Parkinsonism & related disorders最新文献

{"title":"Potential causal association between immune cells, metabolites and Parkinson's disease: A mediation Mendelian randomization study","authors":"Yize Sun ,&nbsp;Zetai Bai ,&nbsp;Zheyi Wang","doi":"10.1016/j.parkreldis.2025.108018","DOIUrl":"10.1016/j.parkreldis.2025.108018","url":null,"abstract":"<div><h3>Background</h3><div>Several studies have indicated a potential link between immune cells and Parkinson's disease (PD). However, the precise causal relationship between them, along with the ambiguous mediatory function of metabolites in this connection, remains largely undefined.</div></div><div><h3>Methods</h3><div>Immune cells, metabolites, and PD have been identified through extensive analysis of summary data from large-scale genome-wide association studies (GWAS). To delve deeper into the causal relationships among these factors, we employed Mendelian randomization (MR) techniques. Our primary statistical approach was inverse variance weighting (IVW). Furthermore, we investigated whether metabolites serve as a mediator in the pathway connecting immune cells to PD.</div></div><div><h3>Results</h3><div>We observed 16 positive and 14 negative causal effects between the genetic predisposition of immune cells and PD. Similarly, there were 19 positive and 21 negative causal relationships identified between metabolites and PD. Furthermore, our results indicate that CD11c⁺ HLA-DR⁺⁺ monocyte %monocyte and CD16 on CD14⁺ CD16⁺ monocyte exert adverse effects on PD by elevating Sphingomyelin (d17:2/16:0, d18:2/15:0) levels.</div></div><div><h3>Conclusions</h3><div>This study reinforces the link between immune cells and the risk of PD, while simultaneously elucidating the mediating role of Sphingomyelin in the causal relationship between these factors.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"140 ","pages":"Article 108018"},"PeriodicalIF":3.4,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145020966","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":"Changes in DTI-ALPS index and its associations with neuronal damage in Lewy body disease","authors":"M.J. Firbank ,&nbsp;P.C. Donaghy ,&nbsp;L.M. Allan ,&nbsp;N. Barnett ,&nbsp;S.H. Barker ,&nbsp;J. Ciafone ,&nbsp;R. Durcan ,&nbsp;G. Greenfinch ,&nbsp;C.A. Hamilton ,&nbsp;K. Olsen ,&nbsp;G. Petrides ,&nbsp;A.J. Thomas ,&nbsp;J.T. O'Brien ,&nbsp;J.-P. Taylor","doi":"10.1016/j.parkreldis.2025.108014","DOIUrl":"10.1016/j.parkreldis.2025.108014","url":null,"abstract":"<div><h3>Introduction</h3><div>Dysfunction of the glymphatic system is thought to lead to build up of toxic proteins including β-amyloid and α-synuclein, and thus may be involved in dementia with Lewy bodies (DLB) and Alzheimer's disease (AD). The Diffusion Tensor Image Analysis Along the Perivascular Space (DTI-ALPS) index has been proposed as a marker of glymphatic function.</div></div><div><h3>Aims</h3><div>To investigate DTI-ALPS in mild cognitive impairment (MCI) and dementia, and determine its relationship with cognitive decline, and biomarkers of neurodegeneration.</div></div><div><h3>Methods</h3><div>DTI-ALPS was calculated on participants with DLB [N = 32], AD [N = 14], MCI with Lewy bodies (MCI-LB) [N = 31], MCI-AD [N = 31] and healthy comparators (HC) [N = 48]. Plasma biomarkers were available for amyloid-β, glial fibrillary acidic protein (GFAP), neurofilament light (NfL), and phosphorylated tau. Amyloid PET imaging with 18F florbetapir was performed on a subset of participants.</div></div><div><h3>Results</h3><div>DTI-ALPS values were significantly lower compared to HC in both DLB (Estimate = −0.084 [-0.14 to −0.03], p = 0.004) and MCI-LB (Estimate = −0.058 [-0.11 to −0.002], p = 0.047) DTI-ALPS was also significantly associated with both baseline (t[147] = 2.22, p = 0.028) and longitudinal decline (t[127] = 2.41,p = 0.017) in cognitive score. There were significant associations of DTI-ALPS with plasma NfL (t[141] = -2.72, p = 0.007), and GFAP (t[141] = -2.83, p = 0.005), but not amyloid levels, nor with amyloid PET uptake.