JAMA neurology最新文献

{"title":"Rizatriptan vs Placebo for Attacks of Vestibular Migraine: A Randomized Clinical Trial.","authors":"Jeffrey P Staab,Scott D Z Eggers,Joanna C Jen,Allison M LeMahieu,Jennifer R Geske,Honghu Liu,Deanna R Hofschulte,G Roxana Gonzalez,Brian A Neff,Neil T Shepard,Devin L McCaslin,Robert W Baloh","doi":"10.1001/jamaneurol.2025.1006","DOIUrl":"https://doi.org/10.1001/jamaneurol.2025.1006","url":null,"abstract":"ImportanceVestibular migraine has no established treatments.ObjectiveTo test the efficacy of rizatriptan for treating vestibular migraine attacks.Design, Setting, and ParticipantsThis double-blind, randomized clinical trial of rizatriptan vs placebo was conducted from December 2014 through July 2020 (data analyses in 2021 and sensitivity analyses in 2022 and 2024) at 2 tertiary neurotologic centers. Adults with vestibular migraine were included.InterventionAll participants underwent prospective observation to confirm diagnosis and illness activity and were then randomized in a 2:1 ratio to receive rizatriptan 10 mg or placebo to treat up to 3 vestibular migraine attacks per participant.Main Outcomes and MeasuresParticipants rated symptoms as absent, mild, moderate, or severe at scheduled intervals. Primary outcomes were the percentage of attacks with reductions in vertigo and unsteadiness/dizziness from moderate or severe to absent or mild at 1 hour. Secondary outcomes were the percentage of attacks with complete resolution of vestibular symptoms at 1 hour; reductions in headache and associated symptoms at 1 hour; use of rescue medications after 1 hour; reductions in vestibular, headache, and associated symptoms at 24 hours without rescue medications; treatment satisfaction and quality of life at 48 hours; and rates of serious adverse effects and discontinuation due to adverse effects.ResultsOf 222 total participants (mean [SD] age, 42.3 [11.7] years; 70.7% were women), 134 (60.4%) with active illness treated 307 attacks. Efficacy was tested using 240 attacks with vestibular symptoms rated as moderate or severe when participants took study drug. At 1 hour, rizatriptan did not differ from placebo for reducing vertigo (73/151 [48.3%] vs 50/88 [56.8%] attacks; odds ratio [OR], 0.71 [95% CI, 0.42-1.21]), unsteadiness/dizziness (29/151 [19.2%] vs 11/89 [12.4%] attacks; OR, 1.69 [95% CI, 0.80-3.57]), or any secondary outcomes. Similar percentages of participants in rizatriptan and placebo groups (26.4% for both groups) added rescue remedies after 1 hour. At 24 hours, rizatriptan had medium effects over placebo for unsteadiness/dizziness (OR, 2.65) and motion sensitivity (OR, 3.58). Post hoc analyses of all treated attacks found a medium effect favoring rizatriptan for headache and photophobia or phonophobia at 24 hours. Treatment satisfaction was equivocal. Quality of life was mixed. No participants experienced serious adverse effects or discontinued treatment for adverse effects.Conclusions and RelevanceIn this study, rizatriptan was ineffective at 1 hour for treating vestibular migraine attacks and had limited benefit on symptoms at 24 hours. Findings do not support using rizatriptan for vestibular migraine attacks.Trial RegistrationClinicalTrials.gov Identifier: NCT02447991.","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":"28 1","pages":""},"PeriodicalIF":29.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932872","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":"Quantitative Muscle Magnetic Resonance Outcomes in Patients With Duchenne Muscular Dystrophy: An Exploratory Analysis From the EMBARK Randomized Clinical Trial.","authors":"Krista Vandenborne,Glenn A Walter,Volker Straub,Rebecca J Willcocks,Sean C Forbes,Eugenio M Mercuri,Francesco Muntoni,Kai Ding,Sravya Ennamuri,Carol Reid,Alexander P Murphy,Marianna Manfrini,Jerry R Mendell,Jacob S Elkins,Louise R Rodino-Klapac","doi":"10.1001/jamaneurol.2025.0992","DOIUrl":"https://doi.org/10.1001/jamaneurol.2025.0992","url":null,"abstract":"ImportanceDelandistrogene