Journal of Neurology最新文献

{"title":"Intrathecal methotrexate in progressive multiple sclerosis: a phase 1 open-label study with long-term follow-up.","authors":"Hadar Kolb, Yuval Shachaf, Karin Fainberg, Maya Golan, Keren Regev, Ifat Vigiser, Lior Fuchs, Avi Gadoth, Meir Kestenbaum, Nurit Omer, Ludmila Shopin, Elissa L Ash, Moran Artzi, Dafna Ben Bashat, Orna Aizenstein, Arnon Karni","doi":"10.1007/s00415-025-13114-z","DOIUrl":"10.1007/s00415-025-13114-z","url":null,"abstract":"<p><p>Progressive multiple sclerosis (PMS) remains challenging to treat effectively. Intrathecal methotrexate (ITMTX) has emerged as a potential therapy for alleviating PMS symptoms. This study aimed to assess the safety, tolerability, and efficacy of ITMTX in PMS patients over short- and long-term periods. A 1-year, open-label, phase 1 study was conducted, administering ITMTX quarterly to eligible PMS patients. Primary endpoints included changes in Expanded Disability Status Scale (EDSS) scores, 25-Foot Walk (25FW), and Symbol Digit Modalities Test (SDMT) from baseline to 1 year. Secondary endpoints encompassed 6-month clinical changes, cerebrospinal fluid immune cell profiling, and MRI measures. Long-term follow-up included retrospective review of patients continuing ITMTX treatment beyond the initial study period. Twenty-two patients were initially enrolled, with 17 completing the 12-month treatment. ITMTX was well-tolerated, with post-LP headache being the most common adverse event (31.8%). No significant changes were observed in EDSS, 25FW, SDMT, CSF IgG levels, or immune cell counts over 12 months. Long-term follow-up of ten patients receiving ITMTX for 2-9 years (mean 4.1 ± 3.1 years) showed stable EDSS in seven patients, with three experiencing minimal worsening (0.5 points). The therapy was well-tolerated long-term, with no evidence of disease progression in most patients. These findings support ITMTX as a promising therapeutic approach for PMS, particularly for patients progressing despite approved disease-modifying therapies or unable to tolerate them. Further large-scale studies are warranted to confirm these results. Clinicaltrials.gov identifier: NCT02644044, year: 2015.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"374"},"PeriodicalIF":4.8,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aging and the neuropsychiatry of multiple sclerosis: a cross-sectional study.","authors":"David E Freedman, Jiwon Oh, Gillian Einstein, Anthony Feinstein","doi":"10.1007/s00415-025-13116-x","DOIUrl":"10.1007/s00415-025-13116-x","url":null,"abstract":"<p><p>Aging in multiple sclerosis (MS) affects clinical and radiological disease activity. Yet, evidence is equivocal about the effects of aging on the neuropsychiatric sequelae of MS, including anxiety, depression, fatigue, and cognitive dysfunction. This study aimed to clarify how the neuropsychiatric symptoms of MS vary across ages. A consecutive cohort of 1194 people with MS (pwMS) underwent neuropsychological testing using the Minimal Assessment of Cognitive Function in MS, the Hospital Anxiety and Depression Scale sub-scales for anxiety (HADS-A) and depression (HADS-D), Modified Fatigue Impact Scale (MFIS), and the Perceived Deficits Questionnaire (PDQ) for cognitive complaints. Participants were stratified into age sub-groups: 18-29, 30-39, 40-49, 50-59 years. t-tests were undertaken to compare symptoms between the 18-29 and 50-59 sub-groups. Linear regression analyses, controlling for disability (Expanded Disability Status Scale; EDSS), sex, educational years, and high-efficacy disease-modifying therapy use, were used to evaluate whether age significantly predicted neuropsychiatric sequelae. Mean age was 42.15 years, 74.12% were female, and median EDSS was 2.00. Older pwMS had reduced HADS-A, PDQ, California Verbal Learning Test (CVLT), Brief Visuospatial Memory Test (BVMT), Symbol Digit Modalities Test (SDMT), and Delis-Kaplan Executive Function System (D-KEFS) scores, all p < 0.01. There were no age differences on the HADS-D, MFIS, Controlled Oral Word Association Test, Judgment of Line Orientation, or Paced Auditory Serial Addition Test. Controlling for covariates, older age independently predicted reduced HADS-A, CVLT, BVMT, SDMT, and D-KEFS scores, all p < 0.01. In summary, as pwMS age, anxiety declines and performance on learning, memory, processing speed, and executive function tests worsens.