Journal of Parkinson's disease最新文献

{"title":"Visual hallucinations in Parkinson's disease are associated with deficits in social perception.","authors":"Louis Albert, Neza Vehar, Jevita Potheegadoo, Fosco Bernasconi, Olaf Blanke","doi":"10.1177/1877718X251336196","DOIUrl":"https://doi.org/10.1177/1877718X251336196","url":null,"abstract":"<p><p>BackgroundMost structured visual hallucinations (VH) in Parkinson's disease (PD) involve animate-social objects, yet current theories fail to account for the prominent social component of VH in PD.ObjectiveTo study social perception in PD patients with VH in a behavioral task and its relationship with social traits such as perceived social isolation and anthropomorphism (tendency to ascribe human-like characteristics to non-human stimuli).MethodsIn this online web-based study, 28 PD with visual hallucinations (PD-VH), 55 PD patients without hallucinations (PD-nH), and 45 age-matched healthy controls (HC) performed a visual social task (human numerosity estimation), a control task, and filled an anthropomorphism and a loneliness questionnaire.ResultsOur data reveal a deficit in social visual perception characterized by a larger overestimation bias in human numerosity estimation in PD-VH versus control PD-nH and HC. Moreover, PD-VH had higher social traits of anthropomorphism and loneliness versus control PD-nH and HC and the overestimation bias was absent for non-human control stimuli.ConclusionsThese data describe a stronger social visual deficit and higher social traits in PD patients with VH, suggesting that neurodegenerative changes in PD-VH predominantly affect structures involved in social visual perception.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251336196"},"PeriodicalIF":4.0,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-year practice effects predict long-term cognitive outcomes in Parkinson's disease.","authors":"Sofía Avila Pérez, Vincent Koppelmans, Kevin M Duff, Marit Fl Ruitenberg","doi":"10.1177/1877718X251339585","DOIUrl":"https://doi.org/10.1177/1877718X251339585","url":null,"abstract":"<p><p><b>Background:</b> Predicting which individuals with Parkinson's disease (PD) will develop cognitive deficits is challenging, but important towards selecting those individuals at higher risk of progression for personalized early intervention and enriching samples for clinical trials of disease modifying agents. <b>Objective:</b> To examine whether practice effects on cognitive tests across one-year are predictive of eventual cognitive impairment (CI) and dementia (PDD) in individuals with PD. <b>Methods:</b> Individuals with PD (<i>n</i> = 549) from the PPMI database who were cognitively intact at baseline were included for analysis. The Montreal Cognitive Assessment (MoCA) was administered at baseline and during annual follow-up visits over at least five years to determine if participants remained intact (MoCA ≥ 26) or developed CI (MoCA ≤ 25) or dementia (MoCA ≤ 21). Participants also completed a neuropsychological battery at baseline and again after a one-year interval. Practice effects on the cognitive tests across one-year were quantified with standardized regression-based change scores using PPMI data from cognitively intact subjects without PD. <b>Results:</b> Based on MoCA scores, 39% of patients developed CI and 10% developed PDD during the study. Linear regressions revealed smaller practice effects across one year in people with PD than in controls. Within the PD group, Cox regression analyses showed that smaller practice effects on tests of various cognitive domains were associated with an increased risk for CI. For PDD, only practice effects on a measure of processing speed significantly predicted cognitive outcomes. <b>Conclusions:</b> These findings demonstrate that practice effects have prognostic value in long-term cognitive outcomes in PD. This has important implications for clinical care and research, as one-year practice effects could help identify individuals at risk for CI and PDD and enrich samples for future clinical trials. Limitations of the present study pertain to the classification of cognitive impairment on the basis of a screening instrument (i.e., the MoCA) without evidence of the absence/presence of functional impairment, and the clinical utility of the one-year interval.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251339585"},"PeriodicalIF":4.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dementia risk prediction in early Parkinson's disease: Validation and genetic integration of the Montreal Parkinson risk of dementia scale (MoPaRDS).","authors":"Aleksandra A Szwedo, Ingvild Dalen, Rachael A Lawson, Alison J Yarnall, Kenn Freddy Pedersen, Angus D Macleod, Carl E Counsell, David Bäckström, Lars Forsgren, Marta Camacho, Caroline H Williams-Gray, Ole-Bjørn Tysnes, Guido Alves, Jodi Maple-Grødem","doi":"10.1177/1877718X251329857","DOIUrl":"https://doi.org/10.1177/1877718X251329857","url":null,"abstract":"<p><p>BackgroundPrediction models for dementia in Parkinson disease (PD) are needed to better identify high-risk patients, but existing risk models often lack validation in early-stage PD, when prognosis is most challenging.ObjectiveThis study aims to validate the Montreal Parkinson Risk of Dementia Scale (MoPaRDS) in six population-based cohorts of newly diagnosed PD and to evaluate if incorporating genetic factors (<i>GBA1</i> and <i>APOE-ε4</i>) enhances its performance.MethodsWe calculated MoPaRDS scores for 1108 newly diagnosed PD patients, and MoPaRDS + <i>GBA1 </i>+ <i>APOE</i> for the 941 patients with complete genetic data. We assessed the scores' performance in predicting dementia diagnosed over 10 years using time-dependent receiver operating characteristic (ROC) curves.ResultsOf the 1108 patients (mean age 69.5 ± 10.0 years; 61.0% men), 350 (31.6%) developed dementia. The area under the time-dependent ROC curve (AUC) was 0.79 for MoPaRDS and 0.80 for MoPaRDS + <i>GBA1 </i>+ <i>APOE.