Journal of Vestibular Research-Equilibrium & Orientation最新文献

{"title":"Functional vision head impulse testing (fvHIT) in children: Feasibility and normative values.","authors":"Lena Van den Bossche, Ingeborg Dhooge, Elizabeth Fuemmeler, Michelle Petrak, Marieke Fontaine, Noor Temmerman, Emmely Van Acker, Leen Maes","doi":"10.1177/09574271261488095","DOIUrl":"https://doi.org/10.1177/09574271261488095","url":null,"abstract":"<p><p>ObjectivesCurrent pediatric vestibular care mainly focuses on motor development and postural control whereas the consequences of impaired gaze stabilization are less frequently addressed. The Functional Vision Head Impulse Test (fvHIT) offers a method to assess functional gaze stabilization during rapid head movements. This study aimed to examine the feasibility of the fvHIT in children and establish normative values.MethodsNinety-four healthy children (4-12 years) underwent fvHIT testing. Feasibility, the percentage of correctly identified optotypes in total scores and per acceleration band were recorded. Statistical analyses assessed side and age differences.ResultsFeasibility increased with age and from the age of six onward, all children (100%) completed the test reliably. No significant side differences were observed in fvHIT scores. Four- and five-year-olds scored significantly lower than older groups. Normative values centered around 90%, increased with age, and showed a slight decline at higher accelerations.ConclusionThe fvHIT is a feasible method for assessing functional gaze stabilization in children. The normative values obtained in this study provide a reference for future research and can support clinical practice in evaluating performance in children who are prone to gaze stabilization difficulties.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"9574271261488095"},"PeriodicalIF":1.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041542","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":"Evaluation of vestibulo-ocular reflex in motion sickness: A comparison of vHIT, SHIMP, and functional head impulse test.","authors":"Kubranur Bilgili, Gulce Kirazli, Mehmet Fatih Ogut","doi":"10.1177/09574271261492459","DOIUrl":"https://doi.org/10.1177/09574271261492459","url":null,"abstract":"<p><p>BackgroundMotion sickness (MS) is an autonomic condition triggered by real or perceived movement. No single objective test reliably identifies MS susceptibility or explains its vestibular basis.ObjectiveTo compare vHIT, SHIMP, and functional head impulse test (fHIT)-with and without optokinetic stimulation-in detecting vestibulo-ocular reflex (VOR) dysfunction in MS, and to examine links between MS susceptibility, dizziness-related handicap, and anxiety.MethodsThirty adults with MS and 30 healthy controls underwent vHIT, SHIMP, fHIT, and optokinetic fHIT (fHIT-OPK), along with the Motion Sickness Susceptibility Questionnaire-Short Form (MSSQ-SF), Dizziness Handicap Inventory (DHI), and State-Trait Anxiety Inventory (STAI).ResultsVOR gain did not differ significantly between groups on vHIT or SHIMP. fHIT percentage of correct answer (CA%) were significantly lower in the MS group for the right anterior (<i>p</i> = 0.049), left anterior (<i>p</i> = 0.001), and right posterior (<i>p</i> = 0.015) canals. fHIT-OPK revealed additional impairment in the right lateral canal (<i>p</i> = 0.031). DHI and STAI scores were significantly elevated in the MS group. MSSQ-SF correlated strongly with DHI total (r = 0.914) and moderately with state and trait anxiety (r = 0.541 and 0.551, respectively).ConclusionsfHIT is more sensitive than vHIT and SHIMP in detecting VOR-related dysfunction in MS. Optokinetic stimulation unmasks visual-vestibular integration deficits. Subjective measures of handicap and anxiety should complement objective testing in this population.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"9574271261492459"},"PeriodicalIF":1.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026615","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":"Cognitive-motor interference during the suppression head impulse paradigm.","authors":"Noa Rozendorn, Nitay Sterenberg, Idit Tessler, Nir Livneh, Amit Wolfovitz, Yoav Gimmon","doi":"10.1177/09574271261487756","DOIUrl":"https://doi.org/10.1177/09574271261487756","url":null,"abstract":"<p><p>ObjectiveThe vestibulo-ocular reflex (VOR) is critical for stabilizing vision during head motion and for daily multitasking activities. The suppression head impulse paradigm (SHIMP) complements the head impulse paradigm (HIMP) and is considered more sensitive for residual vestibular function. This study examined the impact of cognitive and motor dual-tasking on SHIMP in healthy adults.MethodsTwenty-two participants performed single-task HIMP and SHIMP alongside two cognitive dual-task SHIMP (serial subtraction, map navigation) and one motor dual-task SHIMP (counter clicking). Outcomes included VOR gain and anti-compensatory saccade parameters (number, latency, amplitude, duration, and peak velocity).ResultsVOR gain was lower in SHIMP than HIMP (0.827 ± 0.140 vs 0.941 ± 0.123; <i>p</i> < 0.001). Cognitive dual-task markedly affected anti-compensatory saccade, reducing saccade number (15-22%), prolonging latency (39-47%), decreasing amplitude (20%), shortening duration (∼5%), and reducing peak velocity (∼10%) (all <i>p</i> < 0.05). Motor dual-task modestly increased gain (0.868 ± 0.131 vs 0.827 ± 0.140; <i>p</i> = 0.025) but only increased anti-compensatory saccade latency by 17% (<i>p</i> < 0.05).ConclusionsDual-tasking exerted distinct effects on SHIMP outcomes. VOR gain remained largely preserved, whereas anti-compensatory saccades were substantially impaired. These findings highlight the contribution of central and attentional mechanisms to anti-compensatory saccade generation and suggest that these parameters may provide complementary information to VOR gain during SHIMP testing.