Journal of Neurology, Neurosurgery, and Psychiatry最新文献

{"title":"Investigating colour vision and its structural correlates 15 years following a first demyelinating event","authors":"Charmaine Yam, Wallace J Brownlee, Ferran Prados Carrasco, Ahmed Toosy, Olga Ciccarelli","doi":"10.1136/jnnp-2024-334551","DOIUrl":"https://doi.org/10.1136/jnnp-2024-334551","url":null,"abstract":"Background We investigated the long-term colour and contrast vision outcomes, 15 years after a first demyelinating event, with their structural correlates using optical coherence tomography (OCT) and brain MRI. Methods Patients recruited with their first demyelinating event, were invited~15 years later to undergo clinical assessments, OCT and brain MRI and were clinically classified according to multiple sclerosis (MS) phenotypes. Linear mixed models evaluated associations between visual outcomes, MS phenotypes and OCT measures. Results 94 patients were evaluated after a median of 14.3 years. 111 eyes affected by optic neuritis and 77 unaffected eyes were studied. Optic neuritis eyes displayed worse colour vision than unaffected eyes. Unaffected eyes showed worse colour vision in relapsing-remitting MS and secondary progressive MS (SPMS) than clinically isolated syndrome, while no similar discriminatory ability was seen for OCT measures. However, ganglion cell inner plexiform layer (GCIPL) was superior to peripapillary retinal nerve fibre layer (pRNFL) in predicting all visual outcomes. Worse colour vision was associated with lower retinal thicknesses and higher brain T2 lesion load; adding MRI volumetrics to macular GCIPL predictors did not improve model prediction of visual outcomes. Conclusions Colour vision was impaired in unaffected eyes, especially in SPMS. GCIPL thinning underpinned this impairment more than pRNFL, suggesting neuroaxonal loss as the pathobiological substrate. The correlation between worse colour vision and increasing T2 lesion load suggests that colour dysfunction reflects overall greater disease burden. Quantitative evaluation of colour vision in addition to OCT may be useful to assess disease severity in patients after a first demyelinating event. Data are available upon reasonable request. The data that support the findings of this study are available on request to suitably qualified investigators from the corresponding author.","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142186567","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":"Distinct plasma lipids predict axonal injury and multiple sclerosis activity","authors":"Vinicius A Schoeps, Pavan Bhargava, Akash Virupakshaiah, Dimitrios Christos Ladakis, Carson Moseley, Janet Chong, Gregory Aaen, Jennifer S Graves, Leslie Benson, Mark P Gorman, Mary Rensel, Aaron Abrams, Soe Mar, Timothy E Lotze, Tanuja Chitnis, Amy Waldman, Lauren Krupp, Moses Rodriguez, Jan-Mendelt Tillema, John Rose, Teri Schreiner, Ferhan Qureshi, Skyler Peterson, Lisa F Barcellos, T Charles Casper, John Newman, Kamil Borkowski, Emmanuelle Waubant","doi":"10.1136/jnnp-2024-333652","DOIUrl":"https://doi.org/10.1136/jnnp-2024-333652","url":null,"abstract":"Background Lipids are of particular interest for the study of neuroinjury and neuroinflammation as structural lipids are major components of myelin, and a variety of lipid species modulate inflammation. In this study, we performed an in-depth lipidomics analysis to identify lipids associated with injury and disease activity. Methods Plasma samples were collected from paediatric-onset multiple sclerosis (MS) cases within 4 years of disease onset from 17 sites. The lipidome was measured using untargeted and targeted mass spectrometry. For cross-sectional analyses, the agreement between multiple machine learning models was used to predict neurofilament light chain (NfL) levels. In longitudinal analyses, the association between clinical (relapse count) and imaging (MRI count with ≥1 enhancing or new T2 lesion) outcomes with each metabolite was estimated using adjusted negative binomial regression. Results At sample collection, 