Antonio Martínez-Simón

Navarre Institute of Health Research

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Elena Cacho‐Asenjo

Clinica Universidad de Navarra

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

Marta Vidorreta

Siemens (Spain)

Cooperative Institutions

Clinica Universidad de Navarra

Universidad de Navarra

Navarre Institute of Health Research

Centre National de la Recherche Scientifique

Neurological Surgery

Université Paris Cité

Inserm

The University of Texas MD Anderson Cancer Center

Sorbonne Université

Foundation for Medical Research

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Clinical utility of intraoperative arterial spin labeling for resection control in brain tumor surgery at 3 T

NMR in Biomedicine (2023)

Marta Calvo‐Imirizaldu Verónica Aramendía‐Vidaurreta Carmen Sánchez‐Albardíaz Marta Vidorreta M. R. Garcia de Eulate

Resection control in brain tumor surgery can be achieved in real time with intraoperative MRI (iMRI). Arterial spin labeling (ASL), a technique that measures cerebral blood flow (CBF) non-invasively without the use of intravenous contrast agents, can be performed intraoperatively, providing morpho-physiological information. This study aimed to evaluate the feasibility, image quality and potential to depict residual tumor of a pseudo-continuous ASL (PCASL) sequence at 3 T. Seventeen patients with brain tumors, primary (16) or metastatic (1), undergoing resection surgery with iMRI monitoring, were prospectively recruited (nine men, age 56 ± 16.6 years). A PCASL sequence with long labeling duration (3000 ms) and postlabeling delay (2000 ms) was added to the conventional protocol, which consisted of pre- and postcontrast 3D T1 -weighted (T1w) images, optional 3D-FLAIR, and diffusion. Three observers independently assessed the image quality (four-point scale) of PCASL-derived CBF maps. In those with diagnostic quality (Scores 2-4) they evaluated the presence of residual tumor using the conventional sequences first, and the CBF maps afterwards (three-point scale). Inter-observer agreement for image quality and the presence of residual tumor was assessed using Fleiss kappa statistics. The intraoperative CBF ratio of the surgical margins (i.e., perilesional CBF values normalized to contralateral gray matter CBF) was compared with preoperative CBF ratio within the tumor (Wilcoxon's test). Diagnostic ASL image quality was observed in 94.1% of patients (interobserver Fleiss κ = 0.76). PCASL showed additional foci suggestive of high-grade residual component in three patients, and a hyperperfused area extending outside the enhancing component in one patient. Interobserver agreement was almost perfect in the evaluation of residual tumor with the conventional sequences (Fleiss κ = 0.92) and substantial for PCASL (Fleiss κ = 0.80). No significant differences were found between pre and intraoperative CBF ratios (p = 0.578) in patients with residual tumor (n = 7). iMRI-PCASL perfusion is feasible at 3 T and is useful for the intraoperative assessment of residual tumor, providing in some cases additional information to the conventional sequences.

Intraoperative MRI

Arterial spin labeling

Fluid-attenuated inversion recovery

Brain tumor

10.1002/nbm.4938

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Citations (1)

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)

Hindered submicron mobility and long‐term storage of presynaptic dense‐core granules revealed by single‐particle tracking

Developmental Neurobiology (2011)

Bethe A. Scalettar C. Jacobs Audrey L. Fulwiler L. Prahl Antonio Martínez-Simón

Dense-core granules (DCGs) are organelles found in neuroendocrine cells and neurons that house, transport, and release a number of important peptides and proteins. In neurons, DCG cargo can include the secreted neuromodulatory proteins tissue plasminogen activator (tPA) and/or brain-derived neurotrophic factor (BDNF), which play a key role in modulating synaptic efficacy in the hippocampus. This function has spurred interest in DCGs that localize to synaptic contacts between hippocampal neurons, and several studies recently have established that DCGs localize to, and undergo regulated exocytosis from, postsynaptic sites. To complement this work, we have studied presynaptically localized DCGs in hippocampal neurons, which are much more poorly understood than their postsynaptic analogs. Moreover, to enhance relevance, we visualized DCGs via fluorescence labeling of exogenous and endogenous tPA and BDNF. Using single-particle tracking, we determined trajectories of more than 150 presynaptically localized DCGs. These trajectories reveal that mobility of DCGs in presynaptic boutons is highly hindered and that storage is long-lived. We also computed mean-squared displacement curves, which can be used to elucidate mechanisms of transport. Over shorter time windows, most curves are linear, demonstrating that DCG transport in boutons is driven predominantly by diffusion. The remaining curves plateau with time, consistent with motion constrained by a submicron-sized corral. These results have relevance to recent models of presynaptic organization and to recent hypotheses about DCG cargo function. The results also provide estimates for transit times to the presynaptic plasma membrane that are consistent with measured times for onset of neurotrophin release from synaptically localized DCGs.

Neurotrophin-3

Organelle

10.1002/dneu.20984

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Citations (20)

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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Bilateral subgaleal hematoma after a robot-assisted radical prostatectomy: an uncommon complication

Anales del Sistema Sanitario de Navarra (2023)

Íñigo Rubio Baines Antonio Martínez-Simón F.J. Ancizu Isidro Olavide Cristina Honorato‐Cia

Robot-assisted radical prostatectomy is a relatively recent technique. Its advantages include less invasiveness and better pain management, but has specific anesthesia requirements, such as steep Trendelenburg position and pneumoperitoneum. Mild complications are common, e.g., transient hypotension or soft tissue edema. We present a case of a 62-year old male who developed subgaleal hematoma associated with transient neurologic impairment after surgery. Jugular vein insufficiency was suspected as the most likely cause. The patient recovered fully. Robot-assisted radical prostatectomy can be a challenging procedure due to the anesthesia requirements, but most complications are mild and transient. However, patients should be carefully assessed before surgery. We identified potential factors that may have led to this complication: the abnormal prolonged surgical time, the steep Trendelenburg, a non-assessed jugular vein insufficiency, and/or patient`s obesity.

Trendelenburg position

10.23938/assn.1047

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Opposing effects of AMPA and 5-HT1A receptor blockade on passive avoidance and object recognition performance: Correlation with AMPA receptor subunit expression in rat hippocampus

Neuropharmacology (2006)

Lucio Schiapparelli Antonio Martínez-Simón José Antonio del Rı́o Diana Frechilla

10.1016/j.neuropharm.2006.02.005

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Citations (46)

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)