Movement Disorders最新文献

{"title":"Revisiting Coactivation (“Froment's Maneuver”) in Parkinson's Disease: A Physiological Approach","authors":"Mehmet Yücel, Thorsten Odorfer, Jens Volkmann, Daniel Zeller","doi":"10.1002/mds.30226","DOIUrl":"https://doi.org/10.1002/mds.30226","url":null,"abstract":"BackgroundIn the 1920s, Jules Froment extensively studied conditions that might exacerbate rigidity in persons with Parkinson's disease (PD).ObjectiveThis cross‐sectional, controlled study aimed at investigating the physiological basis, in particular motor cortical contribution to enhanced rigidity during contralateral extremity movements.MethodsMotor‐evoked potentials (MEPs) were recorded in 42 patients with PD and 42 age‐matched healthy control subjects. Resting and active motor thresholds, MEP latency and amplitude, contralateral (cCSP) and ipsilateral cortical silent period (iCSP), and transcallosal conduction time (TCT) were obtained without and during coactivation maneuver in the dopaminergic <jats:italic>on</jats:italic> state.ResultsAt baseline, MEP amplitudes, iCSP duration, and TCT were increased in patients with PD as compared with control subjects. During coactivation, motor thresholds and TCT increased, whereas cCSP showed a marked decrease in patients with PD.ConclusionsThe reduction of cCSP during coactivation points to a disinhibition of pyramidal output. Pyramidal disinhibition may most likely underlie the enhancement of rigidity during coactivation. © 2025 International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"36 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909697","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":"Neuronally‐Derived Extracellular Vesicles Transforming Growth Factor Beta‐1 Levels in Progressive Supranuclear Palsy","authors":"Selena Mimmi, Elvira Immacolata Parrotta, Anna Maria Tolomeo, Domenico Maisano, Valentina Crapella, Elisabetta Pingitore, Khushboo Fatima, Anna Maria Zimbo, Mariagrazia Talarico, Costanza Maria Cristiani, Luana Scaramuzzino, Desirèe Valente, Clara Zannino, Gianni Cuda, Aldo Quattrone, Enrico Iaccino, Andrea Quattrone","doi":"10.1002/mds.30222","DOIUrl":"https://doi.org/10.1002/mds.30222","url":null,"abstract":"BackgroundDifferentiating progressive supranuclear palsy (PSP) from other parkinsonian disorders may be challenging.ObjectivesTo investigate the role of transforming growth factor beta‐1 (TGFβ1) in PSP.MethodsA total of 33 PSP, 39 Parkinson's disease (PD), 8 multiple system atrophy (MSA) patients, and 50 healthy controls (HC) were enrolled. TGFβ1 levels, including both active and inactive forms (latency‐associated peptide [LAP]‐TGFβ1), were measured in serum, total extracellular vesicles (EVs), and neuronally‐derived EVs (NDEVs) using microfluidic assays and ELISA.ResultsPSP patients exhibited a marked increase in TGFβ1 and LAP‐TGFβ1 levels in NDEVs, while no differences were observed across groups in serum or total EVs. Receiver operating characteristic (ROC) analysis demonstrated outstanding performance in differentiating PSP from non‐PSP patients (TGFβ1, area under the curve [AUC]: 0.97; LAP‐TGFβ1, AUC: 1.00), HC, AUC: 1.00).ConclusionsThis study highlights TGFβ1 and LAP‐TGFβ1 in NDEVs as promising blood‐based non‐invasive biomarkers for PSP diagnosis, paving the way for further research on these proteins in PSP. © 2025 The Author(s). <jats:italic>Movement Disorders</jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"92 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902937","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":"Bilateral Focused Ultrasound Thalamotomy for Essential Tremor: Clinical Outcomes Compared to Bilateral Deep Brain Stimulation and Probabilistic Lesion Mapping","authors":"Can Sarica, Kazuaki Yamamoto, Christian Iorio‐Morin, Jurgen Germann, Andrew Z. Yang, Brendan Santyr, Michael Colditz, Artur Vetkas, Anton Fomenko, Benjamin Davidson, Franziska Schmidt, Talyta Grippe, Nardin Samuel, Ajmal Zemmar, Oliver Flouty, Cletus Cheyuo, Ghazaleh Darmani, Robert Chen, Alexandre Boutet, Clemens Neudorfer, Mojgan Hodaie, Suneil K. Kalia, Renato P. Munhoz, Alfonso Fasano, Andres M. Lozano","doi":"10.1002/mds.30221","DOIUrl":"https://doi.org/10.1002/mds.30221","url":null,"abstract":"BackgroundThe efficacy and adverse events (AEs) of bilateral magnetic resonance‐guided focused ultrasound (MRgFUS) thalamotomies for essential tremor (ET) have not been compared to those of deep brain stimulation (DBS). Furthermore, it is uncertain whether second‐side thalamotomies can be positioned differently from the first without compromising effectiveness.ObjectiveWe aimed to indirectly compare bilateral MRgFUS and DBS, while