68% of the 435 included individuals were treatment-naive, with a median disease duration of 0.8 years (IQR 0.3–1.7). For longitudinal analyses, 381 and 335 subjects had at least 1 year of clinical and imaging follow-up, respectively. In cross-sectional analyses, NfL chain levels identified structural lipids (phosphatidylcholines and phosphatidylethanolamines) as the highest-performing predictors, including external validation. In contrast, longitudinal analyses found polyunsaturated fatty acids (PUFAs) and their derivatives to be protective from subsequent disease activity (q<0.001, multiple outcomes). Conclusion There are two categories of lipids associated with MS processes. First, structural lipids strongly associated with NfL levels may result from cell lysis secondary to acute inflammation. In contrast, PUFAs, especially ω−3, had a protective effect on subsequent disease activity. Data are available on reasonable request. The data supporting this study’s findings are available from the study team on request to the corresponding author.","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":null,"pages":null},"PeriodicalIF":11.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142186566","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":"The relationship between corticospinal excitability and structural integrity in stroke patients.","authors":"Lina Daghsen, Thomas Checkouri, Aymric Wittwer, Romain Valabregue, Damien Galanaud, François-Xavier Lejeune, Mohammed Doulazmi, Jean-Charles Lamy, Pierre Pouget, Emmanuel Roze, Charlotte Rosso","doi":"10.1136/jnnp-2023-331996","DOIUrl":"https://doi.org/10.1136/jnnp-2023-331996","url":null,"abstract":"<p><strong>Background: </strong>Evaluation of the structural integrity and functional excitability of the corticospinal tract (CST) is likely to be important in predicting motor recovery after stroke. Previous reports are inconsistent regarding a possible link between CST structure and CST function in this setting. This study aims to investigate the structure‒function relationship of the CST at the acute phase of stroke (<7 days).</p><p><strong>Methods: </strong>We enrolled 70 patients who had an acute ischaemic stroke with unilateral upper extremity (UE) weakness. They underwent a multimodal assessment including clinical severity (UE Fugl Meyer at day 7 and 3 months), MRI to evaluate the CST lesion load and transcranial magnetic stimulation to measure the maximum amplitude of motor evoked potential (MEP).</p><p><strong>Results: </strong>A cross-sectional lesion load above 87% predicted the absence of MEPs with an accuracy of 80.4%. In MEP-positive patients, the CST structure/function relationship was bimodal with a switch from a linear relationship (rho=-0.600, 95% CI -0.873; -0.039, p<0.03) for small MEP amplitudes (<0.703 mV) to a non-linear relationship for higher MEP amplitudes (p=0.72). In MEP-positive patients, recovery correlated with initial severity. In patients with a positive MEP <0.703 mV but not in patients with an MEP ≥0.703 mV, MEP amplitude was an additional independent predictor of recovery. In MEP-negative patients, we failed to identify any factor predicting recovery.</p><p><strong>Conclusion: </strong>This large multimodal study on the structure/function of the CST and stroke recovery proposes a paradigm change for the MEP-positive patients phenotypes and refines the nature of the link between structural integrity and neurophysiological function, with implications for study design and prognostic information.