moxeparvovec is a recombinant adeno-associated virus rhesus isolate serotype 74 vector-based gene transfer therapy for the treatment of Duchenne muscular dystrophy (DMD) in patients with a confirmed pathogenic variant of the DMD gene. In a subset of patients in the EMBARK (A Gene Transfer Therapy Study to Evaluate the Safety and Efficacy of Delandistrogene Moxeparvovec [SRP-9001] in Participants With DMD) randomized clinical trial, changes in muscle health and pathology were assessed to evaluate the therapeutic impact of the treatment on disease progression.ObjectiveTo determine the effect of delandistrogene moxeparvovec on muscle quantitative magnetic resonance (QMR) measures of disease progression in patients in the EMBARK trial.Design, Setting, and ParticipantsThis was a phase 3, double-blind, placebo-controlled (October 2021-September 2023; week 52 cutoff date: September 13, 2023), multicenter randomized clinical trial that included 131 patients. Patients were randomized, and 125 were treated with either delandistrogene moxeparvovec (n = 63) or placebo (n = 62). The current study focused on a subset of patients who underwent muscle QMR imaging.InterventionSingle-administration intravenous delandistrogene moxeparvovec (1.33 × 1014 vector genome/kg) or placebo.Main Outcomes and MeasuresChange from baseline to week 52 in muscle MR was a prespecified exploratory end point. Proton MR spectroscopy (MRS) and 8-point Dixon MR imaging (MRI) measured muscle fat fraction (FF); multislice spin echo MRI measured transverse relaxation time (T2). MRS FF was measured in the soleus and vastus lateralis. MRI FF and T2 were measured in 5 leg muscle locations important for ambulation. A post hoc global statistical test combining all muscles and modalities assessed overall treatment effect.ResultsIn this exploratory EMBARK analysis, 39 male participants (delandistrogene moxeparvovec, n = 19; placebo, n = 20; mean [SD] age, 6.10 [1.04] years; mean [SD] baseline North Star Ambulatory Assessment total score, 22.99 [3.71] points) underwent muscle MRI. Treated patients showed less disease progression vs placebo on MR measures. Across muscles and modalities, magnitudes of FF change favored delandistrogene moxeparvovec; between-group differences in least-squares mean change ranged from -1.01 (95% CI, -2.79 to 0.77; soleus) to -0.71 (95% CI, -3.21 to 1.80; vastus lateralis) for MRS FF and -3.09 (95% CI, -7.62 to 1.45; vastus lateralis) to -0.44 (95% CI, -4.01 to 3.12; hamstrings) for MRI FF. T2 reductions (improvements; 4 of 5 muscles) were observed in treated patients vs increases (worsening; all muscles) in placebo patients; within-group differences in least-squares mean change ranged from -1.06 (95% CI, -2.10 to -0.02; soleus) to 0.17 (95% CI, -1.76 to 2.10; biceps femoris) in the delandistrogene moxeparvovec group and from 1.12 (95% CI, 0.08-2.16; soleus) to 2.94 (95% CI, 0.84-5.03; quadriceps) in the placebo group. The global statistical te","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":"125 1","pages":""},"PeriodicalIF":29.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932873","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":"Epilepsy at Precision Medicine Crossroads-Disease Modification, Presymptomatic Treatment, and Early Screening.","authors":"Alina Ivaniuk,Elia Pestana-Knight,Andreas Brunklaus,Dennis Lal","doi":"10.1001/jamaneurol.2025.1179","DOIUrl":"https://doi.org/10.1001/jamaneurol.2025.1179","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":"3 1","pages":""},"PeriodicalIF":29.