</i> Subdividing patients based on their MoPaRDS scores revealed annual observed risks of PDD of 39.4% (n = 8; high risk-), 11.4% (n = 176; intermediate risk-), and 5.0% (n = 942; low risk-group). With the suggested cutoff of ≥4, MoPaRDS had a sensitivity of 21.7% and specificity of 94.9%. Including the genetic items improved the sensitivity to 36.4% while maintaining comparable performance for specificity (91.5%).ConclusionsMoPaRDS demonstrates high specificity but limited sensitivity in early PD, highlighting that a one-size-fits-all approach is inadequate for predicting dementia risk in PD across different disease stages. Integrating genetic items increases sensitivity and identifies more newly diagnosed patients at higher risk of dementia, and may be a useful approach to assist dementia risk assessment in early-stage PD.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251329857"},"PeriodicalIF":4.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of β-adrenoreceptor drugs and Parkinson's disease incidence in women from the French E3N cohort study.","authors":"Thi Thu Ha Nguyen, Agnès Fournier, Émeline Courtois, Fanny Artaud, Pascale Tubert-Bitter, Gianluca Severi, Pei-Chen Lee, Emmanuel Roze, Ismaïl Ahmed, Anne Cm Thiébaut, Alexis Elbaz","doi":"10.1177/1877718X251330993","DOIUrl":"https://doi.org/10.1177/1877718X251330993","url":null,"abstract":"<p><p>BackgroundExperimental and observational studies suggest that β-adrenoreceptor drugs (β2-agonists/β-antagonists) are associated with Parkinson's disease (PD) risk. Previous epidemiological studies may be hampered by reverse causation/confounding.ObjectiveWe examined the association of β-adrenoreceptor drugs with PD incidence, while addressing reverse causation and confounding in the E3N cohort study (2004-2018) using a new-user design.MethodsIncident β2-agonists/β-antagonists users were identified through drug claims databases. Incident PD was ascertained using multiple sources and validated by experts. Drugs-PD associations were assessed using time-varying Cox proportional hazards models adjusted for multiple confounders. Main analyses used a 5y-exposure lag to address reverse causation; sensitivity analyses used a 2y-lag or no lag. We set up a nested case-control study to compare trajectories of β2-agonists/β-antagonists prescriptions before diagnosis using logistic mixed models.ResultsAnalyses for β2-agonists were based on 81,890 women; 15,169 started using β2-agonists and 579 developed PD. PD incidence was 36% lower (hazard ratio = 0.64, 95% confidence interval = 0.41-0.98; p-trend = 0.04 for the number of claims) in users of long-acting/ultra-long-acting β2-agonists (LABAs/ultra-LABAs) compared to never users. There was no significant association for β2-agonists overall and short-acting β2-agonists. Analyses for β-antagonists were based on 75,896 women; 13,081 started using β-antagonists and 552 developed PD. PD incidence was similar in ever and never users in analyses with a 5y-lag but was higher in ever than never users in analyses with 2y-lag or no lag.ConclusionsIncident use of LABAs/ultra-LABAs is associated with lower PD incidence in women. Conversely, the association between β-antagonists and PD in women is likely due to reverse causation.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251330993"},"PeriodicalIF":4.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From past to future: Digital approaches to success of clinical drug trials for Parkinson's disease.","authors":"Cen Cong, Madison Milne-Ives, Ananya Ananthakrishnan, Walter Maetzler, Edward Meinert","doi":"10.1177/1877718X251330839","DOIUrl":"https://doi.org/10.1177/1877718X251330839","url":null,"abstract":"<p><p>Recent years have seen successes in symptomatic drugs for Parkinson's disease, but the development of treatments for stopping disease progression continues to fail in clinical drug trials, largely due to the lack of clinical efficacy of drugs. This may be related to limited understanding of disease mechanisms, data heterogeneity, poor target screening and candidate selection, challenges in determining optimal dosage levels, reliance on animal models, insufficient patient participation, and lack of drug adherence in trials. Most of the recent applications of digital health technologies and artificial intelligence (AI)-based tools focused mainly on stages before clinical drug trials. Recent applications used AI-based algorithms or models to discover novel targets, inhibitors and indications, recommend drug candidates and drug dosage, and promote remote data collection. This paper reviews the state of the literature and highlights strengths and limitations in digital approaches to drug discovery and development for Parkinson's disease from 2021 to 2024, and offers recommendations for future research and practice for the success of drug clinical trials.