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Servicio de Neurología


Servicio de Neurología

Fundació Institut Mar d’Investigacions Mèdiques (IMIM) / Hospital del Mar. Barcelona

The Neurovascular Research Group (NEUVAS) is a multidisciplinary team based at the Clinical Neurology department at Hospital del Mar that has been working for years in the field of cerebrovascular pathology (Coordinator: Dr. Jaume Roquer).

Located in the Barcelona Biomedical Research Park (PRBB) of the Hospital del Mar Medical Research Institute (IMIM), the group is part of the Research in Inflammatory and Cardiovascular Disorders Programme  (RICAD). The team has participated in the HERACLES research network on essential hypertension (Red de Análisis de Canales iónicos de la musculatura Lisa arterial y su Explotación terapéutica Sistemática) since 2006 as the NEUVAS node. This research agenda of ion channel analysis in arterial smooth muscle is now the HERACLES Programme within the Cardiovascular Research Network (RIC).

The NEUVAS location at PRBB and connection to the Hospital del Mar clinical neurology services gives the group the benefit of combining theoretical, epidemiological and technical perspectives on biomedical research with applications and daily practice in the healthcare environment.

BASICMAR Register:

BASICMAR (BASe de datos de ICtus del hospital del MAR) is the main matrix or register supporting most of the NEUVAS research lines. This prospective database of all acute stroke events attended since 2005 at IMIM-Hospital del Mar (Barcelona, Spain) includes both first and recurrent strokes, with no exclusion criteria related to age, sex, or race.
This register is associated with the biological samples collection (BIOBASICMAR) and neuroimaging archives (RADIOBASICMAR). 

  • BASICMAR Data: A patient database of epidemiological and anthropometric data, vascular risk factors, as well as clinical data from the acute phase, hospitalization (if applicable), and 3-month follow-up after the stroke. The primary matrix is derived from various secondary registers depending on the tests and procedures done in each case.
    • BASICMAR (Primary matrix)
    • REHANIM (Register of Nutritional Habits in Stroke Patients, Hospital del Mar)
    • HSA (Register of subarachnoid hemorrhages)
    • ENVAS (Register of Endovascular procedures)
    • CONTROLS (Register of healthy controls)
  • BASICMAR Samples
      • SeroBASICMAR (Serum and plasma)
      • GenoBASICMAR (DNA)
      • PETRA (acute-phase RNA)
      • BACAM/COLMAH (Carotid artery)
      • Cerebral Magnetic Resonance Imaging
      • Brain scan (CAT)
      • Supra-aortic artery images (Doppler/Dupplex)

Research lines:

1. Clinical Markers and Research (clinNEUVAS): Study of cerebrovascular disease and its clinical and epidemiological risk factors, as well as markers of stroke recurrence and evolution. There are 5 internal research lines:

a. Epidemiology and clinical evolution (Dr. Ángel Ois)

  • Microalbuminuria as an etiological marker of prognosis
  • Long-term risk of cardiovascular events
  • Echocardiographic alterations of low or uncertain risk and ischemic stroke etiology

b. Biomarkers (Dra. Elisa Cuadrado-Godia): Study of plasma and serum markers in patients with acute stroke in the acute phase. The objective of this line of research is to identify markers that are useful both in the etiological diagnosis of stroke and in calculating the risk of recurrence or poor prognosis. Diverse laboratory techniques are used, including ELISA, western blot and flow cytometry.

c. Nutrition and lípids (REHANIM) (Dra. Ana Rodríguez-Campello)

  • Diet and cerebrovascular disease: No direct relationship to diet has been demonstrated in complex diseases. Although diet could influence stroke risk by various mechanisms, the dietary habits that prevent stroke are not well established. In recent years, a nutritional habits questionnaire (REHANIM) validated in our population has been administered to patients hospitalized with ictus, with the objective of evaluating the role of diet in cerebrovascular disease. At present our group has nutritional data related to more than 300 strokes. The objective is to conduct comparative controlled studies. An initial comparative controlled study of the REGICOR (Registre Gironi del Cor) database found differences in nutrient intakes between the study populations. We are now recruiting healthy population controls to avoid population bias.
  • Anthropometry and stroke: Obesity is considered an independent risk factor for the development of arteriosclerosis and ictus. The greatest controversy is related to how the distribution of adipose tissue affects the risk of developing cerebrovascular disease. Our group has the anthropometric data (weight, height, BMI, waist circumference) to evaluate the influence of abdominal obesity on stroke and conduct comparative studies with healthy controls.

