Tremor and Other Hyperkinetic Movements最新文献

{"title":"Immediate and Short-Term Effects of Multimodal Neuromodulatory Rehabilitation Following Thalamotomy for Writer's Cramp: A Case Report.","authors":"Moritoshi Kitakami, Takashi Hoei, Seiji Etoh, Tomoko Hanada, Kentaro Kawamura, Ryosuke Hanaya, Megumi Shimodozono","doi":"10.5334/tohm.1154","DOIUrl":"10.5334/tohm.1154","url":null,"abstract":"<p><strong>Background: </strong>Evidence for rehabilitation after thalamotomy for writer's cramp is limited. We report immediate effects of multimodal rehabilitation.</p><p><strong>Case report: </strong>A woman in her 20s with complex writer's cramp underwent left Vo/Vim thalamotomy. Postoperatively, she completed a 6-day program combining fine motor training, transcutaneous electrical nerve stimulation, and vibration. Thalamotomy reduced dystonia (Writer's Cramp Rating Scale [WCRS]: movement, 12 to 4; speed, 2 to 1), and rehabilitation yielded immediate writing speed gains and progressive functional recovery; although WCRS scores remained stable.</p><p><strong>Discussion: </strong>Combining bottom-up neuromodulation with task-specific training was associated with immediate gains, suggesting it may facilitate early motor relearning.</p><p><strong>Highlights: </strong>A young woman with writer's cramp underwent a thalamotomy; followed by early multimodal rehabilitation that combined transcutaneous electrical nerve stimulation, vibratory stimulation, and fine motor training. Video-supported assessments and quantitative measures indicated reproducible within-session gains and short-term improvements in writing time, dexterity, and quality of life.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"16 ","pages":"36"},"PeriodicalIF":1.9,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148228519","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":"Spectrum of Dystonia in Spinocerebellar Ataxia.","authors":"Siva Roja Yellaturi, Adreesh Mukherjee, Sanjay Pandey","doi":"10.5334/tohm.1163","DOIUrl":"10.5334/tohm.1163","url":null,"abstract":"<p><strong>Background: </strong>Spinocerebellar ataxias (SCAs) are a diverse group of inherited disorders characterized by progressive cerebellar dysfunction. Beyond the classic ataxic features, dystonia is an important manifestation across both common and uncommon SCA subtypes. The complete clinical spectrum, pathophysiology, and treatment of dystonia in SCA remain incompletely understood.</p><p><strong>Objectives: </strong>This review aims to summarize the current literature on dystonia in SCAs, outlining its prevalence, clinical presentations, underlying mechanisms, and therapeutic strategies.</p><p><strong>Methods: </strong>The authors conducted a systematic literature review in PubMed (up to October 2025) with various search terms related to dystonia and spinocerebellar ataxia, including specific SCA types. Full text articles were included in the review based on clinical relevance.</p><p><strong>Results: </strong>Dystonia has been observed in the common SCAs such as SCA1, 2, and 3, as well as several of the rarer SCA types. While focal dystonias such as cervical dystonia and task-specific dystonia (writer's cramp) are frequent manifestations, generalized dystonias are also documented. Dystonia may follow the ataxia, or can be the presenting symptom itself. Dystonia in SCA results from dysfunction in the interconnected brain networks primarily involving the cerebellum, basal ganglia, thalamus, and sensorimotor cortex. An altered dopaminergic signalling may be present as well. Treatment responses to levodopa, anticholinergics, botulinum toxin, and deep brain stimulation vary widely, underscoring the need for individualized therapeutic approaches.</p><p><strong>Conclusions: </strong>Recognizing dystonia as a part of the SCA spectrum is important for timely diagnosis and management. Further studies are required to elucidate the mechanisms and explore the targeted interventions.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"16 ","pages":"35"},"PeriodicalIF":1.9,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13220735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138825","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":"Tremor Recurrence in MR-Guided Focused Ultrasound Thalamotomy for Essential Tremor: DBS vs. Re-lesion.","authors":"Nur Walker-Pizarro, Jason L Chan, Jun Yu, Justin D Hilliard, Leonardo Almeida, Michael S Okun, Matthew A Remz","doi":"10.5334/tohm.1194","DOIUrl":"10.5334/tohm.1194","url":null,"abstract":"<p><strong>Clinical vignette: </strong>A 59-year-old man with essential tremor (ET) and bilateral symptoms initially underwent left thalamic MRI-guided focused ultrasound (MRgFUS) at an outside institution to address tremor in the right upper extremity. Despite an initial improvement, the benefit waned within one year, and there was significant progression of right upper extremity tremor and disabling left upper extremity tremor.