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"375"},"PeriodicalIF":4.8,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathological laugher and crying in motor neuron diseases: a matter of bulbar and neurobehavioral involvement with sex imbalance.","authors":"Veronica Faltacco, Eleonora Dalla Bella, Anna Nigri, Alessandra Telesca, Giulia Gandini, Nilo Riva, Maria Vizziello, Jean Paul Medina, Greta Demichelis, Marina Grisoli, Susanna Usai, Giuseppe Lauria, Monica Consonni","doi":"10.1007/s00415-025-12959-8","DOIUrl":"10.1007/s00415-025-12959-8","url":null,"abstract":"<p><strong>Background: </strong>Emotional lability (EL), also known as pathological laughter and crying, is a common but understudied symptom in motor neuron diseases (MND): amyotrophic lateral sclerosis and primary lateral sclerosis. This study aimed to investigate the prevalence of EL in MND and to explore the independent frequency components of laughter and crying in relation to motor, cognitive, neuropsychiatric, and neuroimaging factors.</p><p><strong>Methods: </strong>A total of 198 incident MND patients were enrolled. The Centre of Neurological Study-Lability Scale was used to measure EL. Associations between EL and motor function, mood, neuropsychological variables, and structural MRI were examined, with cortical thinning measured on a subset of 48 patients.</p><p><strong>Results: </strong>EL was identified in 36% of patients showing more severe motor functional disabilities, heightened depressive and anxiety symptoms and behavioral changes than those without EL. Women exhibited more severe EL and altered mood with frequent crying episodes than men. EL was strongly correlated with bulbar involvement. Crying episodes were associated with mood disorders, while laughter correlated with disinhibition and emotional regulation difficulties. EL had a specific association with the thinning of frontal regions, including the right pars orbitalis, which was also linked to altered emotional and behavioral regulation.</p><p><strong>Conclusion: </strong>These findings underscore the role of corticobulbar and frontal pathways in EL pathophysiology. The study highlights the distinct mechanisms underlying pathological crying and laughter and their independency from general cognitive decline. It emphasizes the need for clinicians to recognize EL as an independent symptom, necessitating targeted management strategies to improve patient outcomes and support caregivers.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"372"},"PeriodicalIF":4.8,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age at onset of epilepsy shapes neurocognitive profiles in focal cortical dysplasia.","authors":"Anna-Laura Potthoff, Lukas Tennie, Juri-Alexander Witt, Attila Rácz, Valeri Borger, Hartmut Vatter, Albert Becker, Rainer Surges, Matthias Schneider, Christoph Helmstaedter","doi":"10.1007/s00415-025-13090-4","DOIUrl":"10.1007/s00415-025-13090-4","url":null,"abstract":"<p><strong>Background: </strong>Focal cortical dysplasia (FCD) is a common developmental brain disorder frequently associated with refractory epilepsy and neurocognitive comorbidities. This study examines the neurocognitive profiles of patients with FCD, with particular attention to histopathological classification, age at onset of epilepsy (AOE), FCD lateralization and localization, and antiseizure medication (ASM) load.</p><p><strong>Methods: </strong>This study was conducted on 98 patients with FCD (type IIa: n = 26, type IIb: n = 59) who had undergone surgical treatment for epilepsy. Patients underwent comprehensive presurgical neuropsychological assessments for intelligence (IQ) and six cognitive domains.</p><p><strong>Results: </strong>Patients with FCD type IIb significantly more often exhibited an earlier AOE (< 6 years, 65.5% vs. 38.5%, p = 0.021) and a longer duration of epilepsy at the time of cognitive testing (mean ± SD, 18.8 ± 13.61 vs. 11.88 ± 9.09 years, p = 0.008) compared to patients with FCD type IIa. The most notable differences in cognitive performance were observed between patients with early (< 6 years) and late AOE (≥ 6 years) for IQ and motor functions. In these domains, patients with early AOE consistently scored lower (IQ: 2.24 ± 1.17 vs. 2.79 ± 0.83, p = 0.021, impaired patients: 36% vs.15.8%; motor function: 1.46 ± 1.05 vs. 2.25 ± 0.95, p = 0.002, impaired patients: 74.4% vs. 43.8%). Differences in cognitive performance were not linked to FCD type, lateralization, localization, or ASM load.</p><p><strong>Conclusion: </strong>Our findings indicate that the AOE emerged as the determining factor for cognitive performance in refractory epilepsy patients due to FCD. As expected in cases of early childhood onset epilepsies, a neurodevelopmental disruption particularly of IQ and motor function was seen.