</div></div><div><h3>Conclusions</h3><div>DTI-ALPS is reduced in DLB compared to healthy comparators. Our findings suggest that dysfunction of the glymphatic system may contribute to neuronal damage in Lewy body disease. However further research is needed to clarify the role of the glymphatic system, and also the specificity of DTI-ALPS as a marker of glymphatic function.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"140 ","pages":"Article 108014"},"PeriodicalIF":3.4,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010913","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":"Comparison of tetrabenazine, tiapride and olanzapine in Huntington's disease: a one-year French randomized multicenter study (Neuro-HD)","authors":"Katia Youssov ,&nbsp;Etienne Audureau ,&nbsp;Jérémie Pariente ,&nbsp;Jean-Philippe Azulay ,&nbsp;Isabelle Benatru ,&nbsp;Alexandra Durr ,&nbsp;Pierre Krystkowiak ,&nbsp;Cecilia Marelli ,&nbsp;Christine Tranchant ,&nbsp;Clémence Simonin ,&nbsp;Christophe Verny ,&nbsp;the Huntington French speaking network,&nbsp;Anne-Catherine Bachoud-Lévi","doi":"10.1016/j.parkreldis.2025.108017","DOIUrl":"10.1016/j.parkreldis.2025.108017","url":null,"abstract":"<div><h3>Introduction</h3><div>Chorea and behavioral symptoms in Huntington's disease (HD) have been treated with neuroleptics and related drugs for over 50 years, yet direct randomized comparisons are scarce. This study assessed the efficacy and safety of olanzapine, tetrabenazine, and tiapride in HD, with the Independence Scale as the primary outcome and components of the Unified Huntington's Disease Rating Scale as secondary outcomes.</div></div><div><h3>Methods</h3><div>We conducted a pragmatic, randomized, open-label trial across 11 centers of the French-Speaking Huntington's Network, enrolling 179 patients with Huntington's disease. Participants were randomized into three treatment arms—olanzapine, tiapride, or tetrabenazine—and followed for 52 weeks.</div></div><div><h3>Results</h3><div>Independence Scale declined similarly across all treatment arms from baseline to week 52. Chorea improved significantly with both tetrabenazine and olanzapine, whereas rigidity increased only with olanzapine. Irritability improved with olanzapine and tiapride, and the total behavioral score improved only with olanzapine. Tetrabenazine was most frequently associated with mood disorders and sedation, while olanzapine caused occasional weight gain and mild increases in LDL and total cholesterol. Discontinuation rates were lowest with olanzapine, with significantly fewer withdrawals due to depression or suicidal ideation.</div></div><div><h3>Conclusion</h3><div>Olanzapine improved chorea, behavior, and irritability, although with a slight increase in rigidity. Tetrabenazine confirmed efficacy for chorea but was associated with mood disorders and drowsiness, while tiapride reduced irritability. These results underscore the importance of symptom-specific, individualized treatment.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"140 ","pages":"Article 108017"},"PeriodicalIF":3.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159061","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":"Acute refractory chorea as a novel phenotype of NARS2 gene mutation-related mitochondrial disorder","authors":"Nitish Kamble ,&nbsp;Gautham Arunachal ,&nbsp;Shravan Harish ,&nbsp;Vana Bhaskara Rao ,&nbsp;Vikram V. Holla ,&nbsp;Pramod Kumar Pal","doi":"10.1016/j.parkreldis.2025.108025","DOIUrl":"10.1016/j.parkreldis.2025.108025","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"140 ","pages":"Article 108025"},"PeriodicalIF":3.