-Sebastián, Alejandro, Esteban-García, Noelia, Rodríguez-Rojas, Rafael, Márquez, Raquel, Ciorraga, María, del Álamo, Marta, García-Cañamaque, Lina, Ruiz de Aguiar, Santiago, Rachmilevitch, Itay, Trigo-Damas, Inés, Takada, Masahiko, Obeso, José A., Blesa, Javier, Pineda-Pardo, José A., Inoue, Ken-ichi, Gasca-Salas, Carmen, Balzano, Tiziano, Del Rey, Natalia López-González, Reinares-Sebastián, Alejandro, Esteban-García, Noelia, Rodríguez-Rojas, Rafael, Márquez, Raquel, Ciorraga, María, del Álamo, Marta, García-Cañamaque, Lina, Ruiz de Aguiar, Santiago, Rachmilevitch, Itay, Trigo-Damas, Inés, Takada, Masahiko, and Obeso, José A.

Abstract

Intracerebral vector delivery in nonhuman primates has been a major challenge. We report successful blood-brain barrier opening and focal delivery of adeno-associated virus serotype 9 vectors into brain regions involved in Parkinson’s disease using low-intensity focus ultrasound in adult macaque monkeys. Openings were well tolerated with generally no associated abnormal magnetic resonance imaging signals. Neuronal green fluorescent protein expression was observed specifically in regions with confirmed blood-brain barrier opening. Similar blood-brain barrier openings were safely demonstrated in three patients with Parkinson’s disease. In these patients and in one monkey, blood-brain barrier opening was followed by 18F-Choline uptake in the putamen and midbrain regions based on positron emission tomography. This indicates focal and cellular binding of molecules that otherwise would not enter the brain parenchyma. The less-invasive nature of this methodology could facilitate focal viral vector delivery for gene therapy and might allow early and repeated interventions to treat neurodegenerative disorders.

Published
2023

14. Brain hypometabolism in non-demented microtubule-associated protein tau H1 carriers with Parkinson's disease

Author

Siemens Healthcare, Fundación de Investigación HM Hospitales, Gasca-Salas, Carmen, Trompeta, Clara, López-Aguirre, Miguel, Rodríguez Rojas, Rafael, Clarimon, Jordi, Dols-Icardo, Oriol, El Bounasri, Shaimaa, Guida, Pasqualina, Mata-Marín, David, Hernández-Fernández, Frida, Marras, Connie, García-Cañamaque, Lina, Plaza de Las Heras, Isabel, Obeso, Ignacio, Vela, Lydia, Fernández-Rodríguez, Beatriz, Siemens Healthcare, Fundación de Investigación HM Hospitales, Gasca-Salas, Carmen, Trompeta, Clara, López-Aguirre, Miguel, Rodríguez Rojas, Rafael, Clarimon, Jordi, Dols-Icardo, Oriol, El Bounasri, Shaimaa, Guida, Pasqualina, Mata-Marín, David, Hernández-Fernández, Frida, Marras, Connie, García-Cañamaque, Lina, Plaza de Las Heras, Isabel, Obeso, Ignacio, Vela, Lydia, and Fernández-Rodríguez, Beatriz

Abstract

The microtubule-associated protein tau (MAPT) H1 homozygosity (H1/H1 haplotype) is a genetic risk factor for neurodegenerative diseases, such as Parkinson's disease (PD). MAPT H1 homozygosity has been associated with conversion to PD; however, results are conflicting since some studies did not find a strong influence. Cortical hypometabolism is associated with cognitive impairment in PD. In this study, we aimed to evaluate the metabolic pattern in nondemented PD patients MAPT H1/H1 carriers in comparison with MAPT H1/H2 haplotype. In addition, we evaluated domain-specific cognitive differences according to MAPT haplotype.

Published
2023

15. Prospective Long-term Follow-up of Focused Ultrasound Unilateral Subthalamotomy for Parkinson Disease

Author

Martínez-Fernández, Raúl, Natera-Villalba, Elena, Máñez Miró, Jorge U., Rodríguez-Rojas, Rafael, Álamo, Marta del, Pineda-Pardo, José A., Ammann, Claudia, Obeso, Ignacio, Mata-Marín, David, Hernández-Fernández, Frida, Gasca-Salas, Carmen, Matarazzo, Michele, Alonso-Frech, Fernando, Obeso, José A., Martínez-Fernández, Raúl, Natera-Villalba, Elena, Máñez Miró, Jorge U., Rodríguez-Rojas, Rafael, Álamo, Marta del, Pineda-Pardo, José A., Ammann, Claudia, Obeso, Ignacio, Mata-Marín, David, Hernández-Fernández, Frida, Gasca-Salas, Carmen, Matarazzo, Michele, Alonso-Frech, Fernando, and Obeso, José A.

Abstract

Unilateral magnetic resonance-guided focused ultrasound subthalamotomy (FUS-STN) has been shown to improve the cardinal motor features of Parkinson disease (PD). Whether this effect is sustained is not known. This study aims to report the long-term outcome of patients with PD treated with unilateral FUS-STN.

