Psychiatry and Clinical Neurosciences最新文献

{"title":"Serum cortisol and neuroticism for post-traumatic stress disorder over 2 years in patients with physical injuries.","authors":"Jae-Min Kim, Hee-Ju Kang, Ju-Wan Kim, Hyunseok Jang, Jung-Chul Kim, Byung Jo Chun, Ju-Yeon Lee, Sung-Wan Kim, Il-Seon Shin","doi":"10.1111/pcn.13718","DOIUrl":"10.1111/pcn.13718","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to explore the relationships between serum cortisol levels, personality traits, and the development of Post-Traumatic Stress Disorder (PTSD) over 2 years among individuals with physical injuries.</p><p><strong>Methods: </strong>Participants were consecutively recruited from a trauma center and followed prospectively for 2 years. At baseline, serum cortisol levels were measured, and personality traits were categorized into five dimensions (Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness), using the Big Five Inventory-10. The diagnosis of PTSD during follow-up (at 3, 6, 12, and 24 months post-injury) was determined using the Clinician-Administered PTSD Scale for DSM-5. Binary and multinomial logistic regression analyses were conducted to examine the interactions between cortisol levels, personality traits, and PTSD development.</p><p><strong>Results: </strong>Among 923 patients analyzed, 112 (12.1%) were diagnosed with PTSD at some point during the study period, with prevalence rates decreasing from 8.8% at 3 months to 3.7% at 24 months post-injury. Direct associations between cortisol levels or personality traits and PTSD were not observed. However, a significant interaction between lower cortisol levels and higher Neuroticism in relation to PTSD risk was identified, especially during the early follow-up periods (3 to 6 months), but this association waned from the 12-month follow-up onward.</p><p><strong>Conclusion: </strong>Our findings reveal Neuroticism-dependent associations between serum cortisol levels and PTSD development, exhibiting temporal variations. These results suggest that PTSD development may be influenced by a complex, time-sensitive interplay of biological and psychosocial factors, underscoring the importance of considering individual differences in stress reactivity and personality in PTSD research and treatment.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"612-619"},"PeriodicalIF":5.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898117","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":"Worry: A key player in psychopathology after acquired brain injury?","authors":"Jai Carmichael, Jennie Ponsford","doi":"10.1111/pcn.13689","DOIUrl":"10.1111/pcn.13689","url":null,"abstract":"","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"620-621"},"PeriodicalIF":5.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898118","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 status of MRI databases across the world focused on psychiatric and neurological disorders.","authors":"Saori C Tanaka, Kiyoto Kasai, Yasumasa Okamoto, Shinsuke Koike, Takuya Hayashi, Ayumu Yamashita, Okito Yamashita, Tom Johnstone, Franco Pestilli, Kenji Doya, Go Okada, Hotaka Shinzato, Eri Itai, Yuji Takahara, Akihiro Takamiya, Motoaki Nakamura, Takashi Itahashi, Ryuta Aoki, Yukiaki Koizumi, Masaaki Shimizu, Jun Miyata, Shuraku Son, Morio Aki, Naohiro Okada, Susumu Morita, Nobukatsu Sawamoto, Mitsunari Abe, Yuki Oi, Kazuaki Sajima, Koji Kamagata, Masakazu Hirose, Yohei Aoshima, Sayo Hamatani, Nobuhiro Nohara, Misako Funaba, Tomomi Noda, Kana Inoue, Jinichi Hirano, Masaru Mimura, Hidehiko Takahashi, Nobutaka Hattori, Atsushi Sekiguchi, Mitsuo Kawato, Takashi Hanakawa","doi":"10.1111/pcn.13717","DOIUrl":"10.1111/pcn.13717","url":null,"abstract":"<p><p>Neuroimaging databases for neuro-psychiatric disorders enable researchers to implement data-driven research approaches by providing access to rich data that can be used to study disease, build and validate machine learning models, and even redefine disease spectra. The importance of sharing large, multi-center, multi-disorder databases has gradually been recognized in order to truly translate brain imaging knowledge into real-world clinical practice. Here, we review MRI databases that share data globally to serve multiple psychiatric or neurological disorders. We found 42 datasets consisting of 23,293 samples from patients with psychiatry and neurological disorders and healthy controls; 1245 samples from mood disorders (major depressive disorder and bipolar disorder), 2015 samples from developmental disorders (autism spectrum disorder, attention-deficit hyperactivity disorder), 675 samples from schizophrenia, 1194 samples from Parkinson's disease, 5865 samples from dementia (including Alzheimer's disease), We recognize that large, multi-center databases should include governance processes that allow data to be shared across national boundaries. Addressing technical and regulatory issues of existing databases can lead to better design and implementation and improve data access for the research community. The current trend toward the development of shareable MRI databases will contribute to a better understanding of the pathophysiology, diagnosis and assessment, and development of early interventions for neuropsychiatric disorders.