</p><p><strong>Clinical dilemma: </strong>Tremor recurrence following MRgFUS highlights a common clinical challenge in the management of medication-refractory ET. When tremor re-emerges, clinicians must determine whether to pursue re-lesioning or transition to an alternative surgical strategy such as deep brain stimulation (DBS).</p><p><strong>Clinical solution: </strong>Following a multidisciplinary evaluation, staged bilateral ventral intermediate nucleus of the thalamus DBS (VIM-DBS) surgery was performed and resulted in bilateral tremor control.</p><p><strong>Gap in knowledge: </strong>There is no consensus regarding the optimal management when tremor recurs post-MRgFUS. Guiding principles for balancing re-lesioning vs. DBS remain undefined in clinical practice.</p><p><strong>Highlights: </strong>Tremor recurrence following MR-guided focused ultrasound highlights the limitations of fixed lesioning in a progressive disorder. This case illustrates that staged bilateral deep brain stimulation can provide durable, adjustable tremor control even when stimulation is delivered within a previously focused ultrasound lesioned target.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"16 ","pages":"33"},"PeriodicalIF":1.9,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13220733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138893","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":"Magnetic Resonance Image Guided Focused Ultrasound Thalamotomy for Essential Tremor in a Patient with an Arteriovenous Malformation.","authors":"Tomaima Yousef, Elma A Chowdhury, Piush Sarkar, Hooman Azmi","doi":"10.5334/tohm.1210","DOIUrl":"10.5334/tohm.1210","url":null,"abstract":"<p><strong>Background: </strong>Magnetic Resonance Guided Focused Ultrasound Thalamotomy (MRgFUS) is a non-surgical treatment option for medically refractory Essential Tremor (ET) or tremor dominant Parkinson's Disease.</p><p><strong>Case report: </strong>A 75-year-old left-handed man with medically refractory essential tremor presented for MRgFUS evaluation. During workup, contrast-enhanced brain MRI revealed an incidental right frontal arteriovenous malformation. After discussion of management options, the patient elected not to pursue treatment of the newly diagnosed AVM and proceeded with tremor-focused therapy.</p><p><strong>Discussion: </strong>It is possible to effectively utilize MRgFUS for treatment of tremors in carefully selected patients with cerebral AVMs by designating the malformation as a no pass zone.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"16 ","pages":"34"},"PeriodicalIF":1.9,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13220734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138874","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":"Pallidal Deep Brain Stimulation for Tremor Control in a Child with Juvenile DNAJC6-Associated Parkinsonism.","authors":"Katerina Bernardi, Deyana Valcheva, Rene Marquez Franco, Michael T Barbe, Jochen Wirths, Anne Koy, Moritz Thiel","doi":"10.5334/tohm.1187","DOIUrl":"10.5334/tohm.1187","url":null,"abstract":"<p><strong>Background: </strong>Juvenile DNAJC6-associated Parkinson's disease is a rare cause of early-onset parkinsonism with limited treatment data.</p><p><strong>Case report: </strong>We describe a 15-year-old female with a novel DNAJC6 variant presenting with progressive tremor, bradykinesia, and postural instability. Although initially responsive to levodopa, she developed severe medication-induced motor fluctuations refractory to multiple pharmacological therapies. Due to disabling tremor, bilateral globus pallidus internus deep brain stimulation (GPi-DBS) was performed, resulting in marked and sustained tremor reduction.</p><p><strong>Discussion: </strong>This case highlights the severe course of DNAJC6-associated juvenile parkinsonism and supports GPi-DBS as an effective option for refractory tremor.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"16 ","pages":"32"},"PeriodicalIF":1.9,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13196678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017489","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":"Risk of Cervical Spine Complications in Individuals with Cervical Dystonia Treated with Botulinum Toxin Therapy.","authors":"Samyukta Senthil, Sanjeev Kumar, Aparna Wagle Shukla","doi":"10.5334/tohm.1203","DOIUrl":"10.5334/tohm.1203","url":null,"abstract":"<p><strong>Objective: </strong>To examine the risk of cervical spine complications in individuals with focal cervical dystonia (CD) treated with botulinum toxin (BoNT) injections.</p><p><strong>Background: </strong>CD is a movement disorder characterized by involuntary twisting and turning of the neck, often accompanied by a jerky tremor. Owing to the persistent abnormal forces exerted on the cervical spine, cervical spine pathology has been reported in approximately 30% of patients; however, data on this risk in the context of BoNT therapy are lacking.