Journal of Clinical Neurophysiology最新文献

{"title":"Lifting the Lid on Opercular Epilepsies.","authors":"Dang K Nguyen","doi":"10.1097/WNP.0000000000001281","DOIUrl":"10.1097/WNP.0000000000001281","url":null,"abstract":"","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"474"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linking New Onset Epilepsy Risk-of-Relapse to EEG Connectivity and Microstates.","authors":"Eric Ménétré, Patrick Stancu, Sara Jekic, Jérôme De Massias De Bonne, Margitta Seeck, Stefano Gallotto","doi":"10.1097/WNP.0000000000001236","DOIUrl":"10.1097/WNP.0000000000001236","url":null,"abstract":"<p><strong>Purpose: </strong>Antiseizure medication is the first-line treatment for new-onset-epilepsy, leading to seizure control in 70% to 80% of patients. An early identification of an appropriate treatment is extremely important to avoid seizure relapses, and biomarkers for relapse risk are needed to avoid any delays. The authors investigated electroencephalography (EEG)-based brain connectivity and microstates between patients with new-onset epilepsy who responded to treatment (SZ-FREE) and patients who relapsed (SZ-REL), to link potential differences to treatment response.</p><p><strong>Methods: </strong>Sixty-two patients with new-onset epilepsy for whom an EEG was performed before treatment initiation, after a first seizure event. The authors computed EEG connectivity for delta, theta, alpha, beta, and gamma frequencies, and microstates. By performing mixed-model analyses, the authors tested connectivity differences across frequency bands and microstate characteristic changes between SZ-FREE and SZ-REL.</p><p><strong>Results: </strong>After treatment, 51 patients remained seizure free while 11 relapsed within 6 months. The authors observed a significant interaction between frequency bands and groups ( P < 0.001). Post hoc tests showed delta ( P = 0.006) and theta ( P = 0.012) decreases, and alpha increases ( P < 0.001) for patients with SZ-REL compared with patients with SZ-FREE. Microstate C had a significantly higher global explained variance for patients with SZ-REL than patients with SZ-FREE ( P = 0.021), while microstates A occurred more frequently in SZ-REL ( P = 0.031).</p><p><strong>Conclusions: </strong>EEG connectivity and microstates in the first EEG within 24 hours after the initial seizure hold valuable information related to the drug responsiveness in patients with new-onset epilepsy.</p><p><strong>Significance: </strong>EEG connectivity and microstates are potential markers of treatment response.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"548-554"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Aspects of Opercular Epilepsies.","authors":"Janine Hsu, William Bingaman, Demitre Serletis","doi":"10.1097/WNP.0000000000001247","DOIUrl":"10.1097/WNP.0000000000001247","url":null,"abstract":"<p><strong>Summary: </strong>Operculoinsular epilepsy presents diagnostic and surgical challenges due to the complex anatomy of the opercula, the underlying insula, and their intimate relationships with major vascular and subcortical white matter tracts. Comprehensive evaluation relies on detailed seizure semiology, high-resolution structural and functional neuroimaging, and invasive monitoring (namely, stereoelectroencephalography) to distinguish opercular from insular seizure onset and identify suitable surgical candidates. Advances in invasive recording capabilities, intraoperative mapping, microneurosurgical techniques, and laser ablative technologies have expanded access to epileptogenic networks in this region, improving the safety and precision of operative approaches for the treatment of epilepsy. This review outlines the relevant surgical anatomy of the frontal, parietal, and temporal opercula and deeply-situated insula, emphasizing the need for meticulous preoperative planning and accurate intraoperative recognition of anatomical landmarks. We describe resective strategies (including transsylvian and transopercular approaches), tailored to epileptogenic localization while minimizing risk to critical vasculature and eloquent cortex. Intraoperative electrocorticography, functional mapping, and neurophysiological monitoring further refine surgical margins and help mitigate postoperative deficits. We also highlight stereotactic laser interstitial thermal therapy as a minimally invasive alternative for well-defined epileptogenic zones, particularly in the dominant hemisphere or deep opercular tissue, offering reduced morbidity and shorter hospitalization. Reported seizure-freedom rates following resective operculoinsular epilepsy surgery are 60% to 70%, and around 50% with laser interstitial thermal therapy, with relatively safe complication profiles. Ultimately, a thorough understanding of anatomy, careful patient selection, and judicious use of adjunctive mapping technologies are essential to achieving optimal seizure outcomes in the safe surgical management of operculoinsular epilepsy.