Published
2023

16. BBB opening with focused ultrasound in nonhuman primates and Parkinson’s disease patients: Targeted AAV vector delivery and PET imaging

Author

Blesa, Javier, primary, Pineda-Pardo, José A., additional, Inoue, Ken-ichi, additional, Gasca-Salas, Carmen, additional, Balzano, Tiziano, additional, Del Rey, Natalia López-González, additional, Reinares-Sebastián, Alejandro, additional, Esteban-García, Noelia, additional, Rodríguez-Rojas, Rafael, additional, Márquez, Raquel, additional, Ciorraga, María, additional, del Álamo, Marta, additional, García-Cañamaque, Lina, additional, Ruiz de Aguiar, Santiago, additional, Rachmilevitch, Itay, additional, Trigo-Damas, Inés, additional, Takada, Masahiko, additional, and Obeso, José A., additional

Published
2023
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17. Using Graph Theory to Identify Aberrant Hierarchical Patterns in Parkinsonian Brain Networks

Author

Rodriguez-Rojas, Rafael, Sanabria, Gretel, Melie, Lester, Morales, Juan-Miguel, Carballo, Maylen, Garcia, David, Obeso, Jose A., Rodriguez-Oroz, Maria C., Hutchison, David, editor, Kanade, Takeo, editor, Kittler, Josef, editor, Kleinberg, Jon M., editor, Mattern, Friedemann, editor, Mitchell, John C., editor, Naor, Moni, editor, Nierstrasz, Oscar, editor, Pandu Rangan, C., editor, Steffen, Bernhard, editor, Sudan, Madhu, editor, Terzopoulos, Demetri, editor, Tygar, Doug, editor, Vardi, Moshe Y., editor, Weikum, Gerhard, editor, Ruiz-Shulcloper, José, editor, and Sanniti di Baja, Gabriella, editor

Published
2013
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18. Striatal Blood–Brain Barrier Opening in Parkinson’s Disease Dementia: A Pilot Exploratory Study

Author

Universidad San Pablo-CEU. Facultad de Medicina. Departamento de Ciencias Médicas Clínicas., Grupo: HM Centro Integral de Neurociencia (HM CINAC), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Pineda-Pardo, José A., Obeso Inchausti, José Ángel, Gasca Salas, Carmen, Fernández-Rodríguez, Beatriz, Rodríguez Rojas, Rafael, Álamo, Marta del, Hernández-Fernández, Frida, Trompeta, Clara, Martínez-Fernández, Raúl, Matarazzo, Michele, Mata-Marín, David, Guida, Pasqualina, Duque, Alicia, Albillo, David, Plaza de las Heras, Isabel, Montero Roblas, Juan Ignacio, Foffani, Guglielmo, Toltsis, Gabriella, Rachmilevitch, Itay, Obeso Martín, Ignacio, Blesa de los Mozos, Francisco Javier, Universidad San Pablo-CEU. Facultad de Medicina. Departamento de Ciencias Médicas Clínicas., Grupo: HM Centro Integral de Neurociencia (HM CINAC), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Pineda-Pardo, José A., Obeso Inchausti, José Ángel, Gasca Salas, Carmen, Fernández-Rodríguez, Beatriz, Rodríguez Rojas, Rafael, Álamo, Marta del, Hernández-Fernández, Frida, Trompeta, Clara, Martínez-Fernández, Raúl, Matarazzo, Michele, Mata-Marín, David, Guida, Pasqualina, Duque, Alicia, Albillo, David, Plaza de las Heras, Isabel, Montero Roblas, Juan Ignacio, Foffani, Guglielmo, Toltsis, Gabriella, Rachmilevitch, Itay, Obeso Martín, Ignacio, and Blesa de los Mozos, Francisco Javier

Published
2022

19. Striatal Blood-Brain Barrier Opening in Parkinson's Disease Dementia: A Pilot Exploratory Study

Author

Fundación Mapfre, Agencia Estatal de Investigación (España), Pineda-Pardo, José A., Gasca-Salas, Carmen, Fernández-Rodríguez, Beatriz, Rodríguez-Rojas, Rafael, Álamo, Marta del, Obeso, Ignacio, Hernández-Fernández, Frida, Trompeta, Clara, Martínez-Fernández, Raúl, Matarazzo, Michele, Mata-Marín, David, Guida, Pasqualina, Duque, Alicia, Albillo, David, Plaza de Las Heras, Isabel, Montero, Juan I., Foffani, Guglielmo, Toltsis, Gabriella, Rachmilevitch, Itay, Blesa, Javier, Obeso, José A., Fundación Mapfre, Agencia Estatal de Investigación (España), Pineda-Pardo, José A., Gasca-Salas, Carmen, Fernández-Rodríguez, Beatriz, Rodríguez-Rojas, Rafael, Álamo, Marta del, Obeso, Ignacio, Hernández-Fernández, Frida, Trompeta, Clara, Martínez-Fernández, Raúl, Matarazzo, Michele, Mata-Marín, David, Guida, Pasqualina, Duque, Alicia, Albillo, David, Plaza de Las Heras, Isabel, Montero, Juan I., Foffani, Guglielmo, Toltsis, Gabriella, Rachmilevitch, Itay, Blesa, Javier, and Obeso, José A.

