{"title":"Electroconvulsive Therapy and Clozapine Augmentation in an Older Adult With Bipolar Disorder With Psychotic Features: Case Report.","authors":"Natalie Lomayesva, Ethan Solomon, Chanae Hardamon, Lucy Lan, Parnika Saxena","doi":"10.1097/YCT.0000000000001105","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001105","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of EctPub Date : 2025-01-07DOI: 10.1097/YCT.0000000000001102
Ana S Iltis, Brian J Basden, William V McCall, Peter B Rosenquist, Sandarsh Surya
{"title":"Letter to the Editor: ECT and Forensic Psychiatry.","authors":"Ana S Iltis, Brian J Basden, William V McCall, Peter B Rosenquist, Sandarsh Surya","doi":"10.1097/YCT.0000000000001102","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001102","url":null,"abstract":"","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Plasma microRNA Levels After Electroconvulsive Therapy in Treatment-Resistant Depressed Patients.","authors":"Chiara Galbiati, Vincenzo Dattilo, Marco Bortolomasi, Erika Vitali, Maria Abate, Valentina Menesello, Mattia Meattini, Rosana Carvalho Silva, Massimo Gennarelli, Luisella Bocchio Chiavetto, Alessandra Minelli","doi":"10.1097/YCT.0000000000001100","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001100","url":null,"abstract":"<p><strong>Objectives: </strong>Electroconvulsive therapy (ECT) is one of the most effective treatments for treatment-resistant depression (TRD), even though the molecular mechanisms underlying its efficacy remain largely unclear. This study aimed, for the first time, to analyze plasma levels of miRNAs, key regulators of gene expression, in TRD patients undergoing ECT to investigate potential changes during treatment and their associations with symptom improvement.</p><p><strong>Methods: </strong>The study involved 27 TRD patients who underwent ECT. Plasma samples were collected at baseline (T0) and 1 month after the last ECT session (T1), and miRNA analysis was conducted by qRT-PCR. We also performed gene prediction of miRNAs differentially expressed and KEGG pathway analysis.</p><p><strong>Results: </strong>miR-95-3p, miR-194-5p, miR-324-3p, miR-195-5p, miR-19b-3p, miR-30c-5p, let-7i-5p, and miR-497-5p were nominally downregulated at T1. Changes in miR-324-3p and miR-30c-5p levels between T0 and T1 significantly correlated with symptom improvement. Among the predicted miRNA target genes of these 2 miRNAs, we noticed the presence of VEGF and SIRT1, whose expression regulation has been associated with the ECT mechanism of action in previous studies.</p><p><strong>Conclusions: </strong>The study's most relevant results are related to the correlation between reductions in miR-30c-5p and miR-324-3p and the improvement of symptoms in response to ECT, positioning these miRNAs as promising candidates for further studies. These findings support and extend previous clinical and preclinical research indicating a role of miRNAs in ECT mechanism of action. However, no significant effects in ECT miRNA modulation were observed, highlighting the need for future replications in broader samples to confirm these results.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of EctPub Date : 2024-12-24DOI: 10.1097/YCT.0000000000001092
Maria Francesca Beatino, Francesco Weiss, Samuele Torrigiani, Valerio Caruso, Camilla Elefante, Pierpaolo Medda, Giulio Emilio Brancati, Giulio Perugi
{"title":"Autoimmune Encephalitis in Catatonic and Treatment-Resistant Psychotic Patients Referred to Electroconvulsive Therapy: Two Case Reports and Systematic Review.","authors":"Maria Francesca Beatino, Francesco Weiss, Samuele Torrigiani, Valerio Caruso, Camilla Elefante, Pierpaolo Medda, Giulio Emilio Brancati, Giulio Perugi","doi":"10.1097/YCT.0000000000001092","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001092","url":null,"abstract":"<p><strong>Abstract: </strong>Autoimmune encephalitis (AE) tends to manifest as a mixture of neuropsychiatric and somatic symptoms, either of which may predominate, and often shows a progressive clinical course sometimes leading to life-threatening conditions. Catatonic and psychotic syndromes, regardless of whether associated with dysautonomia, are common manifestations of AE, especially concerning the anti-NMDAR subtype. Several autoantibodies targeting different neuronal epitopes have been linked to specific clinical manifestations and their detection is embedded in some of the diagnostic criteria for AE. Therapeutical management of AE is challenged by limited diagnostic abilities and poor understanding of the underlying pathophysiology for most of its subtypes. Although the prompt delivery of disease-modifying therapies represents the cornerstone of treatment and primarily affects prognosis, less is known about the role of symptom specific supportive measures like electroconvulsive therapy (ECT). Based on a systematic review of 26 patient-level descriptions of individuals, each with a diagnosis of AE treated with ECT, a favorable clinical response was found in more than ¾ of the revised cases (76.9%). The most common indications for ECT administration were catatonic and psychotic syndromes, often nonresponsive to prior pharmacotherapy with benzodiazepines, antipsychotic, and other psychotropic drugs. Noteworthy side effects were only reported for 3 of 26 patients. Though the low number of cases and publication bias should be considered as major limitations, current available reports are in support of the inclusion of ECT in the integrated therapeutic algorithm of AE to address psychiatric conditions such as severe psychosis and catatonia.