identifying optimal lesion/stimulation locations.MethodsWe retrospectively examined 41 ET patients who received either bilateral thalamic DBS (n = 22) or MRgFUS (n = 19) surgery. The primary outcome was the comparison of modalities for change in Clinical Rating Scale for Tremor (CRST) from baseline to post second surgery. We characterized AEs, generated probabilistic maps, and tracked streamlines intersecting lesions. First‐side lesions were always intentionally placed ventrally (<jats:italic>z</jats:italic> = 0/+2 mm above the intercommissural plane [ICP]), and second‐side lesions were placed dorsally (<jats:italic>z</jats:italic> = +3 mm above ICP).ResultsTremor scores improved significantly after second surgeries (MRgFUS: 56.3 ± 7.1 to 24.2 ± 10.4, <jats:italic>P</jats:italic> &lt; 0.001; DBS: 58.8 ± 11.6 to 25.0 ± 13, <jats:italic>P</jats:italic> &lt; 0.05, mean follow‐up: 23/26 months), with no differences between modalities. Following first surgeries, scores were MRgFUS: 37.9 ± 7.9 and DBS: 35.2 ± 13.6, with significant improvement from baseline (<jats:italic>P</jats:italic> &lt; 0.001, mean follow‐up: 40/73 months). All AEs were grade 1–2, with AE‐free rates of 41% for DBS and 32% for MRgFUS. First‐side lesions exhibited maximal efficacy in the ventral Vim, extending to posterior subthalamic area (PSA), whereas second‐side lesions demonstrated maximal efficacy in the dorsomedial Vim‐Vop border. DBS maps corroborated this finding and confined to Vim‐Vop border. Lesions intersecting with networks interconnected with the supplementary motor area, in addition to M1, were associated with improved outcomes.ConclusionsThe efficacies of bilateral MRgFUS and DBS appear comparable. MRgFUS probabilistic maps vary with different targeting methods, revealing two distinct sweet spots: dorsal Vim‐Vop border and ventral Vim/PSA. © 2025 The Author(s). <jats:italic>Movement Disorders</jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"72 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143901406","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":"Neuronal α-Synuclein Disease Stage Progression over 5 Years.","authors":"Tanya Simuni,Caroline Gochanour,Anuprita R Nair,Michael C Brumm,Christopher Coffey,Kathleen L Poston,Lana M Chahine,Daniel Weintraub,Caroline M Tanner,Paulina Gonzalez-Latapi,Catherine M Kopil,Yuge Xiao,Sohini Chowdhury,Tien Dam,Gennaro Pagano,Diane Stephenson,Andrew Siderowf,Billy Dunn,Kenneth Marek,","doi":"10.1002/mds.30191","DOIUrl":"https://doi.org/10.1002/mds.30191","url":null,"abstract":"BACKGROUNDNeuronal α-synuclein disease (NSD) is defined by the presence of an in vivo biomarker of neuronal alpha-synuclein (n-asyn) pathology. The NSD integrated staging system (NSD-ISS) for research describes progression across the disease continuum as stages 0 to 6.OBJECTIVEThe aim was to assess 5-year longitudinal change in NSD-ISS in early disease.METHODSAnalysis included a subset of participants from the Parkinson's Progression Markers Initiative (PPMI) enrolled before 2020 as Parkinson's disease (PD) patients, prodromal PD patients, or healthy controls (HC) who met NSD criteria. Staging was defined based on biomarkers of n-asyn and dopaminergic dysfunction in early stages, clinical features, and severity of functional impairment in stages 3 to 6. Stages were determined annually for 5 years.RESULTSOf 576 NSD participants, 494 were enrolled as PD patients, 74 prodromal PD patients, and 8 HCs. At baseline, 24% of participants were stage 2B, 56% Stage 3, 13% stage 4, and less than 5% in other stages. At year 5, the respective percentages for stages 2B to 4 were 11%, 50%, and 34%, indicating progression through NSD stages. Progression was driven by functional impairment in the predominantly motor domain (95%) for stage 2B to 3, increasing degree of nonmotor dysfunction for stages 3 to 4 (46%), and a combination of domains for stages 4 to 5. Initiation of dopaminergic medications led to stage regression in 8% of participants in Stage 3 but 41% in stage 4.CONCLUSIONSOur analysis supports the utility of NSD-ISS in defining the stages of disease progression, at least in the early clinical and prodromal stages (2B, 3, or 4), suggesting the value of NSD-ISS as a potential research tool for drug development. Further research involving preclinical cohorts is a crucial next step. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"91 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893352","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":"Paired Deep Brain Stimuli Elicit Short‐Term Facilitation in Globus Pallidus Interna and Subthalamic Nucleus","authors":"Sarah Brinkerhoff, Arie Nakhmani, Alex Varghese, Cameron Gordon, Christopher L. Gonzalez, J. Nicole Bentley, Marshall T. Holland, Harrison C. Walker","doi":"10.1002/mds.30203","DOIUrl":"https://doi.org/10.1002/mds.30203","url":null,"abstract":"BackgroundDeep brain stimulation (DBS) elicits oscillatory local field potentials in patients with Parkinson's disease (PD) and other movement disorders. Greater knowledge about the fast dynamics of these neural responses could shed light on circuit pathophysiology and inform novel approaches to neuromodulation therapies.ObjectivesTo compare short‐term neuroplasticity in the globus pallidus interna (GPi) and the subthalamic nucleus (STN), the canonical functional targets for PD and dystonia.MethodsDuring surgery for DBS lead implantation, we delivered pairs of stimuli across various interstimulus intervals and amplitudes and recorded DBS‐evoked responses from unused contacts on the lead. After stimulus artifact removal, we contrasted the magnitude and timing of the local responses by paired pulse interval and brain target. Additionally, we compared the amplitudes of the DBS‐evoked potentials versus resting local field potentials at the same recording site.ResultsIn 14 patients undergoing STN DBS and 9 undergoing GPi DBS, evoked potentials in the STN exhibited greater amplitudes than those in the GPi. However, paired pulse neuroplasticity was larger in the GPi than in the STN. Otherwise, the responses at both sites exhibited similar paired pulse hastening and refractoriness, onset latencies, and frequencies measured by the first two peaks.ConclusionsSingle and paired DBS pulses elicit local oscillations with larger amplitudes in the STN than in the GPi. Otherwise, the responses display similar time dynamics and short‐term neuroplasticity. These findings could inform therapeutic innovation with future DBS systems that utilize sensing technologies. © 2025 The Author(s). <jats:italic>Movement Disorders</jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"35 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143880372","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":"Are there Predictors for the Effects of Subthalamic Versus Thalamic Lesions for the Treatment of Parkinsonian Tremor?","authors":"Steffen Paschen, Elena Natera‐Villalba, Jose A. Pineda‐Pardo, Marta del Álamo, Rafael Rodríguez‐Rojas, Ann‐Kristin Helmers, Johannes Hensler, Günther Deuschl, Jose A. Obeso, Raúl Martínez‐Fernández","doi":"10.1002/mds.30216","DOIUrl":"https://doi.org/10.1002/mds.30216","url":null,"abstract":"","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"9 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884698","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":"Does Dopamine Sensitivity Influence the Choice between Subthalamotomy and Thalamotomy for Parkinsonian Tremor?","authors":"Mickael Aubignat","doi":"10.1002/mds.30215","DOIUrl":"https://doi.org/10.1002/mds.30215","url":null,"abstract":"","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"37 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143884705","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":"Expanding the Allelic and Clinical Heterogeneity of Movement Disorders Linked to Defects of Mitochondrial Adenosine Triphosphate Synthase","authors":"Philip Harrer, Magdalena Krygier, Martin Krenn, Volker Kittke, Martin Danis, Georgi Krastev, Alice Saparov, Virginie Pichon, Marlène Malbos, Clarisse Scherer, Ivana Dzinovic, Matej Skorvanek, Robert Kopajtich, Holger Prokisch, Sara Silvaieh, Anna Grisold, Maria Mazurkiewicz‐Bełdzińska, Jean‐Madeleine de Sainte Agathe, Juliane Winkelmann, Jan Necpal, Robert Jech, Michael Zech","doi":"10.1002/mds.30209","DOIUrl":"https://doi.org/10.1002/mds.30209","url":null,"abstract":"BackgroundDefects of mitochondrial ATP synthase (ATPase) represent an emerging, yet incompletely understood group of neurodevelopmental diseases with abnormal movements.ObjectiveThe aim of this study was to redefine the phenotypic and mutational spectrum of movement disorders linked to the ATPase subunit‐encoding genes <jats:italic>ATP5F1A</jats:italic> and <jats:italic>ATP5F1B</jats:italic>.MethodsWe recruited regionally distant patients who had been genome or exome sequenced. Fibroblast cultures from two patients were established to perform RNA sequencing, immunoblotting, mass spectrometry–based high‐throughput quantitative proteomics, and ATPase activity assays. In silico three‐dimensional missense variant modeling was performed.ResultsWe identified a patient with developmental delay, myoclonic dystonia, and spasticity who carried a heterozygous frameshift c.1404del (p.Glu469Serfs*3) variant in <jats:italic>ATP5F1A</jats:italic>. The