Elena Cacho‐Asenjo

Clinica Universidad de Navarra

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i-10 index

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Antonio Martínez-Simón

Navarre Institute of Health Research

Cristina Honorato‐Cia

Clinica Universidad de Navarra

Jorge M. Núñez‐Córdoba

Clinica Universidad de Navarra

Alfredo Panadero

Clinica Universidad de Navarra

Jorge Guridi

Clinica Universidad de Navarra

Manuel Alegre

Clinica Universidad de Navarra

Bartolomé Bejarano

Clinica Universidad de Navarra

María A. Fernández‐Seara

Clinica Universidad de Navarra

Marta Calvo‐Imirizaldu

Clinica Universidad de Navarra

Irene Aquerreta

Clinica Universidad de Navarra

Cooperative Institutions

Clinica Universidad de Navarra

Universidad de Navarra

Navarre Institute of Health Research

Neurological Surgery

Washington University in St. Louis

Universidad Publica de Navarra

Mallinckrodt (United States)

Instituto de Salud Carlos III

University College London

Chinese Academy of Medical Sciences & Peking Union Medical College

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Effects of dexmedetomidine on subthalamic local field potentials in Parkinson's disease

British Journal of Anaesthesia (2021)

Antonio Martínez-Simón Miguel Valencia Elena Cacho‐Asenjo Cristina Honorato‐Cia Jorge M. Núñez‐Córdoba

BackgroundDexmedetomidine is frequently used for sedation during deep brain stimulator implantation in patients with Parkinson's disease, but its effect on subthalamic nucleus activity is not well known. The aim of this study was to quantify the effect of increasing doses of dexmedetomidine in this population.MethodsControlled clinical trial assessing changes in subthalamic activity with increasing doses of dexmedetomidine (from 0.2 to 0.6 μg kg−1 h−1) in a non-operating theatre setting. We recorded local field potentials in 12 patients with Parkinson's disease with bilateral deep brain stimulators (24 nuclei) and compared basal activity in the nuclei of each patient and activity recorded with different doses. Plasma levels of dexmedetomidine were obtained and correlated with the dose administered.ResultsWith dexmedetomidine infusion, patients became clinically sedated, and at higher doses (0.5–0.6 μg kg−1 h−1) a significant decrease in the characteristic Parkinsonian subthalamic activity was observed (P<0.05 in beta activity). All subjects awoke to external stimulus over a median of 1 (range: 0–9) min, showing full restoration of subthalamic activity. Dexmedetomidine dose administered and plasma levels showed a positive correlation (repeated measures correlation coefficient=0.504; P<0.001).ConclusionsPatients needing some degree of sedation throughout subthalamic deep brain stimulator implantation for Parkinson's disease can probably receive dexmedetomidine up to 0.6 μg kg−1 h−1 without significant alteration of their characteristic subthalamic activity. If patients achieve a 'sedated' state, subthalamic activity decreases, but they can be easily awakened with a non-pharmacological external stimulus and recover baseline subthalamic activity patterns in less than 10 min.Clinical trial registrationEudraCT 2016-002680-34; NCT-02982512.

Dexmedetomidine

Subthalamic Nucleus

10.1016/j.bja.2021.01.036

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Citations (10)

Preoperative Hemoglobin and Actual Need for Blood Transfusion in Brain Tumor Resection Procedures: A Retrospective Cohort Study

Journal of Neurosurgical Anesthesiology (2021)

Ana Tomás-Biosca Antonio Martínez-Simón Jorge Guridi Sonia Tejada Solís Bartolomé Bejarano

Tomás-Biosca, Ana MD; Martinez-Simon, Antonio MD, PhD; Guridi, Jorge MD, PhD; Tejada Solís, Sonia MD, PhD; Bejarano, Bartolomé MD, PhD; Honorato-Cia, Cristina MD, PhD; Cacho-Asenjo, Elena MD, PhD; Nuñez-Cordoba, Jorge M. MD, PhD Author Information

10.1097/ana.0000000000000753

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Citations (2)

Safety Profile of 5-Aminolevulinic Acid as a Surgical Adjunct in Clinical Practice

Journal of Neurosurgical Anesthesiology (2015)

Cristina Honorato‐Cia Antonio Martínez-Simón Elena Cacho‐Asenjo Francisco Guillén‐Grima Sonia Tejada-Solís