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of EctPub Date : 2024-12-24DOI: 10.1097/YCT.0000000000001101
Birong Chen, Yuqian Fu, Ziqiang Li, Xiaowei Tan, Juanjuan Li, Manoza Michaela Herrera, Doris Sok Hian Koh, Phern Chern Tor
{"title":"Use of Electroconvulsive Therapy Treatment in Adolescents in Singapore.","authors":"Birong Chen, Yuqian Fu, Ziqiang Li, Xiaowei Tan, Juanjuan Li, Manoza Michaela Herrera, Doris Sok Hian Koh, Phern Chern Tor","doi":"10.1097/YCT.0000000000001101","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001101","url":null,"abstract":"<p><strong>Background: </strong>Electroconvulsive therapy (ECT) is a highly effective treatment for schizophrenia and mood disorders; however, most evidence is derived from the adult population, with less evidence in adolescents. We sought to determine the use of ECT in adolescents in the Institute of Mental Health (IMH) and evaluate the treatment outcome.</p><p><strong>Methods: </strong>We conducted a retrospective naturalistic analysis of ECT registry data of patients aged from 10 to 19 years from March 2017 to March 2023. Descriptive analysis was used to analyze the demographics and clinical characteristics. Paired t tests were used to compare the change in clinical outcome scores, including the Brief Psychiatric Rating Scale (BPRS), Montgomery-Asberg Depression Rating Scale (MADRS), Clinical Global Impressions Scale - Severity (CGI-S), and Montreal Cognitive Assessment (MoCA) before and after 2 weeks of ECT treatment.</p><p><strong>Results: </strong>Fifty-five patients were included for analysis. There was a significant improvement in BPRS (P < 0.001), MADRS (P = 0.005), and CGI-S (P < 0.001), and the average CGI-I score was 2.275 (SD, 0.81), which is equivalent to \"much improved\" after 6 sessions of treatment. Of all patients, 48.5% showed significant clinical improvement. There was no significant change in MoCA scores (P = 0.218).</p><p><strong>Conclusions: </strong>Our preliminary findings show that ECT is a safe, rapid, and effective treatment for psychotic and mood disorders in adolescents. Further studies with a larger sample size and specific subgroup analysis are needed to establish the effectiveness of ECT and identify predictors of response in this population.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of EctPub Date : 2024-12-24DOI: 10.1097/YCT.0000000000001087
Devika Chauhan, Abhishek Ghosh, Shalini S Naik, Devender K Rana, Shubh Mohan Singh
{"title":"Acceptability, Feasibility, and Effectiveness of Concurrent High-Definition Transcranial Direct Current Stimulation and Cue Exposure in Cannabis Use Disorder: A Pilot Double-Blind Randomized Controlled Trial.","authors":"Devika Chauhan, Abhishek Ghosh, Shalini S Naik, Devender K Rana, Shubh Mohan Singh","doi":"10.1097/YCT.0000000000001087","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001087","url":null,"abstract":"<p><strong>Objectives: </strong>We studied the acceptability, feasibility, tolerability, and preliminary effectiveness of combined cue exposure and anodal high-definition transcranial direct current stimulation (HD-tDCS) on the right dorsolateral prefrontal cortex (DLPFC) on cannabis craving in cannabis use disorder (CUD).</p><p><strong>Methods: </strong>We randomly assigned 48 participants equally in 4 groups: A, tDCS and cannabis cue exposure; B, tDCS and neutral image; C, sham tDCS and cue exposure; and D, sham tDCS and neutral image. The images were validated by Delphi consensus. All participants received 6 sessions. We explored the acceptance, protocol completion, and follow-up rates. We assessed cannabis cravings twice, at the end of sessions and 4 weeks after intervention; change in frequency and amount of cannabis and other substance use were assessed at 4 weeks after intervention; working memory and executive functions were tested at the end of sessions. We performed an intention-to-treat analysis.</p><p><strong>Results: </strong>We observed low acceptance (19.6%) but high completion (91.7%) and follow-up rates. There were motivational and logistical reasons for low acceptance; monetary compensation improved treatment acceptance. Participants in all groups showed significant reductions in cannabis cravings at the end of sessions, except for group C, the reduction in cravings sustained at the follow-up. Frequency and amount of cannabis use reduced, and cognitive outcomes improved in all 4 groups; however, there was no between-group difference, and changes were higher in groups B and D. Adverse effects and attrition were not different between HD-tDCS and sham treatment.</p><p><strong>Conclusions: </strong>Anodal right DLPFC HD-tDCS is a safe and promising treatment for CUD. Cue exposure does not add to its effect.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of EctPub Date : 2024-12-17DOI: 10.1097/YCT.0000000000001095
