Elisa Mantovani, Alice Martini, Alessandro Dinoto, Chiara Zucchella, Sergio Ferrari, Sara Mariotto, Michele Tinazzi, Stefano Tamburin
{"title":"Biomarkers for cognitive impairment in alpha-synucleinopathies: an overview of systematic reviews and meta-analyses.","authors":"Elisa Mantovani, Alice Martini, Alessandro Dinoto, Chiara Zucchella, Sergio Ferrari, Sara Mariotto, Michele Tinazzi, Stefano Tamburin","doi":"10.1038/s41531-024-00823-x","DOIUrl":"10.1038/s41531-024-00823-x","url":null,"abstract":"<p><p>Cognitive impairment (CI) is common in α-synucleinopathies, i.e., Parkinson's disease, Lewy bodies dementia, and multiple system atrophy. We summarize data from systematic reviews/meta-analyses on neuroimaging, neurophysiology, biofluid and genetic diagnostic/prognostic biomarkers of CI in α-synucleinopathies. Diagnostic biomarkers include atrophy/functional neuroimaging brain changes, abnormal cortical amyloid and tau deposition, and cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarkers, cortical rhythm slowing, reduced cortical cholinergic and glutamatergic and increased cortical GABAergic activity, delayed P300 latency, increased plasma homocysteine and cystatin C and decreased vitamin B12 and folate, increased CSF/serum albumin quotient, and serum neurofilament light chain. Prognostic biomarkers include brain regional atrophy, cortical rhythm slowing, CSF amyloid biomarkers, Val66Met polymorphism, and apolipoprotein-E ε2 and ε4 alleles. Some AD/amyloid/tau biomarkers may diagnose/predict CI in α-synucleinopathies, but single, validated diagnostic/prognostic biomarkers lack. Future studies should include large consortia, biobanks, multi-omics approach, artificial intelligence, and machine learning to better reflect the complexity of CI in α-synucleinopathies.</p>","PeriodicalId":19706,"journal":{"name":"NPJ Parkinson's Disease","volume":"10 1","pages":"211"},"PeriodicalIF":6.7,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Livia H. Morais, Joseph C. Boktor, Siamak MahmoudianDehkordi, Rima Kaddurah-Daouk, Sarkis K. Mazmanian
{"title":"α-synuclein overexpression and the microbiome shape the gut and brain metabolome in mice","authors":"Livia H. Morais, Joseph C. Boktor, Siamak MahmoudianDehkordi, Rima Kaddurah-Daouk, Sarkis K. Mazmanian","doi":"10.1038/s41531-024-00816-w","DOIUrl":"https://doi.org/10.1038/s41531-024-00816-w","url":null,"abstract":"<p>Pathological forms of α-synuclein contribute to synucleinopathies, including Parkinson’s disease (PD). Most cases of PD arise from gene-environment interactions. Microbiome composition is altered in PD, and gut bacteria are causal to symptoms in animal models. We quantitatively profiled nearly 630 metabolites in the gut, plasma, and brain of α-synuclein-overexpressing (ASO) mice, compared to wild-type (WT) animals, and comparing germ-free (GF) to specific pathogen-free (SPF) animals (<i>n</i> = 5 WT-SPF; <i>n</i> = 6 ASO-SPF; <i>n</i> = 6 WT-GF; <i>n</i> = 6 ASO-GF). Many differentially expressed metabolites in ASO mice are also dysregulated in human PD patients, including amine oxides, bile acids and indoles. The microbial metabolite trimethylamine N-oxide (TMAO) strongly correlates from the gut to the plasma to the brain in mice, notable since TMAO is elevated in the blood and cerebrospinal fluid of PD patients. These findings uncover broad metabolomic changes that are influenced by the intersection of host genetics and microbiome in a mouse model of PD.