patient's cells exhibited significant reductions in <jats:italic>ATP5F1A</jats:italic> mRNA, underexpression of the α‐subunit of ATPase in association with other aberrantly expressed ATPase components, and compromised ATPase activity. In addition, a novel deleterious heterozygous <jats:italic>ATP5F1A</jats:italic> missense c.1252G&gt;A (p.Gly418Arg) variant was discovered, shared by three patients from two families with hereditary spastic paraplegia (HSP). This variant mapped to a functionally important intersubunit communication site. A third heterozygous variant, c.1074+1G&gt;T, affected a canonical donor splice site of <jats:italic>ATP5F1B</jats:italic> and resulted in exon skipping with significantly diminished <jats:italic>ATP5F1B</jats:italic> mRNA levels, as well as impaired ATPase activity. The associated phenotype consisted of cerebral palsy (CP) with prominent generalized dystonia.ConclusionsOur data confirm and expand the role of dominant <jats:italic>ATP5F1A</jats:italic> and <jats:italic>ATP5F1B</jats:italic> variants in neurodevelopmental movement disorders. <jats:italic>ATP5F1A</jats:italic>/<jats:italic>ATP5F1B</jats:italic>‐related ATPase diseases should be considered as a cause of dystonia, HSP, and CP. © 2025 The Author(s). <jats:italic>Movement Disorders</jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"2 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875799","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":"Corticospinal Tract Development, Evolution, and Skilled Movements","authors":"Emmanuel Roze, Caroline Dubacq, Quentin Welniarz","doi":"10.1002/mds.30199","DOIUrl":"https://doi.org/10.1002/mds.30199","url":null,"abstract":"The evolution of the corticospinal tract (CST) is closely linked to the development of skilled voluntary movements in mammals. The main evolutionary divergence concerns the position of the CST within the spinal cord white matter and its postsynaptic targets in the grey matter. Here, we examine the developmental steps contributing to the CST projection pattern from an evolutionary point of view. Recent studies have highlighted the molecular mechanisms involved in these processes and how they relate to the acquisition of skilled movements. Comparison of the evolution of the CST in different species offers a new perspective on manual dexterity. In particular, it adds a new level of complexity to the classic view linking the evolution of the CST and the sequential improvement of skilled hand movements from rodents to primates. © 2025 The Author(s). <jats:italic>Movement Disorders</jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"8 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875804","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":"Long‐Read Sequencing: The Third Generation of Diagnostic Testing for Dystonia","authors":"Thomas Wirth, Kishore R. Kumar, Michael Zech","doi":"10.1002/mds.30208","DOIUrl":"https://doi.org/10.1002/mds.30208","url":null,"abstract":"Long‐read sequencing methodologies provide powerful capacity to identify all types of genomic variations in a single test. Long‐read platforms such as Oxford Nanopore and PacBio have the potential to revolutionize molecular diagnostics by reaching unparalleled accuracies in genetic discovery and long‐range phasing. In the field of dystonia, promising results have come from recent pilot studies showing improved detection of disease‐causing structural variants and repeat expansions. Increases in throughput and ongoing reductions in cost will facilitate the incorporation of long‐read approaches into mainstream diagnostic practice. Although these developments are likely to transform clinical care, there is currently a discrepancy between the potential benefits of long‐read sequencing and the application of this technique to dystonia. In this review we highlight current opportunities and limitations of adopting long‐read sequencing methods for the investigation of patients with dystonia. We provide examples of long‐read sequencing integration into diagnostic evaluation and the study of pathomechanisms in individuals with dystonic disorders. The goal of this article is to stimulate research into the application and optimization of long‐read analysis strategies in dystonia, thus enabling more precise understanding of the underlying etiology in the future. © 2025 The Author(s). <jats:italic>Movement Disorders</jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.","PeriodicalId":213,"journal":{"name":"Movement Disorders","volume":"35 1","pages":""},"PeriodicalIF":8.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866696","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}