Epilepsia最新文献

{"title":"The future of EEG education in the era of artificial intelligence.","authors":"John R McLaren, Doyle Yuan, Sándor Beniczky, M Brandon Westover, Fábio A Nascimento","doi":"10.1111/epi.18326","DOIUrl":"10.1111/epi.18326","url":null,"abstract":"","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between severity of stroke and poststroke epilepsy among patients with ischemic stroke: Mediating role of infection and early seizure.","authors":"Yue Yu, Miao Tuo, Zhibin Chen, Jiajun Zhang, Yong Yang, Yan Wang","doi":"10.1111/epi.18352","DOIUrl":"https://doi.org/10.1111/epi.18352","url":null,"abstract":"<p><strong>Objective: </strong>Despite extensive studies about the direct effect of stroke severity on poststroke epilepsy (PSE), the pathway of this relationship remains unclear. We examined whether stroke-associated infection (SAI) and early seizure (ES) mediate the association between stroke severity and PSE.</p><p><strong>Methods: </strong>Patients with ischemic stroke from two tertiary hospitals in China were included in our retrospective cohort study. PSE was identified through telephone interviews based on a validated questionnaire and supplemented by a review of medical records. Stroke severity was measured using the National Institutes of Health Stroke Scale (NIHSS) score, and the cohort was divided into four severity levels: mild (NIHSS score = 0-4), intermediate (NIHSS = 5-9), moderate (NIHSS = 10-14), and severe (NIHSS ≥ 15). Mediation analysis applying the Karlson-Holm-Breen method was used to explore the mediating effect of SAI and ES on the association between different stroke severity levels and PSE.</p><p><strong>Results: </strong>A total of 2420 patients were included in the analysis, and 110 (4.5%) developed PSE during follow-up. Stroke severity was associated with SAI, ES, and PSE. Mediation analysis revealed that SAI and ES partially mediated the relationship between stroke severity and PSE. After controlling for covariates, the mediation effect proportion of SAI on the associations between moderate to severe stroke and PSE ranged from 19.71% to 29.27%. ES mediators accounted for 28.17% of the associations between a severe stroke and PSE.</p><p><strong>Significance: </strong>SAI and ES partially mediated the association between stroke severity and PSE. This highlighted the need for additional attention to SAI and ES in patients with ischemic stroke to prevent PSE.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Imbalance between hippocampal projection cell and parvalbumin interneuron architecture increases epileptic susceptibility in mouse model of methyl CpG binding protein 2 duplication syndrome\".","authors":"","doi":"10.1111/epi.18363","DOIUrl":"https://doi.org/10.1111/epi.18363","url":null,"abstract":"","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dravet syndrome: From neurodevelopmental to neurodegenerative disease?","authors":"Arunan Selvarajah, Andrea Sabo, Carolina Gorodetsky, Paula T Marques, Ilakkiah Chandran, Miles Thompson, Quratulain Zulfiqar Ali, Mary Pat McAndrews, Maria Carmela Tartaglia, Victor S T Lira, Linda Huh, Mary Connolly, Arezoo Rezazadeh, Farah Qaiser, Tadeu A Fantaneanu, Monica Duong, Karen Barboza, Lysa Boissé Lomax, Luciana Inuzuka Nakaharada, Kette Valente, Jack Arbinuch, Mariana Espindola, Eliana Garzon, Gianluca Sorrento, Mary Anne Meskis, Nicole Villas, Veronica Hood, Marta Gonzalez, Elena Cardenal-Muñoz, Jose Angel Aiba, Lauraine McKenna, Christine Linehan, Sophine Hohn, Stéphane Auvin, Orrin Devinsky, Ryan Yuen, Anne T Berg, Babak Taati, Alfonso Fasano, Danielle M Andrade","doi":"10.1111/epi.18329","DOIUrl":"https://doi.org/10.1111/epi.18329","url":null,"abstract":"<p><strong>Objective: </strong>Dravet syndrome (DS) is a severe developmental and epileptic encephalopathy caused by SCN1A haploinsufficiency in the majority of cases. Caregivers of adults with DS often complain about the loss of previously acquired skills. We set out to explore these perceptions and determine whether abnormalities reported were detectable in validated tests. We also investigated possible correlations between symptoms, age, and exposure to sodium channel blockers (SCBs).</p><p><strong>Methods: </strong>This cross-sectional, multicenter study used the Vineland Adaptive Behavior Scales, 3rd edition (raw scores) for behavior analyses and Moss-Psychiatric Assessment Schedules checklist to screen for psychiatric symptoms. The Social Communication Questionnaire screened for social communication deficits. Parkinsonian features were evaluated with the modified Unified Parkinson's Disease Rating Scale. For gait evaluation, we validated the use of home videos, using instrumental gait analysis in a subgroup of patients, and then used the home videos for the remainder.