Cerebellum最新文献

{"title":"Transient Response to Liberation Maneuvers in Central Positional Nystagmus Due to Cerebral Metastases Mimicking Benign Paroxysmal Positional Vertigo- A Case Report.","authors":"Maritta Spiegelberg, Joao Lemos, Sun-Uk Lee, Jeong-Yoon Choi, Alexander Andrea Tarnutzer","doi":"10.1007/s12311-025-01851-w","DOIUrl":"10.1007/s12311-025-01851-w","url":null,"abstract":"<p><strong>Background: </strong>Benign paroxysmal positional vertigo (BPPV) is by far the most frequent cause of positional nystagmus (PN). However, PN may also be encountered in central lesions. In this case report we describe a patient with isolated positional vertigo and central PN which mimicked a lateral-canal cupulithiasis, including initial response to liberation maneuvers.</p><p><strong>Case description: </strong>A 44-year-old male patient reported new-onset position-dependent vertigo with nausea and gait-imbalance for 10 days. During supine roll testing for the lateral semicircular canals, he showed a persistent apogeotropic PN (being more intense left-ear-down) accompanied by moderate vertigo. Except for the PN, the neurologic examination was normal. He received a diagnosis of a apogeotropic-variant right-lateral canal BPPV and responded well to a Gufoni maneuver (nose-up). However, on follow-up, apogeotropic PN showed-up again, converted into a geotropic variant after a Barbecue-liberation maneuver, and then disappeared. Due to the re-emergence of the initial PN on the second follow-up consult, a brain-MRI was requested, disclosing disseminated infra- and supratentorial cystic brain metastases. The largest mass compressed midline cerebellar structures. Urgent surgical resection revealed a histopathologic diagnosis of an adeno-carcinoma of the lung.</p><p><strong>Discussion: </strong>Short-lasting responses to liberation maneuvers may also be seen in CPN, mimicking the response-pattern expected in BPPV cases. Thus, response to treatment must be validated on a follow-up consultation. Pressure by a cystic cerebellar mass lesion on the nodulus and uvula that varies with changing head-position relative to gravity, resulting in adaptational changes in PN direction and intensity could explain our findings.</p>","PeriodicalId":50706,"journal":{"name":"Cerebellum","volume":"24 4","pages":"96"},"PeriodicalIF":2.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selection of Clinical Outcome Assessments for Trial Readiness in ARSACS - 2-year Progression and Responsiveness to Change Part 2: Mobility, Balance, and Lower Limb Coordination.","authors":"Isabelle Lessard, Elise Duchesne, Luc J Hébert, Bernard Brais, Xavier Rodrigue, François Routhier, Krista Best, Jean-Denis Brisson, Florentin Thullier, Sébastien Gaboury, Isabelle Côté, Cynthia Gagnon","doi":"10.1007/s12311-025-01849-4","DOIUrl":"10.1007/s12311-025-01849-4","url":null,"abstract":"<p><p>Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is among the most prevalent types of recessive ataxia worldwide. Given the accelerated therapeutic advances for many ataxias, there is a need to improve trial readiness. This study aimed to document the progression of balance, lower limb coordination and mobility in adults with ARSACS according to their mobility stage (walker or not) over the trial-relevant time frame of two years, and responsiveness to change of related clinical outcome assessments (COAs). Sixty participants from two neuromuscular clinics (Saguenay and Québec City, Canada) were included. The COAs were the Lower Extremity Motor Coordination Test (LEMOCOT), Co-contraction index, 30-s Chair Stand test (30 s-CST), Timed Up & Go test (TUG), 10-Meter Walk Test (10mWT), Berg Balance Scale (BBS), and Activities-specific Balance Confidence-simplified (ABC-S) scale. Responsiveness was documented using an anchor-based method with self-perception of the progression of related COA outcomes in the previous year. A significant progression above the standard error of measurement was observed for the TUG (+ 7.8 s [24% compared with baseline]), 10mWT (-0.111 to-0.165 m/s [-17 to -20%]), BBS (-4.3 points [-24%]), and ABC-S (-4.3 points [-15%]), with some differences between mobility stages; participants using a walking aid or wheelchair showed greater progression. The TUG, 10mWT, and BBS were the most sensitive to change in COAs, detecting changes specifically in participants who reported getting worse. These results are pivotal for defining inclusion criteria and selecting COAs for future clinical trials.