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Lage C, Sánchez-Rodríguez A, Rivera-Sánchez M, Sierra M, González-Aramburu I, Madera J, Delgado-Alvarado M, López-García S, Martínez-Dubarbie F, Fernández-Matarrubia M, Martínez-Amador N, Martínez-Rodríguez I, Calvo-Córdoba A, Rodríguez-Rodríguez E, García-Cena C, Sánchez-Juan P, Infante J. Oculomotor Dysfunction in Idiopathic and LRRK2-Parkinson's Disease and At-Risk Individuals. J Parkinsons Dis 2024:JPD230416. [PMID: 38701160 DOI: 10.3233/jpd-230416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
Background Video-oculography constitutes a highly-sensitive method of characterizing ocular movements, which could detect subtle premotor changes and contribute to the early diagnosis of Parkinson's disease (PD). Objective To investigate potential oculomotor differences between idiopathic PD (iPD) and PD associated with the G2019S variant of LRRK2 (L2PD), as well as to evaluate oculomotor function in asymptomatic carriers of the G2019S variant of LRRK2. Methods The study enrolled 129 subjects: 30 PD (16 iPD, 14 L2PD), 23 asymptomatic carriers, 13 non-carrier relatives of L2PD patients, and 63 unrelated HCs. The video-oculographic evaluation included fixation, prosaccade, antisaccade, and memory saccade tests. Results We did not find significant differences between iPD and L2PD. Compared to controls, PD patients displayed widespread oculomotor deficits including larger microsaccades, hypometric vertical prosaccades, increased latencies in all tests, and lower percentages of successful antisaccades and memory saccades. Non-carrier relatives showed oculomotor changes with parkinsonian features, such as fixation instability and hypometric vertical saccades. Asymptomatic carriers shared multiple similarities with PD, including signs of unstable fixation and hypometric vertical prosaccades; however, they were able to reach percentages of successful antisaccade and memory saccades similar to controls, although at the expense of longer latencies. Classification accuracy of significant oculomotor parameters to differentiate asymptomatic carriers from HCs ranged from 0.68 to 0.74, with BCEA, a marker of global fixation instability, being the parameter with the greatest classification accuracy. Conclusions iPD and LRRK2-G2019S PD patients do not seem to display a differential oculomotor profile. Several oculomotor changes in asymptomatic carriers of LRRK2 mutations could be considered premotor biomarkers.
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Affiliation(s)
- Carmen Lage
- Neurology Service, Marqués de Valdecilla University Hospital, Santander, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III (ISCIII), Madrid, Spain
- Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, University of California - San Francisco (UCSF), San Francisco, CA, USA
| | - Antonio Sánchez-Rodríguez
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Spain
- Neurology Service, Hospital de Cabueñes, Gijón, Spain
| | - María Rivera-Sánchez
- Neurology Service, Marqués de Valdecilla University Hospital, Santander, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - María Sierra
- Neurology Service, Marqués de Valdecilla University Hospital, Santander, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III (ISCIII), Madrid, Spain
- University of Cantabria, Santander, Spain
| | - Isabel González-Aramburu
- Neurology Service, Marqués de Valdecilla University Hospital, Santander, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III (ISCIII), Madrid, Spain
- University of Cantabria, Santander, Spain
| | - Jorge Madera
- Neurology Service, Marqués de Valdecilla University Hospital, Santander, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Manuel Delgado-Alvarado
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III (ISCIII), Madrid, Spain
- University of Cantabria, Santander, Spain
- Neurology Service, Hospital de Sierrallana, Santander, Spain
| | - Sara López-García
- Neurology Service, Marqués de Valdecilla University Hospital, Santander, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Francisco Martínez-Dubarbie
- Neurology Service, Marqués de Valdecilla University Hospital, Santander, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Marta Fernández-Matarrubia
- Neurology Service, Marqués de Valdecilla University Hospital, Santander, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Néstor Martínez-Amador
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Spain
- Nuclear Medicine Service, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Isabel Martínez-Rodríguez
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Spain
- University of Cantabria, Santander, Spain
- Nuclear Medicine Service, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Alberto Calvo-Córdoba
- Universidad Politécnica de Madrid, Centre for Automation and Robotics, Escuela Técnica de Ingenieros Industriales (ETSII), Madrid, Spain
| | - Eloy Rodríguez-Rodríguez
- Neurology Service, Marqués de Valdecilla University Hospital, Santander, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III (ISCIII), Madrid, Spain
- University of Cantabria, Santander, Spain