Abstract

Parkinson's disease (PD) exhibits a high prevalence of dementia as disease severity and duration progress. Focused ultrasound (FUS) has been applied for transient blood-brain barrier (BBB) opening of cortical regions in neurodegenerative disorders. The striatum is a primary target for delivery of putative therapeutic agents in PD.

Published
2022

20. Striatal Blood–Brain Barrier Opening in Parkinson's Disease Dementia: A Pilot Exploratory Study

Author

Pineda‐Pardo, José A., primary, Gasca‐Salas, Carmen, additional, Fernández‐Rodríguez, Beatriz, additional, Rodríguez‐Rojas, Rafael, additional, del Álamo, Marta, additional, Obeso, Ignacio, additional, Hernández‐Fernández, Frida, additional, Trompeta, Clara, additional, Martínez‐Fernández, Raúl, additional, Matarazzo, Michele, additional, Mata‐Marín, David, additional, Guida, Pasqualina, additional, Duque, Alicia, additional, Albillo, David, additional, Plaza de las Heras, Isabel, additional, Montero, Juan I., additional, Foffani, Guglielmo, additional, Toltsis, Gabriella, additional, Rachmilevitch, Itay, additional, Blesa, Javier, additional, and Obeso, José A., additional

Published
2022
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24. Cambios estructurales y funcionales inducidos por subtalamotomía en el tratamiento de pacientes con enfermedad de Parkinson.

Author

Rodríguez Rojas, Rafael and Rodríguez Rojas, Rafael

Abstract

La enfermedad de Parkinson (EP) es un proceso neurodegenerativo complejo, caracterizado por la presencia de rigidez, bradicinesia y temblor de reposo. La termoablación de la región motora del subtálamo mediante radiofrecuencia o ultrasonido focal guiado por resonancia magnética (MRgFUS) modula la actividad cortical patológica y disminuye las complicaciones motoras asociadas. No obstante, los mecanismos anatómicos y fisiológicos que soportan esta mejoría no han sido estudiados en detalle. Esta investigación utiliza avanzadas técnicas de adquisición, procesamiento y análisis de imágenes para caracterizar, por primera vez, los cambios en la arquitectura anatómica y funcional de los circuitos ganglios basales-tálamo corticales, inducidos por subtalamotomía. Nuestros resultados indican que la subtalamotomía es un método seguro, eficaz y mínimamente invasivo para el tratamiento de los síntomas motores de la EP. La topografía de la lesión ideal combina el impacto motor en el subtálamo con el efecto anti-discinético de la interrupción de las fibras pálido-fugales. Esta técnica desplaza el patrón metabólico relacionado con la EP hacia valores normales. La correlación de la mejoría en los signos motores con los cambios en distintos marcadores de neuroimágenes, indican que la subtalamotomía opera a través de un amplio efecto modulador sobre las redes anátomo-funcionales del cerebro., Parkinson's disease (PD) is a complex neurodegenerative process, characterized by the presence of rigidity, bradykinesia, and tremor. Thermoablation of the motor region of the subthalamic nucleus using radiofrequency or magnetic resonance-guided focal ultrasound (MRgFUS) modulates pathological cortical activity and reduces associated motor complications. However, the anatomical and physiological mechanisms that support this improvement have not been studied in detail. Using advanced image acquisition, processing and analysis techniques, this study aims to characterize, for the first time, the changes induced by subthalamotomy in the anatomical and functional architecture of the basal ganglia-thalamus-cortical circuits. Our results indicate that subthalamotomy is a safe, effective and minimally invasive method for treating the motor symptoms of PD. The ideal lesion topography combines the motor impact on the subthalamus with the anti-dyskinetic effect of the disruption of the pallidus-fugal fibers. This technique shifts the metabolic pattern related to PD towards normal values. The correlation of the improvement in motor signs with changes in different neuroimaging markers indicates that subthalamotomy operates through a broad modulating effect on the anatomical-functional networks of the brain.