5-Aminolevulinic acid (5-ALA) is used for brain tumor identification during surgery through fluorescence. Its use is linked to side effects such as photodermatosis, anemia, or plaquetopenia. Many institutions take very strict precautions to prevent them. Our hospital's protocol mandates avoidance of direct sunlight during the first 24 hours only.Retrospective cohort observational study of 207 consecutive patients who underwent 5-ALA-guided brain tumor resection between 2008 and 2013, and compared with a control group of 53 patients without 5-ALA.No skin reaction was reported. No difference was found in hemoglobin or platelet level comparisons at different points in time. There was no difference in trends within groups. Mean duration of surgery was longer in the 5-ALA group; the subgroup of patients undergoing their first surgery had a positive correlation with lower hemoglobin levels. In postoperative magnetic resonance imaging, patients in the 5-ALA group had a lower percentage of residual bleeding (19% of all patients; 17.9% in 5-ALA group and 22.7% in non-ALA [P=0.04]). Eight patients in the 5-ALA group required blood transfusion (3.9%), compared with 2 in the control group (3.8%). Four patients in the 5-ALA group required reintervention in the first 48 hours due to bleeding, although none had platelets <150,000/mL.Significant side effects appear to be uncommon. Blood count changes are likely multifactorial; surgical time may account for it partially, whereas 5-ALA role is not clear and may not be significant.

10.1097/ana.0000000000000172

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Citations (17)

Long COVID Research, 2020–2024: A PubMed-Based Bibliometric Analysis

Healthcare (2025)

Cristina Honorato‐Cia Elena Cacho‐Asenjo Antonio Martínez-Simón Irene Aquerreta Jorge M. Núñez‐Córdoba

Long COVID is a SARS-CoV-2 infection-associated chronic condition with great potential to impact health and socioeconomic outcomes. The research efforts to face the challenges related to long COVID have resulted in a substantial amount of publications, which warrants the need for bibliometric profiling. This is a large-scale PubMed-based bibliometric analysis of more than 390,000 COVID-19 publications. The overall aim was to update the profile of long COVID publications in comparison with the rest of the COVID-19 scientific literature through December 2024. The estimated proportion of long COVID publications was relatively low (2.3% of all COVID-19 publications), although the cumulative frequency (n = 8928) continues to pose a challenge for proper information management. Currently, “treatment” and “mechanism” appear to be the most predominant research topics in the long COVID literature. Interestingly, this evaluation revealed a distinctive profile of the long COVID literature, with a clear preponderance of “case report” and “mechanism” research topics when compared with other COVID-19 publications. This evaluation also identified and ranked the most prolific scientific journals in the production of long COVID-related publications. This study may improve the visibility of long COVID research and contribute to the management of the growing scientific knowledge on long COVID.

Pandemic

2019-20 coronavirus outbreak

Profiling (computer programming)

Scientific literature

10.3390/healthcare13030298

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Loading dose of Dexdor ® and optimal sedation during oral and maxillofacial ambulatory surgery procedures: An observational study

Revista Española de Anestesiología y Reanimación (English Edition) (2017)

Antonio Martínez-Simón Elena Cacho‐Asenjo B. Hernando Cristina Honorato‐Cia Luís Naval

Dexmedetomidine

Loading dose

10.1016/j.redare.2017.02.003

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Supplementary Material for: Factors Associated with Tremor Changes during Sedation with Dexmedetomidine in Parkinson's Disease Surgery

Figshare (2015)

Cristina Honorato‐Cia Antonio Martínez-Simón Manuel Alegre Jorge Guridi Elena Cacho‐Asenjo

Introduction: Dexmedetomidine is an α₂-agonist recently proposed as a potentially ideal drug for sedation during the surgical treatment of Parkinsonʼs disease (PD). This report documents the incidence of changes in motor symptoms (especially tremor) in PD patients sedated with dexmedetomidine for deep brain stimulation or ablation procedures. Methods: We reviewed a retrospective cohort of 22 patients who underwent surgery for PD with dexmedetomidine sedation at a single institution from 2010 to 2014. A logistic regression analysis was performed to analyze possible confounding factors. Results: 14 cases of tremor reduction or suppression were recorded (cumulative incidence: 63.6%; 95% CI: 40.7-82.8). No association could be identified between loading dose, β-blocker use and preoperative total Unified Parkinson's Disease Rating Scale III, with tremor changes. The maintenance dose of dexmedetomidine was higher in patients who did not experience changes [median and range for patients with and without tremor alteration 0.75 (0.2-1.0) and 1.0 µg × kg^-1 × h^-1 (0.7-1.4), respectively; p = 0.021]. Conclusion: Dexmedetomidine provides adequate sedation during surgery for PD, but it might affect motor signs making intraoperative testing difficult or even impossible. Dosage appears not to be the determining factor in motor changes, whose cause remains unclear.