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"9574271261487756"},"PeriodicalIF":1.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978520","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":"Restricted gaze behavior under static visual stimuli in patients with persistent postural-perceptual dizziness.","authors":"Ayame Yamazaki, Natsuki Aoki, Keiji Honda, Takeshi Tsutsumi","doi":"10.1177/09574271251400318","DOIUrl":"10.1177/09574271251400318","url":null,"abstract":"<p><p>BackgroundPatients with persistent postural-perceptual dizziness (PPPD) suffer from symptoms of chronic dizziness that exacerbate in a moving environment. However, not much is known regarding gaze behavior in a static condition. The present study investigated gaze stability under static visual stimuli in patients with PPPD.MethodsThree groups of participants were recruited; 22 PPPD, 9 Ménière's disease (MD) and 19 healthy participants (HC). Participants were asked to undergo a free viewing test of emotionally neutral images through a virtual reality headset with a gaze-recording system. Bivariate Contour Ellipse Area (BCEA), a measure for gaze stability, and saliency values at points of gaze fixations were measured.ResultsPPPD showed smaller BCEA compared to MD and HC, with high anxiety state being a possible confounding factor. There was no difference in saliency values between all three groups.ConclusionsPPPD, MD, and HC all tended to fixate on salient parts of the images, but in PPPD, gaze was restricted to a smaller area compared to MD and HC. Considering that previously reported studies on PPPD patients showed gaze instability under dynamic stimuli, the gaze behavior from the present study, involving static stimuli, may reflect the opposite pole to that of dynamic stimuli.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"308-317"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551578","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":"Spatial cognition in cochlear implant users: The role of otolith dysfunction.","authors":"Nizamettin Burak Avcı, Betul Cicek Cinar","doi":"10.1177/09574271251412699","DOIUrl":"10.1177/09574271251412699","url":null,"abstract":"<p><p>BackgroundSensory impairments such as hearing loss and vestibular disorders can affect spatial cognition.ObjectiveThis study assessed the spatial cognitive abilities of cochlear implant (CI) users with hearing loss and compared them based on otolith functions.MethodsThe study has a control group and two subgroups. The first study group had 19 CI users with otolith dysfunction, and the second had 21 without. The control group had 20 healthy, age-, gender-, and education-matched volunteers. The triangle completion task (TCT), the spatial orientation test (SOT), and the four mountains test assessed spatial ability.ResultsResearch indicates that CI users with otolith dysfunction had significantly larger deviation angles and distances in TCT compared to healthy controls (p < .001). Statistically significant differences in SOT were found between groups (p < .001). Healthy controls had the lowest SOT score, whereas CI users with otolith dysfunction had the highest. In 4 MT, CI users with and without otolith dysfunction had more mistakes than controls (p < .05).ConclusionsResearch shows that otolith information is important for path integration and spatial navigation, and hearing loss worsens spatial memory degradation. These impairments impede spatial skills, which are essential for daily tasks like shopping and driving and for spatial memory, learning, and navigation.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"298-307"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834961","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":"Ocular vestibular evoked myogenic potential late peaks are enhanced in superior canal dehiscence and prolonged in vestibular migraine.","authors":"Alyssa C Dyball, Belinda Y C Kwok, Allison S Young, Rachael L Taylor, Nicholas Yang, Konrad P Weber, Miriam S Welgampola, Sally M Rosengren","doi":"10.1177/09574271251413134","DOIUrl":"10.1177/09574271251413134","url":null,"abstract":"<p><p>BackgroundThe ocular vestibular evoked myogenic potential (oVEMP) n1 peak is the first of many that form part of the oscillating waveform. Previous work showed that up to 5 peaks can be elicited when an intact labyrinth is stimulated, with larger peaks contralaterally.ObjectiveWe investigated what happens to these later peaks when the n1 amplitude is enlarged, which is typically