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"563-579"},"PeriodicalIF":5.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005127","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":"Cocaine and dopamine abuse improved by subthalamic nucleus deep brain stimulation in one Parkinsonian patient.","authors":"Valentin Mira, Christelle Baunez, Alexandre Eusebio, Tatiana Witjas, Eve Benchetrit, Jean-Philippe Azulay","doi":"10.1111/pcn.13738","DOIUrl":"https://doi.org/10.1111/pcn.13738","url":null,"abstract":"","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352792","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":"Perceived threat of potential military conflicts between Taiwan and China and psychological distress among Taiwanese individuals: A population-based study.","authors":"Cheng-Fang Yen, Ray C Hsiao, Yu-Hsuan Lin","doi":"10.1111/pcn.13747","DOIUrl":"https://doi.org/10.1111/pcn.13747","url":null,"abstract":"","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352794","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":"Effects of online high-definition transcranial direct current stimulation over left dorsolateral prefrontal cortex on predominant negative symptoms and EEG functional connectivity in patients with schizophrenia: a randomized, double-blind, controlled trial.","authors":"Ta-Chuan Yeh, Yen-Yue Lin, Nian-Sheng Tzeng, Yu-Chen Kao, Yong-An Chung, Chuan-Chia Chang, Hsu-Wei Fang, Hsin-An Chang","doi":"10.1111/pcn.13745","DOIUrl":"https://doi.org/10.1111/pcn.13745","url":null,"abstract":"<p><strong>Aims: </strong>Schizophrenia, a debilitating mental disorder, is characterized by persistent negative symptoms such as avolition and anhedonia. Currently, there are no effective treatments available for these symptoms. Thus, our study aims to assess the efficacy of online high-definition transcranial direct current stimulation (online HD-tDCS) in addressing the negative symptoms of schizophrenia, utilizing a double-blind, randomized, sham-controlled trial design.</p><p><strong>Methods: </strong>Fifty-nine patients with schizophrenia were randomized to receive either active HD-tDCS or sham stimulation, targeting the left dorsolateral prefrontal cortex. Outcomes were measured by changes in the Positive and Negative Syndrome Scale Factor Score for Negative Symptom (PANSS-FSNS). Exact low-resolution electromagnetic tomography was used to assess the functional connectivity.</p><p><strong>Results: </strong>All 59 participants, including 50.84% females with an average age of 43.36 years, completed the trial. In the intention-to-treat analysis, patients receiving active HD-tDCS showed greater improvement in PANSS-FSNS scores compared to those receiving the sham procedure. The differences were 2.34 (95% confidence interval [CI], 1.28-3.40), 4.28 (95% CI, 2.93-5.62), and 4.91 (95% CI, 3.29-6.52) after the intervention, as well as at 1-week and 1-month follow-ups, respectively. A tingling sensation on the scalp was more common in the active group (63.3%) compared to the sham group (10.3%). Additionally, HD-tDCS was associated with a decrease in delta-band connectivity within the default mode network.</p><p><strong>Conclusions: </strong>High-definition transcranial direct current stimulation was effective and safe in ameliorating negative symptoms in patients with schizophrenia when combined with online functional targeting.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352793","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":"Possible association of elevated CSF IL-6 levels with anxiety and frustration in psychiatric disorders.","authors":"Takako Enokida, Kotaro Hattori, Kaori Okabe, Takamasa Noda, Miho Ota, Noriko Sato, Shintaro Ogawa, Megumi Tatsumi, Mikio Hoshino, Hiroshi Kunugi, Kazuyuki Nakagome","doi":"10.1111/pcn.13743","DOIUrl":"https://doi.org/10.1111/pcn.13743","url":null,"abstract":"<p><strong>Aim: </strong>Neuroinflammation is an important causal factor for a variety of psychiatric disorders. We previously reported increased cerebrospinal fluid interleukin-6 levels in patients with schizophrenia and major depressive disorder. The present study aimed to examine the possible association of interleukin-6 levels with anxiety and frustration, negative valence symptoms shared in various psychiatric disorders.