</p><p><strong>Results: </strong>A total of 92 patients were enrolled (age range = 18-51 years, mean = 27.93 ± 8.59 years). Sixty percent of caregivers observed a decline in previously acquired skills, including intelligence, speech, interaction with others, ability to climb stairs and walk without support, and hand coordination. Adaptive skills, parkinsonian symptoms, and gait were worse in older patients and those exposed to SCBs for longer periods of time. Fourteen percent of patients screened positive for affective disorders, 11.6% for dementia, and 10.5% for a psychotic disorder. Fifty-three percent screened positive for social communication deficits.</p><p><strong>Significance: </strong>This is the largest group of adults with DS to be systematically evaluated. They had severe nonseizure symptoms. Older age and longer use of SCBs were associated with worse adaptive skills, gait, and parkinsonism. Some older adults screened positive for depression and dementia. Caregivers identified functional decline in activities of daily living (ADLs). Taken together, the risk of dementia, parkinsonian gait, and decline in ability to perform previously mastered ADLs support that some adults with DS may be developing a neurodegenerative disorder.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seizure outcomes following epilepsy surgery in pediatric and young adult patients with high-grade brain tumors: Results from a European survey.","authors":"Robert Lersch, Till Hartlieb, Tom Pieper, Manfred Kudernatsch, Wiebke Hofer, Carmen Barba, Renzo Guerrini, Flavio Giordano, Marianna Pommella, Susanne Schubert-Bast, Steffen Syrbe, Ricardo Rego, Jorge Pinheiro, Martha Feucht, Alexander Beck, Roland Coras, Ingmar Blumcke, Michael Alber, Moritz Tacke, Jan Rémi, Christian Vollmar, Mathias Kunz, Jay Shetty, Ailsa McLellan, Drahoslav Sokol, Jothy Kandasamy, Kerstin Alexandra Klotz, Victoria San Antonio-Arce, Andreas Schulze-Bonhage, Joshua Pepper, William B Lo, Alexis Arzimanoglou, Stefano Francione, Christian J Braun, Ingo Borggraefe","doi":"10.1111/epi.18323","DOIUrl":"https://doi.org/10.1111/epi.18323","url":null,"abstract":"<p><strong>Objective: </strong>Epilepsy surgery is a standard treatment for drug-resistant epilepsy, resulting in seizure freedom in a significant number of cases. Although frequently performed for low-grade brain tumors, it is rarely considered for high-grade tumors, despite the impact of chronic epilepsy on quality of life and cognition.</p><p><strong>Methods: </strong>This retrospective multicenter study across 43 European centers evaluated epilepsy surgery outcomes in children with high-grade brain tumors (World Health Organization grades III and IV). Two cohorts of patients younger than 25 years were studied: (1) those undergoing epilepsy surgery after tumor resection (n = 14) and (2) those initially suspected of low-grade lesions but diagnosed with high-grade brain tumors postsurgery (n = 11).</p><p><strong>Results: </strong>Eighty percent of patients achieved seizure freedom 1 year after last epilepsy surgery: 71% in Cohort 1 and 91% in Cohort 2. Eighty-four percent were free of disabling seizures (Engel IA-D) after a median follow-up period of 4.3 years (range = 1-15.9 years). No surgery-related deaths occurred. Thirty-two percent of children experienced persistent morbidity, including motor dysfunction, visual impairment, persistent seizures, cognitive deficits, and hydrocephalus.</p><p><strong>Significance: </strong>Epilepsy surgery is effective for medically refractory epilepsy in children with high-grade central nervous system tumors and should be considered early, as seizure freedom is achieved in the majority of patients. Despite involving numerous epilepsy centers, only 25 patients were recruited, indicating that this method is rarely considered for high-grade brain tumor patients with medically refractory epilepsy.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assisted reproduction and the fetal malformation risk associated with antiseizure medication exposure in pregnancy.","authors":"Frank Vajda, Terence O'Brien, Janet Graham, Alison Hitchcock, Piero Perucca, Cecilie Lander, Mervyn Eadie","doi":"10.1111/epi.18335","DOIUrl":"https://doi.org/10.1111/epi.18335","url":null,"abstract":"<p><strong>Objective: </strong>This study was undertaken to explore the possible role of assisted reproduction treatment (ART) in the occurrence of fetal malformation in women with antiseizure medication (ASM)-treated epilepsy.</p><p><strong>Methods: </strong>Data collected in the Australian Pregnancy Register of Antiepileptic Drugs concerning the pregnancies of women with ASM-treated epilepsy were analyzed using standard simple statistical methods.