Published
2021

25. Blood-brain barrier opening with focused ultrasound in Parkinson’s disease dementia

Author

Universidad San Pablo-CEU. Facultad de Medicina. Departamento de Ciencias Médicas Clínicas., Grupo: HM Centro Integral de Neurociencia (HM CINAC), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Gasca Salas, Carmen, Obeso Inchausti, José Ángel, Fernández-Rodríguez, Beatriz, Pineda-Pardo, José A., Rodríguez Rojas, Rafael, Hernández-Fernández, Frida, Álamo, Marta del, Mata-Marín, David, Guida, Pasqualina, Ordás Bandera, Carlos, Montero Roblas, Juan Ignacio, Martínez-Fernández, Raúl, Foffani, Guglielmo, Rachmilevitch, Itay, Obeso Martín, Ignacio, Universidad San Pablo-CEU. Facultad de Medicina. Departamento de Ciencias Médicas Clínicas., Grupo: HM Centro Integral de Neurociencia (HM CINAC), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Gasca Salas, Carmen, Obeso Inchausti, José Ángel, Fernández-Rodríguez, Beatriz, Pineda-Pardo, José A., Rodríguez Rojas, Rafael, Hernández-Fernández, Frida, Álamo, Marta del, Mata-Marín, David, Guida, Pasqualina, Ordás Bandera, Carlos, Montero Roblas, Juan Ignacio, Martínez-Fernández, Raúl, Foffani, Guglielmo, Rachmilevitch, Itay, and Obeso Martín, Ignacio

Published
2021

26. Bilateral staged magnetic resonance-guided focused ultrasound thalamotomy for the treatment of essential tremor: a case series study

Author

Fundación de Investigación HM Hospitales, Insightec, Martínez-Fernández, Raúl, Mahendran, Sujitha, Pineda-Pardo, José A., Imbach, Lukas L., Máñez-Miró, Jorge U., Büchele, Fabian, Álamo, Marta del, Rodríguez-Rojas, Rafael, Hernández-Fernández, Frida, Werner, Beat, Matarazzo, Michele, Obeso, Ignacio, Gonzalez-Quarante, Lain H., Deuschl, Günther, Stieglitz, Lennart, Baumann, Christian R., Obeso, José A., Fundación de Investigación HM Hospitales, Insightec, Martínez-Fernández, Raúl, Mahendran, Sujitha, Pineda-Pardo, José A., Imbach, Lukas L., Máñez-Miró, Jorge U., Büchele, Fabian, Álamo, Marta del, Rodríguez-Rojas, Rafael, Hernández-Fernández, Frida, Werner, Beat, Matarazzo, Michele, Obeso, Ignacio, Gonzalez-Quarante, Lain H., Deuschl, Günther, Stieglitz, Lennart, Baumann, Christian R., and Obeso, José A.

Abstract

Unilateral magnetic resonance-guided focused ultrasound (FUS) thalamotomy is efficacious for the treatment of medically refractory essential tremor (ET). Viability of bilateral FUS ablation is unexplored.

Published
2021

29. Randomized Trial of Focused Ultrasound Subthalamotomy for Parkinson’s Disease

Author

Martínez-Fernández, Raúl, primary, Máñez-Miró, Jorge U., additional, Rodríguez-Rojas, Rafael, additional, del Álamo, Marta, additional, Shah, Binit B., additional, Hernández-Fernández, Frida, additional, Pineda-Pardo, José A., additional, Monje, Mariana H.G., additional, Fernández-Rodríguez, Beatriz, additional, Sperling, Scott A., additional, Mata-Marín, David, additional, Guida, Pasqualina, additional, Alonso-Frech, Fernando, additional, Obeso, Ignacio, additional, Gasca-Salas, Carmen, additional, Vela-Desojo, Lydia, additional, Elias, W. Jeffrey, additional, and Obeso, José A., additional

Published
2020
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31. Letter

Author

Pineda-Pardo, José A, primary, Máñez-Miró, Jorge U, additional, López-Aguirre, Miguel, additional, Rodríguez-Rojas, Rafael, additional, Caballero-Insaurriaga, Jaime, additional, M, Del Álamo, additional, Martínez-Fernández, Raúl, additional, and Obeso, José A, additional

Published
2020
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32. Blood-Brain Barrier Opening with Focused Ultrasound in Parkinson’s Disease Dementia: A Safety and Feasibility Study (1131)

Author

Gasca-Salas, Carmen, primary, Fernández-Rodríguez, Beatriz, additional, Pineda-Pardo, José Ángel, additional, Rodríguez-Rojas, Rafael, additional, Hernández, Frida, additional, Obeso, Ignacio, additional, Marín, David Mata, additional, Guida, Pasqualina, additional, del Álamo, Marta, additional, Bandera, Carlos Ordás, additional, Rachmilevitch, Itay, additional, and Obeso, José A., additional

Published
2020
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33. Focused Ultrasound Subthalamotomy in Parkinson’s Disease: Lesion Topography and Motor Improvement. (1124)

Author

Máñez Miró, Jorge U., primary, Rodríguez-Rojas, Rafael, additional, Martínez-Fernández, Raúl, additional, Del Álamo, Marta, additional, Pineda-Pardo, José A., additional, Hernández-Fernández, Frida, additional, De Luis-Pastor, Esther, additional, Monje, MHG, additional, Fernández-Rodríguez, Beatriz, additional, Alonso-Frech, Fernando, additional, Vela, Lydia, additional, and Obeso, José A., additional

Published
2020
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35. Cambios estructurales y funcionales inducidos por subtalamotomía en el tratamiento de pacientes con enfermedad de Parkinson

Author

Rodríguez Rojas, Rafael., Obeso, José A., CEU Escuela Internacional de Doctorado (CEINDO). Universidad San Pablo-CEU., and Universidad San Pablo-CEU. Facultad de Medicina.

