Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"Safety assessment and feasibility of the TWIICE powered exoskeleton for assisted ambulation in individuals with spinal cord injury.","authors":"Carina Lang, Inge Eriks-Hoogland, Claudio Perret, Mohamed Bouri, Mario Widmer","doi":"10.1186/s12984-025-01727-4","DOIUrl":"10.1186/s12984-025-01727-4","url":null,"abstract":"<p><strong>Background: </strong>Following spinal cord injury (SCI), powered exoskeletons have been shown to enable assisted walking and may also positively impact secondary health conditions. The TWIICE exoskeleton is intended to enable individuals with SCI to train at home or in community during their activities of daily living under the supervision of a therapist. The aim of this pilot clinical trial was to assess the safety and feasibility of the TWIICE powered exoskeleton for assisted ambulation in a clinical setting.</p><p><strong>Methods: </strong>This single-arm, open label feasibility study included 5 non-ambulatory individuals at least 6 months after onset of traumatic or non-traumatic SCI. Participants used the TWIICE exoskeleton during 6 sessions in the therapy premises of a Swiss SCI-specialized clinic undergoing a progressive mobility training. The incidence of adverse device effects (ADEs) was the primary outcome. In addition, standard walking tests such as 10 m Walk Test (10MWT), 6-minute Walk Test (6MWT), and Timed Up and Go (TUG) were performed using the device during the final session to evaluate usability after short-term training. Data are presented as median (range).</p><p><strong>Results: </strong>We recruited 5 non-ambulatory individuals with SCI (2 females / 3 males, 32 (21-45) years of age). Four participants were motor complete (T6-T11) and 1 was motor incomplete (C7). Of the 10 adverse events occurring over the course of the 30 cumulative sessions, 4 were categorized as ADEs: reddening of the skin at contact points with the device (2x), transient intensification of neuropathic pain, and transient increase of spasticity. All ADEs subsided after a short time and without any sequelae. After 6 sessions, participants walked the 10MWT in 33 (24-144) seconds and were able to achieve 98 (37-137) meters during a 6MWT while using the device. Finally, the TUG was performed with the device and moderate assistance in 103 (61-135) seconds.</p><p><strong>Conclusions: </strong>No serious safety concerns were identified during this feasibility study in a clinical setting. After 6 sessions, our relatively young and fit study population showed a variable but generally good performance in clinical measures when compared to reports on commercialized powered exoskeletons.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ID: NCT05926310.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"194"},"PeriodicalIF":5.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective assistance timing using characteristics of paretic ground reaction force in ankle robotic gait training for individuals with hemiparesis after stroke: a cross-sectional study.","authors":"Takayuki Kuwabara, Kimihiko Mori, Naoto Mano, Takanari Kubo, Takuya Mori, Tomoyuki Noda, Tatsuya Teramae, Yuta Chujo, Masanori Wakida, Kimitaka Hase","doi":"10.1186/s12984-025-01728-3","DOIUrl":"10.1186/s12984-025-01728-3","url":null,"abstract":"<p><strong>Background: </strong>Effective ankle plantarflexion assistance (PF assistance) requires precise timing and personalized adjustment using an ankle joint robot that assists both dorsiflexion and plantarflexion during walking. Previous studies suggest that peak paretic propulsion timing (Peak PP timing) is earlier in some individuals, indicating differences in ground reaction force (GRF) characteristics among individuals with stroke. Therefore, this study aimed to identify the effective timing of PF assistance according to anteroposterior GRF characteristics.</p><p><strong>Methods: </strong>The study included twenty-three post-stroke individuals with hemiparesis. The participants walked on a treadmill under an unassisted condition, and at 30-50% and 40-60% gait cycle (GC) PF assisted conditions. The participants were clustered into two groups based on the waveform data of the paretic anteroposterior GRF in the unassisted condition using k-means clustering, and differences in the characteristics between the two groups, and changes in paretic propulsion in each assistance condition within the cluster were analyzed. Additionally, the relationship between changes in paretic propulsion and the timing of paretic propulsion (PP timing) and Peak PP timing, were analyzed within each cluster, relative to the unassisted condition, under each assistance condition.