Tremor and Other Hyperkinetic Movements最新文献

{"title":"Work and Activity Impairment in Individuals with Essential Tremor.","authors":"Margaret E Gerbasi, Rodger J Elble, Holly A Shill, Eddie Jones, Alexander Gillespie, John Jarvis, Elizabeth Chertavian, Zachary Smith, Ludy C Shih","doi":"10.5334/tohm.1034","DOIUrl":"10.5334/tohm.1034","url":null,"abstract":"<p><strong>Background: </strong>Essential tremor (ET) affects nearly 7 million people in the United States and consists of upper limb tremor that can affect activities of daily living, including activities related to work. Research examining the effect of ET on work productivity is limited and there are no studies using validated work productivity instruments.</p><p><strong>Methods: </strong>Clinic-based data were collected between March 2021 and August 2021 from US physicians participating in the Adelphi ET Disease Specific Programme (DSP). Patients were evaluated with the Essential Tremor Rating Assessment Scale (TETRAS), Quality of Life in Essential Tremor (QUEST) questionnaire, and the Work Productivity and Activity Impairment (WPAI) questionnaire. Statistical associations between tremor severity and work productivity were examined.</p><p><strong>Results: </strong>A total of 1,003 ET patients were identified, and 420 patients completed the WPAI questionnaire and were included in this study. Activity impairment was independently associated with tremor severity, adjusting for age, full-time vs. part-time employment, household income, depression, and anxiety. Of those who were employed (n = 165), 133 (80.6%) were employed full-time, and 141 (85.5%) had some level of work impairment. Work impairment was also independently associated with tremor severity, adjusting for the same covariates. Among those patients for whom QUEST responses were available, 47% (64/135) of patients with ET working full-time and 88% (36/41) of those working part-time reported that tremor interfered with work.</p><p><strong>Discussion: </strong>Work impairment is significantly correlated with tremor severity. Although a minority of patients in this clinic-based cohort were identified as employed, nearly all reported a negative impact on work performance.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"29"},"PeriodicalIF":2.5,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding the Alphabet Soup: A Practical Guide to Genetic Testing in Hyperkinetic Movement Disorders.","authors":"Claudia Del Gamba, Giulietta Maria Riboldi","doi":"10.5334/tohm.971","DOIUrl":"10.5334/tohm.971","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis of genetic hyperkinetic movement disorders has become increasingly more complex as new genes are discovered and technologies offer new diagnostic possibilities. As a result, the choice of appropriate gene testing and the interpretation of the results can become difficult to navigate for movement disorder experts and clinicians. In parallel, research is becoming crucial to pair with clinical assessments in order to explore advanced sequencing technologies and allow new genes discovery.</p><p><strong>Methods: </strong>Systematic review of genetic forms of hyperkinetic movement disorders and of the most relevant genetic terminology was performed.</p><p><strong>Results: </strong>Comprehensive descriptions of genetic lexicon, testing selection, and complex genetic findings related to hyperkinetic movement disorders are reported.</p><p><strong>Discussion: </strong>Here we discuss the terminology of genetic diagnosis that is now part of the clinical practice, the difficulties related to the interpretation of complex genetic results, and provide guidance and tips for gene testing selection in order not to miss important diagnosis of genetic hyperkinetic movement disorders.</p><p><strong>Highlights: </strong>To review the most relevant lexicon related to genetic diagnosis, approach to gene testing, testing selection, and complex genetic findings in genetic hyperkinetic movement disorders.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"28"},"PeriodicalIF":2.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scoping Review of Treatment Strategies for Holmes Tremor: Pharmacological and Surgical Interventions.","authors":"Gabriel Chung, Henrique Ballalai Ferraz","doi":"10.5334/tohm.1019","DOIUrl":"10.5334/tohm.1019","url":null,"abstract":"<p><strong>Background: </strong>Holmes tremor is a rare neurological condition, first described in 1904, characterized by a low-frequency tremor that manifests at rest, posture, and action. Despite its recognition for over a century, effective treatment strategies for Holmes tremor remain elusive due to its rarity and challenges in conducting robust studies.</p><p><strong>Methods: </strong>Given that the existent medical literature on Holmes tremor is based on reports and case series, we conducted a survey using the keywords \"Holmes tremor\" and \"Rubral tremor\" to analyze the therapeutic approaches utilized, as well as their success rate.