</p><p><strong>Design/methods: </strong>In a retrospective analysis of CD patients receiving BoNT therapy, we determined the prevalence of cervical spine complications, including degenerative cervical spinal stenosis, myelopathy, radiculopathy, and atlantoaxial dislocation. Data on treatments including pain medications and interventions both surgical such as cervical laminectomy, discectomy, anterior cervical discectomy and fusion (ACDF), posterior cervical instrumentation and fusion (PCF), and non-surgical like radiofrequency ablation, and medial branch blocks were extracted. In addition, we conducted a literature review of cervical spine complications reported as associated with CD.</p><p><strong>Results: </strong>In a cohort of 320 patients receiving regular BoNT therapy and followed longitudinally for 5 or more years, we found 17 individuals (5.3%) with new onset cervical stenosis (n = 11), radiculopathy (n = 5) or myelopathy (n = 4), developing after the diagnosis of CD and initiation of BoNT therapy (58.8% developing in the first 5 years). The neck pain in these individuals was managed with opioid medications in addition to BoNT injections and oral muscle relaxants. While procedures such as medial branch blocks (n = 5), radiofrequency ablation (n = 2), and epidural steroid injections (n = 8) were employed for controlling pain, surgical interventions such as laminectomy (n = 3), discectomy (n = 4), PCF (n = 1), and ACDF (n = 3) were warranted in some individuals.</p><p><strong>Conclusion: </strong>Cervical spine complications following a diagnosis of CD may necessitate opioid therapy, nerve blocks, ablative procedures, and/or surgical interventions. In contrast to prior reports from the predominantly pre-BoNT era, which estimated complication rates of approximately 30%, our cohort, well managed with BoNT therapy, demonstrated a considerably lower risk of cervical spine complications (5.3%). These findings suggest that early initiation of BoNT therapy, by effectively controlling abnormal involuntary forces exerted on the cervical spine, may reduce the risk of secondary cervical spine complications.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"16 ","pages":"31"},"PeriodicalIF":1.9,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13196676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017519","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":"Holmes Tremor in CADASIL Responsive to Multi-Targeting Deep Brain Stimulation (DBS): An Educational Case with Video and Electrophysiology.","authors":"Fahimeh H Akhoundi, Katherine Longardner, Dietrich Haubenberger, Robert Hess, Brenton A Wright, Sharona Ben-Haim","doi":"10.5334/tohm.1128","DOIUrl":"10.5334/tohm.1128","url":null,"abstract":"<p><strong>Background: </strong>Holmes tremor (HT) is a disabling condition, often resistant to medical therapy.</p><p><strong>Case report: </strong>A 51-year-old woman with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) presented with severe right upper limb HT unresponsive to multiple medications. She underwent deep brain stimulation (DBS) with dual-lead, triple-targeting of the left ventral intermediate nucleus (VIM), posterior subthalamic area (PSA), and globus pallidus interna (GPi) with improvement in tremor.</p><p><strong>Discussion: </strong>To our knowledge, this case represents the first reported instance of HT in CADASIL and highlights the potential of multi-target DBS for complex, treatment-refractory hyperkinetic movement disorders.</p><p><strong>Highlights: </strong>We describe the first reported instance of Holmes tremor occurring as a manifestation of CADASIL, successfully treated with triple-target deep brain stimulation of the VIM, PSA, and GPi. This case demonstrates the potential of multi-target DBS to modulate complex motor networks in treatment-resistant tremor and enhance functional outcomes.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"16 ","pages":"30"},"PeriodicalIF":1.9,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869367","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":"Response to Letter to the Editor Regarding: Knowledge and Awareness of Tourette's Syndrome Among Teachers in Eastern Region, Saudi Arabia.","authors":"Zainab Alwusaybie, Mashael AlQuaimi","doi":"10.5334/tohm.1211","DOIUrl":"10.5334/tohm.1211","url":null,"abstract":"<p><p>In this response to the Letter to the Editor regarding our article \"Knowledge and Awareness of Tourette's Syndrome among Teachers in Eastern Region, Saudi Arabia\", we address the correspondents' methodological observations. We clarify that our questionnaire-based assessment was deliberately designed to measure declarative knowledge (the \"knows\" level of Miller's pyramid) rather than applied classroom competence. We acknowledge the correspondents' caution about dichotomising continuous variables using Bloom's cutoff points and confirm that sensitivity analyses using continuous scoring yielded consistent conclusions. We thank the correspondents for their scholarly engagement and agree that future research should incorporate performance-based assessments and continuous scoring approaches.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"16 ","pages":"29"},"PeriodicalIF":1.