</p><p><strong>Results: </strong>Participants were clustered into Clusters A (N = 13) and B (N = 10). Cluster A showed earlier Peak PP timing and increased paretic propulsion in both PF assistance conditions, while Cluster B only improved in the 40-60% GC condition. A significant negative correlation was observed between changes in paretic propulsion and PP timing in Cluster A under the 30-50% GC PF assistance condition (ρ = - 0.665, P = 0.012).</p><p><strong>Conclusions: </strong>Our results suggest that applying PF assistance, particularly during the late paretic stance phase, might be effective for individuals with hemiparesis, as it led to improvements in paretic propulsion in both clusters. Additionally, the results suggest that for participants in Cluster A, it may be important to apply PF assistance at the 30-50% GC while monitoring changes in the GRF waveform data, as this approach may be more effective for some participants in improving paretic propulsion.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"196"},"PeriodicalIF":5.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced episodic memory and LTP-like plasticity in subjective cognitive decline following 10-Hz repetitive transcranial magnetic stimulation.","authors":"Tianjiao Zhang, Qian Lu, Jie Song, Manyu Dong, Chuan He, Zude Zhu, Han Yang, Yilun Qian, Tong Wang, Hanjun Liu, Ying Shen","doi":"10.1186/s12984-025-01741-6","DOIUrl":"10.1186/s12984-025-01741-6","url":null,"abstract":"<p><strong>Background: </strong>Subjective cognitive decline (SCD) is a self-perceived cognitive complaint in the absence of objective impairment, representing an at-risk state along the continuum of cognitive aging. High-frequency repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (L-DLPFC) has shown cognitive benefits in Alzheimer's disease (AD), yet its effects on cognitive functions in SCD remain largely unexplored.</p><p><strong>Objective: </strong>To evaluate the effects of 10-Hz rTMS over the L-DLPFC in individuals with SCD on cognitive functions and long-term potentiation (LTP)-like plasticity, indexed by changes in motor evoked potential (MEP) following intermittent theta burst stimulation, and examine the relationship between brain plasticity and cognitive outcomes.</p><p><strong>Methods: </strong>In this randomized, sham-controlled trial, 42 individuals with SCD received 20 sessions of either active or sham 10-Hz rTMS (n = 21 per group) over four weeks. The primary outcome was delayed episodic memory, evaluated using the Auditory Verbal Learning Test-Huashan version (AVLT-H). Secondary outcomes included additional cognitive measures and MEP amplitudes at baseline and at 5 (T₅), 10 (T₁₀), and 30 (T₃₀) minutes post-intervention.</p><p><strong>Results: </strong>The rTMS group exhibited significant improvements in both delayed episodic memory (AVLT-N5) and MEP amplitudes at T₅ and T₁₀ following the intervention, whereas such changes were not observed in the sham group. Moreover, increased MEP amplitude at T₁₀ was positively correlated with improved AVLT-N5 performance.</p><p><strong>Conclusions: </strong>These findings provide the first evidence for enhanced delayed episodic memory and LTP-like plasticity in individuals with SCD following 10-Hz rTMS over the L-DLPFC, suggesting a potential role of LTP-like plasticity in elucidating the neurophysiological correlates of cognitive improvements for SCD.</p><p><strong>Trial registration: </strong>The study design and analysis plan were preregistered on September 7th, 2023 at Chinese Clinical Trial Registry (No. ChiCTR2300075517).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"197"},"PeriodicalIF":5.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of intermittent theta-burst stimulation on cognition and glymphatic system activity in mild cognitive impairment and very mild Alzheimer's disease: a randomized controlled trial.","authors":"Cheng-Chang Yang, Ko-Yen Huang, Jung-Lung Hsu, Chaur-Jong Hu, Yueh-Hsun Lu, Yi-Chun Kuan","doi":"10.1186/s12984-025-01738-1","DOIUrl":"10.1186/s12984-025-01738-1","url":null,"abstract":"<p><strong>Background: </strong>Repetitive transcranial magnetic stimulation (rTMS) has demonstrated efficacy in alleviating cognitive symptoms in Alzheimer's disease (AD) and mild cognitive impairment (MCI). Although animal studies suggest rTMS may enhance glymphatic system efficiency and reduce amyloid deposits, its impact on human glymphatic activity remains uncertain.</p><p><strong>Methods: </strong>This double-blind, randomized, sham-controlled trial investigated the effects of intermittent theta-burst stimulation (iTBS), a novel rTMS technique, on cognitive function and glymphatic system activity using diffusion tensor image analysis along the perivascular space (DTI-ALPS) in 52 participants with amnestic MCI or very mild AD. Participants underwent 10 sessions of iTBS targeting the left dorsolateral prefrontal cortex over two weeks. Cognitive and glymphatic assessments were conducted at baseline, week 2, and week 6. Of the 52 participants, 28 received active iTBS, while 24 received sham stimulation. After the first two weeks, the sham group transitioned to active iTBS.