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"373"},"PeriodicalIF":4.8,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029505","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":"Analyzing recurrent events in multiple sclerosis: a review of statistical models with application to the MSOAC database.","authors":"David Herman, Julien Tanniou, Emmanuelle Leray, Chloe Pierret, Quentin Pilard","doi":"10.1007/s00415-025-13100-5","DOIUrl":"10.1007/s00415-025-13100-5","url":null,"abstract":"<p><p>Patients with multiple sclerosis (MS) are susceptible to experience recurrent events of disability progression and relapses. Many studies still focus on analyzing MS events with traditional methods such as Cox proportional hazards, Poisson, and logistic regression that either ignore subsequent events or fail to account for overdispersion and dependency between events. The aim of this study was to conduct a literature review to identify the main recurrent event models, with subsequent application of these models to the Multiple Sclerosis Outcome Assessments Consortium (MSOAC) placebo database. A total of nine main recurrent event models were identified, compared and applied to the MSOAC database to evaluate the effect of the disease course on the number of changes in the Expanded Disability Status Scale (EDSS) and relapse rate. Recurrent events methods have provided more precise estimates than traditional methods. Despite the similarities in common and event-specific estimates for clinical MS outcomes, the interpretations of the parameter estimates resulting from the models are different. Medical researchers should prioritize recurrent event methods in their statistical plans to avoid information loss and improve the precision of estimated effects.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"371"},"PeriodicalIF":4.8,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality and causes of death for people with multiple sclerosis: a Finnish nationwide register study.","authors":"Katariina Kuutti, Sini M Laakso, Matias Viitala, Sari Atula, Merja Soilu-Hänninen","doi":"10.1007/s00415-025-13112-1","DOIUrl":"10.1007/s00415-025-13112-1","url":null,"abstract":"<p><strong>Introduction: </strong>Population-based longitudinal data on mortality and causes of death (COD) for people with Multiple Sclerosis (pwMS) is scarce. We studied all-cause and cause-specific mortality in Finnish pwMS in a nationwide registry study.</p><p><strong>Methods: </strong>PwMS from 1st January 1971 until end of 2019 were identified from the Finnish MS registry and national health care register. Standardized mortality ratios (SMRs), excess death rates (EDRs), life expectancies, and causes of death (COD) were determined by linkage to national registries.</p><p><strong>Results: </strong>For 16,602 pwMS, 3936 deaths occurred between 1980 and 2020. During 1980-1999, SMR for pwMS was 3.07 (95% CI 2.91-3.25) and EDR 14.05 (95% CI 13.72-14.37), and during 2000-2020 2.18 (95% CI 2.10-2.26) and 7.48 (95% CI 7.2-7.75), respectively. SMRs were higher for female pwMS and for patients diagnosed under age 30. EDRs were higher for males. Risk of death was lower for pwMS diagnosed 1996-2005 versus 1980-1995 (HR 0.49; 95% CI 0.43-0.55; p < 0.001). MS was the underlying cause in 51.2%, and a mentioned cause in 73.1% of deaths during 2000-2020. Mortality by underlying cause was higher than expected for gastrointestinal diseases (SMR 2.15, 95% CI 1.53-2.77), respiratory infections (SMR 1.99, 95% CI 1.22-2.75), and vascular diseases (SMR 1.38, 95% CI 1.25-1.51). Median lifetime expectancy was shortened by 7 years.</p><p><strong>Conclusion: </strong>Excess mortality in Finnish pwMS has decreased during the last 40 years. Life expectancy is shortened by 7 years and MS itself is the most frequent underlying COD. Risk of death is lower for pwMS diagnosed during the therapeutic era.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"370"},"PeriodicalIF":4.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012274","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":"Impact of LRRK2 and GBA variants on orthostatic hypotension in patients with Parkinson's disease.","authors":"Wen Liu, Yinlian Han, Yuqian Liu, Min Tian, Heyin Liu, Yang Yang, Jinde Liu, Chengyuan Song, Yiming Liu","doi":"10.1007/s00415-025-13086-0","DOIUrl":"10.1007/s00415-025-13086-0","url":null,"abstract":"<p><strong>Backgroud: </strong>Orthostatic hypotension (OH) is not rare in patients with Parkinson's disease (PD). To date, there have been few studies on the association of genetic variants with OH.</p><p><strong>Objectives: </strong>We aimed to evaluate the association of LRRK2 and GBA variants with OH in a large PD cohort.</p><p><strong>Methods: </strong>This study utilized data from the PPMI database, including 863 participants who were divided into the sporadic PD patients (sPD, n = 357), GBA variant carriers (GBA-PD, n = 137), LRRK2 variant carriers (LRRK2-PD, n = 158) and healthy controls (HC, n = 211). LRRK2-PD patients were additionally categorized into G2019S (n = 141) and R1441G (n = 16). GBA-PD patients were categorized into three subgroups by the genomic categorization.