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":null,"pages":null},"PeriodicalIF":8.7,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145809","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":"Intermediate <i>HTT</i> CAG repeats worsen disease severity in amyotrophic lateral sclerosis.","authors":"Maurizio Grassano, Antonio Canosa, Sandra D'Alfonso, Lucia Corrado, Giorgia Brodini, Emanuele Koumantakis, Paolo Cugnasco, Umberto Manera, Rosario Vasta, Francesca Palumbo, Letizia Mazzini, Salvatore Gallone, Cristina Moglia, Ramita Dewan, Ruth Chia, Jinhui Ding, Clifton Dalgard, Raphael J Gibbs, Sonja Scholz, Andrea Calvo, Bryan Traynor, Adriano Chio","doi":"10.1136/jnnp-2024-333998","DOIUrl":"https://doi.org/10.1136/jnnp-2024-333998","url":null,"abstract":"","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":null,"pages":null},"PeriodicalIF":8.7,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145808","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":"Predictors of relapse risk and treatment response in AQP4-IgG positive and seronegative NMOSD: A multicentre study.","authors":"Pakeeran Siriratnam, Paul Sanfilippo, Anneke van der Walt, Sifat Sharmin, Yi Chao Foong, Wei Zhen Yeh, Chao Zhu, Samia Joseph Khoury, Tunde Csepany, Barbara Willekens, Masoud Etemadifar, Serkan Ozakbas, Petra Nytrova, Ayse Altintas, Abdullah Al-Asmi, Bassem Yamout, Guy Laureys, Francesco Patti, Magdolna Simo, Andrea Surcinelli, Matteo Foschi, Pamela A McCombe, Raed Alroughani, José Luis Sánchez-Menoyo, Recai Turkoglu, Aysun Soysal, Jeanette Lechner Scott, Tomas Kalincik, Helmut Butzkueven, Vilija Jokubaitis, Saif Huda, Mastura Monif","doi":"10.1136/jnnp-2024-334090","DOIUrl":"https://doi.org/10.1136/jnnp-2024-334090","url":null,"abstract":"<p><strong>Background: </strong>Neuromyelitis optica spectrum disorder (NMOSD) can be categorised into aquaporin-4 antibody (AQP4-IgG) NMOSD or seronegative NMOSD. While our knowledge of AQP4-IgG NMOSD has evolved significantly in the past decade, seronegative NMOSD remains less understood. This study aimed to evaluate the predictors of relapses and treatment responses in AQP4-IgG NMOSD and seronegative NMOSD.</p><p><strong>Methods: </strong>This was a multicentre, international, retrospective cohort study using the MSBase registry. Recurrent relapse risk was assessed using an Andersen-Gill model and risk of first relapse was evaluated using a Cox proportional hazards model. Covariates that putatively influence relapse risk included demographic factors, clinical characteristics and immunosuppressive therapies; the latter was assessed as a time-varying covariate.</p><p><strong>Results: </strong>A total of 398 patients (246 AQP4-IgG NMOSD and 152 seronegative NMOSD) were included. The AQP4-IgG NMOSD and seronegative NMOSD patients did not significantly differ by age at disease onset, ethnicity or annualised relapse rate. Both low-efficacy and high-efficacy immunosuppressive therapies were associated with significant reductions in recurrent relapse risk, with notably greater protection conferred by high-efficacy therapies in both AQP4-IgG NMOSD (HR 0.27, 95% CI 0.15 to 0.49, p<0.001) and seronegative NMOSD (HR 0.21, 95% CI 0.08 to 0.51, p<0.001). Longer disease duration (HR 0.97, 95% CI 0.95 to 0.99, p<0.001) and male sex (HR 0.52, 95% CI 0.34 to 0.84, p=0.007) were additional protective variables in reducing the recurrent relapse risk for the AQP4-IgG NMOSD group.</p><p><strong>Conclusion: </strong>Although further studies are needed to improve our understanding of seronegative NMOSD, our findings underscore the importance of aggressive treatment with high-efficacy immunotherapies in both NMOSD subtypes, regardless of serostatus.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":null,"pages":null},"PeriodicalIF":8.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132955","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":"Spinal cord motor neuron phenotypes and polygenic risk scores in sporadic amyotrophic lateral sclerosis: deciphering the disease pathology and therapeutic potential of ropinirole hydrochloride.","authors":"Chris Kato, Satoru Morimoto, Shinichi Takahashi, Shinichi Namba, Qingbo S Wang, Yukinori Okada, Hideyuki Okano","doi":"10.1136/jnnp-2024-333690","DOIUrl":"https://doi.org/10.1136/jnnp-2024-333690","url":null,"abstract":"","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":null,"pages":null},"PeriodicalIF":8.