</p><p><strong>Methods: </strong>We included 129 patients with psychiatric disorders and 70 controls. CSF and plasma interleukin-6 levels were measured by immunoassay kits, and psychological symptoms were assessed with the State-Trait Anxiety Inventory, and the Basic Psychological Need Satisfaction and Frustration Scale. To examine regional cerebral blood flow, patients underwent arterial spin labeling analysis using magnetic resonance imaging.</p><p><strong>Results: </strong>Cerebrospinal fluid interleukin-6 levels were significantly correlated with State-Trait Anxiety Inventory-trait anxiety (r = 0.25, P = 0.046) and Basic Psychological Need Satisfaction and Frustration Scale-autonomy frustration scores (r = 0.29, P = 0.018). Patients with abnormally high cerebrospinal fluid interleukin-6 levels (defined >97.5 percentile of the controls) had higher scores for trait anxiety (P = 0.035) and autonomy frustration (P = 0.026), and significantly increased regional cerebral blood flow in the left superior temporal gyrus, bilateral nucleus accumbens, and cerebellum than the remaining patients.</p><p><strong>Conclusion: </strong>Patients with elevated cerebrospinal fluid interleukin-6 constitute a subpopulation of psychiatric disorders associated with anxiety and autonomy frustration, which may be related to altered functions in specific brain areas.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352795","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":"Identification of novel genomic loci for anxiety symptoms and extensive genetic overlap with psychiatric disorders.","authors":"Markos Tesfaye, Piotr Jaholkowski, Alexey A Shadrin, Dennis van der Meer, Guy F L Hindley, Børge Holen, Nadine Parker, Pravesh Parekh, Viktoria Birkenæs, Zillur Rahman, Shahram Bahrami, Gleda Kutrolli, Oleksandr Frei, Srdjan Djurovic, Anders M Dale, Olav B Smeland, Kevin S O'Connell, Ole A Andreassen","doi":"10.1111/pcn.13742","DOIUrl":"10.1111/pcn.13742","url":null,"abstract":"<p><strong>Aims: </strong>Anxiety disorders are prevalent and anxiety symptoms (ANX) co-occur with many psychiatric disorders. We aimed to identify genomic loci associated with ANX, characterize its genetic architecture, and genetic overlap with psychiatric disorders.</p><p><strong>Methods: </strong>We included a genome-wide association study of ANX (meta-analysis of UK Biobank and Million Veterans Program, n = 301,732), schizophrenia (SCZ), bipolar disorder (BIP), major depression (MD), attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD), and validated the findings in the Norwegian Mother, Father, and Child Cohort (n = 95,841). We employed the bivariate causal mixture model and local analysis of covariant association to characterize the genetic architecture including overlap between the phenotypes. Conditional and conjunctional false discovery rate analyses were performed to boost the identification of loci associated with anxiety and shared with psychiatric disorders.</p><p><strong>Results: </strong>Anxiety was polygenic with 12.9k genetic variants and overlapped extensively with psychiatric disorders (4.1k-11.4k variants) with predominantly positive genetic correlations between anxiety and psychiatric disorders. We identified 119 novel loci for anxiety by conditioning on the psychiatric disorders, and loci shared between anxiety and MD <math> <semantics> <mrow> <mfenced><mrow><mi>n</mi> <mo>=</mo> <mn>47</mn></mrow> </mfenced> </mrow> <annotation>$$ left(n=47right) $$</annotation></semantics> </math> , BIP <math> <semantics> <mrow> <mfenced><mrow><mi>n</mi> <mo>=</mo> <mn>33</mn></mrow> </mfenced> </mrow> <annotation>$$ left(n=33right) $$</annotation></semantics> </math> , SCZ <math> <semantics> <mrow> <mfenced><mrow><mi>n</mi> <mo>=</mo> <mn>71</mn></mrow> </mfenced> </mrow> <annotation>$$ left(n=71right) $$</annotation></semantics> </math> , ADHD <math> <semantics> <mrow> <mfenced><mrow><mi>n</mi> <mo>=</mo> <mn>20</mn></mrow> </mfenced> </mrow> <annotation>$$ left(n=20right) $$</annotation></semantics> </math> , and ASD <math> <semantics> <mrow> <mfenced><mrow><mi>n</mi> <mo>=</mo> <mn>5</mn></mrow> </mfenced> </mrow> <annotation>$$ left(n=5right) $$</annotation></semantics> </math> . Genes annotated to anxiety loci exhibit enrichment for a broader range of biological pathways including cell adhesion and neurofibrillary tangle compared with genes annotated to the shared loci.</p><p><strong>Conclusions: </strong>Anxiety is highly polygenic phenotype with extensive genetic overlap with psychiatric disorders, and we identified novel loci for anxiety implicating new molecular pathways. The shared genetic architecture may underlie the extensive cross-disorder comorbidity of anxiety, and the identified molecular underpinnings may lead to potential drug targets.