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Rafael Rodriguez-Rojas

Rafael Rodriguez-Rojas
Centre for Integrative Neurosciences A.C. (HM-CINAC)

PhD

About

134
Publications
18,099
Reads
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1,544
Citations
Additional affiliations
March 2016 - present
Centro Integral de Neurociencias HM-CINAC
Position
  • Researcher
January 2009 - December 2015
Abdus Salam International Centre for Theoretical Physics
Position
  • Research Associate
September 2004 - July 2015
Universidad Tecnológica de la Habana, José Antonio Echeverría
Position
  • Professor (Associate)
Education
January 2017 - June 2020
University Foundation San Pablo CEU
Field of study
  • Translational Medicine (Neurosciences)
September 1998 - July 2000
September 1991 - July 1996
Instituto Superior de Tecnologías y Ciencias Aplicadas
Field of study
  • Nuclear Physics

Publications

Publications (134)
Article
Full-text available
Subthalamotomy using transcranial magnetic resonance-guided focused ultrasound (tcMRgFUS) is a novel and promising treatment for Parkinson’s Disease (PD). In this study, we investigate if baseline brain imaging features can be early predictors of tcMRgFUS-subthalamotomy efficacy, as well as which are the post-treatment brain changes associated with...
Article
Background: Parkinson's disease (PD) exhibits a high prevalence of dementia as disease severity and duration progress. Focused ultrasound (FUS) has been applied for transient blood-brain barrier (BBB) opening of cortical regions in neurodegenerative disorders. The striatum is a primary target for delivery of putative therapeutic agents in PD. Obj...
Article
Dopaminergic denervation in patients with Parkinson's disease is associated with changes in brain metabolism. Cerebral in-vivo mapping of glucose metabolism has been studied in severe stable parkinsonian monkeys, but data on brain metabolic changes in early stages of dopaminergic depletion of this model is lacking. Here, we report cerebral metaboli...
Article
Full-text available
Background: The subthalamic nucleus (STN) is considered a key structure in motor, behavioral, and emotional control. Although identification of the functional topography of the STN has therapeutic implications in the treatment of the motor features of Parkinson's disease (PD), the details of its functional and somatotopic organization in humans ar...
Chapter
Full-text available
The disorders of consciousness (DOC) discussions are actual and permanent subjects for debate in the media and scientific discussion in any forum. Controversies exist in the use of present-day clinical terminology, including terms that may be pejorative in describing patients. The European Task Force on Disorders of Consciousness has proposed a new...
Article
Background Unilateral magnetic resonance-guided focused ultrasound (FUS) thalamotomy is efficacious for the treatment of medically refractory essential tremor (ET). Viability of bilateral FUS ablation is unexplored. Methods Patients diagnosed with medically refractory ET and previously treated with unilateral FUS thalamotomy at least 5 months befo...
Article
Transcranial magnetic resonance-guided focused ultrasound (tMRgFUS) allows to perform incisionless thermoablation of deep brain structures. This feature makes it a very useful tool for the treatment of multiple neurological and psychiatric disorders. Currently, feedback of the thermoablation process is based on peak temperature readings assessed on...
Article
Introduction The subthalamic nucleus (STN) is known to be involved in the pathophysiology of Parkinson´s disease and by reducing its abnormal activity, normal output of basal ganglia can be restored along with improvement in PD cardinal motor features. Deep brain stimulation of the STN is currently the main surgical procedure for PD with motor comp...
Article
Full-text available
MR-guided focused ultrasound (MRgFUS), in combination with intravenous microbubble administration, has been applied for focal temporary BBB opening in patients with neurodegenerative disorders and brain tumors. MRgFUS could become a therapeutic tool for drug delivery of putative neurorestorative therapies. Treatment for Parkinson’s disease with dem...
Article
Background The subthalamic nucleus is the preferred neurosurgical target for deep-brain stimulation to treat cardinal motor features of Parkinson’s disease. Focused ultrasound is an imaging-guided method for creating therapeutic lesions in deep-brain structures, including the subthalamic nucleus. Methods We randomly assigned, in a 2:1 ratio, patie...
Article
Full-text available
Background and objective: Neurodegenerative diseases like Parkinson’s disease often take several years before they can be diagnosed reliably based on clinical grounds. Imaging techniques such as MRI are used to detect anatomical (structural) pathological changes. However, these kinds of changes are usually seen only late in the development. The mea...
Article
Full-text available
A 15-year-old patient with sickle cell disease with recessive homozygous haemoglobin S/HbSS suffered several crises developmentally after the last of which the patient fell into coma. CT scan then revealed a large infarct of the right cerebral hemisphere. Three weeks after the event, the patient began to demonstrate spontaneous eye-opening and spas...