d. Neurosonology (Dra. Elisa Cuadrado-Godia): Study of arterial morphology and functionality in patients with cerebrovascular disease. The objective of this line of research is to analyze the etiopathogenic and prognostic role of endothelial cerebral function in patients with different subtypes of cerebrovascular pathology. Among the tests used is intima-media thickness measurement and the analysis of cerebral vasorreactivity using CO2 testing.

e. Neuroimaging (Dra. Eva Giralt-Steinhauer): Software treatments of radiologic images (e.g., CAT, brain MRI) to measure infarction, hematoma and leukoaraiosis volumes. The application of a validated and rigorous methodology results in precise, reliable phenotypic data with high information value for the study of cerebrovascular diseases.

2. Research in Cerebrovascular Genetics (genNEUVAS): This group develops, participates and collaborates in studies designed to clarify the genetic bases of cerebrovascular pathology. It investigates the genetic and clinical-genetic risk of disease, as well as genetic involvement in the clinical status and development of patients. Our group has a clear commitment to collaboration, exemplified by our coordination and co-leadership of the “Spanish Consortium on the Genetics of Stroke (Genestroke)” and membership in the “International Stroke Genetics Consortium (ISGC)”, participating in various international projects.

  • Types of study:

a. Genome Wide Association Studies (Dr. Jordi Jiménez-Conde)
Technical advances in massive genotyping in recent years have led to platforms that permit genotyping of between 50,000 and 2.7 million SNPs per individual. This has permitted the development of the studies called Genome Wide Association (GWA), which represent an important advance in the genetic study of complex diseases, such as stroke. In genetics, we are carrying out our own studies as well as coordinated GWA projects in the field of cerebrovascular pathology.

b. Genetic and clinical-genetic scores (Dr. Jordi Jiménez-Conde)
In complex diseases, multiple common genetic variants (SNPs) tend to be associated with a phenotype and the strength of the association for each one tends to be low. Therefore, to integrate the information and the predictive capacity of the SNPs associated with a phenotype it is necessary to design appropriate strategies and statistical tools. This is why we work on the design of genetic scores and clinical-genetic and genetic networks that help to explain a mechanism of action or can offer practical applications of the discoveries.

c. Epigenetics (Dra. Carolina Soriano)
Ischemic stroke is a heterogeneous disease for which a genetic component is suggested because the epigenetic component is unknown. Epigenetic mechanisms such as DNA methylation regulate the structure of the chromatin and gene expression. DNA methylation has been associated with cardiovascular diseases and the hypomethylation of DNA with increased risk of ischemic heart disease/ictus. Analysis of DNA methylation could provide new information about the disease, prognosis and the effect of vascular risk factors.

d. Sequencing (Dra. Carolina Soriano/ Marina Mola)

i. Exome Sequencing studies.
Exome sequencing is an efficient strategy to selectively sequence codifying whole-genome regions for a single individual. Exons (approximately 1% of the human genome) are functionally important DNA sequences that represent the regions in genes that are translated into proteins.
We use this technique to compare stroke cases with favorable and unfavorable 3-month prognosis after cerebrovascular ischemic accident.
Utilizamos esta técnica para comparar casos de ictus con pronóstico favorable y desfavorable a los tres meses después del accidente cerebrovascular isquémico.

ii. Sequencing of candidate genes
Target genes that are likely associated or involved in a particular disease, condition or alteration cerebrovascular are specifically sequenced. The objective is to establish associations between the genetic variations of the genes of interest and phenotypes or symptoms of cerebrovascular disease. The selection of candidate genes is based on a priori knowledge of the functional or biological impact of these genes on the clinical condition or disease under study.

