Epilepsia最新文献

{"title":"Artificial intelligence, digital technology, and mobile health in epilepsy.","authors":"Sándor Beniczky, Samden Lhatoo, Michael R Sperling, Philippe Ryvlin","doi":"10.1111/epi.18435","DOIUrl":"https://doi.org/10.1111/epi.18435","url":null,"abstract":"","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985148","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":"Updated classification of epileptic seizures: Position paper of the International League Against Epilepsy.","authors":"Sándor Beniczky, Eugen Trinka, Elaine Wirrell, Fatema Abdulla, Raidah Al Baradie, Mario Alonso Vanegas, Stéphane Auvin, Mamta Bhushan Singh, Hal Blumenfeld, Alicia Bogacz Fressola, Roberto Caraballo, Mar Carreno, Fernando Cendes, Augustina Charway, Mark Cook, Dana Craiu, Birinus Ezeala-Adikaibe, Birgit Frauscher, Jacqueline French, M V Gule, Norimichi Higurashi, Akio Ikeda, Floor E Jansen, Barbara Jobst, Philippe Kahane, Nirmeen Kishk, Ching Soong Khoo, Kollencheri Puthenveettil Vinayan, Lieven Lagae, Kheng-Seang Lim, Angelica Lizcano, Aileen McGonigal, Katerina Tanya Perez-Gosiengfiao, Philippe Ryvlin, Nicola Specchio, Michael R Sperling, Hermann Stefan, William Tatum, Manjari Tripathi, Elza Márcia Yacubian, Samuel Wiebe, Jo Wilmshurst, Dong Zhou, J Helen Cross","doi":"10.1111/epi.18338","DOIUrl":"https://doi.org/10.1111/epi.18338","url":null,"abstract":"<p><p>The International League Against Epilepsy (ILAE) has updated the operational classification of epileptic seizures, building upon the framework established in 2017. This revision, informed by the implementation experience, involved a working group appointed by the ILAE Executive Committee. Comprising 37 members from all ILAE regions, the group utilized a modified Delphi process, requiring a consensus threshold of more than two thirds for any proposal. Following public comments, the Executive Committee appointed seven additional experts to the revision task force to address and incorporate the issues raised, as appropriate. The updated classification maintains four main seizure classes: Focal, Generalized, Unknown (whether focal or generalized), and Unclassified. Taxonomic rules distinguish classifiers, which are considered to reflect biological classes and directly impact clinical management, from descriptors, which indicate other important seizure characteristics. Focal seizures and those of unknown origin are further classified by the patient's state of consciousness (impaired or preserved) during the seizure, defined operationally through clinical assessment of awareness and responsiveness. If the state of consciousness is undetermined, the seizure is classified under the parent term, that is, the main seizure class (focal seizure or seizure of unknown origin). Generalized seizures are grouped into absence seizures, generalized tonic-clonic seizures, and other generalized seizures, now including recognition of negative myoclonus as a seizure type. Seizures are described in the basic version as with or without observable manifestations, whereas an expanded version utilizes the chronological sequence of seizure semiology. This updated classification comprises four main classes and 21 seizure types. Special emphasis was placed on ensuring translatability into languages beyond English. Its aim is to establish a common language for all health care professionals involved in epilepsy care, from resource-limited areas to highly specialized centers, and to provide accessible terms for patients and caregivers.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978843","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":"Prevalence, clinical characteristics, and risk factors for psychosis in people with epilepsy: A multicenter retrospective cohort study.","authors":"Sisi Shen, Hanlin Sun, Zaiquan Dong, Tong Yi, Josemir W Sander, Dong Zhou, Jinmei Li","doi":"10.1111/epi.18409","DOIUrl":"https://doi.org/10.1111/epi.18409","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to assess the prevalence, clinical characteristics, and risk factors for psychosis in a cohort of people with epilepsy in West China.</p><p><strong>Methods: </strong>We used retrospective information from databases of three tertiary epilepsy centers, which included follow-up records from 2006 onward. Those with complete baseline data and at least one follow-up record were included. A psychiatrist confirmed the diagnosis of psychosis. Psychiatric features were evaluated using the Brief Psychiatric Rating Scale, Scale for the Assessment of Positive Symptoms, and Scale for the Assessment of Negative Symptoms. Demographic data and clinical characteristics were used to develop risk models for interictal psychosis (IIP), ictal psychosis (IP), and postictal psychosis (PIP).