Examinando por Autor "Leon Ariza, Juan S."

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    Evidences in Neurological Surgery and a Cutting Edge Classification of the Trigeminocardiac Reflex : A Systematic Review
    (2018-08) Leon Ariza, Daniel S.; Leon Ariza, Juan S.; Nangiana, Jasvinder; Vargas Grau, Gabriel; Leon Sarmiento, Fidias E.; Quiñones Hinojosa, Alfredo
    The trigeminocardiac reflex (TCR) is characterized by bradycardia, decrease of mean arterial blood pressure, and sometimes, asystole during surgery. We critically reviewed TCR studies and devised a novel classification scheme for assessing the reflex. Methods A comprehensive systematic literature review was performed using PubMed, MEDLINE, Web of Science, EMBASE, and Scielo databases. Eligible studies were extracted based on stringent inclusion and exclusion criteria. Statistical analyses were used to assess cardiovascular variables. TCR was classified according to morphophysiologic aspects involved with reflex elicitation. Results A total of 575 patients were included in this study. TCR was found in 8.9% of patients. The reflex was more often triggered by interventions made within the anterior cranial fossa. The maxillary branch (type II in the new classification) was the most prevalent nerve branch found to trigger the TCR. Heart rate and mean arterial blood pressure were similarly altered (P = 0.06; F = 0.3912809), covaried with age (P = 0.012; F = 9.302), and inversely correlated to each other (r = −0.27). Conclusions TCR is a critical cardiovascular phenomenon that must be quickly identified and efficiently classified and should trigger vigilance. Prompt therapeutic measures during neurosurgical procedures should be carefully addressed to avoid unwanted complications. Accurate categorization using the new classification scheme will help to improve understanding and guide the management of TCR in the perioperative period.
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    Smell status in functional movement disorders : New clues for diagnosis and underlying mechanisms
    (2019) Leon Sarmiento, Fidias E.; Bayona Prieto, Jaime; Leon Ariza, Juan S.; Leon Ariza, Daniel S.; Jacob, Alexandra E.; LaFaver, Kathrin; Doty, Richard L.
    Objective: Functional movement disorders (FMDs) mimic a range of movements, neuropsychiatric and neurodegenerative disorders known to have smell dysfunction, which has been neglected in terms of its application to FMD. We aim to determine the smell status in FMD patients tested by a non-invasive, reliable and validated olfactory test. Patients and methods: We quantitatively assessed in thirty-five FMD patients their smell status and compared it to that of healthy age- and sex-matched controls, and of patients with Parkinson’s disease (PD). All participants were administered the Brief Smell Identification Test (B-SIT), a standardized short version of the University of Pennsylvania Smell Identification Test (UPSIT). The Picture Identification Test (PIT), a visual test analogous in content and form to the UPSIT designed to control for non-olfactory cognitive confounds, was also administered. Results: The B-SIT scores of the FMD patients were higher than those from PD patients [respective means (standard deviations: SDs) = FMD, 9.54 (1.57); PD, 4.64 (1.05), p < 0.01)] but similar to the smell scores from healthy controls [9.97 (1.77), p=0.35]. Gender, age, time of disease onset, smoking status, and phenotypic expression did not influence the test scores. Fourteen FMD patients who mentioned having olfactory dysfunction before smell testing have their test results within normal range. PIT scores from patients and healthy controls were within normal range. Conclusions: These findings indicate that FMD patients have normal olfactory function. Olfactory testing may be helpful in identifying and differentiating FMD from other movement, neurodegenerative and neuropsychiatric diseases for which smell function is altered.
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    The Three Nociceptive Responses of the Orbicularis Oculi Reflex in Alzheimer’s Disease : State of the Evidence and Meta-analysis
    (2019-01) Leon Ariza, Daniel S.; Leon Ariza, Juan S.; Prada, Diddier G.; Castillo, Camilo; Leon Sarmiento, Fidias E.
    There is an emerging belief that electrically elicited blink reflexes (BR) may distinguish Alzheimer’s disease (AD) from other disorders characterized by memory dysfunction. To qualitatively and quantitatively distinguish the effects that electrical stimulation has over the blink reflex (eBR) recorded from patients with AD and healthy controls (HCs), we did a systematic review of the literature, and conducted a meta-analysis. Following our selected criteria, 94 AD patients and 97 HCs were identified from articles published in English between 1950 and 2017. Although the 3 responses (R1, R2 and R3) of the eBR were studied in a number of patients, only the R2 response was quantified in all studies. Thresholds and stimulation intensities parameters were found to be used in a miscellaneous form, and the majority of times, such parameters deviated from validated guidelines. The stimulation frequencies used to elicit the BR responses ranged between 0.14 and 0.2 Hz. These frequencies favored HCs compared with AD patients (odds ratio = 1.08; 95% CI = 0.30-1.85), I2 = 0% [P = .99]; Q = 271.89 [df = 7, P < .000]). Egger’s regression test suggested publication bias (intercept = 32.38; 95% CI = −8.98 to −3.2; P = .001). Our results unveiled key shortcomings in the data reported; such shortcomings need to be corrected in future AD research looking for obtaining more reliable and reproducible eBR studies; otherwise, interventions may be misleading.