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932840","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":"Clinical and Neuropathological Evaluations of the New Brunswick Neurological Syndrome of Unknown Cause.","authors":"Nathaniel Bendahan,Sylvia Gautreau,Alex Medina Escobar,Gerard H Jansen,Eslam Abdellah,Sarmad Al-Shamaa,Gabriela S Gilmour,Lorraine V Kalia,Sarah C Lidstone,M Jason MacDonald,Maria Carmela Tartaglia,Annette Thebeau,Anthony E Lang","doi":"10.1001/jamaneurol.2025.1718","DOIUrl":"https://doi.org/10.1001/jamaneurol.2025.1718","url":null,"abstract":"ImportanceIn 2019, an alleged \"mystery\" neurological illness emerged in New Brunswick, Canada. Despite extensive media attention, no case description has been published to date.ObjectiveTo report on 25 patients with a diagnosis of New Brunswick neurological syndrome of unknown cause (NSUC) who subsequently received a second, independent clinical reassessment or neuropathological examination between 2020 and 2025.Design, Setting, and ParticipantsThis cross-sectional study of cases derived from a cohort of patients (n = 222) who had received an NSUC diagnosis. Four movement disorder neurologists and 2 behavioral neurologists carried out clinical evaluations at 2 hospitals in New Brunswick and Ontario, Canada. Neuropathological diagnoses were obtained in Ontario by a neuropathologist and a second reviewer, both blinded to the case histories. Eligible patients were offered a second opinion; 4 families of deceased patients provided consent for reporting autopsies and waivers of consent were obtained for 7.ExposureNSUC as described in the case definition circulated by Public Health New Brunswick in 2021.Main Outcomes and MeasuresFindings from the independent clinical evaluations and diagnoses obtained through neuropathological examination.ResultsAmong 105 eligible patients, 14 patients (aged 20-55 years; 8 female, 6 male) received clinical evaluations, and 11 patients (aged 56-82 years; 5 female, 6 male) had neuropathological diagnoses. Well-known conditions were identified in all 25 cases, including common neurodegenerative diseases, functional neurological disorder, traumatic brain injury, and metastatic cancer. Based on the 11 autopsy cases, a new disease was extremely unlikely, with a probability less than .001. When applying the 95% confidence interval for the true probability of no new disease, the data revealed a high probability between 87% and 100%.Conclusions and RelevanceThere was no evidence supporting a diagnosis of NSUC in this cohort. The data inclusive of independent examinations and neuropathology strongly supported the presence of several neurodegenerative and non-neurodegenerative conditions. Unfounded concerns that a potentially fatal mystery disease, possibly induced by an environmental toxin, is causing the patients' neurological symptoms has been amplified in traditional and social media. Second, independent clinical evaluations are needed for any patient given a diagnosis of NSUC.","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":"21 1","pages":""},"PeriodicalIF":29.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143915208","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":"Fremanezumab for the Treatment of Patients With Migraine and Comorbid Major Depressive Disorder","authors":"Richard B. Lipton, Verena Ramirez Campos, Zipi Roth-Ben Arie, Maja Galic, Dimos Mitsikostas, Cristina Tassorelli, Lex Denysenko, Joshua M. Cohen","doi":"10.1001/jamaneurol.2025.0806","DOIUrl":"https://doi.org/10.1001/jamaneurol.2025.0806","url":null,"abstract":"ImportanceMigraine and major depressive disorder are frequently comorbid; however, evidence evaluating the efficacy of preventive migraine therapy in patients with both diseases is limited.ObjectiveTo evaluate the efficacy and safety of fremanezumab in adults with migraine and comorbid major depressive disorder.Design, Setting, and ParticipantsThe UNITE study was a double-blind, placebo-controlled, parallel-group, randomized clinical trial consisting of a 4-week screening period, 12-week double-blind period, and 12-week open-label extension (OLE), conducted between July 9, 2020, and August 31, 2022. The trial was conducted at 55 centers across 12 countries. Eligible patients were adults with episodic migraine (EM) or chronic migraine (CM), history of major depressive disorder according to <jats:italic>Diagnostic