Article
A 15-year-old patient with sickle cell disease with recessive homozygous haemoglobin S/HbSS suffered several crises developmentally after the last of which the patient fell into coma. CT scan then revealed a large infarct of the right cerebral hemisphere. Three weeks after the event, the patient began to demonstrate spontaneous eye opening and spas...
Article
Full-text available
Purpose Subthalamotomy using magnetic resonance–guided focused ultrasound (MRgFUS) has become a potential treatment option for the cardinal features of Parkinson’s disease (PD). The purpose of this study was to evaluate the effects of MRgFUS-subthalamotomy on brain metabolism using different scale levels. Methods We studied resting-state glucose m...
Article
A 15- year- old patient with sickle cell disease with recessive homozygous haemoglobin S/HbSS suffered several crises developmentally after the last of which the patient fell into coma. CT scan then revealed a large infarct of the right cerebral hemisphere. Three weeks after the event, the patient began to demonstrate spontaneous eye opening and sp...
Article
A 15-year-old patient with sickle cell disease with recessive homozygous haemoglobin S/HbSS suffered several crises developmentally after the last of which the patient fell into coma. CT scan then revealed a large infarct of the right cerebral hemisphere. Three weeks after the event, the patient began to demonstrate spontaneous eye opening and spas...
Article
Full-text available
Objective: To evaluate the precision, effectiveness and safety in the identification and lesion of subthalamic nucleus using a new surgical strategy, guided by images and multi-unit deep brain electrical recording. Special attention was given to ventricular dilation and cerebral atrophy in relation to electrode trajectory and the accuracy of the su...
Article
Background: Transcranial magnetic resonance-guided focused ultrasound (tcMRgFUS) thalamotomy is a novel and effective treatment for controlling tremor in essential tremor patients. Objective: To provide a comprehensive characterization of the radiological, topographical, and volumetric aspects of the tcMRgFUS thalamic lesion, and to quantify how...
Article
A major unmet need in Parkinson's disease (PD) is to slow the inexorable progression of neurodegeneration. Clinical trials that evaluated promising pharmacological strategies have repeatedly failed. Nonetheless, the advent of focused ultrasound provides new opportunities toward the goal of developing a safe and effective disease‐modifying therapy f...
Article
Full-text available
We compare and discuss three cases including: a clearly brain-dead patient, a vegetative state/unresponsive wakefulness syndrome (VS/UWS) patient and a patient diagnosed as brain-dead (BD) demonstrating some but not all clinical features of a BD state. Two of the patients demonstrated clear presentation allowing for an effective determination of st...
Article
Background The high acoustic impedance of the skull limits the performance of transcranial magnetic resonance‐guided focused ultrasound (tcMRgFUS) therapy. Subject suitability screening is based on skull parameters estimated from computed tomography (CT) scans. Purpose To assess the feasibility of screening for tcMRgFUS based on zero echo time (ZT...
Article
Essential tremor is the most common movement disorder in adults. In patients who are not responsive to medical treatment, functional neurosurgery and, more recently, transcranial MR‐guided focused ultrasound thalamotomy are considered effective therapeutic approaches. However, the structural brain changes following a thalamotomy that mediates the c...
Chapter
Full-text available
The disorders of consciousness (DOC) discussions are actual and permanent subjects for debate in the media and scientific discussion in any forum. Controversies exist in the use of present-day clinical terminology, including terms that may be pejorative in describing patients. Thw European Task Force on Disorders of Consciousness has proposed a new...
Article
Full-text available
Auditory and visual pathways may be affected as a consequence of temporal lobe epilepsy surgery because of their anatomical relationships with this structure. The purpose of this paper is to correlate the results of the auditory and visual evoked responses with the parameters of tractography of the visual pathway, and with the state of connectivity...
Article
For many years the subthalamic nucleus had a poor reputation among neurosurgeons as a result of the acute movement disorders that develop after its lesion or manipulation through different surgical procedures. However, this nucleus is now considered a key structure in relation to parkinsonism, and it is currently one of the preferred therapeutic ta...
Article
Full-text available
Sutton and Clauss presented a detailed review about the effectiveness of zolpidem, discussing recoveries from brain damage due to strokes, trauma and hypoxia. A significant finding has been the unexpected and paradoxical increment of brain activity in vegetative state/unresponsive wakefulness syndrome (VS/UWS). On the contrary, zolpidem is consider...
Article
Objective Subthalamotomy is an effective alternative for the treatment of Parkinson’s disease (PD). However, uncertainty about the optimal target location and the possibility of inducing haemichorea-ballism have limited its application. We assessed the correlation between the topography of radiofrequency-based lesions of the subthalamic nucleus (ST...