</p><p><strong>Results: </strong>No significant difference was found in the incidence of OH among the four groups at baseline. Lower University of Pennsylvania Scent Identification Test (UPSIT) scores, higher Rapid Eye Movement Sleep Behavior Disorder Screening Questionnaire (RBDSQ) score and the risk GBA mutations were significantly associated with OH cross-sectionally. Higher Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) total and part II scores, higher Epworth Sleepiness Scale (ESS) scores, higher RBDSQ scores and higher Scales for Outcomes in Parkinson's Disease-Autonomic Questionnaire (SCOPA-AUT) scores were strongly linked with OH progression over time. LRRK2 mutations especially LRRK2 G2019S mutation were significantly associated with the lower risk of OH progression.</p><p><strong>Conclusion: </strong>LRRK2-PD, particularly the LRRK2-G2019S-PD, were found to have a lower risk of OH. In contrast, the role of GBA mutations in OH appears more complex, with no further evidence to suggest that GBA is associated with the progression of OH in PD.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"369"},"PeriodicalIF":4.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of prognostic differences and risk factors in patients with atrial fibrillation known before ischemic stroke and atrial fibrillation diagnosed after ischemic stroke.","authors":"Dongjie Liu, Yan Zhao, Bingwei Zhang, Qi Lao, Lijia Wang, Xia Yi, Geng Chang","doi":"10.1007/s00415-025-13056-6","DOIUrl":"10.1007/s00415-025-13056-6","url":null,"abstract":"<p><strong>Aims: </strong>To compare the 1-year prognoses of patients with atrial fibrillation known before stroke (KAF) with those diagnosed after (AFDAS) and to explore the reasons for any observed differences.</p><p><strong>Methods: </strong>420 ischemic stroke patients were assigned to the KAF and AFDAS group. Follow-up information for both groups included the incidence of ischemic stroke recurrence, poor neurofunctional outcomes, and all-cause mortality within one year after the original ischemic stroke episode. The differences in the two groups' prognoses were assessed, and Cox/logistic regression models were employed to identify the underlying factors influencing this prognostic gap.</p><p><strong>Results: </strong>AFDAS had significantly lower rates of ischemic stroke recurrence (11.06% vs. 19.34%, P = 0.018) and poor neurofunctional outcome (25.48% vs. 36.79%, P = 0.012) compared to KAF. One-year all-cause mortality was similar between the two groups (7.69% vs. 9.91%, P = 0.424). AFDAS had a significantly lower risk of ischemic stroke recurrence even after adjusting for mortality factors (HR, 0.542; 95% CI, 0.325-0.903; P = 0.019). The incidence rate of ischemic stroke recurrence was significantly lower in AFDAS compared to KAF after adjustment for non-cardiac factors (HR, 0.561; 95% CI, 0.316-0.995; P = 0.042). However, there was no discernible difference in the two groups after adjustment for cardiac factors (HR, 0.659/0.588; 95% CI, 0.390-1.115/0.327-1.058; P = 0.120/0.077). The probability of a poor neurofunctional outcome was 3.758-fold higher in patients with recurrent ischemic stroke compared to those without recurrence (HR, 3.758; 95% CI, 1.587-8.900; P = 0.003). Compared to KAF, AFDAS was 88% less likely to have a poor neurofunctional outcome (HR, 0.120; 95% CI, 0.052-0.277; P < 0.001).</p><p><strong>Conclusion: </strong>Patients with AFDAS have a better prognosis than those with KAF.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"368"},"PeriodicalIF":4.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Incidence and mortality of ALS: a 42-year population-based nationwide study.","authors":"Lotte Sahin Levison, Jakob Udby Blicher, Henning Andersen","doi":"10.1007/s00415-025-13076-2","DOIUrl":"10.1007/s00415-025-13076-2","url":null,"abstract":"","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"365"},"PeriodicalIF":4.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987941","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: A real-life experience with eculizumab and efgartigimod in generalized myasthenia gravis patients.","authors":"Chiara Pane, Vincenzo Di Stefano, Nunzia Cuomo, Alessio Sarnataro, Claudia Vinciguerra, Liliana Bevilacqua, Filippo Brighina, Nicasio Rini, Giorgia Puorro, Angela Marsili, Matteo Garibaldi, Laura Fionda, Francesco Saccà","doi":"10.1007/s00415-025-13061-9","DOIUrl":"10.1007/s00415-025-13061-9","url":null,"abstract":"","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"366"},"PeriodicalIF":4.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988516","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}