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251330839"},"PeriodicalIF":4.0,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparing for Parkinson's disease prevention trials: Current progress and future directions.","authors":"Sarah Bouhadoun, Aline Delva, Michael A Schwarzschild, Ronald B Postuma","doi":"10.1177/1877718X251334050","DOIUrl":"https://doi.org/10.1177/1877718X251334050","url":null,"abstract":"<p><p>In recent decades, numerous clinical trials have aimed to delay or prevent Parkinson's disease (PD) progression. Despite the theoretical promise and encouraging preclinical data, none have shown clear efficacy in slowing or preventing PD progression, related to several key limitations. Conventional motor and non-motor scales often fall short in detecting early disease changes, while the heterogeneity of PD phenotypes complicates treatment efficacy. The timing of interventions is also critical, as most trials target patients already in advanced stages of neurodegeneration. A deeper understanding of the preclinical phase and the emergence of new pathological frameworks have shifted the focus toward preventing the onset of clinical PD. Recent advances in biomarker research, including tissue, fluid, and imaging markers, are poised to transform PD research by improving patient selection, stratification, and disease progression monitoring. New biologically grounded frameworks for classifying synucleinopathies aim to distinguish biological subtypes from clinical phenotypes, enabling more targeted prevention trials. Successful PD prevention trials will require early enrollment of individuals at the highest risk, employing low-risk personalized interventions, with biomarkers or sensitive clinical markers as endpoints. Early involvement of key stakeholders will be essential to ensure that trials are timely, ethically sound, and aligned with the needs of the PD community.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251334050"},"PeriodicalIF":4.0,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dopamine-responsive post-anoxic parkinsonism.","authors":"Tina Liu, J Eric Ahlskog, James Bower, Orhun Kantarci, Rodolfo Savica","doi":"10.1177/1877718X251335044","DOIUrl":"https://doi.org/10.1177/1877718X251335044","url":null,"abstract":"<p><p>BackgroundParkinsonism following hypoxic ischemic damage of the basal ganglia is an uncommon phenomenon that has been infrequently reported. However, only a few cases have noted improvement of symptoms with dopaminergic therapy. We report the clinical and imaging features of five patients with post-anoxic parkinsonism responsive to dopamine supplementation.ObjectiveTo describe a retrospective case series of five cases of dopamine-responsive post-anoxic parkinsonism.MethodsWe identified all the cases using the Mayo Clinic Data Management System utilizing advanced data explorer search engine for any patients evaluated for post anoxic parkinsonism and its associated acronyms from 2000-2024. Clinical features, neuroimaging, medication trials, and responses were obtained from chart review of identified patients.ResultsFive patients met the inclusion criteria. All patients underwent anoxic events followed by development of parkinsonism. Patients exhibited parkinsonism described as combinations of bradykinesia, rigidity, tremor, and postural instability. All patients underwent evaluation by a neurologist, MRI imaging, and treatment by dopaminergic agents. Of the five patients, four received carbidopa/levodopa whereas one received a dopamine agonist. All patients were clinically followed for a median of approximately 4 years and showed improvement in parkinsonism.ConclusionsParkinsonism following a hypoxic ischemic insult is a rare occurrence but response to dopaminergic therapy in those cases is even more scarcely described. Our cases series provides important implications for treatment options for patients with post anoxic parkinsonism.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251335044"},"PeriodicalIF":4.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The fixel GI Parkinson's research and integrated support model (PRISM).","authors":"Grace Hey, Manuel Amaris, Matthew Beke, Nur Walker-Pizarro, Candice Rogers, Vinata Vedam-Mai, Rachael Dorsey, Nicole Herndon, Michael S Okun, Adolfo Ramirez-Zamora","doi":"10.1177/1877718X251335047","DOIUrl":"https://doi.org/10.1177/1877718X251335047","url":null,"abstract":"<p><p>BackgroundThe complexity of gastrointestinal (GI) disorders associated with Parkinson's disease (PD) and the significant interactions between GI medications and the dopaminergic axis necessitates expert management. The integrated care model for disorders of the brain-gut interaction (DBGI) has advantages, however, has not been applied in concurrent DBGI and PD.ObjectiveTo test the hypothesis that our Parkinson's Research and Integrated Support Model (PRISM) will reduce symptom severity and improve the quality of life (QOL) in patients with GI symptoms associated with PD.MethodsPatients with refractory GI symptoms referred to the PRISM clinic were evaluated and treated by the integrated efforts of movement disorder specialists, neurogastroenterologists, dietitians, occupational therapists, speech-swallow therapists, and neuroscientists. Patients underwent a battery of GI symptoms and QOL questionnaires and personalized actionable