Article
Background: Ablative neurosurgery has been used to treat Parkinson's disease for many decades. MRI-guided focused ultrasound allows focal lesions to be made in deep brain structures without skull incision. We investigated the safety and preliminary efficacy of unilateral subthalamotomy by focused ultrasound in Parkinson's disease. Methods: This...
Article
Full-text available
We compare and discuss three cases including: a clearly brain-dead patient, a vegetative state/unresponsive wakefulness syndrome (VS/UWS) patient and a patient diagnosed as brain-dead (BD) demonstrating some but not all clinical features of a BD state. Two of the patients demonstrated clear presentation allowing for an effective determination of st...
Article
Full-text available
Objective: To evaluate the accuracy, effectiveness and safety of STN targeting using a non-standard method for image-guided surgical approach. Special attention was focused on the impact of ventricular dilatation and brain atrophy over the electrode trajectory and targeting accuracy. Methods: A prospective study of targeting data collected duri...
Article
Unilateral subthalamotomy is an effective treatment for the cardinal motor features of Parkinson´s disease (PD). However, non-motor changes possibly associated with right or left subthalamotomy remain unknown. Our aim was to assess cognitive, psychiatric and neuroimaging changes after treatment with unilateral subthalamotomy. Fourteen medicated pat...
Article
Full-text available
Introduction: Autistic spectrum disorder (ASD) can be better understood by examining its nature by analyzing brain connectivity. Objective: To better understand the nature of brain connectivities in autistics electrophysiologically. Methods: Brain connectivity can be subdivided into structural or anatomical connectivity (AC) and functional connec...
Thesis
Full-text available
Antecedentes: El trastorno del espectro autista (TEA) es complejo trastorno del neurodesarrollo que se caracteriza clínicamente por dificultades de la interacción social, alteraciones del lenguaje, variados estereotipos de comportamiento, y déficits cognitivos. Hoy en día muchos autores consideran a TEA como una “epidemia” a nivel mundial. Muchos a...
Chapter
Full-text available
Persistent vegetative states (PVS) and locked-in syndrome (LIS) are well-differentiated disorders of consciousness that can be reached after a localized brain injury in the brainstem. The relations of the lesion topography with the impairment in the whole-brain architecture and functional disconnections are poorly understood. Methods: Two patients...
Chapter
Full-text available
One of the major limitations of FLAIR imaging is the ventricular CSF pulsation artifact (VCSFA). This artifact could compromise the study of ventricular abnormalities by leading to false-negative or false-positive interpretations. We report 4 young persistent vegetative state (PVS) patients with severe ventriculomegaly and brain atrophy who showed...
Article
Background: Voxel-based morphometric (VBM) studies in neuromyelitis optica (NMO) have shown limited reproducibility. A previous study suggests that the number of optic neuritis (ON) attacks may be a confounding factor when comparing NMO patients with controls if it is not taken into account during VBM analysis. Purpose: To investigate the potent...
Chapter
Full-text available
This chapter summarizes findings of the morphological and functional brain changes in autistic spectrum disorders (ASD), demonstrated by a growing body of researches that employs diverse neuroimaging methods. We discuss major anatomical findings from studies in ASD utilizing structural magnetic resonance imaging (MRI) and diffusion tensor imaging (...
Article
Full-text available
A group of 21 autistic children were studied for determining the relationship between the anatomic (AC) versus functional (FC) connectivity, considering short-range and long-range brain networks. AC was assessed by the DW-MRI technique and FC by EEG coherence calculation, in three experimental conditions: basal, watching a popular cartoon with audi...
Article
Introducción La efectividad y seguridad de la cirugía ablativa en los trastornos del movimiento (Enfermedad de Parkinson (EP), distonías y temblor esencial) dependen, entre otros elementos, de la localización de las lesiones en las regiones nucleares de interés y del volumen de estas lesiones. Este trabajo tiene como objetivo mostrar los métodos...
Article
Full-text available
Identification and localization of epileptogenic zone (EZ) is vital in patients with medically-intractable focal epilepsy, who may be candidates for potentially curative resective epilepsy surgery. Presence of a lesion on magnetic resonance imaging (MRI) influences both diagnostic classification and selection for surgery. However, the implications...
Article
Parkinson´s disease (PD) is characterized by sev-eral motor and cognitive symptoms reflecting the progression of the underlying pathology. The neuroanatomical basis and to-pography of the neurobiological processes that account for mo-tor and cognitive impairments have not been well characterized in the early stage of PD. Diffusion tensor imaging (D...
Article
Full-text available
We studied autistics by quantitative EEG spectral and coherence analysis during three experimental conditions: basal, watching a cartoon with audio (V–A), and with muted audio band (VwA). Significant reductions were found for the absolute power spectral density (PSD) in the central region for delta and theta, and in the posterior region for sigma a...