</p><p><strong>Results: </strong>We have found 121 Holmes tremor patients across 97 publications. Levodopa and anticholinergics emerged as the most common employed pharmacological treatments, demonstrating significant response rates. Dopaminergic agonists are also promising therapeutic approaches, albeit with fewer reported cases. From the surgical perspective, functional neurosurgery offers substantial benefits to the symptomatic control of patients, with deep brain stimulation electrodes being a promising strategy.</p><p><strong>Discussion: </strong>Pharmacological treatment, specifically levodopa, anticholinergics and dopaminergic agonists exhibit the highest success rate in managing Holmes tremor. Additionally, surgical strategies may help tremor control as supported by previous reviews with quantitative analysis. However, the heterogeneity in the reporting of these cases underscores the need for standardized case descriptions to permit conclusions.</p><p><strong>Highlights: </strong>This study brings a new perspective to the treatment of HT, as it estimates which medications and interventions may be more consistent for the treatment for Holmes Tremor.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"27"},"PeriodicalIF":2.5,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Experiences with VMAT2 Inhibitors in Pediatric Hyperkinetic Movement Disorders.","authors":"Sujal Manohar, Jennifer Jacobe, Rebecca Berger, Joseph Jankovic, Mariam Hull","doi":"10.5334/tohm.1023","DOIUrl":"10.5334/tohm.1023","url":null,"abstract":"<p><strong>Background: </strong>Vesicular monoamine transporter 2 (VMAT2) inhibitors are often prescribed for the treatment of hyperkinetic movement disorders such as tics, stereotypy, tardive dyskinesia and chorea. These dopamine depleters have been FDA approved in adults for the treatment of chorea in Huntington's disease and tardive dyskinesia. Use of VMAT2 inhibitors in pediatric hyperkinetic movement disorders, however, is limited due to lack of pediatric FDA approval. We review the real-world prescribing practices and patient experiences with VMAT2 inhibitors in children.</p><p><strong>Methods: </strong>We performed a retrospective chart review of patients treated with VMAT2 inhibitors at a pediatric movement disorders clinic from 2011 to 2023. Demographics, indication, medical history, and clinical notes were reviewed.</p><p><strong>Results: </strong>We identified 340 pediatric patients (65.3% male, average age 11.9 years) who had been prescribed a VMAT2 inhibitor for a variety of hyperkinetic movement disorders (359 total prescriptions) at our large pediatric movement disorders center. Of the 359 prescriptions for VMAT2 inhibitors, 94% included tetrabenazine, 4.6% deutetrabenazine, and 1.4% valbenazine. Most common clinical indication was tics (73.5%), followed by chorea (9.1%) and self-injurious stereotypy (7.1%). Of these prescriptions, 75.8% (N = 275) successfully commenced treatment. Most patients (62.8%) had clinical improvement with an average Clinical Global Impression-Improvement of 1.8 (±1.2), indicating \"very much\" or \"much\" improved, but 11.5% experienced no improvement in symptoms. Most patients (63.9%) reported some side effects, most commonly drowsiness; however, only 35 (10.1%) necessitated discontinuation due to side effects. Seven patients were transitioned from tetrabenazine to deutetrabenazine with resolution of side effects, and one to valbenazine with similar effect. Of the 359 prescriptions, 194 (54%) experienced at least one denial from insurance companies; 24.2% were unable to initiate treatment due to barriers such as insurance denials and 19.6% expressed financial concerns regarding medication affordability.</p><p><strong>Discussion: </strong>Our study suggests that VMAT2 inhibitors are effective for treating pediatric hyperkinetic movement disorders. Furthermore, this study provides insights into barriers to access to these drugs by pediatric patients.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"26"},"PeriodicalIF":2.5,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lesion-Induced Blepharospasm: Epidemiology and Clinical Characteristics.","authors":"Elina Myller, Rolle Halonen, Daniel T Corp, Juho Joutsa","doi":"10.5334/tohm.1025","DOIUrl":"10.5334/tohm.1025","url":null,"abstract":"<p><strong>Background: </strong>Lesion-induced blepharospasm is considered rare. However, this information is based on a small number of heterogenous retrospective cohorts without routine neuroimaging.</p><p><strong>Objectives: </strong>To study the epidemiology and clinical characteristics of lesion-induced blepharospasm.