</p><p><strong>Results: </strong>Eight hundred eighty-two people were identified. Of them, 112 (13%) were diagnosed with psychosis of epilepsy (POE), including 62 with IIP (7%), 29 with IP (3%), and 21 with PIP (2%). Twenty-seven of the 882 (3%) were diagnosed with epilepsy following the onset of psychosis. Individuals with pre-epilepsy psychosis, compared to those with POE, exhibited a lower proportion of refractory epilepsy, less frequent seizures, reduced seizure severity, and higher frequency and severity of hallucinations and delusions. In people with POE, bizarre behavior, avolition, and anhedonia were the three most common psychotic symptoms. Modeling identified several risk factors; earlier age at seizure onset, family history of schizophrenia, current frequent seizures, temporal lobe epilepsy (TLE), hippocampal sclerosis, perampanel use, and taking at least two antiseizure medications were associated with an increased risk of IIP. Severe head trauma, current frequent seizures, and TLE were risk factors for PIP, whereas current frequent seizures alone were a risk factor for IP.</p><p><strong>Significance: </strong>Psychosis is often comorbid with epilepsy. Our study suggests that the prevalence of POE may be two times higher than previously reported. Prompt recognition and early management of psychosis are warranted.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959465","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":"Deep learning-based detection of generalized convulsive seizures using a wrist-worn accelerometer.","authors":"Antoine Spahr, Adriano Bernini, Pauline Ducouret, Christoph Baumgartner, Johannes P Koren, Lukas Imbach, Sàndor Beniczky, Sidsel A Larsen, Sylvain Rheims, Martin Fabricius, Margitta Seeck, Berhard J Steinhoff, Isabelle Beuchat, Jonathan Dan, David A Atienza, Charles-Edouard Bardyn, Philippe Ryvlin","doi":"10.1111/epi.18406","DOIUrl":"https://doi.org/10.1111/epi.18406","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a wrist-worn accelerometer-based, deep-learning tunable algorithm for the automated detection of generalized or bilateral convulsive seizures (CSs) to be integrated with off-the-shelf smartwatches.</p><p><strong>Methods: </strong>We conducted a prospective multi-center study across eight European epilepsy monitoring units, collecting data from 384 patients undergoing video electroencephalography (vEEG) monitoring with a wrist-worn three dimensional (3D)-accelerometer sensor. We developed an ensemble-based convolutional neural network architecture with tunable sensitivity through quantile-based aggregation. The model, referred to as Episave, used accelerometer amplitude as input. It was trained on data from 37 patients who had 54 CSs and evaluated on an independent dataset comprising 347 patients, including 33 who had 49 CSs.</p><p><strong>Results: </strong>Cross-validation on the training set showed that optimal performance was obtained with an aggregation quantile of 60, with a 98% sensitivity, and a false alarm rate (FAR) of 1/6 days. Using this quantile on the independent test set, the model achieved a 96% sensitivity (95% confidence interval [CI]: 90%-100%), a FAR of <1/8 days (95% CI: 1/9-1/7 days) with 1 FA/61 nights, and a median detection latency of 26 s. One of the two missed CSs could be explained by the patient's arm, which was wearing the sensor, being trapped in the bed rail. Other quantiles provided up to 100% sensitivity at the cost of a greater FAR (1/2 days) or very low FAR (1/100 days) at the cost of lower sensitivity (86%).</p><p><strong>Significance: </strong>This Phase 2 clinical validation study suggests that deep learning techniques applied to single-sensor accelerometer data can achieve high CS detection performance while enabling tunable sensitivity.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991910","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":"Features affecting treatment decisions and outcome in refractory status epilepticus.","authors":"Charlotte Damien, Nathan Torcida Sedano, Chantal Depondt, Benjamin Legros, Nicolas Gaspard","doi":"10.1111/epi.18423","DOIUrl":"https://doi.org/10.1111/epi.18423","url":null,"abstract":"<p><strong>Objective: </strong>Refractory status epilepticus (RSE) is associated with worse outcomes than responsive established status epilepticus (SE). Guidelines recommend that refractory convulsive SE should be treated with continuous intravenous anesthetic drugs (CIVADs). Many cases of nonconvulsive SE are not reated with CIVADs, and the use of anesthesia might be associated with increased mortality. The factors leading to the decision to use anesthesia and how these might affect outcome are still largely unknown. Our goal was to identify features of refractory SE associated with treatment choices and outcome.</p><p><strong>Methods: </strong>A single-center, retrospective study was conducted of all consecutive patients with RSE admitted to a tertiary center between January 2015 and December 2020. We collected demographic and clinical variables at SE onset and at time of third-line treatment, including ictal burden during the hour preceding the administration of the third-line treatment. The primary outcome measure was the decision to use CIVADs as third-line treatment. Secondary outcome measures were in-hospital mortality and functional outcome at discharge.