seen in superior canal dehiscence (SCD) and sometimes vestibular migraine (VM).MethodsWe measured oVEMPs elicited to air- (AC) and bone-conducted (BC) stimuli in 14 patients with SCD, 20 with SCD and classical migraine, 26 with clinically definite VM, and 20 with clinically definite VM and enlarged n1 peaks. We compared these results to 49 healthy volunteers.ResultsBoth groups of SCD patients had the largest peaks, but the same number of peaks as healthy volunteers (maximum 4 for AC; 5 for BC). In contrast, patients with VM had more later peaks than other groups (maximum 6 for both stimuli).ConclusionsAs the patients with the largest amplitudes did not have prolonged oscillation in their waveforms, our results suggest that the oscillation may be enhanced by central processes, such as lack of habituation that is reported in patients with VM.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"274-288"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919024","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":"Bedside evaluation of peripheral positional downbeating nystagmus: Toward the new definition of down-beating BPPV.","authors":"Francesca Viberti, Daniele Nuti, Lorenzo Salerni, Marco Mandalà","doi":"10.1177/09574271251412829","DOIUrl":"10.1177/09574271251412829","url":null,"abstract":"<p><p>BackgroundPositional downbeat nystagmus (pDBN) may have multiple etiologies.ObjectivesDescription of a case series and further considerations about pDBN characteristics, pathogenesis, and differential diagnosis.MethodsDescriptive study concerning 153 consecutive patients with pDBN of presumed peripheral origin that were recruited and observed. They were treated only with Brandt-Daroff Exercises.Results56% reported symptoms of \"typical positional vertigo,\" 44% described postural instability during head movements or a continuous sense of dizziness. 40% of patients were symptom- and nystagmus-free after 1 week and almost 60% after 2 weeks 5% were still affected by pDBN after 1 month. Several pathogenetic hypotheses have been advanced: otoconia in the anterior canal, an apogeotropic variant of posterior canal, or in the short arm of the posterior canal.ConclusionDown-beat nystagmus arising from the semicircular canals must contain a torsional component and be in \"canal-plane\" - presenting more torsional when gaze is towards the affected canal, and more purely vertical when directed away, whereas central causes of DBN may be \"pure\" down-beat. Peripheral pDBN is fatigable, often no nystagmus when returning in sitting position and, highly relevantly, it is self-limiting (95% disappears with only Brandt-Daroff Exercises), with no central signs. Patients may complain of long-term dizziness, trunk oscillation, and prolonged motion sickness. New guidelines may consider the term of Down-Beating BPPV or Down-Beating peripheral positional vertigo, even if the otoconia's exact position is still uncertain: in our opinion pDBN might be considered as an \"apogeotropic variant of PC-BPPV\".</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"289-297"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846851","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":"Novel gaze stability training improves dynamic visual acuity for 6 months.","authors":"Daniel Ludwig, Amrita Mukunda, Americo A Migliaccio, Colin Grove, Jennifer Millar, Jamie Perin, Ann Ervin, Michael C Schubert","doi":"10.1177/09574271251400311","DOIUrl":"10.1177/09574271251400311","url":null,"abstract":"<p><p>ObjectivesPeripheral vestibular hypofunction (PVH) affects a significant portion of the population and impairs visual acuity during head motion (dynamic visual acuity, DVA). This study compared the effectiveness of a novel gaze stability training called Incremental VOR Adaptation (IVA) versus traditional vestibular physical therapy (VPT) for improving DVA.MethodsThe Incremental Velocity Error as a New Treatment in Vestibular Rehabilitation (INVENT) trial is a randomized, controlled, cross-over study involving 24 participants with chronic unilateral or bilateral PVH. Participants underwent either IVA or VPT for 3 weeks, followed by a washout period and then the alternate intervention (IVA-VPT or VPT-IVA). DVA was measured at baseline, after each intervention, at the completion of the washout period, and at 6-month follow-up.ResultsThere was a significant main effect of treatment Group, <i>F</i> (1,19) = 7.75, <i>p</i> = 0.012, with (IVA-VPT) consistently demonstrating lower DVA scores than VPT-IVA. A significant main effect of Side was also observed, <i>F</i> (1,19) = 13.35, <i>p</i> = 0.0017, indicating lower DVA scores for contralesional compared to ipsilesional head rotation. We found no effect of Time (<i>F</i> (4,76) = 1.44, <i>p</i> = 0.23), suggesting that scores remained stable from baseline through the 6-months follow-up. There were no significant interactions, including Group × Side (<i>F</i> (1,19) = 0.11, <i>p</i> = 0.74), Group × Time (<i>F</i> (4,76) = 1.33, <i>p</i> = 0.27), or Group × Side × Time (<i>F</i> (4,76) = 0.59, <i>p</i> = 0.67).ConclusionDVA scores were consistently better at all time points after participants completed IVA. Using an intent to treat analysis, with no baseline demographic differences between groups, our data support that exposure to the first gaze stability training type exerts a stable influence on DVA that persisted to 6-month follow-up. Clinically, this implies that once DVA improvements are established through either IVA or VPT, they tend to remain stable over 6 months.Level of EvidenceLevel 2.