</p><p><strong>Methods: </strong>Patients with blepharospasm with uncertain etiology prior to brain imaging were systematically searched from the electronic medical records of Turku University Hospital (1996-2022). Clinical information and imaging data were extracted from the patients' records and re-evaluated by the investigators. Etiology of blepharospasm was evaluated by an in-depth review of the clinical information in the context of available literature on lesion-induced dystonias. The prevalence and annual incidence of blepharospasm were calculated based on the annual population count in the area.</p><p><strong>Results: </strong>The search identified 57 patients, of whom four (7.0%) were considered to have lesion-induced blepharospasm, corresponding to a population-based prevalence of 2.5 per million and annual incidence of 0.3 per million. All patients with lesion-induced blepharospasm had atypical features, which were all significantly more common than in patients with idiopathic blepharospasm (<i>P</i> < 0.05).</p><p><strong>Conclusions: </strong>Lesion-induced blepharospasm is more common than thought previously. However, all these patients showed atypical features, suggesting that brain imaging in blepharospasm can be limited to patients with atypical features only.</p><p><strong>Highlights: </strong>This study investigated the epidemiology of lesion-induced blepharospasm by systematically re-evaluating all patients with blepharospasm with uncertain etiology prior to structural brain imaging from a university hospital (1996-2022).Our results show that lesion-induced blepharospasm is more common that thought previously (7.0% of included patients, prevalence 2.5 per million, annual incidence 0.3 per million).All patients with lesion-induced blepharospasm showed clinical features that were considered atypical for idiopathic blepharospasm, indicating that routine brain imaging is not needed in patients with typical symptoms.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"25"},"PeriodicalIF":2.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Whip-Like Cervical Tics as an Indication For Thalamic Deep Brain Stimulation: Report of Two Cases.","authors":"Masamune Tsuji, Kei Yamashiro, Takashi Morishita, Atsushi Hirota, Hitoshi Iida, Yasuhiko Baba, Hiroshi Abe","doi":"10.5334/tohm.1010","DOIUrl":"10.5334/tohm.1010","url":null,"abstract":"<p><strong>Background: </strong>Cervical spinal cord injury caused by cervical tics associated with Tourette syndrome (TS) is a recognized complication; however, the role of deep brain stimulation (DBS) in mitigating the risk of such injuries remains unclear.</p><p><strong>Case report: </strong>We report two cases of TS with severe cervical tics, both of which responded favorably to DBS. In one case, DBS prevented the progression of cervical spinal cord injury, whereas in the other case, it prevented its onset.</p><p><strong>Discussion: </strong>Poor control of severe cervical tics is a significant risk factor for cervical spinal cord injury, and early consideration of DBS is recommended.</p><p><strong>Highlights: </strong>This case report presents two cases in which deep brain stimulation (DBS) was effective for patients with Tourette syndrome exhibiting severe cervical tics. Through this report, we demonstrate the potential effectiveness of DBS as a treatment to reduce the risk of cervical spinal cord injury caused by severe cervical tics.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"24"},"PeriodicalIF":2.5,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Hyperkinetic\" and \"Hypokinetic\": Is There a Need for a Third Category (i.e., \"Mixed\")?","authors":"Sara M Schaefer, Elan D Louis","doi":"10.5334/tohm.997","DOIUrl":"10.5334/tohm.997","url":null,"abstract":"<p><p>Terminology in the field of movement disorders has evolved multiple times over the years. Traditionally, classification schema have utilized a two-category approach, with a hyper- and hypokinetic branchpoint as the first step towards describing movement disorders and elucidating phenomenological diagnoses. However, this terminology falls short, as it does not adequately capture the complexity of several abnormalities of movement- including ataxia and rigidity- at the electrophysiologic and phenotypic levels. Rather, these movement disorders are characterized by mixed hyper- and hypokinetic phenomena. We propose a third category, \"mixed\", which would optimally classify the full range of movements.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"23"},"PeriodicalIF":2.5,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dyskinesia-Hyperpyrexia Syndrome in Parkinson's Disease May Benefit from GPi Deep Brain Stimulation: A Case Report.","authors":"Shi-Shi Huang, Lu-Lu Ma, Han-Song Sheng, Rong-Pei Liu, Shi-Guo Zhu, Shan-Shan Xu, Mei-Ling Sheng, Zhu-Ling Chen, Nu Zhang, Xiong Zhang, Jian-Yong Wang","doi":"10.5334/tohm.912","DOIUrl":"10.5334/tohm.912","url":null,"abstract":"<p><strong>Background: </strong>Dyskinesia-hyperpyrexia syndrome (DHS) is a rare but life-threatening complication in Parkinson's disease (PD). Its prevention and treatment are clinical challenges.