Subjects
Subtalamotomía, Positron emission tomography, Magnetic resonance imaging, Subthalamotomy, Ultrasonido focal guiado por resonancia magnética, Resonancia magnética, Parkinson’s disease, Tractografía, Tomografía por emisión de positrones, Magnetic resonance-guided focused ultrasound, Tractography
Abstract

Tesis-CEINDO, Universidad San Pablo CEU, Programa en Medicina Traslacional, leida el 12 de junio 2020 La enfermedad de Parkinson (EP) es un proceso neurodegenerativo complejo, caracterizado por la presencia de rigidez, bradicinesia y temblor de reposo. La termoablación de la región motora del subtálamo mediante radiofrecuencia o ultrasonido focal guiado por resonancia magnética (MRgFUS) modula la actividad cortical patológica y disminuye las complicaciones motoras asociadas. No obstante, los mecanismos anatómicos y fisiológicos que soportan esta mejoría no han sido estudiados en detalle. Esta investigación utiliza avanzadas técnicas de adquisición, procesamiento y análisis de imágenes para caracterizar, por primera vez, los cambios en la arquitectura anatómica y funcional de los circuitos ganglios basales-tálamo corticales, inducidos por subtalamotomía. Nuestros resultados indican que la subtalamotomía es un método seguro, eficaz y mínimamente invasivo para el tratamiento de los síntomas motores de la EP. La topografía de la lesión ideal combina el impacto motor en el subtálamo con el efecto anti-discinético de la interrupción de las fibras pálido-fugales. Esta técnica desplaza el patrón metabólico relacionado con la EP hacia valores normales. La correlación de la mejoría en los signos motores con los cambios en distintos marcadores de neuroimágenes, indican que la subtalamotomía opera a través de un amplio efecto modulador sobre las redes anátomo-funcionales del cerebro. Parkinson's disease (PD) is a complex neurodegenerative process, characterized by the presence of rigidity, bradykinesia, and tremor. Thermoablation of the motor region of the subthalamic nucleus using radiofrequency or magnetic resonance-guided focal ultrasound (MRgFUS) modulates pathological cortical activity and reduces associated motor complications. However, the anatomical and physiological mechanisms that support this improvement have not been studied in detail. Using advanced image acquisition, processing and analysis techniques, this study aims to characterize, for the first time, the changes induced by subthalamotomy in the anatomical and functional architecture of the basal ganglia-thalamus-cortical circuits. Our results indicate that subthalamotomy is a safe, effective and minimally invasive method for treating the motor symptoms of PD. The ideal lesion topography combines the motor impact on the subthalamus with the anti-dyskinetic effect of the disruption of the pallidus-fugal fibers. This technique shifts the metabolic pattern related to PD towards normal values. The correlation of the improvement in motor signs with changes in different neuroimaging markers indicates that subthalamotomy operates through a broad modulating effect on the anatomical-functional networks of the brain.

Published
2020

36. Randomized Trial of Focused Ultrasound Subthalamotomy for Parkinson’s Disease

Author

Universidad San Pablo-CEU. Facultad de Medicina. Departamento de Ciencias Médicas Clínicas., Grupo: HM Centro Integral de Neurociencia (HM CINAC), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Martínez-Fernández, Raúl, Obeso Inchausti, José Ángel, Máñez-Miró, Jorge, Rodríguez Rojas, Rafael, Álamo, Marta del, Shah, B. B., Hernández-Fernández, Frida, Pineda-Pardo, José A., Monje, Mariana H. G., Fernández-Rodríguez, Beatriz, Sperling, S. A., Mata-Marín, David, Guida, Pasqualina, Alonso-Frech, Fernando, Gasca Salas, Carmen, Vela Desojo, Lydia, Elias, W. J., Obeso Martín, Ignacio, Universidad San Pablo-CEU. Facultad de Medicina. Departamento de Ciencias Médicas Clínicas., Grupo: HM Centro Integral de Neurociencia (HM CINAC), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Martínez-Fernández, Raúl, Obeso Inchausti, José Ángel, Máñez-Miró, Jorge, Rodríguez Rojas, Rafael, Álamo, Marta del, Shah, B. B., Hernández-Fernández, Frida, Pineda-Pardo, José A., Monje, Mariana H. G., Fernández-Rodríguez, Beatriz, Sperling, S. A., Mata-Marín, David, Guida, Pasqualina, Alonso-Frech, Fernando, Gasca Salas, Carmen, Vela Desojo, Lydia, Elias, W. J., and Obeso Martín, Ignacio

