Open Access
Asymmetric white matter degeneration in amyotrophic lateral sclerosis: a diffusion kurtosis imaging study of motor and extra-motor pathways
(Frontiers Media, 2025-04-25) Quizhpilema Cedeño, Juan Carlos; Legarda, Ane; Hidalgo, José Manuel ; Lecumberri Villamediana, Pablo; Jericó Pascual, Ivonne; Cabada Giadás, María Teresa; Ciencias de la Salud; Osasun Zientziak; Ingeniería Eléctrica, Electrónica y de Comunicación; Ingeniaritza Elektrikoa, Elektronikoa eta Telekomunikazio Ingeniaritza; Gobierno de Navarra / Nafarroako Gobernua
Background: Amyotrophic Lateral Sclerosis (ALS) is a progressive neurodegenerative disease that lacks effective early biomarkers. This study investigated the potential of diffusion kurtosis imaging (DKI) as a non-invasive biomarker for detecting and monitoring ALS progression through a comprehensive analysis of white matter alterations. Methods: We performed a cross-sectional analysis of magnetic resonance images with advanced diffusion imaging techniques in ALS patients recruited from a neurodegenerative consultation service over a 3-year period and healthy controls. Our methodology employed multi-shell multi-tissue constrained spherical deconvolution (MSMT-CSD) for tract reconstruction and diffusion kurtosis imaging for microstructural analysis. The study focused particularly on the corticospinal tract and associated pathways, utilizing both tract-specific Bundle Analytics (BUAN) and whole-brain Tract-Based Spatial Statistics (TBSS) approaches. Results: The study included 33 ALS patients and 37 controls with no significant differences in age or gender. ALS patients predominantly presented with spinal onset and exhibited moderate functional impairment (ALSFRS-R: 39.09 ± 5). Whole-brain TBSS revealed widespread white matter alterations, with increased MD, RD, and AD, and decreased FA notably in the corona radiata, internal capsule, and corticospinal tracts. Detailed fiber tracking of the corticospinal tracts showed significant microstructural changes, with the left CST displaying pronounced increases in MD and AD alongside reduced FA, while the right CST exhibited distinctive regional variations. Additionally, analyses of the frontopontine and parietopontine tracts uncovered further alterations in diffusion metrics. Despite imaging findings, clinical-radiological correlations with functional scores and disease progression were not statistically significant. Conclusions: This study explores DKI as a potential biomarker for ALS pathology, revealing microstructural changes in both motor and extra-motor pathways. Using whole-brain TBSS analysis and tractography with DIPY, we identified an asymmetric pattern of degeneration and involvement of integrative neural networks, providing new insights into ALS pathophysiology. These findings contribute to our understanding of the complex structural alterations in ALS and suggest that DKI-derived metrics may have utility in characterizing the disease process.
Open Access
Motor abnormalities and cognitive impairment in first-episode psychosis patients, their unaffected siblings and healthy controls
(Elsevier, 2018) Cuesta, Manuel J.; Moreno-Izco, Lucía; Ribeiro Fernández, María; López-Ilundain, José M.; Lecumberri Villamediana, Pablo; Cabada Giadás, María Teresa; Lorente Omeñaca, Ruth; Sánchez Torres, Ana María; Gómez Fernández, Marisol; Peralta Martín, Víctor; Ciencias de la Salud; Osasun Zientziak; Matemáticas; Matematika
Motor abnormalities (MAs) may be already evidenced long before the beginning of illness and are highly prevalent in psychosis. However, the extent to which the whole range of MAs are related to cognitive impairment in psychosis remains understudied. This study aimed to examine comparatively the relationships between the whole range of motor abnormalities and cognitive impairments in the first-episode of psychosis (FEP), their unaffected siblings and healthy control subjects. Fifty FEP patients, 21 of their healthy siblings and 24 age- and sex matched healthy controls were included. Motor assessment included catatonic, extrapyramidal and neurological soft signs (NSS) by means of standardized instruments. An exhaustive neuropsychological battery was also performed to extract the 7 cognitive dimensions of MATRICS initiative. Higher scores on NSS but not on extrapyramidal and catatonic signs showed significant associations with worse cognitive performance in the three study groups. However, the pattern of associations regarding specific cognitive functions was different among the three groups. Moreover, extrapyramidal signs showed significant associations with cognitive impairment only in FEP patients but not in their unaffected siblings and healthy controls. Catatonic signs did not show any significant association with cognitive functioning in the three study groups. These findings add evidence to the associations between motor abnormalities, particularly NSS and extrapyramidal signs, and cognitive impairment in first-episode psychosis patients. In addition, our results suggest that the specific pattern of associations between MAs and cognitive functioning is different in FEP patients from those of the unaffected siblings and healthy subjects.
Open Access
Estudio descriptivo del perfil neuropsicológico y psicopatológico en pacientes con distrofia miotónica tipo 1
(Viguera Editores, 2015) Seijas Gómez, Raquel; Basterra Jiménez, Izaskun; Luna Lario, Pilar; Tirapu Ustárroz, Javier; Cabada Giadás, María Teresa; Iridoy Zulet, Marina; Jericó Pascual, Ivonne; Gargallo Vaamonde, Alvaro; López-Goñi, José Javier; Psicología y Pedagogía; Psikologia eta Pedagogia
Introducción. La distrofia miotónica tipo 1 (DM-1) o enfermedad de Steinert es un trastorno multisistémico y progresivo. Se han encontrado déficits cognitivos, clínica depresiva y alta incidencia de rasgos de personalidad ansiosos con afectación tanto en la funcionalidad como en la calidad de vida de estos pacientes. Objetivo. Describir el perfil cognitivo y psicopatológico de una muestra de pacientes con la variante adulta de DM-1. Pacientes y métodos. Se seleccionó una muestra de 27 pacientes con diagnóstico de DM-1 en seguimiento en el Servicio de Neurología del Complejo Hospitalario de Navarra. Los criterios de inclusión fueron tener menos de 50 años y descartar cualquier otra patología o condición física que impidiese realizar la evaluación psicológica. Se utilizó una batería de evaluación neuropsicológica específicamente diseñada para este tipo de patología, además de medidas de psicopatología y funcionalidad. Resultados. La evaluación neuropsicológica reflejó, principalmente, déficits en habilidades visuoconstructivas, visuoespaciales, atención alternante y en sintomatología disejecutiva heteroinformada. El grupo de pacientes no presentó sintomatología depresiva ni ansiosa clínicamente significativa, pero sí puntuaciones elevadas en obsesión-compulsión, sensibilidad interpersonal, ideación paranoide y psicoticismo. Los resultados orientaron hacia un deterioro en la funcionalidad. Conclusiones. En el abordaje integral de la DM-1, la caracterización y el seguimiento evolutivo del perfil cognitivo, psicopatológico y de personalidad, así como del nivel de funcionalidad, contribuyen a la mejora de la calidad de vida de estos pacientes.

Cabada Giadás, María Teresa

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