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132956","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":"Long-term disability trajectories in multiple sclerosis: a group-based trajectory analysis of the AusLong cohort.","authors":"Amin Zarghami, Mohammad Akhtar Hussain, Ingrid van der Mei, Steve Simpson-Yap, Anne-Louise Ponsonby, Jeanette Lechner-Scott, Simon A Broadley, Robyn M Lucas, Yuan Zhou, Xin Lin, AusLong Investigator Group, Bruce V Taylor","doi":"10.1136/jnnp-2024-333632","DOIUrl":"https://doi.org/10.1136/jnnp-2024-333632","url":null,"abstract":"<p><strong>Background: </strong>Previous natural history studies highlighted a consistent heterogeneity of disability trajectories among individuals with primary or secondary progressive multiple sclerosis (MS). However, evidence on disability progression in relapsing onset MS is scarce.The aim of this study was to investigate heterogeneity in disability accumulation over 10 years following a first clinical diagnosis of central nervous system demyelination (FCD) and identify genetic, demographic, environmental and clinical factors associated with these trajectories.</p><p><strong>Methods: </strong>We used group-based trajectory models to measure heterogeneity in disability trajectories based on the Expanded Disability Status Scale (EDSS) in a prospectively assessed cohort of 263 participants. To capture sustained neurological impairments and avoid issues related to significant changes in EDSS associated with relapse, we did not consider EDSS points recorded within 3 months of a relapse.</p><p><strong>Results: </strong>We identified three distinct and clinically meaningful disability trajectories: No/minimal, moderate and severe. Those in the no/minimal disability trajectory showed no appreciable progression of disability (median EDSS∼1 at 10-year review) while those in the moderate and severe disability trajectories experienced disability worsening (median time to reach EDSS 4 was 9 and 7 years, respectively). Compared with the no/minimal disability trajectory, those with older age, a higher number of relapses within the first 5 years post-FCD, and a higher number of comorbidities at baseline were more likely to be in the worse disability trajectory. Surprisingly, baseline MRI and anatomical site of initial symptoms did not influence long-term outcomes.</p><p><strong>Conclusions: </strong>Those at higher risk of faster MS disability progression can be identified based on their early clinical characteristics with potential therapeutic implications for early intervention and treatment escalation.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":null,"pages":null},"PeriodicalIF":8.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132943","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":"Total bilirubin modified the association between diabetes and stroke: a cross-sectional study from NHANES 2011-2016.","authors":"Zhang Xia, Guozheng Xu, Mingyang Zhao, Yuhao Li, Peiyu Ye, Yijian Liu, Herbert Y Gaisano, Yan He","doi":"10.1136/jnnp-2024-334408","DOIUrl":"https://doi.org/10.1136/jnnp-2024-334408","url":null,"abstract":"<p><strong>Background: </strong>Total bilirubin (TBIL) has antioxidant and anti-inflammatory properties. This study aimed to determine whether elevated TBIL could modify the association between diabetes and stroke.</p><p><strong>Method: </strong>Data were obtained from the National Health and Nutrition Examination Survey 2011-2016. TBIL was stratified by median (10.3 µmol/L). The association between diabetes and stroke was quantified using multivariable logistic regression models. The cut-off concentration for the presence of TBIL modification effects was identified by Johnson-Neyman analyses. Mediation analyses were performed to determine the influence of TBIL on mediating factors that mediate the relationship between diabetes and stroke.