Abstract

BACKGROUND The subthalamic nucleus is the preferred neurosurgical target for deep-brain stimulation to treat cardinal motor features of Parkinson’s disease. Focused ultrasound is an imaging-guided method for creating therapeutic lesions in deep-brain structures, including the subthalamic nucleus. METHODS We randomly assigned, in a 2:1 ratio, patients with markedly asymmetric Parkinson’s disease who had motor signs not fully controlled by medication or who were ineligible for deep-brain stimulation surgery to undergo focused ultrasound subthalamotomy on the side opposite their main motor signs or a sham procedure. The primary efficacy outcome was the between-group difference in the change from baseline to 4 months in the Movement Disorder Society–Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) motor score (i.e., part III) for the more affected body side (range, 0 to 44, with higher scores indicating worse parkinsonism) in the off-medication state. The primary safety outcome (procedure-related complications) was assessed at 4 months. RESULTS Among 40 enrolled patients, 27 were assigned to focused ultrasound subthalamotomy (active treatment) and 13 to the sham procedure (control). The mean MDS-UPDRS III score for the more affected side decreased from 19.9 at baseline to 9.9 at 4 months in the active-treatment group (least-squares mean difference, 9.8 points; 95% confidence interval [CI], 8.6 to 11.1) and from 18.7 to 17.1 in the control group (least-squares mean difference, 1.7 points; 95% CI, 0.0 to 3.5); the between-group difference was 8.1 points (95% CI, 6.0 to 10.3; P<0.001). Adverse events in the active-treatment group were dyskinesia in the off-medication state in 6 patients and in the on-medication state in 6, which persisted in 3 and 1, respectively, at 4 months; weakness on the treated side in 5 patients, which persisted in 2 at 4 months; speech disturbance in 15 patients, which persisted in 3 at 4 months; facial weakness in 3 patients, which persisted i

Published
2020

37. Randomized Trial of Focused Ultrasound Subthalamotomy for Parkinson's Disease

Author

Fundación HM Hospitales, Focused Ultrasound Foundation, Fundación Mapfre, Insightec, University of Virginia, Martínez-Fernández, Raúl, Máñez-Miró, Jorge U., Rodríguez-Rojas, Rafael, Álamo, Marta del, Shah, Binit B., Hernández-Fernández, Frida, Pineda-Pardo, José A., Monje, Mariana H. G., Fernández-Rodríguez, Beatriz, Sperling, Scott A., Mata-Marín, David, Guida, Pasqualina, Alonso-Frech, Fernando, Obeso, Ignacio, Gasca-Salas, Carmen, Vela-Desojo, Lydia, Elias, W Jeffrey, Obeso, José A., Fundación HM Hospitales, Focused Ultrasound Foundation, Fundación Mapfre, Insightec, University of Virginia, Martínez-Fernández, Raúl, Máñez-Miró, Jorge U., Rodríguez-Rojas, Rafael, Álamo, Marta del, Shah, Binit B., Hernández-Fernández, Frida, Pineda-Pardo, José A., Monje, Mariana H. G., Fernández-Rodríguez, Beatriz, Sperling, Scott A., Mata-Marín, David, Guida, Pasqualina, Alonso-Frech, Fernando, Obeso, Ignacio, Gasca-Salas, Carmen, Vela-Desojo, Lydia, Elias, W Jeffrey, and Obeso, José A.

Abstract

The subthalamic nucleus is the preferred neurosurgical target for deep-brain stimulation to treat cardinal motor features of Parkinson's disease. Focused ultrasound is an imaging-guided method for creating therapeutic lesions in deep-brain structures, including the subthalamic nucleus.

Published
2020

38. Transcranial Magnetic Resonance-Guided Focused Ultrasound Thalamotomy in Essential Tremor: A Comprehensive Lesion Characterization

Author

Pineda-Pardo, José Angel, primary, Urso, Daniele, additional, Martínez-Fernández, Raul, additional, Rodríguez-Rojas, Rafael, additional, del-Alamo, Marta, additional, Millar Vernetti, Patricio, additional, Máñez-Miró, Jorge U, additional, Hernández-Fernández, Frida, additional, de Luis-Pastor, Esther, additional, Vela-Desojo, Lydia, additional, and Obeso, José A, additional

Published
2019
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40. Zero TE MRI applications to transcranial MR‐guided focused ultrasound: Patient screening and treatment efficiency estimation

Author

Caballero‐Insaurriaga, Jaime, primary, Rodríguez‐Rojas, Rafael, additional, Martínez‐Fernández, Raúl, additional, Del‐Alamo, Marta, additional, Díaz‐Jiménez, Laura, additional, Ávila, María, additional, Martínez‐Rodrigo, María, additional, García‐Polo, Pablo, additional, and Pineda‐Pardo, José A., additional

Published
2019
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41. Cognitive safety after unilateral magnetic resonance-guided focused ultrasound thalamotomy for essential tremor