Angela Dylewski, Amanda C Holder, Jamie N Brown
{"title":"Use of Cholinesterase Inhibitors for Treatment and Prevention of Cognitive Adverse Effects of Electroconvulsive Therapy: A Systematic Review.","authors":"Angela Dylewski, Amanda C Holder, Jamie N Brown","doi":"10.1097/YCT.0000000000001095","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001095","url":null,"abstract":"<p><strong>Abstract: </strong>Although electroconvulsive therapy (ECT) is effective for treating depression, schizophrenia, and mania, cognitive adverse effects may limit use. One possible mechanism for these effects includes cholinergic transmission alterations, supporting potential use of cholinesterase inhibitors for prevention and treatment of these cognitive deficits. The objective of this review is to determine efficacy and safety of cholinesterase inhibitors clinically used for dementia in reducing ECT cognitive adverse effects. PubMed, EMBASE, and CENTRAL were searched in August 2024 for randomized controlled trials using terms and keywords related to cholinesterase inhibitors (acetylcholinesterase inhibitor, cholinesterase inhibitor, donepezil, galantamine, or rivastigmine) and ECT (electroconvulsive therapy, electroconvulsive, electroshock therapy, or ECT). A total of 8 randomized controlled trials were reviewed with mean patient ages ranging from 28.6 to 59.33 years and most common diagnoses including depressive disorders, schizophrenia/psychosis, and bipolar disorder. Six of the 8 trials showed benefits of using cholinesterase inhibitors in patients undergoing ECT. Significant improvements were found in immediate memory after ECT and recovery of personal memory, repetition, alertness, orientation, and impersonal memory compared with placebo. Trials varied in cognitive assessment scales, length of therapy, dosing strategy, ECT schedule, and ECT type/parameters. Cholinesterase inhibitors may be effective for reducing cognitive adverse effects of ECT and appear safe and well tolerated. The most commonly studied medication was donepezil 5 mg daily started shortly before and continued throughout ECT. Additional studies are needed to clarify optimal dosing, titration, duration of therapy, and the role of treatment for older adults, preexisting cognitive impairment, and neurologic comorbidities.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of EctPub Date : 2024-12-17DOI: 10.1097/YCT.0000000000001097
Kaissar Sassi, Etienne Bechet, Louise Martin, Manuel Pichon, Antoine Yrondi, Vincent Minville
{"title":"Investigating Anxiety's Impact on Seizure Quality in Electroconvulsive Therapy: A Prospective Observational Study.","authors":"Kaissar Sassi, Etienne Bechet, Louise Martin, Manuel Pichon, Antoine Yrondi, Vincent Minville","doi":"10.1097/YCT.0000000000001097","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001097","url":null,"abstract":"<p><strong>Background: </strong>Electroconvulsive therapy (ECT) is a medical procedure for treating severe depression and other mental health disorders, with anesthesia management being crucial for patient safety. Despite extensive research on factors influencing seizure quality during ECT, the impact of pre-ECT anxiety remains insufficiently explored.</p><p><strong>Methods: </strong>This prospective observational study aimed to investigate the influence of pre-ECT anxiety, as measured by the Amsterdam Preoperative Anxiety and Information Scale, on electroencephalogram ictal characteristics during ECT and to explore anesthesia-related factors that may enhance seizure quality.</p><p><strong>Results: </strong>A total of 38 patients participated in 168 documented ECT sessions over a 2-month period. Data analysis revealed a significant association between higher levels of pre-ECT anxiety, lidocaine doses exceeding 0.36 mg/kg, and decreased seizure quality during ECT sessions.</p><p><strong>Conclusion: </strong>These findings suggest an association between pre-ECT anxiety, lidocaine dosage, and decreased seizure quality during ECT. Further research, including interventional studies, is required to better understand the causal factors.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of EctPub Date : 2024-12-17DOI: 10.1097/YCT.0000000000001094