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"532-541"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role and Function of the Opercula.","authors":"Luca Zigiotto, Silvio Sarubbo","doi":"10.1097/WNP.0000000000001283","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001283","url":null,"abstract":"<p><strong>Summary: </strong>The frontal, temporal, and parietal opercula are usually described through the lens of classical language localization. Yet, evidence from direct electrical stimulation, connectomics, tractography and microdissection, and functional meta-analysis indicates that these cortices are better understood as an interactive perisylvian system linking effectors, integrative relays, associative hubs, and elaborative territories. In this review, we synthesize the functional anatomy of the frontal, temporal, and parietal opercula, together with the auditory cortex, superior temporal gyrus, temporal pole, ventral premotor cortex, precentral and postcentral gyri, supramarginal gyrus, angular gyrus, and related perisylvian territories. We emphasize how cortical function emerges from the interaction between dorsal sensorimotor-phonologic systems, ventral semantic-identification systems, auditory-temporal systems, and temporo-parietal integrative systems. We further review the crucial contribution of short U-fibers and long association pathways, especially the arcuate fasciculus/superior longitudinal fasciculus complex, inferior fronto-occipital fasciculus, uncinate fasciculus, inferior longitudinal fasciculus, and acoustic radiation. Finally, we discuss how this network-based framework refines resection planning, intraoperative testing, and functional risk prediction in epilepsy surgery and glioma surgery. The central message is that the opercular region should not be approached as a set of isolated gyri, but as a hierarchy of interacting hubs and exits whose preservation determines postoperative language, auditory, praxis, and socio-semantic outcomes.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":"43 6","pages":"495-503"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuromuscular Ultrasound and Electrophysiologic Correlation of Median Mononeuropathy at the Wrist in Symptomatic Hereditary Transthyretin Amyloidosis.","authors":"Kira S Kopacz, Marcus V Pinto, Andrea J Boon, Marianne T Luetmer, Ruple S Laughlin, Brendan Putko, William J Litchy, Michelle L Mauermann, James B Meiling","doi":"10.1097/WNP.0000000000001293","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001293","url":null,"abstract":"<p><strong>Purpose: </strong>Hereditary transthyretin amyloidosis (ATTRv) is a progressive multisystem disease in which median mononeuropathy at the wrist (MNW) is common and often precedes systemic involvement. Nerve conduction studies (NCS) have historically been the gold standard for MNW, but neuromuscular ultrasound (NMUS) is complementary. The aim of this study was to compare NMUS with electrodiagnostic (EDX) testing for the diagnosis of MNW in patients with symptomatic ATTRv.</p><p><strong>Methods: </strong>A retrospective review was performed of patients 18 years and older with ATTRv confirmed by genetic testing who underwent both EDX testing and NMUS of the median nerve between 2019 and 2025. Demographic, NMUS, and EDX data were collected.</p><p><strong>Results: </strong>Data from 15 upper limbs in 10 patients were analyzed. Median nerve cross-sectional area at the wrist was significantly greater than reference values (P = 0.041). MNW was identified in 80% of wrists by NMUS and 100% by NCS, with no significant difference between modalities. Median nerve cross-sectional area at the wrist did not significantly correlate with MNW severity determined by NCS (r = -0.018; P = 0.941) or with any NCS parameters (all P > 0.080). Concurrent polyneuropathy was diagnosed in 60% of patients, but there was no association between polyneuropathy and MNW detection by either modality (P > 0.197).</p><p><strong>Conclusions: </strong>NMUS and NCS demonstrate comparable diagnostic accuracy for MNW in ATTRv. Given its noninvasive nature and efficiency, NMUS may serve as an adjunct to classic EDX testing in this population.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facial Single-Fiber Electromyography After Prior Botulinum Toxin Exposure: A Retrospective Clinical Cohort.","authors":"Tony Zhang, Grace M N Dominguez, Sarah E Berini, Brian A Crum, Ruple S Laughlin","doi":"10.1097/WNP.0000000000001294","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001294","url":null,"abstract":"<p><strong>Purpose: </strong>Single-fiber electromyography (SFEMG) is highly sensitive for disorders of neuromuscular transmission but may be confounded by prior botulinum neurotoxin (BoNT) exposure. Although BoNT is known to transiently elevate jitter, the duration of its electrophysiologic effects remains unclear.</p><p><strong>Methods: </strong>Retrospective cohort study of patients 18 years and older who underwent voluntary SFEMG of the frontalis or orbicularis oculi over a 10-year period with a history of local facial BoNT exposure. Patients with coexisting neuromuscular disorders were excluded.