</p><p><strong>Results: </strong>The malformed fetal occurrence rate tended to be higher in women with epilepsy (WWE) treated with ASMs than in those untreated in at least the earlier months of pregnancy, the risk being statistically significantly higher (p < .05) in relation to valproate monotherapy. The malformation risk was greater when the pregnancy had been initiated via ART (n = 152, malformation rate = 11.18%) than when ART was not involved (n = 2388, malformation rate = 6.49%, relative risk [RR] = 1.72, 95% confidence interval [CI] = 1.07-2.77) and also greater versus ASM-treated pregnancy not involving ART (n = 2191, malformation rate = 6.79%, RR = 1.64, 95% CI = 1.02-2.64). The anatomical sites affected by the malformations also differed, the heart and great vessels being more often involved when ART had been involved. Multivariate logistic regression analysis suggested that the heightened malformation risk associated with ART plus ASM exposure seemed to be related to use of hormones in ART more than to in vitro fertilization.</p><p><strong>Significance: </strong>WWE undertaking pregnancy through ART should be aware of the increased risk of fetal malformation beyond that related to ASM exposure. If this finding is supported in further studies, evaluations of fetal malformation risk rates associated with ASM exposure may need to be adjusted for possible overestimation because of confounder effects of ART, if ART was involved in the pregnancies studied.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing seizure induction in patients with intracranial EEG recording.","authors":"Hina Dave, Morgan McCreary, Antonio Guerra, Michael R Sperling","doi":"10.1111/epi.18331","DOIUrl":"https://doi.org/10.1111/epi.18331","url":null,"abstract":"<p><strong>Objective: </strong>To shorten inpatient epilepsy monitoring unit (EMU) stays during epilepsy surgery evaluation, physicians utilize techniques to induce seizures including antiseizure medication (ASM) reduction, sleep deprivation, and chemical stimulation. We assessed the relative efficacy of these techniques.</p><p><strong>Methods: </strong>We reviewed data from patients admitted for intracranial video-EEG (electroencephalography) evaluation at a single center. Demographics, baseline seizure frequency, seizure type, sleep deprivation, reduction in ASM, chemical stimulation method, and seizures were recorded. Statistical analyses were performed in R with survival analyses.</p><p><strong>Results: </strong>A total of 209 patients were evaluated. We observed an increase in the risk of seizure occurrence of 1% for every increase of one seizure per week of baseline seizure frequency (confidence interval [CI] = 1.00-1.02, p = .009). Complete cessation of both sodium channel and non-sodium channel ASMs increase the rate of seizure occurrence (CI = 1.46-2.08, p < .0001 and CI = 1.28-1.80, p < .0001, respectively). A partial reduction in sodium channel drugs within 24 h of admission or previous seizure in the EMU increased seizure risk by 40% (CI = 1.18-1.72, p = .0002). For each seizure occurring during admission, the risk of seizure recurrence increased by 5% (CI = 1.03-1.08, p < .0001). Patients with temporal lobe epilepsy exhibited a 19% lower risk of seizures within the initial 24 h of admission than patients with extratemporal seizures (CI = .68-.97, p = .02). Neither chemical stimulation nor sleep deprivation impacted seizure risk.</p><p><strong>Significance: </strong>We found that ASM reduction was the only method that effectively induced seizures in hospitalized patients; sleep deprivation and chemical induction failed to do so. Prospective studies are needed to further understand these induction methods.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic resonance imaging findings in SCN1A-related epilepsies and Dravet syndrome: A systematic review.","authors":"Lydia Viviana Falsitta, Helen Cross, Camilla Lindan, Elizabeth George, P Ellen Grant, Sniya Sudhakar, Cesar Alves, Joseph Sullivan, Suresh Pujar, Felice D'Arco","doi":"10.1111/epi.18344","DOIUrl":"https://doi.org/10.1111/epi.18344","url":null,"abstract":"<p><p>We systematically reviewed the literature on neuroimaging findings in Dravet syndrome (DS) and SCN1A-related epilepsies to classify the reported structural abnormalities observed on magnetic resonance imaging (MRI). We searched PubMed and MEDLINE from January 2000 to June 2024 for studies describing brain MRI findings in DS and SCN1A-related epilepsies through specific keywords and MeSH (Medical Subject Headings) terms. Duplicates were removed, and titles and abstracts were screened. Studies with absent/marginal MRI focus and reviews were excluded. Images available were evaluated by two pediatric neuroradiologists in consensus. Manual reference checks were performed. For the selection process, we followed the latest PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Nineteen studies met the inclusion criteria, all of which had an observational design, including case reports (n = 3), case series (n = 7), and larger cohorts (n = 9). The most observed brain MRI findings were cortical/parenchymal atrophy, hippocampal sclerosis (HS), and malformations of cortical development. Less frequent abnormalities