</p><p><strong>Results: </strong>Significant cognitive improvements were observed at week 6 in the iTBS group, indicating delayed cognitive enhancement, though no immediate changes in cognition or glymphatic system activity (measured by the ALPS index) were observed. No adverse events were reported.</p><p><strong>Conclusions: </strong>These findings suggest that iTBS can produce delayed cognitive enhancement in individuals with amnestic MCI and very mild AD, while the impact on the glymphatic system remains uncertain and requires further investigation.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov (NCT04555941).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"195"},"PeriodicalIF":5.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical feasibility of motor hotspot localization based on electroencephalography using convolutional neural networks in stroke.","authors":"Ga-Young Choi, Jeong-Kweon Seo, Kyoung Tae Kim, Won Kee Chang, Sung Whan Yoon, Nam-Jong Paik, Won-Seok Kim, Han-Jeong Hwang","doi":"10.1186/s12984-025-01736-3","DOIUrl":"10.1186/s12984-025-01736-3","url":null,"abstract":"<p><strong>Background: </strong>Although transcranial magnetic stimulation (TMS) is the optimal tool for identifying individual motor hotspots-specific regions of the brain that are essential for controlling voluntary muscle movements-it involves a cumbersome procedure that requires patients to visit the hospital regularly and relies on expert judgment. To address this, we propose an advanced electroencephalography (EEG)-based motor hotspot identification algorithm using a deep-learning and assess its clinical feasibility and benefits by applying it to EEGs for stroke patients, considering the noticeable variations in EEG patterns between stroke patients and healthy controls.</p><p><strong>Methods: </strong>Motor hotspot locations were estimated using a two-dimensional convolutional neural network (CNN) model. We utilized various types of input data, depending on the five processing levels, the five types of input data, depending on the processing levels, to assess the signal processing capability of our proposed deep-learning model using EEGs of thirty healthy subjects measured during a simple hand movement task. Furthermore, we applied our proposed deep-learning algorithm to the hand-movement-related EEGs of twenty-nine stroke patients.</p><p><strong>Results: </strong>The mean error distance between the motor hotspot locations identified by TMS and our approach for healthy subjects was 0.35 ± 0.04 mm when utilizing power spectral density (PSD) features. The mean error distance was 2.27 ± 0.27 mm for healthy subjects and 1.64 ± 0.14 mm for stroke patients, when using raw data without any feature engineering. Our proposed motor hotspot identification algorithm showed robustness concerning the number of electrodes; the mean error distance was 2.34 ± 0.19 mm when using only 9 channels around the motor area for healthy subjects, and 1.77 ± 0.15 mm using only 5 channels around the motor area for stroke patients.</p><p><strong>Conclusion: </strong>We demonstrate that our EEG-based deep-learning approach can effectively identify individual motor hotspots, and the clinical feasibility of our algorithm by successfully applying the proposed approach to stroke patients. It can be used as an alternative to TMS for identifying motor hotspots, potentially enhancing the effectiveness of rehabilitation strategies.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"193"},"PeriodicalIF":5.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Transcranial direct current stimulation over the motor and premotor cortex with mirror therapy improves motor control, muscle function, and brain activity in chronic stroke: a double-blind randomized sham-controlled trial.","authors":"Wan-Wen Liao, Chia-Yi Lin, Yi-Shiung Horng, Chia-Ling Chen, Tsong-Hai Lee, Ching-Yi Wu","doi":"10.1186/s12984-025-01739-0","DOIUrl":"10.1186/s12984-025-01739-0","url":null,"abstract":"","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"192"},"PeriodicalIF":5.