| | - Cecilia García-Cena
- Universidad Politécnica de Madrid, Centre for Automation and Robotics, UPM-CSIC, Escuela Técnica Superiorde Ingeniería y Diseño Industrial, Madrid, Spain
| | - Pascual Sánchez-Juan
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III (ISCIII), Madrid, Spain
- CIEN Foundation/Queen Sofia Foundation Alzheimer Center, Madrid, Spain
| | - Jon Infante
- Neurology Service, Marqués de Valdecilla University Hospital, Santander, Spain
- Institute for Research Marqués de Valdecilla (IDIVAL), Santander, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III (ISCIII), Madrid, Spain
- University of Cantabria, Santander, Spain
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Fernández-Torre JL, Paramio-Paz A, Campos-Fernández S, Rivera-Sánchez M, Orizaola P, Hernández-Hernández MA. Typical Absence Status Epilepticus in Later Life Precipitated by Spirometry. Can J Neurol Sci 2024; 51:333-335. [PMID: 36657985 DOI: 10.1017/cjn.2023.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- José L Fernández-Torre
- Department of Clinical Neurophysiology, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain
- Department of Physiology and Pharmacology, School of Medicine, University of Cantabria, Santander, Cantabria, Spain
- Biomedical Research Institute (IDIVAL), Santander, Cantabria, Spain
| | - Alicia Paramio-Paz
- Department of Clinical Neurophysiology, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain
- Biomedical Research Institute (IDIVAL), Santander, Cantabria, Spain
| | - Sandra Campos-Fernández
- Department of Intensive Medicine, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain
| | - María Rivera-Sánchez
- Department of Neurology, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain
| | - Pedro Orizaola
- Department of Clinical Neurophysiology, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain
| | - Miguel A Hernández-Hernández
- Biomedical Research Institute (IDIVAL), Santander, Cantabria, Spain
- Department of Intensive Medicine, Marqués de Valdecilla University Hospital, Santander, Cantabria, Spain
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Cerveró A, Sánchez-Rodríguez A, Rivera-Sánchez M, Martínez-Rodríguez I, Sierra M, González-Aramburu I, Gutiérrez-González A, Andrés-Pacheco J, Sánchez-Peláez MV, Casado A, Infante J. Analysis of retinal nerve layers in idiopathic, LRRK2-associated Parkinson's disease and unaffected carriers of G2019S mutation. Parkinsonism Relat Disord 2023; 106:105246. [PMID: 36529112 DOI: 10.1016/j.parkreldis.2022.105246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/15/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION In both prodromal and early symptomatic stages of idiopathic PD (iPD) peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell layer (mGCL) thinning have been identified. Here we assessed whether these alterations can also be detected in symptomatic and presymptomatic stages of LRRK2-PD. METHODS 218 eyes belonging to 20 iPD, 19 LRRK2-PD (L2PD), 24 LRRK2 non-manifesting carriers (L2NMC), and 46 controls (HCs). pRNFL, mGCL thickness (squares), and Bruch's membrane opening minimum rim width were evaluated by SD-OCT. In L2NMC, 123I-ioflupane SPECT (DaT-SPECT) with semi-quantitative analysis was carried out. RESULTS Compared to HCs, iPD patients showed significant thinning of the temporal (BMO-MRW and pRNFL), superior-temporal (BMO-MRW), inferior-temporal (BMO-MRW), superior-nasal (BMO-MRW) and central sectors (BMO-MRW) (p < 0.05), as well as in five mGCL sectors (p < 0.05). No significant differences were found between the L2PD or L2NMC and HCs. BMO-MRW thickness in its temporal-superior, superior-nasal and middle sectors was influenced by disease duration (p < 0.05) and mGCL thickness in sectors TS1, TS2, TS3, NS1 and NS3 was influenced by UPDRSIII and age (p < 0.05). CONCLUSION LRRK2-PD is distinguished from iPD by absent or less retinal nerve involvement, both in clinical and preclinical stages.
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Affiliation(s)
- Andrea Cerveró
- Ophthalmology Service, University Hospital Marqués de Valdecilla-IDIVAL, University of Cantabria (UC), Santander, Spain
| | | | - María Rivera-Sánchez
- Neurology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain
| | - Isabel Martínez-Rodríguez
- Nuclear Medicine, Department, Molecular Imaging Group (IDIVAL), University Hospital Marqués de Valdecilla, Santander, Spain
| | - María Sierra
- Neurology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Isabel González-Aramburu
- Neurology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Angela Gutiérrez-González
- Nuclear Medicine, Department, Molecular Imaging Group (IDIVAL), University Hospital Marqués de Valdecilla, Santander, Spain
| | - Javier Andrés-Pacheco
- Nuclear Medicine, Department, Molecular Imaging Group (IDIVAL), University Hospital Marqués de Valdecilla, Santander, Spain
| | | | - Alfonso Casado
- Ophthalmology Service, University Hospital Marqués de Valdecilla-IDIVAL, University of Cantabria (UC), Santander, Spain
| | - Jon Infante
- Neurology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain; Universidad de Cantabria (UC), Spain.