Maarten Laroy, Koen Van Laere, Mathieu Vandenbulcke, Louise Emsell, Filip Bouckaert
{"title":"Molecular Positron Emission Tomography and Single-Photon Emission Computed Tomography Imaging for Understanding the Neurobiological Mechanisms of Electroconvulsive Therapy: A Scoping Review.","authors":"Maarten Laroy, Koen Van Laere, Mathieu Vandenbulcke, Louise Emsell, Filip Bouckaert","doi":"10.1097/YCT.0000000000001094","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001094","url":null,"abstract":"<p><strong>Abstract: </strong>Electroconvulsive therapy (ECT) effectively treats severe psychiatric disorders such as depression, mania, catatonia, and schizophrenia. Although its exact mechanism remains unclear, ECT is thought to induce neurochemical and neuroendocrine changes. Positron emission tomography (PET) and single-photon emission computed tomography (SPECT) have provided vital insights into ECT's neurobiological effects. This scoping review investigates the role of molecular imaging in understanding these effects. A systematic search across PubMed, EMBASE, Web of Science, Cochrane, and Scopus databases yielded 857 unique records, from which 45 peer-reviewed articles in English with longitudinal PET or SPECT measures in ECT patients were included. The review identifies 2 main research directions: ECT's impact on brain activity and neurotransmitters. Initial research assessed regional cerebral blood flow and regional glucose metabolism during ictal (during ECT), postictal (within 24 hours), short-term (within a week), and long-term (beyond a week) follow-up as markers of brain activity. Initial findings showed an anterior-posterior regional cerebral blood flow gradient during the ictal phase, with subsequent normalization of hypoperfusion in frontal and parietal regions, and persistent long-term effects. Later, research shifted to the monoamine hypothesis of depression, examining ECT's impact on serotonin and dopamine systems via PET imaging. Results on receptor availability post-ECT were mixed, showing both reductions and no significant changes, indicating variable effects. This scoping review further highlights the need to explore new targets, tailor methodologies for patient populations, and foster multicenter studies. Although SPECT has been valuable, advances in PET imaging now make it preferable, offering unparalleled insights into ECT's molecular and neurobiological mechanisms.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Journal of EctPub Date : 2024-12-10DOI: 10.1097/YCT.0000000000001079
Alistair Carroll, Caroline D Rae, Donel Martin, Socrates Dokos, Colleen Loo
{"title":"The Effect of Cranial Sutures Should Be Considered in Transcranial Electrical Stimulation.","authors":"Alistair Carroll, Caroline D Rae, Donel Martin, Socrates Dokos, Colleen Loo","doi":"10.1097/YCT.0000000000001079","DOIUrl":"https://doi.org/10.1097/YCT.0000000000001079","url":null,"abstract":"<p><strong>Background: </strong>Computational modeling is used to optimize transcranial electrical stimulation (tES) approaches, and the precision of these models is dependent on their anatomical accuracy. We are unaware of any computational modeling of tES that has included cranial sutures.</p><p><strong>Objectives: </strong>The aims of the study were to review the literature on the timing of closure of the coronal and squamous sutures, which are situated under electrode placements used in tES; to review the literature regarding differences in skull and suture conductivity and to determine a more accurate conductivity for sutures; and to identify magnetic resonance image (MRI) techniques that could be used to detect cranial sutures.</p><p><strong>Methods: </strong>A scoping review of medical literature was conducted. We conducted computational modeling of a cranial bone plug using COMSOL Multiphysics finite element software, utilizing methodology and results from a previous study. We assessed use of the \"3D Slicer\" software to identify sutures in routine T1-weighted MRI scans.</p><p><strong>Results: </strong>Reports from forensic examinations and computed tomography (CT) scans showed suture closure does not correlate with age. Our computational modeling determined a cranial suture conductivity of 0.32 S/m, which is much higher than for skull (compact skull 0.004 S/m, standard trilayer 0.013 S/m). 3D slicer enabled rapid and precise identification of the anatomy and location of cranial sutures.</p><p><strong>Conclusions: </strong>Cranial sutures persist throughout the lifespan and have a far higher conductivity than skull bone. Cranial sutures can be localized quickly and precisely using a combination of MRI and readily available modeling software. Sutures should be included in tES computational modeling and electroencephalography source imaging to improve the accuracy of results.</p>","PeriodicalId":54844,"journal":{"name":"Journal of Ect","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}