</p><p><strong>Results: </strong>Sixty-one patients were identified, with 51 demonstrating elevated jitter measured as mean consecutive difference (MCD). The median MCD (n = 51) was 72 µs (range: 26-150), with blocking present in 78%. The median time since last BoNT injection was 6 months (range: <3-240); however, 16 patients had elevated MCD despite testing ≥12 months after the last injection. MCD was higher in studies performed <12 months compared with ≥12 months since the last BoNT injection (80 vs. 43 µs; P = 0.007). Common indications for BoNT included cosmetic use (30/51) and migraine (16/51). Six of 51 patients underwent follow-up SFEMG (ranging from 5 to 13 months); five had significant reduction in MCD. Two-Hz repetitive facial nerve stimulation was performed in 44/51; none demonstrated an abnormal decrement. Ten patients had normal MCD despite prior BoNT exposure, with a median interval of 25 months (range: 4-120) since last injection.</p><p><strong>Conclusions: </strong>Elevated MCD is associated with more recent BoNT exposure but may persist well beyond 12 months in some patients, underscoring the need for cautious interpretation of SFEMG results in patients with prior BoNT exposure.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Sensorimotor Physiology and Cortical Mapping With Stereoelectroencephalography Electrical Stimulation.","authors":"Ammar Kheder, Puneet Jain","doi":"10.1097/WNP.0000000000001292","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001292","url":null,"abstract":"<p><strong>Summary: </strong>Stereoelectroencephalography (SEEG) has materially broadened the landscape of sensorimotor mapping by enabling access to sulcal, medial, and subcortical structures that remain largely beyond the reach of subdural electrodes (SDE). The inherent sampling bias of SDE toward gyral crests and dorsolateral cortices constrains the exploration of the central sulcus-where primary motor and sensory cortices predominantly reside-and limits insight into deeper epileptogenic networks. In routine practice, this topographic restriction is not trivial; it shapes both our hypotheses and our blind spots. SEEG addresses many of these limitations while allowing a three-dimensional, patient-tailored exploration of sensorimotor circuits that more closely reflects individual anatomy and network organization. Of particular importance is its access to medial cortices, including the supplementary motor area, sensorimotor precuneus, and cingulate sulcus-regions that often prove consequential within epilepsy networks yet are difficult to evaluate comprehensively with surface arrays. This manuscript addresses key considerations for sensorimotor exploration in both pediatric and adult clinical settings. In experienced hands, SEEG can delineate motor, sensory, and integrative areas with a degree of precision that supports identification of eloquent and negative motor regions. It yields clinically relevant information on myelination and age-dependent changes in sensorimotor pathways-issues of special importance in pediatric populations, where developmental state and network plasticity influence both mapping interpretation and surgical risk. By facilitating targeted resections while preserving critical functions, SEEG may contribute to improved surgical outcomes, particularly when epileptogenic networks intersect or approximate eloquent cortex. Compared with SDE, SEEG provides broader anatomical reach through dispersed but deep sampling. That dispersion can appear sparse on a two-dimensional rendering, yet in complex cases involving deep or medial structures, it often proves more informative than dense but superficial coverage. Ongoing innovations-including multimodal integration, cortico-cortical evoked potentials (CCEPs), advanced stimulation techniques, and AI-driven analysis-indicate that SEEG's role will continue to evolve. Its applications may extend beyond epilepsy into movement disorders and neuroprosthetics as we refine both acquisition and interpretation. Deliberate efforts to standardize protocols and address ethical considerations will be essential if SEEG is to bridge persistent gaps between sensorimotor research and clinical care. With careful stewardship, it appears poised to reshape aspects of neurologic practice rather than merely supplement existing approaches.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Source Localization of Subclinical Rhythmic EEG Discharge of Adult Using Magnetoencephalography.","authors":"Thandar Aung, Hiroatsu Murakami, Richard Burgess","doi":"10.1097/WNP.0000000000001290","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001290","url":null,"abstract":"<p><strong>Purpose: </strong>Subclinical rhythmic EEG discharge of adult (SREDA) is a rare, benign EEG phenomenon. To date, no studies have reported the analysis of SREDA using magnetoencephalography (MEG). Here, we report MEG source localization of SREDA in two patients.</p><p><strong>Methods: </strong>MEG-EEG recordings of two patients with SREDA were analyzed using the single equivalent current dipole model with sequential dipole analysis.