Annals of Clinical and Translational Neurology最新文献

{"title":"Association Between Motor Pathway Damage and Motor Deficit in Upper and Lower Limb in People With MS.","authors":"Mathilde Liffran, Malo Gaubert, Alice Dufey, Elise Bannier, Audrey Rico, Jean-Christophe Ferré, Raphaël Chouteau, Laure Michel, Emmanuelle Le Page, Virginie Callot, Bertrand Audoin, Sarah Demortière, Benoît Combès, Anne Kerbrat","doi":"10.1002/acn3.70418","DOIUrl":"https://doi.org/10.1002/acn3.70418","url":null,"abstract":"<p><strong>Objective: </strong>Corticospinal tract damage is common in people with MS, but the degree of clinical symptoms varies. We hypothesize that corticospinal tract lesions are more extensive and severe in people with MS with motor impairments in both upper and lower limbs. We compared three groups of patients: isolated hyperreflexia (A), motor deficits limited to the lower limbs (B), or in both upper and lower limbs (C).</p><p><strong>Methods: </strong>We included 100 people with MS in a prospective cross-sectional study. Corticospinal tract lesions were segmented on 3D FLAIR (brain) and axial T2* and T2-weighted images (cervical and thoracic spinal cord). MP2RAGE quantitative T1 was used to assess microstructural damage severity in the brain and cervical spinal cord corticospinal tract.</p><p><strong>Results: </strong>Ninety-two people with MS were included in the analysis (A = 38, B = 31, C = 23). Lesion volume was higher in groups B and C than in group A in the brainstem and cervical corticospinal tract (all p < 0.001), and quantitative T1 was higher only in the cervical corticospinal tract (all p < 0.05). In the multivariate analysis, age, disease duration, lesion volume in the brainstem, and quantitative T1 in the cervical spinal cord distinguished group A from groups B and C, but no differentiating factors were identified between groups B and C.</p><p><strong>Interpretation: </strong>Our study suggests that motor deficit in pwMS was associated with brainstem and cervical spinal cord corticospinal tract damage. Differences between pwMS with lower limb deficits and those with both lower and upper limb deficits could not be established.</p>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Impact of NOTCH3 Variant Location After First Stroke in CADASIL.","authors":"Léa Aguilhon, Hugues Chabriat, Dominique Hervé, Stéphanie Guey, Sophie Tezenas Du Montcel, Juliette Ortholand","doi":"10.1002/acn3.70424","DOIUrl":"https://doi.org/10.1002/acn3.70424","url":null,"abstract":"<p><strong>Objective: </strong>Despite its monogenic origin, Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy exhibits marked variability in clinical expression and severity. Variants in the NOTCH3 gene, within epidermal growth factor-like repeat domains 1-6 or 7-34, are known to influence disease onset, but their impact on long-term progression remains unclear. This study assesses mutation location effects on post-first stroke clinical trajectories.</p><p><strong>Methods: </strong>Clinical data from a large cohort were analyzed (Patients EGFR 1-6 mutation group n = 210 and 7-34 mutation group n = 116) with target emulated trial framework. To study the impact of mutation location on stroke recurrence, disability (modified Rankin score ≥ 3) and mortality, following a first stroke event. Propensity score matching was used to balance covariates between mutation location groups and principal stratification to consider truncation by death. Events occurrence differences were compared using Restricted Mean Survival Time at 2, 5, 10 and 15 years.</p><p><strong>Results: </strong>At first stroke, patients with mutation in domains 1-6 were younger than those in the 7-34 mutation group (49.51 ± 7.4 vs. 55.00 ± 7.4 years). Ten years after first stroke event, mortality occurred slightly later in the 7-34 group (9.63 [9.33-9.92] vs. 9.11 [8.71-9.52] years, p = 0.04), also at 15 years (14.0 [13.42-14.63] vs. 12.4 [11.62-13.24] years; p = 0.002). Second stroke occurrence did not differ between groups. Time beyond modified Rankin of 3 slightly differed between groups at 5 and 10 years, with a difference of 0.22 [0.01-0.044] and 0.72 [0.14-1.30] year respectively (p = 0.044 and 0.017).</p><p><strong>Interpretation: </strong>Although NOTCH3 variants location influences the delay to the first stroke, it has no or little impact on the recurrence of stroke, risk of disability and death after the first stroke manifestation.</p>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial and Volumetric Characteristics of Glioblastoma: Associations With Clinical Presentation and Survival.","authors":"Daniel J Zhou, Marc Jaskir, Julian Gal, Yombe Fonkeu, Christos Davatzikos, MacLean P Nasrallah, Jose Garcia, Stephen J Bagley, Arati Desai, Richard E Phillips, Steven Tobochnik, Colin A Ellis, James J Gugger, Nishant Sinha, Joel M Stein, Kathryn A Davis","doi":"10.1002/acn3.70420","DOIUrl":"https://doi.org/10.1002/acn3.70420","url":null,"abstract":"<p><strong>Objective: </strong>We aim to comprehensively analyze how regional tumor and edema characteristics are associated with clinical presentations and survival outcomes in a large cohort of glioblastoma patients.