</p><p><strong>Results: </strong>One hundred sixty-one RSE episodes were included. Of these, 29 (18%) received CIVADs as third-line treatment and 61 (38%) died. The type of third-line treatment was not associated with mortality. CIVADs were more likely to be used with higher ictal burden, fewer comorbidities, a lower Glasgow Coma Scale (GCS) score at time of third-line administration, and in the absence of history of epilepsy (odds ratio [OR] = 1.03, .76, .66, and .25, respectively). Multivariable analyses also identified comorbidities, an acute etiology, and lower GCS score at time of third-line administration as risk factors of mortality (OR = 1.43, .09-.28, and .80, respectively). Ictal burden was not associated with outcome.</p><p><strong>Significance: </strong>Ictal burden, semiology, and consciousness at time of third-line treatment are associated with the decision to use CIVADs in SE. Semiology and consciousness at time of third-line treatment are also associated with mortality.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986183","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":"Insights from stereoelectroencephalography in KCNT1-related focal epilepsy suggest a multifocal and migrating epileptogenic network.","authors":"Zeynep Gokce-Samar, Gaëtan Lesca, Julie Bourgeois-Vionnet, Jean Isnard, Sébastien Boulogne, Luc Valton, Hélène Catenoix, Claire Marcon-Mohsen, Karine Ostrowsky-Coste, Nicolas Chatron, Marc Guenot, Sylvain Rheims, Alexandra Montavont","doi":"10.1111/epi.18425","DOIUrl":"https://doi.org/10.1111/epi.18425","url":null,"abstract":"<p><p>The most characteristic syndrome related to KCNT1 is epilepsy of infancy with migrating focal seizures. Unifocal epilepsies have also been reported, the most common being sleep-related hypermotor epilepsy (SHE) of frontal origin. Only 10 cases of focal extrafrontal epilepsies with an insulo-opercular or temporal origin have been reported. Among these patients suffering from focal epilepsy, only seven underwent stereoelectroencephalography (S-EEG) describing focal or multifocal ictal onsets. We performed three S-EEGs and one S-EEG in two unrelated patients suffering from refractory magnetic resonance imagining-negative SHE with insulo-opercular seizures. None of the patients had any familial history of epilepsy or intellectual disability. They suffered from nocturnal seizures with stereotyped ictal symptoms suggestive of insulo-opercular SHE (IO-SHE). The four S-EEGs revealed multifocal, bilateral, and migrating ictal activity, whereas clinical ictal semiology remained stereotyped. These S-EEG findings led us to carry out genetic analysis, and a pathogenic missense variant of KCNT1 was found in each patient (p.Arg928Cys and p.Arg933His). Considering these two new patients, IO-SHE represents the second most frequent type of KCNT1-related focal epilepsy, and these S-EEG findings, never described before, suggest that migrating ictal activity might be a common feature of KCNT1-related epilepsy despite different syndromic presentations.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991336","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":"Pharmacodynamic interactions between seletracetam and antiseizure comedications in the human photosensitivity model.","authors":"Wolfgang Löscher, Armel Stockis, Pavel Klein, Dorothee Kasteleijn-Nolst Trenité","doi":"10.1111/epi.18420","DOIUrl":"https://doi.org/10.1111/epi.18420","url":null,"abstract":"<p><p>We recently reported that seletracetam (SEL), a highly potent derivative of levetiracetam (LEV), reduces or abolishes the photoparoxysmal electroencephalographic response (PPR) to intermittent photic stimulation (IPS) in patients with epilepsy. Most of the 27 patients in this study were on comedication with different antiseizure medications (ASMs). Here, we reanalyzed the raw data of this clinical trial to determine which, if any, of the ASMs reduced (or increased) the effect of SEL on PPR in individual patients. This was possible because a group of six patients were not taking any ASM, and groups of similar size received different comedications. The effect size of SEL on the standard photosensitivity range (SPR) was calculated by the area under the effect curve from 0 to 8 h (AUEC [0-8]) as SPR change from predose. All patients experienced PPRs in response to IPS during placebo treatment, indicating that the PPR was resistant to treatment with their steady-state ASMs. Oral single-dose treatment with SEL reduced/abolished PPR in most (32/36) exposures, but significant effects of ASM comedication were found. Patients comedicated with LEV + lamotrigine or LEV + valproate exhibited significantly lower AUEC (0-8)s than patients without comedication, whereas no significant effects of lamotrigine or valproate alone were found. Despite the significant reduction of AUEC (0-8) in patients on comedication with LEV, SEL still reduced or abolished PPR in the majority (7/9) of exposures.