</p><p><strong>Results: </strong>The source localization results of SREDA discharges in two patients were asynchronous activity between the right and left hemispheres. The early portions of the SREDA episodes were localized to the posterior temporo-perisylvian regions (superior temporal sulcus and temporal operculum), whereas later components localized to the lateral parietal cortex, including the parietal operculum. In both cases, although the SREDA EEG activities were alarming, MEG SREDA activity had little change in frequency, morphology, distribution, abrupt ending, and no associated focal slowing activity or after going slow wave activity.</p><p><strong>Conclusions: </strong>The consistent MEG waveform and localization of the SREDA discharges reported in the two cases suggest neurophysiological mechanisms arising from the posterior supra and infra perisylvian regions, including the parietal operculum, which is not matched with watershed vascular territory. Despite the alarming appearance of SREDA in EEG, MEG waveforms were subtle in both patients. MEG has unique advantages to assess benign SREDA, which requires exceptional caution to avoid misdiagnosis.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focal Hippocampal Onset and its Effect on Surgical Outcomes: A Case Report and Case Series.","authors":"Robert Rifkin, Hart Fogel, Andrew Michalak, Shraddha Srinivasan, Carl Bazil, Paul Kent, Neil Feldstein, Marla J Hamberger, Guy McKhann, Catherine Schevon","doi":"10.1097/WNP.0000000000001288","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001288","url":null,"abstract":"<p><strong>Summary: </strong>In mesial temporal lobe epilepsy, resection or ablation-typically of anterior temporal structures-is highly successful in achieving seizure freedom. However, in a substantial proportion of patients, seizures recur for unclear reasons. Invasive hippocampal recordings suggest that, in some patients, hippocampal seizures are highly focal, often restricted to the anterior or posterior hippocampus. This led us to hypothesize that resection or ablation limited to the hippocampal subregion(s) involved at seizure onset is more likely to control seizures than surgery that does not address the specific onset locations. We present a case in which seizures were successfully controlled after posterior hippocampal ablation, as well as a retrospective case series of 18 patients in which 10 cases demonstrated focal onsets within the anterior or posterior hippocampus. Better outcomes occurred when surgery was concordant with the onset region(s) versus discordant (n = 7 concordant vs. 11 discordant patients, P = 0.046, Barnard Exact test). These data suggest that mesial temporal lobe epilepsy can be subdivided according to whether the hippocampal onset pattern is focal or nonfocal, and that targeting localized seizure onset zones within the hippocampus can be effective for seizure control, while limiting surgical morbidity and potentially the risk of adverse cognitive outcomes.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Electrode Impedance Performance in Ambulatory Video-EEG: A Retrospective Comparison of Two Adhesives.","authors":"Ewan Nurse, Kristan Marlow, Patrick J Hennessy, Rory Knight-Sadler, Tim Nelson, Patrick Kwan, Dean R Freestone, Mark J Cook, Kyle D Slater","doi":"10.1097/WNP.0000000000001291","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001291","url":null,"abstract":"<p><strong>Purpose: </strong>To compare collodion and a water-soluble adhesive for maintaining electrode impedance during prolonged ambulatory video-EEG.</p><p><strong>Methods: </strong>We retrospectively analyzed sequential ambulatory video-EEG studies performed from September 2022 to May 2024 across 22 Australian clinics. The primary outcome was the proportion of analyzed electrodes with impedance <10 kOhm over study days 0 to 6. Adjusted longitudinal associations were assessed using generalized estimating equations.</p><p><strong>Results: </strong>Among 4,844 patients, 4,602 received water-soluble adhesive and 242 received collodion. Mean proportions of electrodes with impedance <10 kOhm were closely comparable on study days 0 to 2, with progressive separation thereafter, reaching 75.4% with water-soluble adhesive and 45.2% with collodion by day 6. Day-specific adjusted comparisons were significant on days 1 and 3 to 6 after multiple comparison correction. In adjusted analyses of 16,737 patient-days, impedance performance declined with study day, but this decline was less steep with water-soluble adhesive, as reflected by a significant day-by-adhesive interaction. The adhesive main effect was not significant, indicating that the principal difference emerged over time rather than at baseline.</p><p><strong>Conclusions: </strong>Water-soluble adhesive was associated with greater longitudinal electrode impedance stability than collodion during prolonged ambulatory video-EEG. Adhesive choice may influence technical performance during prolonged ambulatory video-EEG and may help preserve channel-level impedance targets during week-long recordings.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}