biomarkers (motility testing and swallowing studies). Inflammatory markers and stool tests were collected. An individualized standard of care treatment was established based on the specific DBGI diagnosis uncovered during the PRISM evaluation.Results44 adult PD patients with GI complaints were evaluated. The most common symptoms included constipation (97%), dysphagia (61%), and gastroesophageal reflux (34%). Actionable biomarkers were highly positive revealing esophageal dysmotility (20/21, 95%), slow-transit constipation (40/42, 90%), intestinal methanogen overgrowth (7/8, 87%), gastroparesis (17/20, 85%), oropharyngeal dysphagia (28/44, 63%), and dyssynergic defecation (27/42, 61%). GI symptom severity and QOL significantly improved (<i>p</i> < 0.05) as measured by all questionnaires.ConclusionsMore severely affected patients with Parkinson's treated with the Fixel PRISM approach showed significant improvements in GI symptom frequency, severity, and QOL.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251335047"},"PeriodicalIF":4.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential of distributed diagnostics for the early detection of Parkinson's disease.","authors":"Amit Khanna, James Beck, Kathleen Poston, Michael A Schwarzschild, Graham B Jones","doi":"10.1177/1877718X251336118","DOIUrl":"https://doi.org/10.1177/1877718X251336118","url":null,"abstract":"<p><p>Parkinson's disease represents a major healthcare burden with over 1 million confirmed cases and economic costs of care exceeding $50 billion in the United States alone. A challenge in the evaluation of potentially disease delaying, preventing, or reversing agents is identification of patients in the very early, prodromal (asymptomatic, non-motor, or early motor) stages, which can span decades. Currently, diagnosis is based almost exclusively on clinical history and physical examination conducted by trained experts. Unfortunately for many patients, access to neurology and movement disorder specialists is geographically limited and coupled with the absence of coordinated disease awareness campaigns can contribute to substantial delays in diagnosis. As with any campaign, a key success factor is having multiple approaches which can appeal to a wide range of patient archetypes. Herein we elaborate on some emerging opportunities, which if fully developed could invigorate the approach to early detection and, critically, engage patients in this process. They include 1) Use of personal digital health technologies and community based point-of-care diagnostic instrumentation, 2) The potential to leverage annual testing services at non-traditional venues including optometry, dental and pharmacy, and 3) A consumer focused campaign to raise awareness of the importance of early detection, paralleling efforts in other diseases. There is every hope that combining traditional and non-traditional approaches to enhance early diagnosis rates can have an overall positive impact on patient outcomes and contribute substantively to efforts to develop new interventions. We urge the community to embrace these possibilities and begin active dialog on how to thoughtfully implement the approaches into routine care.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251336118"},"PeriodicalIF":4.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent advances of transcranial electrical stimulation in healthy aging and Parkinson's disease: Effects on dual tasking.","authors":"Martina Putzolu, Alessandro Botta, Carola Cosentino, Susanna Mezzarobba, Gaia Bonassi, Elisa Ravizzotti, Sara Terranova, Giovanna Lagravinese, Elisa Pelosin, Laura Avanzino","doi":"10.1177/1877718X251327758","DOIUrl":"https://doi.org/10.1177/1877718X251327758","url":null,"abstract":"<p><p>Dual tasking involves the simultaneous execution of two actions. In the context of healthy aging and neurodegenerative disorders, such as Parkinson's disease (PD) engagement in dual tasking frequently results in impaired gait or upper limb performance, thereby affecting functional independence. Transcranial electrical stimulation is a non-invasive technique able to modulate brain activity, which might represent a potential tool for reducing dual task interference. The goal of this review is to provide a comprehensive summary of the most recent findings about the use of transcranial electrical stimulation in improving dual tasking in the elderly and people with PD, including considerations about the optimal stimulation parameters. Differences in terms of stimulation protocols emerged across the included studies. Among transcranial electrical stimulation techniques, transcranial direct current stimulation (tDCS) was the most frequently employed. Currently, using tDCS to target dorsolateral prefrontal cortex either alone or in a multi-site fashion, along with a concurrent complex task, appears to be the most promising method for reducing dual task interference. Nevertheless, the lack of control over interindividual variability, the heterogeneity in outcome measures assessing dual tasking, and the variations in protocol elements like the frequency and the number of sessions prevented us from drawing definitive conclusions about the best paradigm.</p>","PeriodicalId":16660,"journal":{"name":"Journal of Parkinson's disease","volume":" ","pages":"1877718X251327758"},"PeriodicalIF":4.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}