</p>","PeriodicalId":50706,"journal":{"name":"Cerebellum","volume":"24 4","pages":"95"},"PeriodicalIF":2.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055929","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 Cerebellar Neuropsychiatric Rating Scale in the Spinocerebellar Ataxias.","authors":"Anna L Burt, Maureen P Daly, Janet C Sherman, Jeremy D Schmahmann","doi":"10.1007/s12311-025-01840-z","DOIUrl":"10.1007/s12311-025-01840-z","url":null,"abstract":"<p><p>There is currently no established screening instrument that detects neuropsychiatric features in individuals with cerebellar ataxia. We hypothesized that the Cerebellar Neuropsychiatric Rating Scale (CNRS) would capture the neuropsychiatry of patients enrolled in the natural history study of the Clinical Research Consortium for the Study of Cerebellar Ataxia, and provide novel insights not revealed by other measures. We studied CNRS data in 362 patients with spinocerebellar ataxia types 1, 2, 3, 6, 7, 8, 10, and 27B, and cerebellar ataxia, neuropathy, vestibular areflexia syndrome (CANVAS). We grouped patients by mild, moderate, and severe disease severity according to Friedreich Ataxia Rating Scale (FARS) functional stage. We analyzed scores on the CNRS and its five constituent domains for the entire cohort and by severity subgroup. We fit a mixed effects model to examine the effect of severity. We analyzed correlations with other clinical measures: Cerebellar Cognitive Affective / Schmahmann Syndrome Scale (CCAS-S), Patient-Reported Outcome Measure of Ataxia (PROM-Ataxia), Patient Health Questionnaire-9 (PHQ-9), Euro-Qol 5-Dimension (EQ-5D), and Fatigue Severity Scale (FSS). The CNRS detected neuropsychiatric symptoms, with highest scores on Attentional and Emotional Control domains. The mixed effects model revealed that ataxia severity influences scores, with mean scores increasing with ataxia severity. The CNRS correlated with the PROM-Ataxia Mental domain, particularly between Emotional Control and section 1 (psychiatric) items. Emotional Control also correlated with PHQ-9 and EQ-5D. Correlations with the CCAS-S Affect and FSS were weak. The CNRS provides novel neuropsychiatric insights into spinocerebellar ataxia that are missed by other measures.</p>","PeriodicalId":50706,"journal":{"name":"Cerebellum","volume":"24 4","pages":"94"},"PeriodicalIF":2.7,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993243","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":"Terra Incognita - Contributions of the Olivo-Cerebellar System to Autism Spectrum Disorder.","authors":"Pranav Shibu, Daniel Ra, Jemima Elise Robins, Samuel Joseph, Sheeba Anteraper","doi":"10.1007/s12311-025-01843-w","DOIUrl":"10.1007/s12311-025-01843-w","url":null,"abstract":"<p><p>The inferior olivary nuclei (ION), a key component of the olivo-cerebellar system, remain understudied in autism spectrum disorder (ASD) research despite evident cerebellar involvement. This perspective piece aims to elucidate the critical role of the ION in cerebellar microcircuitry and its potential implications in ASD pathophysiology. We review the olivo- cerebellar system and the structural and functional alterations of the ION in autism, highlighting findings from neuroanatomical, neuroimaging, and behavioral studies. ION disruptions, although underexplored, may have a major role in the symptomatology of ASD, particularly higher-order cognitive abilities, rapid stimuli processing, and motor coordination. Specifically, we highlight how anomalies in olivary neuron morphology and olivo-cerebellar connectivity patterns may underlie deficits in temporal processing and motor learning observed in ASD. Furthermore, we discuss the challenges in brainstem imaging and recent advancements in ultra-high field (UHF) 7 T MRI technology, as standard neuroimaging techniques. As these neuroimaging techniques continue to evolve, further investigation of the functional territories of the ION holds promise for providing essential understandings into ASD processes and may lead to pioneering therapeutic options targeting this crucial brainstem area.