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869467","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":"Machine Learning for Differentiating Essential Tremor: A Scoping Review.","authors":"David M Fletcher, Kaitlyn E Heintzelman, Sumesh B Ramasamy, Allison Marks, Joseph C Melott, Amy W Amara, Adeel A Memon","doi":"10.5334/tohm.1182","DOIUrl":"10.5334/tohm.1182","url":null,"abstract":"<p><strong>Background: </strong>Essential tremor (ET) is the most common movement disorder, affecting ~6% of adults over 65 [1]. Differentiating ET from other tremors remains clinically challenging due to overlapping features and variable presentation. Artificial intelligence (AI), particularly machine learning (ML), has emerged a potential tool to support neurologists by enhancing pattern recognition and complementing traditional assessments in complex cases. This is the first scoping review examining ML's potential role in distinguishing essential tremor from other tremor types.</p><p><strong>Methods: </strong>A systematic, scoping search was conducted using PubMed, Cochrane, and Scopus through April 2025, in accordance with PRISMA guidelines-ScR [2]. Studies applying AI to distinguish ET from other tremors were included. Of 548 studies screened, 97 underwent full-text review, with data extracted from 46.</p><p><strong>Results: </strong>46 included studies encompassed 6,051 patients, including 2,358 with ET. ML models utilized diverse inputs: accelerometers, gyroscopes, voice recordings, Archimedes spirals, EMG, and video. Common algorithms were included vector machines (18 articles), k-nearest neighbors (9 articles), and convolutional neural networks (8 articles). There was a high amount of heterogeneity in reporting data, severely limiting between study comparisons. Reported classification accuracies ranged from 60% to 100% (mean: 89%). However, heterogeneity in data types, methodologies, and reporting limited cross-study comparability.</p><p><strong>Conclusions: </strong>ML shows promise as a decision-support tool by recognizing tremor features that may complement, but not replace, expert clinical assessment, particularly in diagnostically ambiguous cases. To enable clinical adoption, future studies must address current heterogeneity, develop standardized datasets, implement automated preprocessing, and focus on clinically feasible data sources.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"16 ","pages":"28"},"PeriodicalIF":1.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869499","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":"Perceptual and Acoustical Features of Dysarthria in Essential Tremor: An Observational Study that Expands the Cerebellar Features of Essential Tremor.","authors":"Nayanika Ghosh, Nora Hernandez, Ethan Wainman, Isabella Forestieri, Elan D Louis, Rosemary A Lester-Smith","doi":"10.5334/tohm.1180","DOIUrl":"10.5334/tohm.1180","url":null,"abstract":"<p><strong>Background: </strong>Clinical, neuroimaging and postmortem studies indicate cerebellar dysfunction in essential tremor (ET). Clinically this is reflected in intention tremor, gait ataxia, and impaired motor timing. However, the effect of cerebellar dysfunction on speech in ET remains unclear, and research on dysarthria in ET is limited. This study aimed to 1) identify the perceptual features of dysarthria in ET, 2) verify the prominent perceptual features using acoustical analyses, and 3) determine the percentage of participants exhibiting hyperkinetic, ataxic or mixed hyperkinetic-ataxic dysarthria.</p><p><strong>Methods: </strong>Speech samples from fifteen participants with ET were analyzed. An expert rater completed auditory-perceptual ratings, and acoustical analyses were completed that corresponded to perceptual features detected in participants' speech, including speech timing, prosody, and voice quality measures.</p><p><strong>Results: </strong>Perceptual analyses revealed slow and variable speech rate, prolonged interword intervals and phonemes, imprecise consonants, distorted vowels, hypernasality, vocal tremor, harshness, breathiness, hoarseness, reduced loudness, and excess loudness variation in more than 50% of the participants. Acoustical analyses confirmed the presence of vocal tremor as well as numerically lower articulation rate, longer and more variable syllable duration, and lower smoothed cepstral peak prominence in more than 50% of participants compared to normative data from prior studies. Acoustical analyses classified one participant as ataxic and 14 participants as mixed hyperkinetic-ataxic.</p><p><strong>Discussion: </strong>This study revealed the presence of cerebellar signs of dysarthria in speakers with ET, primarily supporting a mixed hyperkinetic-ataxic dysarthria profile in ET. The data indicate that cerebellar dysfunction in ET does not spare speech and voice.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"16 ","pages":"30"},"PeriodicalIF":1.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869491","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}