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145020967","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":"Huntington’s disease-like 2 patients’ profile in a Brazilian cohort","authors":"Dayany Leonel Boone MD, MSc ,&nbsp;Vitor Tumas MD, PhD ,&nbsp;Gabriel Vilela MD ,&nbsp;Vanderci Borges MD, PhD ,&nbsp;Roberta Arb Saba Rodrigues Pinto MD, PhD ,&nbsp;Mariana Cavalcanti Costa MD ,&nbsp;Henrique Ballalai Ferraz MD, PhD","doi":"10.1016/j.parkreldis.2025.108023","DOIUrl":"10.1016/j.parkreldis.2025.108023","url":null,"abstract":"<div><h3>Background</h3><div>Huntington disease-like 2 (HDL2) is an autosomal dominant disorder caused by an abnormal CAG/CTG repeat in exon 2A of junctophilin-3. This is the most common Huntington's Disease phenocopy and is characterized by psychiatric, cognitive, and movement disorders. This study aimed to describe the clinical phenotype of HDL2 patients in Brazil and compare the findings with those in the literature.</div></div><div><h3>Methods</h3><div>This was a descriptive, observational study with a cross-sectional and retrospective component that evaluated 33 genetically confirmed HDL2 patients. Clinical data were collected using the Unified Huntington's Disease Rating Scale (UHDRS) and additional scales assessing sleep, mood, and cognition.</div></div><div><h3>Results</h3><div>The sample had a balanced gender distribution and was predominantly comprised of white individuals. Median disease duration was 11 years, median age at diagnosis was 44 years, and CAG repeats were 47. On the non-motor scales, the median scores were 33 points for fatigue, 31 points for apathy, and 18 points for depression. A significant negative correlation was observed between CAG repeat length and age at symptom onset (r = −0.76, p = 0.002). The median diagnosis delay was 4.5 years.</div></div><div><h3>Conclusion</h3><div>While some findings, such as sex ratio and median CAG repeat length, were consistent with those of previous cohorts, this Brazilian sample exhibited longer diagnostic delays, an older age at assessment, and more severe motor scores. However, due to the small sample size, the results should be interpreted cautiously. Larger studies are needed to confirm these associations.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"139 ","pages":"Article 108023"},"PeriodicalIF":3.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996710","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":"Expert commentary for first case of Cayman ataxia far North of the Caribbean: A 20-year-old Inuit male with homozygous deletion in ATCAY gene.","authors":"Andona Milovanović, Nataša Dragašević-Mišković, Iva Stanković","doi":"10.1016/j.parkreldis.2025.108024","DOIUrl":"https://doi.org/10.1016/j.parkreldis.2025.108024","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":" ","pages":"108024"},"PeriodicalIF":3.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016044","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":"Hand muscle strength in Parkinson's disease: A Sarcopenic epiphenomenon or a meaningful biomarker?","authors":"Emmi K. Saarinen ,&nbsp;Tomi Kuusimäki ,&nbsp;Kalle Niemi ,&nbsp;Tommi Noponen ,&nbsp;Elina Jaakkola ,&nbsp;Elina Myller ,&nbsp;Mikael Eklund ,&nbsp;Simo Nuuttila ,&nbsp;Toni Ihalainen ,&nbsp;Kirsi Murtomäki ,&nbsp;Tuomas Mertsalmi ,&nbsp;Reeta Levo ,&nbsp;Tero Vahlberg ,&nbsp;Juho Joutsa ,&nbsp;Filip Scheperjans ,&nbsp;Valtteri Kaasinen","doi":"10.1016/j.parkreldis.2025.108021","DOIUrl":"10.1016/j.parkreldis.2025.108021","url":null,"abstract":"<div><h3>Introduction</h3><div>Sarcopenia, the age-related loss of muscle mass and function, has been reported in Parkinson's disease (PD). While grip strength is a key marker of sarcopenia and has been linked to PD risk and progression, its relationship with underlying neurodegenerative processes remains unclear. This study examines whether grip strength is impaired in PD and reflects disease severity or dopaminergic function.