Thesis
Full-text available
Con la presente le adjuntamos el artículo científico: “EEG Spectral and Coherence Assessment of Autistic Children in Three Different Experimental Conditions”, del Dr. Calixto Machado Curbelo, y coautores, que ha sido evaluado por nuestro Consejo Científico, y lo considera un aporte original en el estudio de los trastornos de la conciencia, y lo pro...
Conference Paper
Full-text available
Background: Persistent vegetative states (PVS) and locked-in syndrome (LIS) are well-differentiated disorders of consciousness that can be reached after a localized brain injury in the brainstem. The relations of the lesion topography with the impairment in the whole-brain architecture and functional disconnections are poorly understood. Methods: T...
Conference Paper
Full-text available
Background: Persistent vegetative states (PVS) and locked-in syndrome (LIS) are well-differentiated disorders of consciousness that can be reached after a localized brain injury in the brainstem. The relations of the lesion topography with the impairment in the whole-brain architecture and functional disconnections are poorly understood. Methods: T...
Article
Full-text available
Objective: To study the Zolpidem arousing effect in persistent vegetative state (PVS) patients combining clinical evaluation, autonomic assessment by heart rate variability (HRV), and EEG records. Methods: We studied a group of 8 PVS patients and other 8 healthy control subjects, matched by age and gender. The patients and controls received drug...
Article
Full-text available
Background Focal thalamic lesions have been associated with a variety of involuntary movements such as tremor, dystonia, and chorea-ballism. Methods. We describe a patient with severe hyperkinesias of the right arm secondary to a thalamic infarction in the left postero-ventral region of the thalamus. ResultsThe dystonia and tremor of the right uppe...
Article
INTRODUCCIÓN: Los cambios de la actividad neuronal en la región sensorimotora del Globo Pálido Medial (GPi) se consideran alteraciones fundamentales en la génesis de las distonías. La lesión y la estimulación de esa región mejora la distonía, pero ese efecto no está suficientemente estudiado. OBJETIVO: Estudiar el efecto y evolución a corto, median...
Conference Paper
Mild cognitive impairment (MCI) is common in Parkinson’s Disease (PD) patients and it is key to predict the development of dementia. There is not report of discriminant accuracy for MCI using based-surface cortical morphometry. This study used Cortical-Thickness (CT) combined to Local-Gyrification-Index (LGI) to assess discriminant accuracy for MCI...
Conference Paper
The topology of complex brain networks allows efficient dynamic interactions between spatially distinct regions. Neuroimaging studies have provided consistent evidence of dysfunctional connectivity among the cortical circuitry in Parkinson’s disease; however, little is known about the topological properties of brain networks underlying these altera...
Article
Full-text available
We studied autistics by quantitative EEG spectral and coherence analysis during three experimental conditions: basal, watching a cartoon with audio (V-A), and with muted audio band (VwA). Significant reductions were found for the absolute power spectral density (PSD) in the central region for delta and theta, and in the posterior region for sigma a...
Article
Full-text available
Introduction: Zolpidem is a non-benzodiazepine drug used for the therapy of insomnia, which has selectivity for stimulating the effect of GABA-A receptors. Recently, a paradoxical arousing effect of zolpidem in patients with severe brain damage has been repeatedly reported. Methods: A placebo-controlled magnetic resonance study was conducted to...
Article
Full-text available
Recent neuroimaging studies show that brain abnormalities in neuromyelitis optica (NMO) are more frequent than earlier described. Yet, more research considering multiple aspects of NMO is necessary to better understand these abnormalities. A clinical feature of relapsing NMO (RNMO) is that the incremental disability is attack-related. Therefore, as...
Data
Axial, sagittal and coronal selected slices at four brain levels (levels shown as white lines in the figures on the right side) presenting the statistical parametric map of brain perfusion decrease in the RNMO group compared with the control group (in cyan). This group-comparison analysis was performed using an extent threshold determined by the ex...
Article
Full-text available
We report unusual twisting of the brainstem in MRI tractography in a patient who survived a traumatic brain injury with upper spinal dislocation. A 39-year-old male patient involved in a high-speed car accident was admitted in coma on February 2003. He had a Glasgow Coma Scale of 4, respiratory arrhythmia and tetraplegia. Four weeks later he was di...
Article
Full-text available
Background: Persistent vegetative states (PVS) and locked-in syndrome (LIS) are well differentiated disorders of consciousness that can be reached after a localized brain injury in the brainstem. The relations of the lesion topography with the impairment in the whole-brain architecture and functional disconnections are poorly understood. Methods: T...