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Sánchez-Rodríguez A, Tirnauca C, Salas-Gómez D, Fernández-Gorgojo M, Martínez-Rodríguez I, Sierra M, González-Aramburu I, Stan D, Gutierrez-González A, Meissner JM, Andrés-Pacheco J, Rivera-Sánchez M, Sánchez-Peláez MV, Sánchez-Juan P, Infante J. Sensor-based gait analysis in the premotor stage of LRRK2 G2019S-associated Parkinson's disease. Parkinsonism Relat Disord 2022; 98:21-26. [PMID: 35421781 DOI: 10.1016/j.parkreldis.2022.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/30/2022] [Accepted: 03/31/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION There is a need for biomarkers to monitor the earliest phases of Parkinson's disease (PD), especially in premotor stages. Here, we studied whether there are early gait alterations in carriers of the G2019S mutation of LRRK2 that can be detected by means of an inertial sensor system. METHODS Twenty-one idiopathic PD patients, 20 LRRK2-G2019S PD, 27 asymptomatic carriers of LRRK2-G2019S mutation (AsG2019S) and 36 controls walked equipped with 16 lightweight inertial sensors in three different experiments: i/normal gait, ii/fast gait and iii/dual-task gait. In the AsG2019S group, DaT-SPECT (123I-ioflupane) with semi-quantitative analysis was carried out. Motor and cognitive performance were evaluated using MDS-UPDRS-III and MoCA scales. We employed neural network techniques to classify individuals based on their walking patterns. RESULTS PD patients and controls showed differences in speed, stride length and arm swing amplitude, variability and asymmetry in all three tasks (p < 0.01). In the AsG2019S group, the only differences were detected during fast walking, with greater step time on the non-dominant side (p < 0.05), lower step/stride time variability (p < 0.01) and lower step time asymmetry (p < 0.01). DaT uptake showed a significant correlation with step time during fast walking on the non-dominant side (r = -0.52; p < 0.01). The neural network was able to differentiate between AsG2019S and healthy controls with an accuracy rate of 82.5%. CONCLUSION Our sensor-based analysis did not detect substantial and robust changes in the gait of LRRK2-G2019S asymptomatic mutation carriers. Nonetheless, step or stride time during fast walking, supported by the observed correlation with striatal DaT binding deserves consideration as a potential biomarker in future studies.
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Affiliation(s)
- Antonio Sánchez-Rodríguez
- Neurology Service, Hospital Universitario de Cabueñes, Gijón, Spain; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - Cristina Tirnauca
- Departamento de Matemáticas, Estadística y Computación. Universidad de Cantabria, Santander, Spain
| | - Diana Salas-Gómez
- Gimbernat-Cantabria Research Unit (SUIGC), University Schools Gimbernat-Cantabria, Attached to the University of Cantabria, Torrelavega, Spain
| | - Mario Fernández-Gorgojo
- Gimbernat-Cantabria Research Unit (SUIGC), University Schools Gimbernat-Cantabria, Attached to the University of Cantabria, Torrelavega, Spain
| | - Isabel Martínez-Rodríguez
- Nuclear Medicine Department, Molecular Imaging Group (IDIVAL). University Hospital Marqués de Valdecilla, Santander, Spain
| | - María Sierra
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain; Neurology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain
| | - Isabel González-Aramburu
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain; Neurology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain
| | - Diana Stan
- Departamento de Matemáticas, Estadística y Computación. Universidad de Cantabria, Santander, Spain
| | - Angela Gutierrez-González
- Nuclear Medicine Department, Molecular Imaging Group (IDIVAL). University Hospital Marqués de Valdecilla, Santander, Spain
| | - Johannes M Meissner
- Departamento de Matemáticas, Estadística y Computación. Universidad de Cantabria, Santander, Spain
| | - Javier Andrés-Pacheco
- Nuclear Medicine Department, Molecular Imaging Group (IDIVAL). University Hospital Marqués de Valdecilla, Santander, Spain
| | - María Rivera-Sánchez
- Neurology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain
| | | | - Pascual Sánchez-Juan
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain; Alzheimer's Centre Reina Sofia-CIEN Foundation, 28031, Madrid, Spain
| | - Jon Infante
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Spain; Neurology Service, University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain; Departamento de Medicina y Psiquiatría. Universidad de Cantabria, Santander, Spain.