</div></div><div><h3>Methods</h3><div>Grip strength was assessed in 147 PD patients and 35 healthy controls, alongside motor symptoms and striatal dopamine transporter (DAT) binding using [¹²³I]FP-CIT single photon emission computed tomography. Longitudinal follow-up included 84 PD patients with clinical reassessment (median 4.1 years) and 40 patients with both clinical and DAT imaging re-evaluations (median 6.2 years). Associations between grip strength, motor symptom severity and dopaminergic function were analyzed.</div></div><div><h3>Results</h3><div>At baseline, mean grip strength did not differ between PD patients and healthy controls, and it did not correlate with striatal DAT binding (p &gt; 0.37). While striatal DAT binding declined in PD (4.2 % annually, p &lt; 0.001) and was associated with worsening motor function (p = 0.004), grip strength was not independently associated with DAT binding decline (p &gt; 0.62). However, grip strength declined alongside worsening motor symptoms (p = 0.029).</div></div><div><h3>Conclusion</h3><div>Upper limb muscle strength remains largely preserved in mild to moderate PD and does not reliably reflect dopaminergic function or disease progression. Although sarcopenia has been reported in PD, grip strength declines in parallel with motor symptom progression and DAT loss rather than directly reflecting the disease process, suggesting it is an epiphenomenon rather than an independent pathophysiological feature.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"140 ","pages":"Article 108021"},"PeriodicalIF":3.4,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145021027","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":"Bilateral subthalamic deep brain stimulation in Parkinson's disease with RAB32 mutation","authors":"Bedia Samanci ,&nbsp;Basak Bolluk Kilic ,&nbsp;Erdi Sahin ,&nbsp;Ozgun Koksal ,&nbsp;Basar Bilgic ,&nbsp;Ali Zirh ,&nbsp;Hasmet Hanagasi","doi":"10.1016/j.parkreldis.2025.108022","DOIUrl":"10.1016/j.parkreldis.2025.108022","url":null,"abstract":"","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"139 ","pages":"Article 108022"},"PeriodicalIF":3.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144996711","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":"Add-on therapies to levodopa improve pain modulation in Parkinson's disease with motor fluctuations: A prospective cohort study","authors":"Elisa Andrenelli,&nbsp;Nicolò Baldini,&nbsp;Filippo Augusto Barbini,&nbsp;Matteo Benedetti,&nbsp;Jacopo Brambatti,&nbsp;Marianna Capecci,&nbsp;Maria Gabriella Ceravolo","doi":"10.1016/j.parkreldis.2025.108019","DOIUrl":"10.1016/j.parkreldis.2025.108019","url":null,"abstract":"<div><h3>Background</h3><div>Pain is a common and often underestimated non-motor symptom in Parkinson's disease (PD), affecting quality of life (QOL) and frequently associated with motor fluctuations. Although the pathophysiological mechanisms underlying pain in PD remain unclear, most hypothesize the involvement of dopaminergic and non-dopaminergic pathways.</div></div><div><h3>Objective</h3><div>To evaluate the effect of MAO-B and COMT inhibitors, used as add-on therapies to levodopa, on pain thresholds in people with PD (pwPD) with motor fluctuations, either with or without pain.</div></div><div><h3>Methods</h3><div>This prospective cohort study enrolled 40 pwPD with motor fluctuations who were started on selegiline, rasagiline, safinamide, or opicapone. Pain thresholds (tactile, pain, and tolerance) were assessed using electrical stimulation at baseline and after 3 and 6 months. Normative data were collected from 11 healthy subjects. Outcome measures in pwPD targeted motor impairment (UPDRS), pain perception (King's PD Pain Scale), mood, fatigue, sleep, and QOL.