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991590","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":"Updating the ILAE seizure classification.","authors":"Sándor Beniczky, Eugen Trinka, Elaine Wirrell, Nicola Specchio, Fernando Cendes, J Helen Cross","doi":"10.1111/epi.18399","DOIUrl":"https://doi.org/10.1111/epi.18399","url":null,"abstract":"","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990646","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":"Frequency-specific alterations in brain connectivity induced by pulvinar stimulation.","authors":"Emma Acerbo, Aude Jegou, Stanislas Lagarde, Francesca Pizzo, Julia Makhalova, Agnès Trébuchon, Christian-George Bénar, Fabrice Bartolomei, Romain Carron","doi":"10.1111/epi.18405","DOIUrl":"https://doi.org/10.1111/epi.18405","url":null,"abstract":"<p><strong>Objective: </strong>Deep brain stimulation (DBS) is emerging as a promising therapy for patients with drug-resistant epilepsy, particularly those who are either unsuitable for or unresponsive to resective surgery. The potential benefit of DBS in these patients may stem from its ability to reduce excessive brain functional connectivity (FC). Given that patients undergoing presurgical evaluation in our institution are implanted with stereoelectroencephalographic (SEEG) electrodes in the thalamus, specifically in the pulvinar medialis (PuM), our aim was to investigate the impact of different stimulation frequencies on brain FC. We sought to determine whether specific frequencies were more effective in modulating FC.</p><p><strong>Methods: </strong>SEEG was used to investigate the effects of PuM stimulation across a broad frequency range (1-200 Hz) in a cohort of 14 patients with drug-resistant focal epilepsy. FC was assessed using the nonlinear correlation coefficient (h²) and node strength calculations.</p><p><strong>Results: </strong>Our findings revealed a reduction in FC at stimulation frequencies of 10 Hz and >90 Hz, contrasting with an increase in FC in the 20-80-Hz range. This modulation of FC extended beyond the epileptogenic zone, influencing all assessed brain lobes, with the parietal, insular, and subcortical regions particularly affected by high-frequency stimulation. Within the epileptogenic zone, however, the observed FC changes were notably more complex.</p><p><strong>Significance: </strong>These results underscore the potential of high-frequency stimulation to decrease interictal FC in epilepsy patients, although intermediate frequencies may exacerbate it and warrant caution. Crucially, this study highlights the effects of PuM stimulation on FC patterns, supporting the role of high-frequency thalamic stimulation as a promising DBS parameter for improving epilepsy management strategies.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989841","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":"Sustained rescue of seizure control in patients with highly refractory chronic epilepsy using empiric immunotherapy.","authors":"Elisabeth Doran, Albert Kelly, Raluca Stanila, Laura Healy, Colin P Doherty","doi":"10.1111/epi.18417","DOIUrl":"https://doi.org/10.1111/epi.18417","url":null,"abstract":"<p><strong>Objective: </strong>Following emerging evidence of autoimmune-associated seizures in medication-refractory epilepsy, we began offering a trial of immunotherapy to selected patients. Here, we review this approach's treatment response, predictive clinical features, and utility.</p><p><strong>Methods: </strong>This was a retrospective single-center cohort study (2018-2022) of empiric, palliative immunotherapy in 31 adults with highly refractory, highly active epilepsy. Since 2018, in line with the International League Against Epilepsy's addition of \"immune\" as an etiology in the Classification of Epilepsy, we initiated immunotherapy after comprehensive antiseizure medication failures while at the same time screening for an autoimmune origin. The workup included assessing clinical features, serum autoantibody testing, cerebrospinal fluid testing (where feasible), magnetic resonance imaging (MRI), and electroencephalography. All patients received intravenous methylprednisolone or IV immunoglobulin according to previously published protocols, and follow-up was for at least 12 months.</p><p><strong>Results: </strong>Nine patients (29%) in this highly refractory cohort demonstrated a sustained treatment response, measured as a greater than 50% improvement in seizure frequency for at least 12 months. Three patients (10%) became seizure-free. Six patients (20%) were classified as partial responders and experienced an initial response that was not sustained. Apart from a trend toward a diagnosis of focal epilepsy, we did not identify any specific serological, clinical, electrodiagnostic, or imaging features with statistical significance that were predictive of treatment response.</p><p><strong>Significance: </strong>This patient group demonstrated a reasonable response rate to an immunotherapy trial. These findings are surprising but support the consideration of an immunotherapy trial in patients with refractory epilepsy. Requirements for repeated courses of immunotherapy differed significantly between patients, and this is an area of interest for further research. The basis for response in this cohort remains unclear; in some cases, antiseizure medication changes may have contributed; however, without any apparent autoimmune features, we consider potential blood-brain barrier repair or a placebo effect as hypothetical alternative mechanisms of action for the response to immunotherapy.</p>","PeriodicalId":11768,"journal":{"name":"Epilepsia","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985480","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}