Latest publications

  • Vivanco-Hidalgo RM, Gomez A, Moreira A, Díez L, Elosua R, Roquer J Prevalence of cardiovascular risk factors in people with epilepsy. Brain Behav 2017; 7: e00618

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  • Sayols-Baixeras S, Subirana I, Lluís-Ganella C, Civeira F, Roquer J, Do AN, Absher D, Cenarro A, Muñoz D, Soriano-Tarraga C, Jiménez-Conde J, Ordovas JM, Sentí M, Aslibekyan S, Marrugat J, Arnett DK, Elosua R Identification and validation of seven new loci showing differential DNA methylation related to serum lipid profile: an epigenome-wide approach. The REGICOR study. Hum. Mol. Genet. 2016; 25: 4556-4565

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  • Ruiz-Carmona C, Diaz-Duran C, Sevilla N, Cuadrado E, Clarà A Long-term Survival after Carotid Endarterectomy in a Population with a Low Coronary Heart Disease Fatality: Implications for Decision Making. Ann Vasc Surg 2016; 36: 153-158

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  • García García J, Roquer J, Serena J, Castillo J, Blanco M, Díaz-Maroto I, Segura T Carotid Intima-Media Thickness is Not Associated with Markers of Atherosclerosis in Stroke Patients. J Stroke Cerebrovasc Dis 2016; 25: 1070-1075

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  • Suárez C, Pose A, Montero-Pérez-Barquero M, Roquer J, Gállego J, Ràfols C, Cazorla D, Vivancos J [Validation of satisfaction questionnaire ACTS in outpatients with atrial fibrillation treated with oral anticoagulants in Spain. ALADIN Study]. Med Clin (Barc) 2016; 147: 192-198

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  • Álvarez-Guerrico I, Royo I, Andreu M, Roquer-González J, Munteis E [Protocol for neurophysiological studies of the pelvic floor to appraise anorectal dysfunction in patients with multiple sclerosis]. Rev Neurol 2016; 62: 211-7

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  • Soriano-Tarraga C, Giralt-Steinhauer E, Mola-Caminal M, Vivanco-Hidalgo RM, Ois A, Rodríguez-Campello A, Cuadrado-Godia E, Sayols-Baixeras S, Elosua R, Roquer J, Jiménez-Conde J Ischemic stroke patients are biologically older than their chronological age. Aging (Albany NY) 2016; 8: 2655-2666

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  • Anderson CD, Falcone GJ, Phuah CL, Radmanesh F, Brouwers HB, Battey TW, Biffi A, Peloso GM, Liu DJ, Ayres AM, Goldstein JN, Viswanathan A, Greenberg SM, Selim M, Meschia JF, Brown DL, Worrall BB, Silliman SL, Tirschwell DL, Flaherty ML, Kraft P, Jagiella JM, Schmidt H, Hansen BM, Jiménez-Conde J, Giralt-Steinhauer E, Elosua R, Cuadrado-Godia E, Soriano C, van Nieuwenhuizen KM, Klijn CJ, Rannikmäe K, Samarasekera N, Al-Shahi Salman R, Sudlow CL, Deary IJ, Morotti A, Pezzini A, Pera J, Urbanik A, Pichler A, Enzinger C, Norrving B, Montaner J, Fernandez-Cadenas I, Delgado P, Roquer J, Lindgren A, Slowik A, Schmidt R, Kidwell CS, Kittner SJ, Waddy SP, Langefeld CD, Abecasis G, Willer CJ, Kathiresan S, Woo D, Rosand J Genetic variants in CETP increase risk of intracerebral hemorrhage. Ann. Neurol. 2016; 80: 730-740

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  • Soriano-Tarraga C, Jiménez-Conde J, Giralt-Steinhauer E, Mola-Caminal M, Vivanco-Hidalgo RM, Ois A, Rodríguez-Campello A, Cuadrado-Godia E, Sayols-Baixeras S, Elosua R, Roquer J Epigenome-wide association study identifies TXNIP gene associated with type 2 diabetes mellitus and sustained hyperglycemia. Hum. Mol. Genet. 2016; 25: 609-19

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  • Marrugat J, Elosua R, Icaza G, Morales-Salinas A, Dégano IR [Practicality of cardiovascular risk functions]. Medwave 2016; 16: e6792

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All publications

An initiative of

Ministerio de Economía y Competitividad Fondo Europeo de Desarrollo Regional IMIM - Parc de Salut Mar