</p><p><strong>Methods: </strong>Patients with IDH-wildtype glioblastoma who received brain MRI from 2010 to 2023 were included. The enhancing tumor, necrotic core, and edema/infiltration volumes were automatically segmented across brain regions. Multivariable regression assessed associations between regional volumes, presenting symptomatology, and survival outcomes.</p><p><strong>Results: </strong>Of 526 patients analyzed, initial presentations included seizure (29%), aphasia (26%), confusion (25%), headache (24%), focal weakness (22%), memory problems (20%), ataxia (16%), visual field deficits (11%), personality change (10%), and focal sensory abnormalities (7%). Distinct regional tumor patterns emerged: seizures were associated with smaller overall tumor burden but with relatively greater cortical involvement, headache with increased subcortical volumes, confusion with left hemisphere and temporal involvement, personality changes with frontal-cingulate-basal ganglia involvement, and focal neurologic deficits with mostly predictable patterns. While no initial presentation correlated with survival, the presence of postoperative seizures was associated with improved overall survival. Increased volume of enhancing tumor, particularly in the insula and brainstem, was associated with worse overall survival.</p><p><strong>Interpretation: </strong>Anatomical tumor distribution provided prognostic information beyond overall tumor burden in glioblastoma. Regional patterns expand on the anatomical basis of symptoms. The survival benefit associated with postoperative seizures suggests distinct tumor biology or microenvironmental factors. Incorporating regional characteristics into clinical and prognostic models may improve risk stratification and inform treatment planning.</p>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening Routine Clinical Notes for Epilepsy Surgery Candidates Using Large Language Models.","authors":"Uriel Fennig, Nadav Amir, Maya Schiller, Roni Loebenstein, Johnatan Nissan, Marina Boxer, Shany Guly Gofrit, Gal Goshen, Sándor Beniczky, Nicola Maggio","doi":"10.1002/acn3.70427","DOIUrl":"https://doi.org/10.1002/acn3.70427","url":null,"abstract":"<p><strong>Objective: </strong>Epilepsy surgery is severely underutilized despite proven efficacy, with substantial under-referral of eligible patients in routine clinical practice. This study evaluated the potential role of large language models (LLMs) as decision-support tools for screening unstructured clinical notes to identify epilepsy surgery candidates and stratify them according to prognostic indicators.</p><p><strong>Methods: </strong>We retrospectively analyzed free-text medical records in a non-English language (Hebrew) from 110 patients in a tertiary epilepsy clinic. Six LLMs (Gemini 2.5 Pro, 2.5 Flash, 2.0 Flash; GPT-5, GPT-5 mini; and o4-mini) were prompted to extract surgical eligibility criteria, parameters of the Seizure Freedom Scale (SFS) for surgical prognostication, completion of presurgical evaluations, and previous surgical consideration. Model outputs were compared with expert manual review.</p><p><strong>Results: </strong>Model performance in identifying core eligibility parameters demonstrated high sensitivity (up to 1.00) and specificity (up to 0.96), with favorable predictive values (PPV up to 0.92, NPV up to 1.00). Majority voting yielded near-perfect sensitivity (1.00 in this cohort) for identifying surgical eligibility. Notably, 45% (13/29) of patients meeting surgical criteria had no prior consideration of surgery. Models demonstrated high accuracy in SFS score evaluation (sensitivity 0.95, specificity 0.93) and strong performance in identifying completed presurgical evaluations.</p><p><strong>Interpretation: </strong>These findings suggest the potential role of LLMs to act as decision-support tools for identifying patients who may benefit from surgical evaluation but have not been recognized in routine care. This is supported by the models' high performance in correctly identifying eligible patients, as well as prognostic parameters. As this performance was achieved using off-the-shelf general-purpose models applied directly to raw, non-English clinical notes, it suggests a practical and scalable screening approach across diverse clinical settings.