include callosal dysgenesis and postseizure changes on diffusion-weighted imaging. There was variability in the description across studies, as expected. This review represents a valuable reference database for current and future genetic therapy trials. DS, particularly when associated with SCN1A variants, involves a variety of neuroimaging abnormalities, including HS, diffuse brain atrophy, and malformations of cortical development. The spectrum of these findings probably reflects the interplay between genetic susceptibility, seizure duration/severity, medication effects, and timing of imaging. To date, high-quality studies on brain MRI findings are limited, and future research, with more standardized methodologies, a longitudinal design, and larger sample sizes, are needed to further uncover these relationships and improve our understanding of the disease.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blocking the innate immune CD1d/NKT cell axis prevents the development of cortical hyperexcitability and posttraumatic epilepsy.","authors":"Xingjie Ping, Wenhui Xiong, Raj Priya, Jianyun Liu, Season K Wyatt-Johnson, Randy R Brutkiewicz, Xiaoming Jin","doi":"10.1111/epi.18332","DOIUrl":"https://doi.org/10.1111/epi.18332","url":null,"abstract":"<p><strong>Objective: </strong>Posttraumatic epilepsy (PTE) that develops after a traumatic brain injury (TBI) cannot be prevented by current treatments. Although neuroinflammation is involved in epileptogenesis, a potential role for cellular immunity in this process is largely unknown. Natural killer T (NKT) cells are innate-like T lymphocytes that recognize lipid antigens presented by the major histocompatibility complex class I-like CD1d molecule and play a crucial role in regulating immune responses. Herein we examined the role of the CD1d/NKT cell axis in PTE.</p><p><strong>Methods: </strong>We used an undercut surgery to induce TBI in wild-type (WT) and CD1d-deficient (CD1d knockout [KO], CD1d KO) or NKT cell-deficient (Traj18 KO) mice. A pentylenetetrazol (PTZ) test was used to determine seizure susceptibility in vivo, and field potential recordings were made from cortical slices in vitro. Continuous video and wireless EEG monitoring was undertaken of WT and CD1d KO mice between 5 and 8 weeks after brain injury. Because statins are known to impair antigen presentation by CD1d to NKT cells, we also treated WT mice with simvastatin for 10 days after injury and performed the PTZ test. Immunofluorescence and flow cytometry were used to determine changes in immune cells in brain tissue.</p><p><strong>Results: </strong>CD1d KO or Traj18 KO TBI mice had a significantly lower seizure susceptibility than WT mice on the PTZ test. CD1d KO mice had a significantly lower rate of detectable epileptiform activities during field potential recording. Video and EEG monitoring showed that CD1d KO TBI mice had a significantly lower frequency of spontaneous epileptic seizures. There was increased infiltration of immune cells, but reduced microgliosis in the brains of these mice. Simvastatin treatment significantly reduced seizure susceptibility in TBI mice.</p><p><strong>Significance: </strong>Neuroinflammation initiated by the CD1d/NKT cell axis is involved in the development of cortical hyperexcitability and PTE; early treatment with simvastatin following a TBI exerts a prophylactic effect on posttraumatic epileptogenesis by blocking this axis.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operational definition of developmental and epileptic encephalopathies to underpin the design of therapeutic trials.","authors":"Ingrid E Scheffer, Jacqueline French, Kette D Valente, Stéphane Auvin, J Helen Cross, Nicola Specchio","doi":"10.1111/epi.18265","DOIUrl":"https://doi.org/10.1111/epi.18265","url":null,"abstract":"<p><p>Developmental and epileptic encephalopathies (DEEs) are the most severe group of epilepsies, characterized by drug-resistant seizures and developmental slowing or regression. DEEs encompass many epilepsy syndromes, although not all patients with a DEE can be classified into a specific syndrome. Our understanding of the etiologies of DEEs has been revolutionized with next-generation sequencing, with more than 900 genes implicated, in addition to structural causes. It is therefore now possible to consider precision medicine and novel therapeutic approaches for these devastating diseases with trials of repurposed and new drugs, including gene therapies. Trials are being designed to target either DEE diseases more broadly, specific DEE syndromes, or specific genetic DEEs. To serve this purpose, a clear operational definition of DEEs is needed to ensure that appropriate patients are selected for trials with precisely defined, targeted outcome measures. Herein we propose the operational definition of DEEs to set the stage for the development of DEE therapies.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}