Author

Universidad San Pablo-CEU. Facultad de Medicina. Departamento de Ciencias Médicas Clínicas., Grupo: HM Centro Integral de Neurociencia (HM CINAC), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Gasca Salas, Carmen, Obeso Inchausti, José Ángel, Guida, Pasqualina, Piredda, Rosanna, Vela Desojo, Lydia, Martínez-Fernández, Raúl, Hernández-Fernández, Frida, Máñez-Miró, Jorge, Pineda-Pardo, José A., Álamo, Marta del, Rodríguez Rojas, Rafael, Mata-Marín, David, Alonso-Frech, Fernando, Luis, Esther de, Obeso Martín, Ignacio, Universidad San Pablo-CEU. Facultad de Medicina. Departamento de Ciencias Médicas Clínicas., Grupo: HM Centro Integral de Neurociencia (HM CINAC), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Gasca Salas, Carmen, Obeso Inchausti, José Ángel, Guida, Pasqualina, Piredda, Rosanna, Vela Desojo, Lydia, Martínez-Fernández, Raúl, Hernández-Fernández, Frida, Máñez-Miró, Jorge, Pineda-Pardo, José A., Álamo, Marta del, Rodríguez Rojas, Rafael, Mata-Marín, David, Alonso-Frech, Fernando, Luis, Esther de, and Obeso Martín, Ignacio

Published
2019

42. Microstructural changes of the dentato‐rubro‐thalamic tract after transcranial MR guided focused ultrasound ablation of the posteroventral VIM in essential tremor

Author

Pineda‐Pardo, Jose A., primary, Martínez‐Fernández, Raul, additional, Rodríguez‐Rojas, Rafael, additional, Del‐Alamo, Marta, additional, Hernández, Frida, additional, Foffani, Guglielmo, additional, Dileone, Michele, additional, Máñez‐Miró, Jorge U., additional, De Luis‐Pastor, Esther, additional, Vela, Lydia, additional, and Obeso, José A., additional

Published
2019
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44. Relation of Structural and Functional Changes in Auditory and Visual Pathways after Temporal Lobe Epilepsy Surgery

Author

Báez-Martín, Margarita, primary, Morales-Chacón, Lilia, additional, García-Maeso, Iván, additional, Estupiñán-Díaz, Bárbara, additional, García-Navarro, María, additional, Pérez Téllez, Yamila, additional, Lorigados-Pedre, Lourdes, additional, Quintanal-Cordero, Nelson, additional, Valdés-Llerena, Ricardo, additional, González González, Judith, additional, Garbey-Fernández, Randis, additional, Cabrera-Abreu, Ivette, additional, Alarcón-Calaña, Celia, additional, Bender del Busto, Juan, additional, Rodríguez Rojas, Rafael, additional, Batista García-Ramó, Karla, additional, and Galvizu Sánchez, Reinaldo, additional

Published
2018
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45. Focused ultrasound subthalamotomy in patients with asymmetric Parkinson's disease: a pilot study

Author

Fundación de Investigación HM Hospitales, Insightec, Martínez-Fernández, Raúl, Rodríguez-Rojas, Rafael, Álamo, Marta del, Hernández-Fernández, Frida, Pineda-Pardo, José A., Dileone, Michele, Alonso-Frech, Fernando, Foffani, Guglielmo, Obeso, Ignacio, Gasca-Salas, Carmen, Luis-Pastor, Esther de, Vela, Lydia, Obeso, José A., Fundación de Investigación HM Hospitales, Insightec, Martínez-Fernández, Raúl, Rodríguez-Rojas, Rafael, Álamo, Marta del, Hernández-Fernández, Frida, Pineda-Pardo, José A., Dileone, Michele, Alonso-Frech, Fernando, Foffani, Guglielmo, Obeso, Ignacio, Gasca-Salas, Carmen, Luis-Pastor, Esther de, Vela, Lydia, and Obeso, José A.

Abstract

Ablative neurosurgery has been used to treat Parkinson's disease for many decades. MRI-guided focused ultrasound allows focal lesions to be made in deep brain structures without skull incision. We investigated the safety and preliminary efficacy of unilateral subthalamotomy by focused ultrasound in Parkinson's disease.

Published
2018

46. Focused ultrasound subthalamotomy in patients with asymmetric Parkinson’s disease: a pilot study

Author

Universidad San Pablo-CEU. Facultad de Medicina. Departamento de Ciencias Médicas Clínicas., Grupo: HM Centro Integral de Neurociencia (HM CINAC), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Martínez-Fernández, Raúl, Obeso Inchausti, José Ángel, Rodríguez Rojas, Rafael, Álamo, Marta del, Hernández-Fernández, Frida, Pineda-Pardo, José A., Dileone, Michele, Alonso-Frech, Fernando, Foffani, Guglielmo, Gasca Salas, Carmen, Luis, Esther de, Vela Desojo, Lydia, Obeso Martín, Ignacio, Universidad San Pablo-CEU. Facultad de Medicina. Departamento de Ciencias Médicas Clínicas., Grupo: HM Centro Integral de Neurociencia (HM CINAC), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Martínez-Fernández, Raúl, Obeso Inchausti, José Ángel, Rodríguez Rojas, Rafael, Álamo, Marta del, Hernández-Fernández, Frida, Pineda-Pardo, José A., Dileone, Michele, Alonso-Frech, Fernando, Foffani, Guglielmo, Gasca Salas, Carmen, Luis, Esther de, Vela Desojo, Lydia, and Obeso Martín, Ignacio