and Statistical Manual of Mental Disorders</jats:italic> (Fifth Edition) criteria for 12 or more months before screening, and active symptoms of depression (9-item Patient Health Questionnaire score of 10 or more) at screening.InterventionsPatients were randomized 1:1 to receive monthly fremanezumab (225 mg) or matched placebo. All patients in the OLE received quarterly fremanezumab (675 mg).Main Outcomes and MeasuresThe primary end point was the mean change from baseline in monthly migraine days during the 12-week double-blind period.ResultsOf the 540 patients screened for the study, 353 patients (mean [SD] age, 42.9 [12.3] years; 310 female [88%]; EM, 48%; CM, 52%) were eligible and randomized to receive fremanezumab (n = 175) or placebo (n = 178). Mean (SE) change from baseline in monthly migraine days during the 12-week double-blind period was −5.1 (0.50; 95% CI, −6.09 to −4.13) for fremanezumab and −2.9 (0.49; 95% CI, −3.89 to −1.96) for placebo (<jats:italic>P</jats:italic> &amp;amp;lt;.001). Mean (SE) change from baseline in the Hamilton Depression Rating Scale–17 Items score at week 8 was −6.0 (0.55; 95% CI, −7.10 to −4.95) for fremanezumab and −4.6 (0.54; 95% CI, −5.66 to −3.55) for placebo (least squares mean [SE] difference: −1.4 [0.61]; 95% CI, −2.61 to −0.22; <jats:italic>P</jats:italic> = .02). Adverse events were consistent with other fremanezumab trials. Results were maintained throughout the OLE.Conclusions and RelevanceTreatment with fremanezumab compared with placebo resulted in significant reductions in monthly migraine days and depressive symptoms. No new safety concerns were observed. To the authors’ knowledge, this was the first placebo-controlled, randomized clinical trial, specifically designed to assess patients with migraine and comorbid depressive disorder, to demonstrate significant improvements in migraine and depressive symptoms with a single pharmacological intervention.Trial RegistrationClinicalTrials.gov Identifier: <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" ext-link-type=\"uri\" xlink:href=\"https://www.clinicaltrials.gov/study/NCT04041284\">NCT04041284</jats:ext-link>","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":"29 1","pages":""},"PeriodicalIF":29.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909975","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":"Opsoclonus-Myoclonus-Ataxia Syndrome in a Patient With Subacute Sclerosing Panencephalitis.","authors":"Akhil Sahib, Arun Koul, Ashwin K Panda","doi":"10.1001/jamaneurol.2025.0899","DOIUrl":"https://doi.org/10.1001/jamaneurol.2025.0899","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":""},"PeriodicalIF":20.4,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019781","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":"General AI May Revolutionize Neurology—Or It Might Be Bad","authors":"M. Brandon Westover, Alek M. Westover","doi":"10.1001/jamaneurol.2025.0905","DOIUrl":"https://doi.org/10.1001/jamaneurol.2025.0905","url":null,"abstract":"This Viewpoint urges neurology stakeholders to consider the potential dangers of the proliferation of artificial intelligence (AI) in neurology, as well as across the wider health care field.","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":"1 1","pages":""},"PeriodicalIF":29.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909972","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":"CT Perfusion Imaging After Selection for Late-Window Endovascular Stroke Treatment: Secondary Analysis of the MR CLEAN-LATE Randomized Trial.","authors":"Susanne G H Olthuis,Florentina M E Pinckaers,M M Quirien Robbe,Inger R de Ridder,Jan W Hoving,Esmee Venema,Jasper D Daems,F A V Anne Pirson,Julie Staals,Bart J Emmer,Hester F Lingsma,Stefan D Roosendaal,Anouk van der Hoorn,Miou S Koopman,Alida A Postma,Diederik W J Dippel,Charles B Majoie,Robert J van Oostenbrugge,Wim H van Zwam,","doi":"10.1001/jamaneurol.2025.0716","DOIUrl":"https://doi.org/10.1001/jamaneurol.2025.0716","url":null,"abstract":"ImportanceMR