</div></div><div><h3>Results</h3><div>PwPD showed higher tactile thresholds and lower pain and pain tolerance thresholds than controls. At 6 months, both rasagiline and safinamide significantly improved pain thresholds and tolerance compared to opicapone. Experiencing pain was more frequent in women and was associated with anxiety, poor sleep, and motor complications. Regression analyses revealed that cognitive status, sex, disease duration, age, anxiety levels and treatment with MAO-B inhibitors were key modulators of pain processing.</div></div><div><h3>Conclusion</h3><div>Pain processing is altered in pwPD, independently of subjective pain complaints. MAO-B inhibitors, particularly safinamide and rasagiline, appear to restore pain thresholds and improve QOL, supporting their role in managing pain in PD.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"140 ","pages":"Article 108019"},"PeriodicalIF":3.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145047376","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":"Efficacy and safety of DaxibotulinumtoxinA for injection in adults with cervical dystonia: Pooled global analysis of ASPEN-1 and ASPEN-1-CN randomized trials","authors":"Aaron Ellenbogen ,&nbsp;Hu Xingyue ,&nbsp;Jin Lingjing ,&nbsp;Marta Banach ,&nbsp;Atul T. Patel ,&nbsp;Todd M. Gross ,&nbsp;Rashid Kazerooni ,&nbsp;Conor J. Gallagher ,&nbsp;Fan Xiaojing ,&nbsp;Hui Wang ,&nbsp;Ge Lei ,&nbsp;Wan Xinhua ,&nbsp;David A. Hollander","doi":"10.1016/j.parkreldis.2025.108015","DOIUrl":"10.1016/j.parkreldis.2025.108015","url":null,"abstract":"<div><h3>Background</h3><div>DaxibotulinumtoxinA for injection (DAXI), the first long-acting botulinum toxin (BoNT) type A, is FDA approved for cervical dystonia (CD). DAXI's novel formulation, which includes a custom-engineered peptide, is designed to provide an extended duration of clinical benefit.</div></div><div><h3>Objective</h3><div>To evaluate the pooled efficacy and safety of DAXI for CD across two phase 3, multicenter, randomized, double-blind, placebo-controlled trials: ASPEN-1, conducted in North America and Europe, and ASPEN-1-CN, a similarly designed, smaller pivotal clinical trial, conducted in China.</div></div><div><h3>Methods</h3><div>Adults with moderate-to-severe CD were randomized (3:3:1) to receive DAXI 125U, DAXI 250U, or placebo. The primary endpoint was change from baseline in Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) total score averaged across weeks 4 and 6. A key secondary endpoint was duration, defined as time until loss of &gt;80 % of peak effect.</div></div><div><h3>Results</h3><div>In all, 357 subjects were randomized and received DAXI 125U (n = 149), DAXI 250U (n = 154), or placebo (n = 54). DAXI 125U (−12.0) and DAXI 250U (−11.9) significantly improved the mean TWSTRS total score versus placebo (−4.6; <em>P</em> &lt; 0.0001). Median (95 % CI) duration of effect was 24.1 (20.6–28.9) weeks for DAXI 125U and 22.0 (20.1–24.3) weeks for DAXI 250U. Rates of treatment-related dysphagia (125U: 4.7 %, 250U: 4.5 %) and muscle weakness (125U: 5.4 %, 250U: 4.5 %) were low for both active doses.</div></div><div><h3>Conclusions</h3><div>This pooled analysis of two phase 3 trials demonstrates that DAXI is an effective, safe, and long-acting treatment for CD. Key adverse events occurred at rates lower than prior pivotal trials of BoNTs for CD.</div></div>","PeriodicalId":19970,"journal":{"name":"Parkinsonism & related disorders","volume":"140 ","pages":"Article 108015"},"PeriodicalIF":3.4,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080962","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}