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Sánchez-Rodríguez A, Martínez-Rodríguez I, Sánchez-Juan P, Sierra M, González-Aramburu I, Rivera-Sánchez M, Andrés-Pacheco J, Gutierrez-González Á, García-Hernández A, Madera J, Delgado-Alvarado M, Infante J. Serial DaT-SPECT imaging in asymptomatic carriers of LRRK2 G2019S mutation: 8 years' follow-up. Eur J Neurol 2021; 28:4204-4208. [PMID: 34407293 DOI: 10.1111/ene.15070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 08/09/2021] [Accepted: 08/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Carriers of the G2019S mutation of LRRK2 provide a great opportunity to investigate the premotor stages of Parkinson's disease (PD). We have studied by serial clinical and dopamine transporter single photon emission computed tomography (DaT-SPECT) evaluations a cohort of asymptomatic carriers of the LRRK2-G2019S mutation in order to evaluate the usefulness of these tools as biomarkers. Here we report the results of the extended follow-up of this cohort at 8 years. METHODS Seventeen participants, of the 25 available from the 4-year evaluation, completed the 8-year assessment. UPDRS-III, UPSIT test and DaT-SPECT imaging (123 I-ioflupane) were performed. We used repeated-measures linear mixed effects models to examine the changes in DaT binding over time. RESULTS Three carriers had converted to PD at 4 years. One additional carrier converted at 8 years. PD-converters had lower striatal DaT binding at baseline than non-converters. There was a significant decline of DaT binding over time, with a mean annual rate of 3.5%, with somewhat inter-individual and intra-individual variability and comparable between PD-converters and non-converters. No carrier with DAT binding ratio above an undefined threshold between 0.5 and 0.8 developed PD symptoms. The age-adjusted UPSIT score did not change significantly over time. CONCLUSIONS The rate of conversion to PD at 8 years in this cohort aged ~58 years at baseline was 16%. The observed decline of DaT binding over time and its association with the phenotype render DaT-SPECT a potentially useful tool for monitoring the premotor stage of the disease, although at the individual level its ability to predict phenoconversion is limited.
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Affiliation(s)
- Antonio Sánchez-Rodríguez
- Neurology Service, University Hospital Marqués de Valdecilla-IDIVAL, University of Cantabria (UC), Santander, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Isabel Martínez-Rodríguez
- Nuclear Medicine Department, Molecular Imaging Group (IDIVAL), University Hospital Marqués de Valdecilla, Santander, Spain
| | - Pascual Sánchez-Juan
- Neurology Service, University Hospital Marqués de Valdecilla-IDIVAL, University of Cantabria (UC), Santander, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - María Sierra
- Neurology Service, University Hospital Marqués de Valdecilla-IDIVAL, University of Cantabria (UC), Santander, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Isabel González-Aramburu
- Neurology Service, University Hospital Marqués de Valdecilla-IDIVAL, University of Cantabria (UC), Santander, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - María Rivera-Sánchez
- Neurology Service, University Hospital Marqués de Valdecilla-IDIVAL, University of Cantabria (UC), Santander, Spain
| | - Javier Andrés-Pacheco
- Nuclear Medicine Department, Molecular Imaging Group (IDIVAL), University Hospital Marqués de Valdecilla, Santander, Spain.,Neurology Service, Sierrallana Hospital-IDIVAL, University of Cantabria (UC), Torrelavega, Spain
| | - Ángela Gutierrez-González
- Nuclear Medicine Department, Molecular Imaging Group (IDIVAL), University Hospital Marqués de Valdecilla, Santander, Spain
| | - Adrián García-Hernández
- Neurology Service, University Hospital Marqués de Valdecilla-IDIVAL, University of Cantabria (UC), Santander, Spain
| | - Jorge Madera
- Neurology Service, University Hospital Marqués de Valdecilla-IDIVAL, University of Cantabria (UC), Santander, Spain
| | - Manuel Delgado-Alvarado
- Nuclear Medicine Department, Molecular Imaging Group (IDIVAL), University Hospital Marqués de Valdecilla, Santander, Spain
| | - Jon Infante
- Neurology Service, University Hospital Marqués de Valdecilla-IDIVAL, University of Cantabria (UC), Santander, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
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