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http://hdl.handle.net/20.500.14454/10

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Examinando Investigación por Autor "Acera Gil, María Ángeles"

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    Effect of sex on the progression of non-motor symptoms in Parkinson's disease: a registry-based cohort study
    (Spanish Society of Neurology, 2025) Murueta-Goyena Larrañaga, Ane; Pino, Rocío del; Carmona Abellán, Mar; Tijero Merino, Beatriz; Ruiz López, Marta; Acera Gil, María Ángeles; Morera Herreras, Teresa; Miguélez Palomo, Cristina; Sáez Atxukarro, Oihane; Fernández Valle, Tamara; Gabilondo Cuellar, Iñigo; Gómez Esteban, Juan Carlos
    Introduction: Differences in the trajectory of non-motor symptoms (NMS) between male and female Parkinson's disease (PD) patients over the course of the disease are not well-understood. Methods: PD patients were rated with Non-Motor Symptom Scale (NMSS) at two time points with a median follow-up of 3.8 years (IQR 2.1–5.6 years). Sex, age, disease duration, Unified Parkinson's Disease Rating Scale and doses of PD-related medication were registered. Linear mixed models (LMMs) and multinomial logistic regression (MLR) models were fitted to explore the association of sex with changes in NMSS domains over time. Results: Eighty-seven PD patients (30 females and 57 males) were enrolled. Baseline demographic and clinical characteristics were similar between female and male PD patients. The mean increase in NMS frequency and severity over time was non-significant, as well as the interaction term for disease duration × sex. However, gastrointestinal symptoms worsened in both males and females. According to the minimal detectable change of NMSS, <50% of PD patients experienced changes at follow-up beyond measurement error of the scale. Male sex predicted sexual function worsening (adjusted OR = 10.1, p = 0.038). Also, PD patients with more severe symptoms at baseline had increased odds of improving over time. However, high initial scores in attention/memory and cardiovascular domains also posed individuals at a higher risk of symptom worsening (OR [95% CI] = 1.4 [1.0-1.8], p = 0.034 and OR [95% CI] = 2.1 [1.2-3.7], p = 0.01, respectively). Conclusion: NMS progression over the disease course in PD shows large inter-individual variability without observable effect of sex.
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    Retinal thickness predicts the risk of cognitive decline in Parkinson disease
    (John Wiley and Sons Inc, 2021-01) Murueta-Goyena Larrañaga, Ane ; Pino, Rocío del; Galdos Iztueta, Marta; Arana Larrea, Begoña; Acera Gil, María Ángeles ; Carmona Abellán, Mar; Fernández Valle, Tamara ; Tijero Merino, Beatriz ; Lucas Jiménez, Olaia; Ojeda del Pozo, Natalia ; Ibarretxe Bilbao, Naroa ; Peña Lasa, Javier; Cortés, Jesús; Ayala Fernández, Unai; Barrenechea Carrasco, Maitane; Gómez Esteban, Juan Carlos ; Gabilondo Cuellar, Iñigo
    Objective: This study was undertaken to analyze longitudinal changes of retinal thickness and their predictive value as biomarkers of disease progression in idiopathic Parkinson's disease (iPD). Methods: Patients with Lewy body diseases were enrolled and prospectively evaluated at 3 years, including patients with iPD (n = 42), dementia with Lewy bodies (n = 4), E46K-SNCA mutation carriers (n = 4), and controls (n = 17). All participants underwent Spectralis retinal optical coherence tomography and Montreal Cognitive Assessment, and Unified Parkinson's Disease Rating Scale score was obtained in patients. Macular ganglion cell–inner plexiform layer complex (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) thickness reduction rates were estimated with linear mixed models. Risk ratios were calculated to evaluate the association between baseline GCIPL and pRNFL thicknesses and the risk of subsequent cognitive and motor worsening, using clinically meaningful cutoffs. Results: GCIPL thickness in the parafoveal region (1- to 3-mm ring) presented the largest reduction rate. The annualized atrophy rate was 0.63μm in iPD patients and 0.23μm in controls (p < 0.0001). iPD patients with lower parafoveal GCIPL and pRNFL thickness at baseline presented an increased risk of cognitive decline at 3 years (relative risk [RR] = 3.49, 95% confidence interval [CI] = 1.10–11.1, p = 0.03 and RR = 3.28, 95% CI = 1.03–10.45, p = 0.045, respectively). We did not identify significant associations between retinal thickness and motor deterioration. Interpretation: Our results provide evidence of the potential use of optical coherence tomography–measured parafoveal GCIPL thickness to monitor neurodegeneration and to predict the risk of cognitive worsening over time in iPD