</p>","PeriodicalId":50706,"journal":{"name":"Cerebellum","volume":"24 4","pages":"93"},"PeriodicalIF":2.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042778","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 Nuclear Transitory Zone: A Key Player in the Cerebellar Development.","authors":"Farshid Ghiyamihoor, Azam Asemi Rad, Hassan Marzban","doi":"10.1007/s12311-025-01848-5","DOIUrl":"10.1007/s12311-025-01848-5","url":null,"abstract":"<p><p>The nuclear transitory zone (NTZ), while crucial during cerebellar development, has remained elusive due to its transient nature and the technical limitations in observing this dynamic structure in vivo. Traditionally considered an assembly point for immature neurons of the prospective cerebellar nuclei, recent studies highlight the NTZ's rich cellular and molecular heterogeneity in the early-developing region at the rostral end of the cerebellar primordium. While much is known about its molecular diversity, the precise functional role of NTZ in cerebellar development remains unclear. This review synthesizes current knowledge of the NTZ, focusing on its developmental origin, cellular and molecular composition, and potential role in regulating cerebellar development. We explore studies primarily conducted in mice, exploring the NTZ development from the rhombic lip, the ventricular zone, and possibly the mesencephalon. Special attention is given to molecules such as TLX3, Contactin-1 (CNTN1), OLIG2, Reelin (RELN), LMX1A, and TBR2, which are prominently expressed in the NTZ during early cerebellar development. Evidence suggests that the NTZ is more than just a neuronal assembly site; its molecular markers and gene expression profile indicate a role in circuit formation and regulation within the cerebellar primordium. We suggest that the NTZ may contribute to early cerebellar circuit formation, potentially acting as a regulator or organizer of cerebellar development. However, caution is necessary in attributing developmental roles solely based on gene expression patterns. Future studies should focus on the functional consequences of gene expression in the NTZ and its interactions with developing cerebellar circuits.</p>","PeriodicalId":50706,"journal":{"name":"Cerebellum","volume":"24 4","pages":"92"},"PeriodicalIF":2.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042371","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":"Current and future applications of brain magnetic resonance imaging in ARSACS.","authors":"Alessandra Scaravilli, Davide Negroni, Claudio Senatore, Filippo Maria Santorelli, Sirio Cocozza","doi":"10.1007/s12311-025-01842-x","DOIUrl":"10.1007/s12311-025-01842-x","url":null,"abstract":"<p><p>Magnetic Resonance Imaging (MRI) is a tool with an unquestionable role in the study of neurodegenerative disorders, both for diagnostic purposes and for its ability of providing imaging-derived biomarkers with a growing central role as reliable outcomes in clinical trials. This is even more relevant when dealing with rare disorders such as the Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay (ARSACS), in which the search of diagnostic and prognostic biomarker is crucial. Due to the rarity of this condition, a comprehensive knowledge of MRI signs observed in ARSACS is lacking. Furthermore, many domains remain still unexplored in ARSACS, especially with reference to the application of advanced imaging techniques that could shed light on the pathophysiological mechanisms of brain damage in this disorder. In this review, after a brief introduction on the major conventional and advanced MRI techniques that can used for diagnostic and research purposes, we present current neuroradiological knowledge in ARSACS. Having discussed strength and weak points of conventional and advanced imaging findings, we also suggest possible future research in this neurologically complex clinical condition.</p>","PeriodicalId":50706,"journal":{"name":"Cerebellum","volume":"24 4","pages":"91"},"PeriodicalIF":2.