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"318-325"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574854","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":"Evaluating the effect of antidepressants for persistent postural-perceptual dizziness: A systematic review.","authors":"Danielle Bukovsky, Jianmeng Song, Helen Shewchuk, Edgardo Carmona-Torres, Elizabeth Crawford, Wanda A Dillon, Ariel Graff-Guerrero, Shannen Kyte, John Rutka, Shaleen Sulway, Felix Tyndel, Fumihiko Ueno, Robert Ure, Philip Gerretsen","doi":"10.1177/09574271261468395","DOIUrl":"https://doi.org/10.1177/09574271261468395","url":null,"abstract":"<p><p>BackgroundPersistent postural-perceptual dizziness (PPPD) is a functional neurological disorder characterized by chronic, non-spinning dizziness exacerbated by motion, visual stimulation, or upright posture. Although antidepressants are commonly prescribed for PPPD, their efficacy and tolerability have not been well established.ObjectiveTo evaluate the available evidence on antidepressant use in PPPD, with a focus on clinical outcomes.MethodsA systematic search of Embase, APA PsycINFO, and MEDLINE was conducted via the Ovid platform for any studies on antidepressant use in PPPD (or related symptoms under prior diagnostic terms) published before May 8, 2025.ResultsThirteen studies met inclusion criteria, comprising two randomized controlled trials (RCTs), seven open-label trials, and four observational or retrospective studies including a total of 807 participants. Four studies enrolled participants with a PPPD diagnosis, while others included participants with symptoms mirroring PPPD or precursor terms for the disorder. Specific antidepressant regimens varied greatly. Across studies, antidepressants were generally associated with reductions in both dizziness and psychiatric symptoms. Reported treatment response rates ranged from 55% to 84%. However, up to 25% of participants were unable to tolerate treatment. Reported adverse events included gastrointestinal symptoms, sedation or fatigue, sexual adverse effects, and headache.ConclusionsCurrent evidence regarding the use of antidepressants for the treatment of PPPD and precursor chronic dizziness disorders is limited by low-quality studies, heterogeneous designs, and inconsistent diagnostic criteria. The available evidence suggests antidepressants may be effective for PPPD; however, high-quality, randomized placebo-controlled trials are urgently needed to clarify the efficacy and tolerability of antidepressants for PPPD.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"9574271261468395"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867466","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 role of the vestibular system in depersonalization and derealization: Evidence from a systematic review.","authors":"Samuel Cento, Roberto Gammeri, Claudio Zavattaro, Emanuele Cirillo, Hilary Serra, Raffaella Ricci","doi":"10.1177/09574271251412707","DOIUrl":"10.1177/09574271251412707","url":null,"abstract":"<p><p>BackgroundEmerging evidence indicates an association between vestibular dysfunction and Depersonalization/Derealization (DD) symptoms. However, substantial heterogeneity in the studied populations, experimental paradigms, and assessment methodologies limits clear conclusions regarding the involvement of the vestibular system in the onset of DD symptoms.ObjectiveTo clarify the contribution of the vestibular system to DD symptoms in vestibular patients and healthy individuals undergoing vestibular stimulation.MethodsFollowing PRISMA guidelines, we reviewed studies examining: (1) DD symptoms in vestibular patients, and (2) DD symptoms in healthy individuals during vestibular stimulation.ResultsTwenty-three studies met the inclusion criteria. Among these, 86.9% reported DD symptoms either in patients with vestibular disorders (14/15) or in healthy individuals during vestibular stimulations (6/8). Additionally, 82.61% of the studies identified an association between DD symptoms and anxiety or spatial disorientation.ConclusionsTogether, these findings indicate that vestibular alterations may contribute to the emergence of DD symptoms. Anxiety and spatial disorientation were found to frequently co-occur suggesting an interaction between vestibular processing, affective regulation, and spatial cognition. This association can be interpreted within a neurofunctional framework, which posits that vestibular alterations disrupt multisensory integration in parietotemporal, insular, and hippocampal regions, contributing to the core phenomenology of DD.</p>","PeriodicalId":49960,"journal":{"name":"Journal of Vestibular Research-Equilibrium & Orientation","volume":" ","pages":"326-351"},"PeriodicalIF":1.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919027","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}