Abstract

Background Ablative neurosurgery has been used to treat Parkinson's disease for many decades. MRI-guided focused ultrasound allows focal lesions to be made in deep brain structures without skull incision. We investigated the safety and preliminary efficacy of unilateral subthalamotomy by focused ultrasound in Parkinson’s disease. Methods This prospective, open-label pilot study was done at CINAC (Centro Integral de Neurociencias), University Hospital HM Puerta del Sur in Madrid, Spain. Eligible participants had Parkinson’s disease with markedly asymmetric parkinsonism. Patients with severe dyskinesia, history of stereotactic surgery or brain haemorrhage, a diagnosis of an unstable cardiac or psychiatric disease, or a skull density ratio of 0·3 or less were excluded. Enrolled patients underwent focused ultrasound unilateral subthalamotomy. The subthalamic nucleus was targeted by means of brain images acquired with a 3-Tesla MRI apparatus. Several sonications above the definitive ablation temperature of 55°C were delivered and adjusted according to clinical response. The primary outcomes were safety and a change in the motor status of the treated hemibody as assessed with part III of the Movement Disorders Society–Unified Parkinson’s Disease Rating Scale (MDS–UPDRS III) in both off-medication and on-medication states at 6 months. Adverse events were monitored up to 48 h after treatment and at scheduled clinic visits at 1, 3, and 6 months after treatment. The study is registered with ClinicalTrials.gov, number NCT02912871. Findings Between April 26 and June 14, 2016, ten patients with markedly asymmetric parkinsonism that was poorly controlled pharmacologically were enrolled for focused ultrasound unilateral subthalamotomy. By 6 months follow-up, 38 incidents of adverse events had been recorded, none of which were serious or severe. Seven adverse events were present at 6 months. Three of these adverse events were directly related to subthalamotomy: off-medication dyski

Published
2017

47. Unilateral subthalamotomy in Parkinson's disease: Cognitive, psychiatric and neuroimaging changes

Author

Fundación Caja Madrid, Obeso, Ignacio, Casabona, Enrique, Rodríguez-Rojas, Rafael, Bringas, María Luisa, Macías, Raúl, Pavón, Nancy, Obeso, José A., Jahanshahi, Marjan, Fundación Caja Madrid, Obeso, Ignacio, Casabona, Enrique, Rodríguez-Rojas, Rafael, Bringas, María Luisa, Macías, Raúl, Pavón, Nancy, Obeso, José A., and Jahanshahi, Marjan

Abstract

Unilateral subthalamotomy is an effective treatment for the cardinal motor features of Parkinson's disease (PD). However, non-motor changes possibly associated with right or left subthalamotomy remain unknown. Our aim was to assess cognitive, psychiatric and neuroimaging changes after treatment with unilateral subthalamotomy. Fourteen medicated patients with PD were evaluated before and after (mean 6 months after operation) unilateral subthalamotomy (5 right, 9 left). In addition to motor assessments, cognitive (global cognition and executive functions), psychiatric (apathy, depression, anxiety, mania, hypo- and hyperdopaminergic behaviours, impulsivity), quality of life evaluations and volume of lesions were obtained. After surgery, significant improvement of motor signs was observed. Unilateral subthalamotomy improved general cognitive status, but left subthalamotomy reduced semantic verbal fluency compared to the pre-operative state. Depression and quality of life were improved with both right and left subthalamotomy. However, hyper-emotionality was present after surgery and right subthalamotomy increased impulsivity and disinhibition (on NeuroPsychiatric Inventory and Ardouin Scale for Behaviour in PD), a result linked to larger lesion volumes. We conclude that unilateral subthalamotomy is effective for treating the cardinal motor features of PD and improves mood. Right subthalamotomy is associated with greater risk of impulsivity and disinhibition, while left subthalamotomy induces further impairment of semantic verbal fluency.

Published
2017

50. Brain Tissue Volumes and Perfusion Change with the Number of Optic Neuritis Attacks in Relapsing Neuromyelitis Optica: A Voxel-Based Correlation Study

Author

Sánchez-Catasús, Carlos A., primary, Cabrera-Gomez, José, additional, Almaguer Melián, William, additional, Giroud Benítez, José Luis, additional, Rodríguez Rojas, Rafael, additional, Bayard, Jorge Bosch, additional, Galán, Lídice, additional, Sánchez, Reinaldo Galvizu, additional, Fuentes, Nancy Pavón, additional, and Valdes-Sosa, Pedro, additional

Published
2013
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