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12043731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crossed Cerebellar Diaschisis in a Patient with MELAS Syndrome: A Case Report.","authors":"Ivana Karla Franić, Andreja Bujan Kovač, Branko Malojčić","doi":"10.1007/s12311-025-01847-6","DOIUrl":"10.1007/s12311-025-01847-6","url":null,"abstract":"<p><p>Mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) is a rare genetic disorder from a spectrum of mitochondrial diseases. Most commonly it presents with stroke-like symptoms, seizures, encephalopathy and myopathy. As it affects predominantly metabolically active organs, it can cause cardiomyopathy, diabetes mellitus, etc. We report a case of a young male patient with genetically proven MELAS who had a history of periodical generalized tonic-clonic seizures and then developed recurrent transient paresthesia of the right extremities, speech disturbance and apraxia. During work-up, an MRI done after a generalized tonic-clonic seizure showed hypoperfusion and edema in right cerebellar hemisphere caused by the contralateral cerebral acute ischemic lesion in left insular cortex which produced initial symptoms. This interesting finding is called crossed cerebellar diaschisis (CCD). CCD is a rare entity which refers to a decrease in metabolism, perfusion, and overall function in a cerebellar hemisphere because of a contralateral cerebral lesion. The disturbance of the function in an area distant from the location of initial brain lesion is possible because the two areas are connected via fiber tracts. This pathology most commonly occurs after ischemic stroke but also after seizures, supratentorial tumors, encephalitis etc. Our patient continued to have recurrent occasional transient paresthesia of the right extremities, but the follow-up MRI showed complete regression of hyperintensities in the left cerebral cortex and edema in right cerebellar hemisphere. In this paper we report co-existence of a rare neuroradiological finding such as CCD, in patient with rare cerebrovascular disease.</p>","PeriodicalId":50706,"journal":{"name":"Cerebellum","volume":"24 4","pages":"90"},"PeriodicalIF":2.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020200","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":"Clinical Characteristics of Spinocerebellar Ataxia Type 3 in Uruguay.","authors":"Nicolás Sommaruga, Nicolás Labaure, Andrea Zamora, Santiago Giménez, Gonzalo Pérez-Hornos, Cristina Vázquez","doi":"10.1007/s12311-025-01839-6","DOIUrl":"10.1007/s12311-025-01839-6","url":null,"abstract":"<p><p>Spinocerebellar ataxias (SCAs) are autosomal dominant genetic disorders characterized by progressive cerebellar degeneration and phenotypic variability. MJD/SCA3, the most prevalent form around the world and in Latin America, is also likely the most common hereditary ataxia in Uruguay. Despite its relevance, Uruguay lacks comprehensive epidemiological studies, and molecular diagnostics remain inaccessible in public health systems. This review provides a phenotypic description on genetically confirmed patients with MJD/SCA3 as a first step towards generating knowledge on this matter in our country. A retrospective review of 37 Uruguayan patients with suspected SCA was conducted. Sixteen patients with confirmed molecular diagnosis of MJD/SCA3 were included on this review. Data collected encompassed demographic information, genetic testing results, clinical manifestations, and imaging findings. Patients were evaluated at the Ataxias Polyclinic, Hospital de Clínicas, between 2019 and 2024 by the authors. Statistical analyses were performed using SPSS version 29.0. The mean age of symptom onset was 41.75 years, with gait ataxia as the initial symptom in 87.5% of cases. Clinical findings included appendicular ataxia (100%), dysarthria (90%), and oculomotor alterations (90%), with diverse deep sensitivity impairment in 62.5%. Genetic testing revealed an average of 72.9 CAG repeats in the ATXN3 gene. Cerebellar atrophy was observed in 75% of patients with MRI. Most had a diagnostic delay of 6.5 years and an autosomal dominant family history. Findings align with international descriptions of MJD/SCA3 while highlighting regional characteristics, including a potential genetic link with southern Brazil. The absence of dysautonomia, typically prevalent in MJD/SCA3, suggests underdiagnosis or insufficient evaluation. This study underscores the need for systematic clinical and molecular evaluations in Uruguay and serves as a foundation to understand hereditary ataxias at a national level. Further research is essential for improving diagnosis and management of this complex pathology.