Dexmedetomidine

10.6084/m9.figshare.5128996

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Recovery time after oral and maxillofacial ambulatory surgery with dexmedetomidine: an observational study

Clinical Oral Investigations (2018)

B. Hernando Antonio Martínez-Simón Elena Cacho‐Asenjo Iñaki F. Trocóniz Cristina Honorato‐Cia

Dexmedetomidine

Bispectral index

10.1007/s00784-018-2447-5

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Citations (4)

3-T MR-guided focused ultrasound thalamotomy for tremor in patients with a cardiac pacemaker: case series and review of the literature

Neurosurgical FOCUS (2024)

Lain Hermes González-Quarante Antonio González-Crespo Alana Arcadi Marta Macias-de-la-Corte Icíar Avilés-Olmos

MR-guided focused ultrasound (MRgFUS) has proven its efficacy and safety for the treatment of essential tremor (ET) and/or Parkinson’s disease (PD). However, having a cardiac pacemaker has been considered an exclusion criterion for the use of MRgFUS. Only 2 patients with a cardiac pacemaker treated with MRgFUS have been previously reported, both treated using 1.5-T MRI. In this paper, the authors present their experience performing 3-T MRgFUS thalamotomy in 4 patients with an implanted cardiac pacemaker. Treatments were uneventful regarding complications or severe side effects. MRgFUS using 3-T MRI was found to be an efficient and safe treatment for ET and/or PD in patients with an MRI-compatible pacemaker.

Thalamotomy

Cardiac pacemaker

Focused Ultrasound

10.3171/2024.6.focus24171

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Factors Associated with Headache and Nausea During Magnetic Resonance–Guided Focused Ultrasound for Tremor

Movement Disorders Clinical Practice (2021)

Elena Cacho‐Asenjo Cristina Honorato‐Cia Jorge M. Núñez‐Córdoba Miguel Fernández-Martínez Lain Hermes González-Quarante

During magnetic resonance-guided focused ultrasound for essential or parkinsonian tremor, adverse events (headache, nausea/vomiting, or anxiety) may alter the outcome of the procedure despite being mostly transient and mild.Our aim was to analyze the relationship between demographic, procedural, and anesthetic characteristics with magnetic resonance/ultrasound-related events.This was a retrospective study at the Clinica Universidad de Navarra of patients undergoing thalamotomy with magnetic resonance-guided focused ultrasound between September 2018 and October 2019. The anesthesia protocol included headache and nausea/vomiting prophylaxis and rescue therapy. Dexmedetomidine was used for anxiolysis in some patients after thorough multidisciplinary assessment.A total of 123 patients were included. Headache was directly related to skull density ratio (P < 0.001) and skull thickness (P = 0.02). Patients with a skull density ratio less than 0.48 had 3 times the odds of experiencing moderate or severe headache (odds ratio [OR], 3.08; 95% confidence interval [CI], 1.21-7.82) and had a higher odds of aborting sonication due to pain. Sex was associated with increased nausea (P = 0.007). Women had 4 times the odds of nausea than men (OR, 4.4; 95% CI, 1.61-12.11). Dexmedetomidine did not reduce headache or nausea incidence. Patients who received dexmedetomidine had a higher number (P = 0.01) and total minutes of sonication (P = 0.01).Patients with lower skull density ratios and higher skull thicknesses could benefit from an aggressive analgesic prophylaxis. Women are more likely to experience nausea. Dexmedetomidine did not reduce headache and nausea, but increased the number and duration of sonications. Its exact effect on tremor is still unclear.

Dexmedetomidine

10.1002/mdc3.13210

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Citations (10)

Improving the Robustness of Pseudo-Continuous Arterial Spin Labeling in the Intraoperative MRI Setting.

Proceedings on CD-ROM - International Society for Magnetic Resonance in Medicine. Scientific Meeting and Exhibition/Proceedings of the International Society for Magnetic Resonance in Medicine, Scientific Meeting and Exhibition (2024)

Carmen Sánchez‐Albardíaz Marta Calvo‐Imirizaldu Verónica Aramendía‐Vidaurreta Marta Vidorreta Bartolomé Bejarano

Motivation: Improvement of the intraoperative pseudo-continuous arterial spin labeling images for resection control in brain tumor surgery at 3T. Goal(s): Evaluate the effect of shortening RF pulse duration and gap on the labeling efficiency of PCASL and to test it in the intraoperative setting. Approach: A study in 10 healthy volunteers was done approximating the off-resonance effects at the labeling plane. 2 PCASL sequences were tested in 2 patients. Results: A PCASL sequence robust to off-resonance effects is obtained by shortening RF duration and gap. Impact: Shortening the RF duration and gap improves the PCASL labeling efficiency at high B0 off-resonance values at the labeling plane.

Robustness

Arterial spin labeling

10.58530/2024/2020

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