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294094","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":"Association of benzodiazepine and Z‐hypnotic use with cardiovascular disease risk: insights from a prospective study of 10 million people in China","authors":"Ruotong Yang, Huan Yu, Junhui Wu, Siyue Wang, Hongbo Chen, Mengying Wang, Xueying Qin, Tao Wu, Yiqun Wu, Yonghua Hu","doi":"10.1111/pcn.13735","DOIUrl":"https://doi.org/10.1111/pcn.13735","url":null,"abstract":"AimTo assess the association between Benzodiazepines (BZDs) or Z‐hypnotic use and cardiovascular diseases (CVD) incidence in residents in Beijing, China.MethodsWe included 2,415,573 individuals with a prescription record for BZDs or Z‐hypnotics in the Beijing Medical Claim Data for Employees database during 2010–2017, and 8,794,356 non‐users with other prescriptions for the same period. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional risk models for 712,850 exposed and 712,850 unexposed participants who were matched 1:1 by propensity score.ResultsBZDs or Z‐hypnotics users had a higher risk of CVD than non‐users, with an HR of 1.11 (95% CI: 1.10, 1.13). Compared with non‐users, those who used them for less than 3 months had the lowest risk of CVD, and those for more than 5 years had the highest risk, with HRs of 0.50 (0.48, 0.51) and 1.78 (1.72, 1.83), respectively. The risk of CVD was relatively low in those who used only one of the long‐acting BZDs, short‐acting BZDs, or Z‐hypnotics compared to unexposed individuals. Individuals exposed to all three types of drugs had the highest risk, 2.33 (2.22, 2.44) times that of non‐users. Users below the median dose had a lower risk of CVD compared to non‐users, whereas users exceeding the median dose had an increased risk.ConclusionBZD or Z‐hypnotic use in general was nominally associated with an elevated risk of CVD. However, for short‐term, single‐type, and low‐to‐moderate‐dose users, not only did this elevated risk disappear, but drug use also demonstrated a protective effect.","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":"4 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251857","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":"Magnetic resonance imaging–based machine learning classification of schizophrenia spectrum disorders: a meta‐analysis","authors":"Fabio Di Camillo, David Antonio Grimaldi, Giulia Cattarinussi, Annabella Di Giorgio, Clara Locatelli, Adyasha Khuntia, Paolo Enrico, Paolo Brambilla, Nikolaos Koutsouleris, Fabio Sambataro","doi":"10.1111/pcn.13736","DOIUrl":"https://doi.org/10.1111/pcn.13736","url":null,"abstract":"BackgroundRecent advances in multivariate pattern recognition have fostered the search for reliable neuroimaging‐based biomarkers in psychiatric conditions, including schizophrenia. These approaches consider the complex pattern of alterations in brain function and structure, overcoming the limitations of traditional univariate methods. To assess the reliability of neuroimaging‐based biomarkers and the contribution of study characteristics in distinguishing individuals with schizophrenia spectrum disorder (SSD) from healthy controls (HCs), we conducted a systematic review of the studies that used multivariate pattern recognition for this objective.MethodsWe systematically searched PubMed, Scopus, and Web of Science for studies on SSD classification using multivariate pattern analysis on magnetic resonance imaging data. We employed a bivariate random‐effects meta‐analytic model to explore the classification of sensitivity (SE) and specificity (SP) across studies while also evaluating the moderator effects of clinical and non‐clinical variables.ResultsA total of 119 studies (with 12,723 patients with SSD and 13,196 HCs) were identified. The meta‐analysis estimated a SE of 79.1% (95% confidence interval [CI], 77.1%–81.0%) and a SP of 80.0% (95% CI, 77.8%–82.0%). In particular, the Positive and Negative Syndrome Scale and the Global Assessment of Functioning scores, age, age of onset, duration of untreated psychosis, deep learning, algorithm type, features selection, and validation methods had significant effects on classification performance.ConclusionsMultivariate pattern analysis reliably identifies neuroimaging‐based biomarkers of SSD, achieving ∼80% SE and SP. Despite clinical heterogeneity, discernible brain modifications effectively differentiate SSD from HCs. Classification performance depends on patient‐related and methodological factors crucial for the development, validation, and application of prospective models in clinical settings.","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":"51 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251856","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}