</p>","PeriodicalId":50706,"journal":{"name":"Cerebellum","volume":"24 4","pages":"89"},"PeriodicalIF":2.7,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027399","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":"New Perspectives on Non-Invasive Cerebellar Stimulation for Social and Affective Functions in Children and Adolescents.","authors":"Ludovica Pasca, Romina Romaniello, Renato Borgatti, Andrea Ciricugno","doi":"10.1007/s12311-025-01844-9","DOIUrl":"10.1007/s12311-025-01844-9","url":null,"abstract":"<p><p>Cerebellar dysfunction affects socio-affective abilities beyond motor control. Recent studies suggest that non-invasive cerebellar neurostimulation can modulate social cognition networks, offering potential therapeutic benefits for children with autism, ADHD, and mood disorders. However, its application in pediatrics remains largely unexplored. This review summarizes emerging pediatric research on cerebellar transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). We discuss their mechanisms, potential benefits, and safety considerations, highlighting preliminary findings that suggest feasibility and effectiveness. Ethical concerns and technical challenges related to pediatric neuroanatomy and stimulation parameters are also addressed. While early results are promising, further clinical trials and neurophysiological studies are essential to optimize protocols and confirm long-term efficacy. Advancing our understanding of cerebellar involvement in socio-affective functions could lead to innovative rehabilitation strategies for neurodevelopmental disorders.</p>","PeriodicalId":50706,"journal":{"name":"Cerebellum","volume":"24 4","pages":"88"},"PeriodicalIF":2.7,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping Anatomical Landmarks of the Cerebellum Central Core: Enhancing Precision in Surgical Interventions for Cerebellar Lesions.","authors":"Luis Gustavo Biondi-Soares, Richard Gonzalo Párraga, Rene Alejandro Apaza-Tintaya, Lucca B Palavani, Veronica Alzate-Carvajal, Felipe Salvagni, Alexander Feliciano Vilcahuaman Paitán, Gabriel Ataide Monção, Luis Ángel Canache Jiménez, Raphael Wuo-Silva, Feres Chaddad-Neto","doi":"10.1007/s12311-025-01841-y","DOIUrl":"10.1007/s12311-025-01841-y","url":null,"abstract":"<p><p>Similar to the cerebrum, the cerebellum exhibits a central neuronal core region enveloped by a network of white fibers, identified as the central nucleus. The dentate nucleus and the extension of its fibers into the superior cerebellar peduncle play a key role. Understanding this anatomical and functional concept would improve the accuracy of surgical interventions for cerebellar infiltrative lesions. Twenty-two formalin-fixed and frozen human cerebellar and brainstems were stored at -16º C for two weeks, according to the Klingler protocol. Dissection was performed to identify the cerebellar central nucleus and its structures. Images were captured, analyzed, and processed for the distribution of landmarks in each dissection phase. We defined the cerebellar landmarks proximal to the central nucleus. The anatomical division into planes: Superoinferior; we found the superior border of the amygdala and the MCP. Superior: the anterior portion of the horizontal fissure, the MCP, and the origin of the V cranial nerve. Anteroposterior plane: the cerebello-mesencephalic fissure and the postclival fissure. In the medio-lateral plane, we identify the cerebellar vermis's PCS and lateral border. Laterally, the fibers of the MCP and the lateral aspect of the tonsil. The biventral lobule may obscure this landmark, and we consider it an alternative landmark. This study provides reliable anatomical landmarks of the cerebellum, which describe the central cerebellar nucleus. Establishing these landmarks favors three-dimensional knowledge and helps avoid associated neurological damage in this crucial structure.</p>","PeriodicalId":50706,"journal":{"name":"Cerebellum","volume":"24 4","pages":"87"},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020279","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}