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12434904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nigral stimulation for freezing of gait: kinematic gait parameters inform optimization of stimulation frequency.","authors":"Daniel Weiss, Idil Cebi, Lisanne Dorrmann, Moritz Löffler, Philipp Klocke, Marlieke Schneider, Alireza Gharabaghi","doi":"10.1186/s12984-025-01712-x","DOIUrl":"10.1186/s12984-025-01712-x","url":null,"abstract":"<p><p>Innovative technology allows for personalization of stimulation frequency in dual-site deep brain stimulation (DBS), offering promise for challenging symptoms in advanced Parkinson's disease (PD), particularly freezing of gait (FoG). Early results suggest that combining standard subthalamic nucleus (STN) stimulation with substantia nigra pars reticulata (SNr) stimulation may improve FoG outcomes. However, patient response and the optimal SNr stimulation frequency vary. Our randomized controlled trial studied patients with advanced PD and persistent FoG, while recording gait kinematics through wearable inertial sensors, along with clinical assessments and patient-reported outcomes. In a with-subjects design, we compared a no-stimulation control with four stimulation conditions: Mono-site STN stimulation at 119 Hz and three dual-site protocols (STN + SNr) with SNr stimulation at 119 Hz, 71 Hz, or 30 Hz, keeping total electrical energy delivered (TEED) constant between SNr conditions. Significant interindividual variability was observed for the optimal stimulation protocol, with comparable proportions favoring STN, STN + SNr119, and STN + SNr71. Changes in spatial and temporal gait parameters, such as stride length and swing time, correlated significantly with FoG clinical improvements, with high correlation coefficients (> 0.8). Optimized stimulation parameters also led to improvements in patient-reported outcomes, highlighting the potential of digital biomarkers in tailoring DBS protocols for individualized outcomes.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"191"},"PeriodicalIF":5.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Frequency-specific modulation of motor cortical excitability by transcranial alternating current stimulation.","authors":"Lei Tingting, Chen Lilin, Wang Chuangjia, Si Jiamen, Zhang Shuxian, Ai Yinan, Liu Hanjun, Zheng Haiqing","doi":"10.1186/s12984-025-01732-7","DOIUrl":"10.1186/s12984-025-01732-7","url":null,"abstract":"","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"189"},"PeriodicalIF":5.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Wristful thinking: exploring the effects of robotic rehabilitation and cross-education for persons with multiple sclerosis.","authors":"Kailynn Mannella, Giulia A Albanese, Valentina Massone, Kevin E Power, Duane C Button, Jonathan P Farthing, Shawn M Beaudette, Dave S Ditor, Craig D Tokuno, Jacopo Zenzeri, Michael W R Holmes","doi":"10.1186/s12984-025-01733-6","DOIUrl":"10.1186/s12984-025-01733-6","url":null,"abstract":"","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"190"},"PeriodicalIF":5.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcutaneous spinal stimulation paired with visual feedback facilitates retention of improved weight transfer toward the affected side in people post-stroke.","authors":"Hyunje Park, Beom-Chan Lee, Dimitry Sayenko, Sheng Li, Seoung Hoon Park","doi":"10.1186/s12984-025-01673-1","DOIUrl":"10.1186/s12984-025-01673-1","url":null,"abstract":"<p><strong>Background: </strong>Many individuals with hemiparesis after stroke are reluctant to transfer their body weight toward the affected side and rely more heavily on the unaffected leg while walking. Although visual feedback (VF) has been utilized to improve their weight transfer during walking, the effects of transcutaneous spinal stimulation (TSS) paired with VF during locomotor training in people post-stroke remain largely unexplored. The purpose of this study, therefore, was to determine whether phasic TSS paired with VF regarding weight shifting to the affected leg during treadmill walking would enhance weight transfer toward the affected side.</p><p><strong>Methods: </strong>Eleven individuals post-stroke participated in two testing conditions (i.e., TSS + VF & Sham + VF) in a random order with a 10-minute break. Each condition consisted of (1) walking 30 strides (baseline), (2) walking 100 strides with either TSS + VF or Sham + VF (adaptation), and (3) walking 30 strides (post-adaptation).</p><p><strong>Results: </strong>Participants exhibited similar changes in weight transfer toward the affected side during the early post-adaptation period for both testing conditions (P = 0.20). However, enhanced weight transfer was shown during the late post-adaptation period in the TSS + VF condition, compared with the Sham + VF condition (P = 0.019). Further, the TSS + VF condition induced greater enhancement in muscle activation of affected hip abductors (P = 0.002) during the early post-adaptation period, along with greater improvements in stance time of the affected leg (P = 0.04) and symmetry of stance time (P = 0.01), compared with the effect of the Sham + VF condition.</p><p><strong>Conclusion: </strong>Targeted spinal stimulation paired with visually guided weight transfer during locomotor training can facilitate improvements in weight transfer and enhanced use of the affected leg, which may lead to symmetrical gait patterns in individuals with hemiparesis after a stroke.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"188"},"PeriodicalIF":5.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}