</p>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147831203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Plasma p-tau181 on Cognition, Motor Phenotypes, and Disease Course in ALS.","authors":"Elisabeth Kasper, Annaliis Lehto, Nina Nordmann, Oliver Peters, Julian Hellmann, Josef Priller, Eike Jakob Spruth, Gabor C Petzold, Ina Vogt, Patrick Weydt, Sarah Bernsen, Elisabeth Dinter, Björn Falkenburger, René Günther, Emrah Düzel, Wenzel Glanz, Matthis Synofzik, Lukas Beichert, Annika Spottke, Michael Wagner, Frederic Brosseron, Matthias C Schmid, Anja Schneider, Stefan Teipel, Johannes Prudlo, Andreas Hermann","doi":"10.1002/acn3.70423","DOIUrl":"https://doi.org/10.1002/acn3.70423","url":null,"abstract":"<p><p>Phosphorylated tau181 (p-tau181), an Alzheimer's disease biomarker, was recently evaluated in amyotrophic lateral sclerosis (ALS). We investigated plasma p-tau181 in 202 ALS/ALS-FTD patients and 94 healthy controls, assessing cognitive performance, motor function, and longitudinal dynamics. Plasma p-tau181 and NfL were significantly elevated in ALS, with p-tau181 increasing over 1 year while NfL remained stable. Neither marker correlated with cognitive performance, and only NfL was associated with disease severity and progression. Plasma p-tau181 was higher in patients with predominant lower motor neuron involvement. The results indicate that p-tau181 reflects peripheral processes in ALS, providing a complementary, mechanistically distinct biomarker from NfL.</p>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147808961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MOGAD Is the Most Common Cause of Isolated Optic Neuritis in Children.","authors":"Chaitanya Aduru, Akansha Chandrasekar, Kyla Blasingame, Jonathan Rosen, Jesse M Levine, Karla Salazar, Madhuri Chilakapati, Rod Foroozan, Victoria Hardwick, Jonathan M Yarimi, Nikita Shukla, Timothy E Lotze, Kristen S Fisher, Alexander J Sandweiss","doi":"10.1002/acn3.70422","DOIUrl":"https://doi.org/10.1002/acn3.70422","url":null,"abstract":"<p><strong>Objectives: </strong>The study aimed to characterize the clinical features, etiologies, and outcomes of isolated, first-time pediatric ON in the post-MOG-IgG era.</p><p><strong>Methods: </strong>This was a single-center retrospective cohort study at Texas Children's Hospital of patients diagnosed with first-time ON between 2018-2024, with follow-up data collected through 2025. Inclusion criteria required monocular or binocular subacute vision loss with supportive paraclinical signs. Subjects were excluded if they had a prior history of demyelinating disease or extra-orbital demyelinating lesions on initial brain/spine MRI. Primary outcomes were the proportion of MOG-IgG seropositivity, retinal nerve fiber layer thickness, and visual acuity at onset and most recent follow-up.</p><p><strong>Results: </strong>Of 73 children with ON, 38 met criteria for isolated first-time ON. Etiologies included MOGAD (n = 27, 71.1%) and idiopathic/monophasic (n = 9, 23.7%), while none of the 38 subjects were later diagnosed with multiple sclerosis. MOGAD-ON was associated with less severe vision loss at presentation (p < 0.01) compared to idiopathic cases. At most recent follow-up, both groups achieved excellent functional recovery, yet both demonstrated significant retinal nerve fiber layer thinning from ON presentation. Linear regression revealed worse presenting LogMAR significantly correlated to thinner follow-up RNFL (F(1,18) = 8.467, R² = 0.32, p < 0.01). One (3.7%) MOGAD-ON patient relapsed during follow-up.</p><p><strong>Interpretation: </strong>In isolated pediatric ON, no patients were diagnosed with MS, and MOGAD is the predominant etiology. The linear correlation between initial LogMAR and subsequent RNFL atrophy suggests a permanent reduction in neurological reserve dependent on the degree of functional severity at ON onset.</p>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147808920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent Hypothermia and Autonomic Dysfunction Secondary to Shapiro Syndrome.","authors":"Naveen Kumar, Jeremy Johnson, Susanne Watkins, Eoin Mulroy","doi":"10.1002/acn3.70419","DOIUrl":"https://doi.org/10.1002/acn3.70419","url":null,"abstract":"<p><p>A 44-year-old man presented with recurrent hypothermia, diaphoresis and hypertension. Extensive investigation for infectious, inflammatory, metabolic and endocrine aetiologies was negative. MR scan of the brain demonstrated no lesions but revealed callosal dysgenesis, consistent with Shapiro syndrome. We describe the pathophysiologic basis of central thermoregulation and an approach to the assessment and management of patients presenting with disorders thereof, including the importance of considering central thermoregulatory failure after systemic disease has been carefully excluded.