</p><p><strong>Case report: </strong>We herein present a case of a female PD patient who experienced recurrent episodes of DHS and levodopa-induced dyskinesia. The complications were alleviated after bilateral globus pallidus internus (GPi) deep brain stimulation (DBS).</p><p><strong>Discussion: </strong>Our report provides evidence that GPi DBS may reduce the susceptibility to DHS. More evidences are warranted to validate this hypothesis.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"20"},"PeriodicalIF":2.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Features of Essential Tremor and its Impact on Quality of Life in Japan.","authors":"Shohei Okusa, Toshiki Tezuka, Yoshihiro Nihei, Jin Nakahara, Morinobu Seki","doi":"10.5334/tohm.1006","DOIUrl":"https://doi.org/10.5334/tohm.1006","url":null,"abstract":"<p><strong>Background: </strong>Essential tremor (ET) is primarily characterized by action tremor, but is also associated with various non-motor symptoms (NMS). However, the diagnostic relevance of NMS in ET remains unclear. This study aimed to compare NMS and motor symptoms of ET with those of Parkinson's disease-tremor dominant type (PD-TDT) and healthy controls (HCs) and to identify the presence and diagnostic relevance of NMS.</p><p><strong>Methods: </strong>Twenty-three ET patients, 23 PD-TDT patients, and 22 HCs were enrolled. Diagnoses of ET and PD were confirmed using Movement Disorder Society (MDS) criteria and Dopamine transporter single-photon emission computed tomography. Motor symptoms, NMS and quality of life (QOL) were evaluated using validated scales, including the Clinical Rating Scale for Tremor (CRST), MDS-Unified Parkinson's Disease Rating Scale (UPDRS), Non-Motor Symptoms Scale for Parkinson's Disease (NMSS), Odor Stick Identification Test for Japanese (OSIT-J), and Quality of Life in Essential Tremor Questionnaire (QUEST).</p><p><strong>Results: </strong>ET patients had significantly higher NMSS total scores and MDS-UPDRS part IB scores than HCs, with more severe sleep disturbances, fatigue, and urinary problems. CRST scores were significantly correlated with QUEST scores. Logistic regression identified CRST Part B and OSIT-J as key factors distinguishing ET from PD-TDT, with 87% sensitivity and 90% specificity.</p><p><strong>Discussion: </strong>ET patients showed more severe NMS than HCs. Differentiating ET from PD-TDT requires motor and sensory assessments, highlighting the diagnostic relevance of NMS. Comprehensive evaluation is essential for accurate diagnosis and management of ET.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"21"},"PeriodicalIF":2.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Orthostatic Tremor on Quality of Life - a Cohort Study.","authors":"Wietske A Babeliowsky, Bart Swinnen, Jeroen Hoogland, Rob M A de Bie, Anne-Fleur van Rootselaar","doi":"10.5334/tohm.1008","DOIUrl":"https://doi.org/10.5334/tohm.1008","url":null,"abstract":"<p><strong>Background: </strong>Orthostatic tremor (OT) is characterized by a lower extremity tremor causing unsteadiness while standing, urging patients to lean, walk, or sit to ease symptoms. This severely disrupts daily life and reduces quality of life (QoL), though the extent of QoL impairment remains largely unknown. The objective of this cohort study was to evaluate the effect of OT on daily functioning and well-being over time.</p><p><strong>Methods: </strong>In this prospective single-center and community based cohort study, OT patients annually completed self-report scales from 2018 to 2024, including the Dutch OT-questionnaire, Hospital Anxiety and Depression Scale (HADS), (instrumental) Activities of Daily Living, and the Short Form-36 (SF-36) to evaluate QoL.</p><p><strong>Results: </strong>Fifty-three OT patients participated in the study. OT patients showed reduced well-being compared to the general population based on outcomes from the SF-36 and HADS, with 30 out of 53 patients experiencing potential or suspected depression and/or anxiety. Despite viewing OT as progressive, most patients saw no significant changes in overall well-being or daily functioning, although a significant difference was found between baseline and last follow-up for physical role limitation.</p><p><strong>Discussion: </strong>Although OT patients report reduced well-being, both daily functioning and overall well-being remained stable over time, despite progressive symptoms. This is likely due to patients increased ability to adapt to OT symptoms. Additionally, a substantial portion had potential or suspected depression or anxiety.</p><p><strong>Highlights: </strong>Orthostatic tremor (OT) patients report reduced quality of life, with worsened walking ability and increased weather sensitivity over time. Despite this, daily functioning and overall well-being remained stable throughout the study. A significant portion of patients also showed potential or suspected depression and/or anxiety.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"22"},"PeriodicalIF":2.5,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}