CLEAN-LATE (Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands for Late Arrivals) showed efficacy of endovascular treatment (EVT) in the late window (6-24 hours after stroke symptom onset or time last seen well) among patients with ischemic stroke selected based on collateral flow. Therefore, the future role of computed tomography perfusion (CTP) imaging in patient selection for late-window EVT may change.ObjectiveTo investigate the interaction among CTP parameters (core volumes, penumbra volumes, and mismatch ratio) and the association of EVT with functional outcomes among patients in the late window after ischemic stroke selected based on collateral flow.Design, Setting, and ParticipantsThis is a post hoc secondary analysis of MR CLEAN-LATE, a multicenter randomized clinical trial, with open-label treatment and blinded end point, conducted from February 2, 2018, to January 27, 2022, in 18 Dutch stroke intervention centers. Participants included 502 patients with anterior circulation large vessel occlusion and present collateral flow on results of computed tomographic angiography in the late window after stroke, who gave deferred consent and were included in MR CLEAN-LATE. All patients had completed follow-up at 90 days. This secondary analysis included 313 patients (62%) with available CTP results. Statistical analysis was performed in September 2023.InterventionPatients were randomized to receive EVT (EVT group) and best medical management vs best medical management alone (no EVT group).Main Outcomes and MeasuresThe primary outcome was functional outcome at 90 days measured by the modified Rankin Scale score. The treatment effect was analyzed in subgroups of core volumes, penumbra volume, and mismatch ratios using ordinal regression analysis. An interaction analysis was performed to assess whether CTP parameters modified the EVT effect on the modified Rankin Scale score at 90 days. All analyses were adjusted for relevant prognostic factors.ResultsAmong the 313 patients (158 women [50%]) in the study, the median age was 73 years (IQR, 63-80 years), and the EVT group had fewer male participants than the no EVT group (73 of 168 [43%] vs 82 of 145 [57%]). Penumbra volumes significantly modified the association of EVT with outcomes (P &lt; .001 for interaction), with the largest effect size among patients with penumbras of 120 mL or more (adjusted common odds ratio [ACOR], 6.89 [95% CI, 2.96-16.04]) and the smallest effect size among patients with penumbras of 72 mL or less (ACOR, 0.49 [95% CI, 0.22-1.08]). Core volume and mismatch ratio did not modify the EVT effect.Conclusions and RelevanceBased on results from this secondary analysis of the MR CLEAN-LATE randomized clinical trial, there was a direct interaction between penumbra volume and treatment effect, and a trend toward potential harm of EVT was seen among patients with the smallest penumbras, which warrants further research","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":"101 1","pages":""},"PeriodicalIF":29.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143915215","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":"Immortal Time Bias and Nonlinear Stroke Recurrence Risk-Reply.","authors":"Lucas V A Boersma, David J Werring, David J Seiffge","doi":"10.1001/jamaneurol.2025.0392","DOIUrl":"10.1001/jamaneurol.2025.0392","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":" ","pages":"527-528"},"PeriodicalIF":20.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752836","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":"JAMA Neurology Peer Reviewers in 2024.","authors":"","doi":"10.1001/jamaneurol.2025.0293","DOIUrl":"https://doi.org/10.1001/jamaneurol.2025.0293","url":null,"abstract":"","PeriodicalId":14677,"journal":{"name":"JAMA neurology","volume":"82 5","pages":"e250293"},"PeriodicalIF":20.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988447","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}