</p>","PeriodicalId":19706,"journal":{"name":"NPJ Parkinson's Disease","volume":"15 1","pages":""},"PeriodicalIF":8.7,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142541481","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":"Structural basis of epitope recognition by anti-alpha-synuclein antibodies MJFR14-6-4-2.","authors":"Ilva Liekniņa, Lasse Reimer, Teodors Panteļejevs, Alons Lends, Kristaps Jaudzems, Aadil El-Turabi, Hjalte Gram, Anissa Hammi, Poul Henning Jensen, Kaspars Tārs","doi":"10.1038/s41531-024-00822-y","DOIUrl":"10.1038/s41531-024-00822-y","url":null,"abstract":"<p><p>Alpha-synuclein (α-syn) inclusions in the brain are hallmarks of so-called Lewy body diseases. Lewy bodies contain mainly aggregated α-syn together with some other proteins. Monomeric α-syn lacks a well-defined three-dimensional structure, but it can aggregate into oligomeric and fibrillar amyloid species, which can be detected using specific antibodies. Here we investigate the aggregate specificity of monoclonal MJFR14-6-4-2 antibodies. We conclude that partial masking of epitope in unstructured monomer in combination with a high local concentration of epitopes is the main reason for MJFR14-6-4-2 selectivity towards aggregates. Based on the structural insight, we produced mutant α-syn that when fibrillated is unable to bind MJFR14-6-4-2. Using these fibrils as a tool for seeding cellular α-syn aggregation, provides superior signal/noise ratio for detection of cellular α-syn aggregates by MJFR14-6-4-2. Our data provide a molecular level understanding of specific recognition of toxic amyloid oligomers, which is critical for the development of inhibitors against synucleinopathies.</p>","PeriodicalId":19706,"journal":{"name":"NPJ Parkinson's Disease","volume":"10 1","pages":"206"},"PeriodicalIF":6.7,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Favaro, Ankur Butala, Thomas Thebaud, Jesús Villalba, Najim Dehak, Laureano Moro-Velázquez
{"title":"Unveiling early signs of Parkinson's disease via a longitudinal analysis of celebrity speech recordings.","authors":"Anna Favaro, Ankur Butala, Thomas Thebaud, Jesús Villalba, Najim Dehak, Laureano Moro-Velázquez","doi":"10.1038/s41531-024-00817-9","DOIUrl":"10.1038/s41531-024-00817-9","url":null,"abstract":"<p><p>Numerous studies proposed methods to detect Parkinson's disease (PD) via speech analysis. However, existing corpora often lack prodromal recordings, have small sample sizes, and lack longitudinal data. Speech samples from celebrities who publicly disclosed their PD diagnosis provide longitudinal data, allowing the creation of a new corpus, ParkCeleb. We collected videos from 40 subjects with PD and 40 controls and analyzed evolving speech features from 10 years before to 20 years after diagnosis. Our longitudinal analysis, focused on 15 subjects with PD and 15 controls, revealed features like pitch variability, pause duration, speech rate, and syllable duration, indicating PD progression. Early dysarthria patterns were detectable in the prodromal phase, with the best classifiers achieving AUCs of 0.72 and 0.75 for data collected ten and five years before diagnosis, respectively, and 0.93 post-diagnosis. This study highlights the potential for early detection methods, aiding treatment response identification and screening in clinical trials.</p>","PeriodicalId":19706,"journal":{"name":"NPJ Parkinson's Disease","volume":"10 1","pages":"207"},"PeriodicalIF":6.7,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mari Muldmaa, Emmanuelle Schmitt, Roberto Infante, Andrea Kistner, Valérie Fraix, Anna Castrioto, Sara Meoni, Pierre Pélissier, Bettina Debû, Elena Moro