</p><p><strong>Results: </strong>This cross-sectional study included 16 130 participants, with the mean age of 46.8±0.4 years and 48.5% of men. Diabetes was associated with the presence of stroke at TBIL <10.3 µmol/L (OR=2.19, 95% CI 1.58 to 3.05) but not at TBIL ≥10.3 µmol/L (OR=1.27, 95% CI 0.85 to 1.88) after adjustment for confounders. Above associations were significantly different between the two TBIL concentrations (<i>P</i> for interaction=0.03). Moreover, the modification effect of TBIL specifically occurred in men (<i>P</i> for interaction=0.02) rather than in women (<i>P</i> for interaction=0.08). The cut-off concentration for the presence of TBIL modification effects was 17.05 µmol/L. Additionally, the TBIL of ≥10.3 µmol/L inhibited mediating effects of hypersensitive C reactive protein (mediating effect=0.03, 95% CI -0.15 to 0.22, <i>P</i>=0.72) and systemic immune-inflammation index (mediating effect=0.01, 95% CI -0.01 to 0.04, <i>P</i>=0.29) as compared with the TBIL of <10.3 µmol/L.</p><p><strong>Conclusions: </strong>Elevated TBIL modified the association between diabetes and stroke through inhibiting mediating effects of inflammatory factors.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":null,"pages":null},"PeriodicalIF":8.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132958","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":"Prognosis prediction and immunotherapy optimisation for cryptogenic new-onset refractory status epilepticus.","authors":"Yoonhyuk Jang, Soo Hyun Ahn, Kyung-Il Park, Bum-Sup Jang, Han Sang Lee, Jae-Han Bae, Yoonkyung Lee, Jun-Sang Sunwoo, Jin-Sun Jun, Keun Tae Kim, Su Yee Mon, Ji Hye You, Tae-Joon Kim, Hyunsuk Shin, Dohyun Han, Yong Won Cho, Divyanshu Dubey, Kon Chu, Sang Kun Lee, Soon-Tae Lee","doi":"10.1136/jnnp-2024-334285","DOIUrl":"https://doi.org/10.1136/jnnp-2024-334285","url":null,"abstract":"<p><strong>Background: </strong>Cryptogenic new-onset refractory status epilepticus (cNORSE) currently lacks comprehensive knowledge regarding its clinical dynamics, prognostic factors and treatment guidance. Here we present the longitudinal clinical profiles, predictive factors for outcomes and the optimal duration of immunotherapy in patients with cNORSE.</p><p><strong>Methods: </strong>This retrospective secondary endpoint analysis investigated patients with cNORSE identified from a prospective autoimmune encephalitis cohort at a national referral centre in Korea. The main outcomes included longitudinal functional scales, seizure frequency and the number of antiseizure medications. Measures encompassed NORSE-related clinical parameters such as the duration of unconsciousness, immunotherapy profiles, cytokine/chemokine analysis, and serial MRI scans.</p><p><strong>Results: </strong>A total of 74 patients with cNORSE were finally analysed (mean age: 38.0±18.2; 36 (48.6%) male). All patients received first-line immunotherapy, and 91.9% (68/74) received second-line immunotherapy. A total of 83.8% (62/74) regained consciousness within a median duration of 30 days (14-56), and 50% (31/62) achieved good outcome (mRS ≤2) at 2 years. Poor 1-year outcomes (mRS ≥3) were predicted by the presence of mesial temporal lobe (mTL) and extra-mTL lesions at 3-month MRI, and prolonged unconsciousness (≥60 days). Those with mTL atrophy exhibited a higher seizure burden post-NORSE. The optimal duration of immunotherapy appeared to be between 18 weeks and 1-year post-NORSE onset.</p><p><strong>Conclusions: </strong>This study elucidates longitudinal clinical dynamics, functional outcomes, prognostic factors and immunotherapy response in patients with cNORSE. These findings might contribute to a more standardised understanding and clinical decision-making for cNORSE.</p>","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":null,"pages":null},"PeriodicalIF":8.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140350","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":"Predictors of outcome in cNORSE: hope for tomorrow.","authors":"Laura Mantoan Ritter","doi":"10.1136/jnnp-2024-334475","DOIUrl":"https://doi.org/10.1136/jnnp-2024-334475","url":null,"abstract":"","PeriodicalId":16418,"journal":{"name":"Journal of Neurology, Neurosurgery, and Psychiatry","volume":null,"pages":null},"PeriodicalIF":8.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140349","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}