</p>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CAR T-Cell Therapy in Neurology: A Scoping Review of Neuro-Oncology, Autoimmune Diseases & Neurotoxicity.","authors":"Omar Alqaisi, Mohammed Dibas, Patricia Tai, Ala Dibas, Osama Souied, Suhair Al-Ghabeesh","doi":"10.1002/acn3.70415","DOIUrl":"https://doi.org/10.1002/acn3.70415","url":null,"abstract":"<p><p>Chimeric antigen receptor (CAR) T-cell therapy has been investigated in neurological diseases, encompassing both central nervous system malignancies and autoimmune disorders, thereby extending its application beyond hematological cancers. This scoping review evaluates CAR T-cell therapy applications in neurological conditions, assessing therapeutic efficacy, safety profiles, and neurotoxicity management strategies. A literature search across four databases (January 2020-December 2025) identified 33 studies meeting the inclusion criteria, encompassing original and secondary research from international centers. CAR T-cell therapy demonstrated promising efficacy across diverse neurological conditions. In glioblastoma trials, 44% of patients (n = 128) achieved partial or complete clinical/radiographic responses with favorable safety profiles. Moreover, compelling results emerged from neuromyelitis optica spectrum disorder studies, in which 92% of patients (11/12) achieved sustained relapse-free remission over a median follow-up of 5.5 months. Multiple sclerosis, myasthenia gravis, and stiff-person syndrome cases exhibited excellent treatment tolerance without significant immune effector cell-associated neurotoxicity syndrome (ICANS), which is a major concern affecting 27% of patients with hematological malignancies. Overall, CAR T-cell therapy emerges as a novel therapeutic strategy in neurology, encompassing both oncological and autoimmune conditions. Toxicity profiles in neurological CAR T-cell applications differ substantially from those observed in hematologic malignancies, underscoring the need for condition-specific risk assessment frameworks and customized management approaches. Future research should prioritize larger multicenter trials with extended follow-up to establish definitive efficacy and safety profiles in neurological indications.</p>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Pituitary Cyclase-Activating Polypeptide Targeted Treatments for the Treatment of Primary Headache Disorders\".","authors":"","doi":"10.1002/acn3.70409","DOIUrl":"https://doi.org/10.1002/acn3.70409","url":null,"abstract":"","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sertraline Treatment Can Mimic Niemann-Pick Type C Biomarker Profile: A Diagnostic Pitfall.","authors":"Maria Makrygianni, Cecile Pagan, Antony Citterio-Quentin, Isabelle Rouvet, Giulia Dingeo, Cyril Hanin, Claudine Laurent-Levinson, Samia Pichard, Bénédicte Héron, Clément Gourguechon, Daniele Mandia, Jerome Guitton, Carole Lacout, Nicolas Schleinitz, Florient Potier, Olivier Flabeau, Elsa Besse-Pinot, Foudil Lamari, Magali Pettazzoni, Yann Nadjar","doi":"10.1002/acn3.70411","DOIUrl":"https://doi.org/10.1002/acn3.70411","url":null,"abstract":"<p><strong>Background: </strong>Oxysterols (cholestane-3β,5α,6β-triol and 7-ketocholesterol) and N-palmitoyl-O-phosphocholineserine (PPCS) are sensitive biomarkers for Niemann-Pick disease type C (NPC) screening. However, false-positive results occur, with a biomarker profile suggestive of NPC despite the absence of pathogenic variants in genes involved in NPC or other inborn errors of metabolism.</p><p><strong>Objective: </strong>To identify causes of false-positive biomarker profiles mimicking NPC.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective study of 15 patients with false-positive oxysterols and PPCS profiles referred between 2017 and 2022 to two French NPC reference laboratories. Clinical data were collected via standardized chart review. The impact of Sertraline on NPC-like biological features was evaluated using the filipin test in fibroblasts and biomarker analysis in sertraline-treated patients.</p><p><strong>Results: </strong>Thirteen of 15 patients with false-positive biomarkers were treated with sertraline. Two patients who discontinued sertraline showed normalization of biomarkers. The filipin test revealed that Sertraline disrupts intracellular cholesterol trafficking, a hallmark of NPC cellular features. Finally, among 47 sertraline-treated patients without NPC-suspicion, 26 (55%) had biomarker profile mimicking NPC.</p><p><strong>Interpretation: </strong>Sertraline use is frequently associated with elevated biomarkers that mimic NPC, representing a primary cause of false-positive results in NPC screening. Genetic analysis of NPC1 and NPC2 remains essential to confirm NPC diagnosis. Most sertraline-treated patients with false-positive biomarkers presented predominantly atypical psychiatric symptoms, though one exhibited a clinical picture highly suggestive of NPC following prolonged sertraline exposure. The long-term clinical effects of sertraline use need further evaluation.</p>","PeriodicalId":126,"journal":{"name":"Annals of Clinical and Translational Neurology","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}