{"title":"Deciphering the effects of STN DBS on neuropsychiatric fluctuations in Parkinson’s disease","authors":"Mari Muldmaa, Emmanuelle Schmitt, Roberto Infante, Andrea Kistner, Valérie Fraix, Anna Castrioto, Sara Meoni, Pierre Pélissier, Bettina Debû, Elena Moro","doi":"10.1038/s41531-024-00811-1","DOIUrl":"https://doi.org/10.1038/s41531-024-00811-1","url":null,"abstract":"<p>The impact of subthalamic nucleus (STN) deep brain stimulation (DBS) on neuropsychiatric fluctuations in Parkinson´s disease (PD) remains unclear. The Neuropsychiatric Fluctuations Scale (NFS) can help to fill this gap, directly measuring fluctuations between the OFF- and ON-medication conditions. The NFS provides NFS-plus (hyperdopaminergic) and NFS-minus (hypodopaminergic) sub-scores. Based on these, the NFS global scores express the overall magnitude of neuropsychiatric symptoms in both the OFF- and ON-medication states. The total fluctuation score (TFS) represents the difference between ON- vs. OFF-medication NFS global scores, thus assessing fluctuations amplitude. The NFS was used to evaluate changes in neuropsychiatric fluctuations between the OFF- and ON-medication conditions before and 1-year after bilateral STN-DBS in 45 PD patients (32 males; mean age, 61.3 ± 7.2 years; PD duration, 10.2 ± 3.0 years). After surgery, the amplitude of neuropsychiatric fluctuations was significantly reduced (<i>p</i> < 0.001), confirming the efficacy of STN-DBS on these symptoms.</p>","PeriodicalId":19706,"journal":{"name":"NPJ Parkinson's Disease","volume":"44 1","pages":""},"PeriodicalIF":8.7,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490292","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}
Alireza Gharabaghi, Idil Cebi, Dallas Leavitt, Maximilian Scherer, Patrick Bookjans, Bastian Brunnett, Luka Milosevic, Daniel Weiss
{"title":"Randomized crossover trial on motor and non-motor outcome of directional deep brain stimulation in Parkinson’s disease","authors":"Alireza Gharabaghi, Idil Cebi, Dallas Leavitt, Maximilian Scherer, Patrick Bookjans, Bastian Brunnett, Luka Milosevic, Daniel Weiss","doi":"10.1038/s41531-024-00812-0","DOIUrl":"https://doi.org/10.1038/s41531-024-00812-0","url":null,"abstract":"<p>Deep brain stimulation (DBS) with electric field steering may avoid areas responsible for side effects. This prospective randomized cross-over trial compared omnidirectional (OS) and directional (DS) subthalamic DBS in 19 patients. Electromyographically measured rigidity was the primary outcome. Motor and non-motor scores were secondary outcomes. There were no significant differences between OS and DS. In the acute setting, both conditions improved motor scores compared to no stimulation. Motor symptoms improved after 3 weeks of OS relative to acute measurements, whereas they worsened under DS. The more ventral the active contact, and the less the motor improvement sweet spot was stimulated, the greater the benefit of DS over OS for executive function. Accurate OS of the dorsal subthalamic nucleus ensures motor and non-motor improvements. While DS can mitigate executive decline stemming from off-target stimulation, it may lead to worse motor outcomes. Larger, long-term studies are needed to confirm these findings. (Registration: subthalamic steering for therapy optimization in Parkinson’s Disease ClinicalTrials.gov: NCT03548506, 2018-06-06).</p>","PeriodicalId":19706,"journal":{"name":"NPJ Parkinson's Disease","volume":"14 1","pages":""},"PeriodicalIF":8.7,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490344","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":"Microbial biomarker discovery in Parkinson’s disease through a network-based approach","authors":"Zhe Zhao, Jing Chen, Danhua Zhao, Baoyu Chen, Qi Wang, Yuan Li, Junyi Chen, Chaobo Bai, Xintong Guo, Nan Hu, Bingwei Zhang, Rongsheng Zhao, Junliang Yuan","doi":"10.1038/s41531-024-00802-2","DOIUrl":"https://doi.org/10.1038/s41531-024-00802-2","url":null,"abstract":"<p>Associations between the gut microbiota and Parkinson’s disease (PD) have been widely investigated. However, the replicable biomarkers for PD diagnosis across multiple populations remain elusive. Herein, we performed a meta-analysis to investigate the pivotal role of the gut microbiome in PD and its potential diagnostic implications. Six 16S rRNA gene amplicon sequence datasets from five independent studies were integrated, encompassing 550 PD and 456 healthy control samples. The analysis revealed significant alterations in microbial composition and alpha and beta diversity, emphasizing altered gut microbiota in PD. Specific microbial taxa, including <i>Faecalibacterium</i>, <i>Roseburia</i>, and <i>Coprococcus_2</i>, known as butyrate producers, were notably diminished in PD, potentially contributing to intestinal inflammation. Conversely, genera such as <i>Akkermansia</i> and <i>Bilophila</i> exhibited increased relative abundances. A network-based algorithm called NetMoss was utilized to identify potential biomarkers of PD. Afterwards, a classification model incorporating 11 optimized genera demonstrated high performance. Further functional analyses indicated enrichment in pathways related to neurodegeneration and metabolic pathways. These findings illuminate the intricate relationship between the gut microbiota and PD, offering insights into potential therapeutic interventions and personalized diagnostic strategies.</p>","PeriodicalId":19706,"journal":{"name":"NPJ Parkinson's Disease","volume":"35 1","pages":""},"PeriodicalIF":8.7,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490343","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}
Hannah Oas, Lola Cook, Tae-Hwi Schwantes-An, Laurence E. Walsh, Anne-Marie Wills, Ignacio F. Mata, Martha A. Nance, James C. Beck, Anna Naito, Karen Marder, Roy N. Alcalay, Jennifer Verbrugge
{"title":"Participant-reported personal utility of genetic testing for Parkinson’s disease and interest in clinical trial participation","authors":"Hannah Oas, Lola Cook, Tae-Hwi Schwantes-An, Laurence E. Walsh, Anne-Marie Wills, Ignacio F. Mata, Martha A. Nance, James C. Beck, Anna Naito, Karen Marder, Roy N. Alcalay, Jennifer Verbrugge","doi":"10.1038/s41531-024-00805-z","DOIUrl":"https://doi.org/10.1038/s41531-024-00805-z","url":null,"abstract":"<p>Genetic testing for Parkinson’s disease (PD) is infrequently performed due to perceptions of low utility. We investigated the personal utility in PD GENEration and how results lead to enrollment in additional research studies. Participants (<i>n</i> = 972) underwent genetic testing, results disclosure, genetic counseling, and completed a survey examining the perceived personal utility of their results and interest in participating in additional studies. Most participants found their genetic test results useful, including satisfying curiosity (81%), feeling good about helping the medical community (80%), and having information to share with family (77%). There were no significant differences in responses based on result type. Forty-five percent of participants expressed interest in participating in research studies; whereas 16% of participants confirmed enrollment. Our results suggest that participants find personal utility in genetic testing regardless of results. Although participants may be interested in enrolling in additional research, they may need support and resources.</p>","PeriodicalId":19706,"journal":{"name":"NPJ Parkinson's Disease","volume":"30 1","pages":""},"PeriodicalIF":8.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490346","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}
Beatrice Orso, Pietro Mattioli, Eun-Jin Yoon, Yu Kyeong Kim, Heejung Kim, Jung Hwan Shin, Ryul Kim, Francesco Famà, Andrea Brugnolo, Federico Massa, Agostino Chiaravalloti, Mariana Fernandes, Matteo Spanetta, Fabio Placidi, Matteo Pardini, Matteo Bauckneht, Silvia Morbelli, Jee-Young Lee, Claudio Liguori, Dario Arnaldi
{"title":"Progression trajectories from prodromal to overt synucleinopathies: a longitudinal, multicentric brain [18F]FDG-PET study","authors":"Beatrice Orso, Pietro Mattioli, Eun-Jin Yoon, Yu Kyeong Kim, Heejung Kim, Jung Hwan Shin, Ryul Kim, Francesco Famà, Andrea Brugnolo, Federico Massa, Agostino Chiaravalloti, Mariana Fernandes, Matteo Spanetta, Fabio Placidi, Matteo Pardini, Matteo Bauckneht, Silvia Morbelli, Jee-Young Lee, Claudio Liguori, Dario Arnaldi","doi":"10.1038/s41531-024-00813-z","DOIUrl":"https://doi.org/10.1038/s41531-024-00813-z","url":null,"abstract":"<p>The phenoconversion trajectory from idiopathic/isolated Rapid eye movement (REM) sleep behavior disorder (iRBD) towards either Parkinson’s Disease (PD) or Dementia with Lewy Bodies (DLB) is currently uncertain. We investigated the capability of baseline brain [<sup>18</sup>F]FDG-PET in differentiating between iRBD patients eventually phenoconverting to PD or DLB, by deriving the denovoPDRBD-related pattern (denovoPDRBD-RP) from 32 de novo PD patients; and the denovoDLBRBD-RP from 30 de novo DLB patients, both with evidence of RBD at diagnosis. To explore [<sup>18</sup>F]FDG-PET phenoconversion trajectories prediction power, we applied these two patterns on a group of 115 iRBD patients followed longitudinally. At follow-up (25.6 ± 17.2 months), 42 iRBD patients progressed through overt alpha-synucleinopathy (21 iRBD-PD and 21 iRBD-DLB converters), while 73 patients remained stable at the last follow-up visit (43.2 ± 27.6 months). At survival analysis, both patterns were significantly associated with the phenoconversion trajectories. Brain [<sup>18</sup>F]FDG-PET is a promising biomarker to study progression trajectories in the alpha-synucleinopathy continuum.</p>","PeriodicalId":19706,"journal":{"name":"NPJ Parkinson's Disease","volume":"6 1","pages":""},"PeriodicalIF":8.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142489737","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}
Konstantin Senkevich, Sitki Cem Parlar, Cloe Chantereault, Eric Yu, Jamil Ahmad, Jennifer A. Ruskey, Farnaz Asayesh, Dan Spiegelman, Cheryl Waters, Oury Monchi, Yves Dauvilliers, Nicolas Dupré, Irina Miliukhina, Alla Timofeeva, Anton Emelyanov, Sofya Pchelina, Lior Greenbaum, Sharon Hassin-Baer, Roy N. Alcalay, Ziv Gan-Or
{"title":"Are rare heterozygous SYNJ1 variants associated with Parkinson’s disease?","authors":"Konstantin Senkevich, Sitki Cem Parlar, Cloe Chantereault, Eric Yu, Jamil Ahmad, Jennifer A. Ruskey, Farnaz Asayesh, Dan Spiegelman, Cheryl Waters, Oury Monchi, Yves Dauvilliers, Nicolas Dupré, Irina Miliukhina, Alla Timofeeva, Anton Emelyanov, Sofya Pchelina, Lior Greenbaum, Sharon Hassin-Baer, Roy N. Alcalay, Ziv Gan-Or","doi":"10.1038/s41531-024-00809-9","DOIUrl":"https://doi.org/10.1038/s41531-024-00809-9","url":null,"abstract":"<p>Previous studies have established that rare biallelic <i>SYNJ1</i> mutations cause autosomal recessive parkinsonism and Parkinson’s disease (PD). We analyzed 8165 PD cases, 818 early-onset-PD (EOPD, < 50 years) and 70,363 controls. Burden meta-analysis revealed an association between rare nonsynonymous variants and variants with high Combined Annotation-Dependent Depletion score (> 20) in the Sac1 SYNJ1 domain and PD (Pfdr = 0.040). A meta-analysis of EOPD patients demonstrated an association between all rare heterozygous <i>SYNJ1</i> variants and PD (Pfdr = 0.029).</p>","PeriodicalId":19706,"journal":{"name":"NPJ Parkinson's Disease","volume":"114 1","pages":""},"PeriodicalIF":8.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142490345","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}