Acta neurologica Belgica最新文献

{"title":"Efficacy of aripiprazole and valbenazine in the treatment of tourette syndrome: a systematic review and meta-analysis of randomized controlled trials.","authors":"Muneeb Ahmad Muneer, Ume Habiba, Shajjia Shehzad, Washija Batool, Dawood Shah, Zain Shahzad, Muhammad Khizar Kirmani, Zohaib Hassan Siddiqui, Areeb Amjad, Ameer Hamza, Muhammad Faizan Khan, Fahad Siddique Butt, Syed Tehseen Haider","doi":"10.1007/s13760-025-02864-2","DOIUrl":"https://doi.org/10.1007/s13760-025-02864-2","url":null,"abstract":"<p><strong>Background: </strong>Tourette Syndrome (TS) is a neurodevelopmental disorder characterized by involuntary motor and vocal tics, typically manifesting in childhood. Pharmacological interventions play a crucial role in symptom management, yet the comparative efficacy of the most important agents remain underexplored.</p><p><strong>Objective: </strong>To evaluate and compare the efficacy of aripiprazole and valbenazine in the treatment of TS through a systematic review and meta-analysis of randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, Scopus, and ClinicalTrials.gov was conducted up to March 30, 2025. Eligible RCTs included participants aged 6 to 65 years with a clinical diagnosis of TS, comparing aripiprazole or valbenazine to placebo. The primary outcomes were changes in the Yale Global Tic Severity Scale-Total Tic Score (YGTSS-TTS) and Clinical Global Impression of Tourette Syndrome (CGI-TS). Data were analyzed using random-effects models with assessment of heterogeneity.</p><p><strong>Results: </strong>Eight RCTs involving 626 participants were included. Aripiprazole significantly reduced tic severity (YGTSS-TTS: mean difference [MD] = - 5.96; 95% CI: -9.59 to - 2.33; p < 0.001) and improved global functioning (CGI-TS: MD = - 0.56; 95% CI: -1.10 to - 0.02; p < 0.001), with low heterogeneity. Valbenazine demonstrated a significant trend toward tic reduction (YGTSS-TTS: MD = - 1.93; 95% CI: -2.94 to -0.93; p < 0.001) and significantly improved CGI-TS scores (MD = - 0.36; 95% CI: -0.69 to - 0.02; p < 0.001), though the effects were less pronounced than with aripiprazole.</p><p><strong>Conclusions: </strong>This meta-analysis indicates that aripiprazole is more effective than valbenazine in reducing tic severity and improving overall clinical outcomes in individuals with TS. While both agents demonstrated statistically significant benefits over placebo, aripiprazole yielded a greater magnitude of improvement with consistent results across studies. These findings support the continued use of aripiprazole as a first-line pharmacologic option, while highlighting valbenazine as a potential alternative in select cases. Further high-quality trials are warranted to clarify the role of valbenazine and optimize individualized treatment strategies for TS.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833698","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":"Cerebral tumefactive demyelinating lesions: clinical spectrum, long-term outcomes, and treatment.","authors":"Özgü Kizek, Ahmed Serkan Emekli, Tuncay Gündüz, Murat Kürtüncü, Mefkure Eraksoy","doi":"10.1007/s13760-025-02863-3","DOIUrl":"https://doi.org/10.1007/s13760-025-02863-3","url":null,"abstract":"<p><strong>Background: </strong>Tumefactive demyelinating lesions (TDLs) are tumor-like inflammatory demyelinating lesions that may occur within the spectrum of multiple sclerosis (MS) or other neuroinflammatory conditions. TDLs account for 1.4-8.2% of MS cases. However, information on their clinical course and treatment options is limited.</p><p><strong>Methods: </strong>In this study, the demographic, clinical, radiological characteristics, disease course, and long-term follow-up data of 41 patients diagnosed with tumefactive multiple sclerosis or tumefactive demyelinating lesions were retrospectively evaluated over a 40-year period (1981 to 2021) at a tertiary MS center.</p><p><strong>Results: </strong>The female to male ratio of the cohort was 2.7:1 (30/11). The median age of disease onset was 25 (IQR: 17-37) years, with a median follow-up (first admission to last clinical evaluation) period of 7 (IQR: 5-14) years. According to disease onset characteristics, there were 29 (70.7%) patients with clinically isolated syndrome (CIS) and 12 (29.3%) patients with MS. One patient diagnosed with neuromyelitis optica spectrum disorder and one with myelin oligodendrocyte glycoprotein (MOG) associated disease. Ten (24%) of the patients had pediatric onset (< 16 years of age). The median disease duration (onset of symptoms to last clinical evaluation) of patients with pediatric onset was significantly longer compared to adults (16 vs. 7 years, p = 0.006). A relapsing disease course was observed in 32 (78%) patients, while 8 (20%) patients had a monophasic course, and 1 (2%) patient had transitioned to secondary progressive MS. Although the baseline Expanded Disability Status Scale (EDSS) scores were similar, the median final EDSS scores of patients with monophasic course was significantly lower than those with a relapsing course (1 vs. 2, p = 0.007). The median final EDSS score was 2.0 (1.0-2.7). High-efficacy therapies (fingolimod, natalizumab, cladribine, ocrelizumab, alemtuzumab) were administered to 20 (48.8%) patients, whereas platform therapies (interferon β-1a, interferon β-1b, glatiramer acetate, dimethyl fumarate, teriflunomide) were used in 11 (26.8%) patients. Four (9.8%) patients received no disease-modifying treatment.</p><p><strong>Conclusion: </strong>Our findings demonstrate that TDLs represent a radiological phenotype associated within a spectrum of neuroinflammatory disorders, with MS being the most frequent underlying diagnosis in our cohort. Although their often alarming radiological appearance, the long-term clinical outcomes are generally favorable. Although most commonly associated with MS, diagnostic clarification through MOG IgG and anti-aquaporin-4 IgG antibody testing remains essential. Furthermore, the timely initiation of disease-modifying therapies following acute-phase treatments demonstrates clear benefits in long-term follow-up.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815476","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":"Neurovascular complications in Loeys-Dietz syndrome: a comprehensive systematic review and case report.","authors":"Mohammed Maan Al-Salihi, Maryam Sabah Al-Jebur, Noor Mozahem, Kelly Nicol, Ahmed Abd Elazim, Ali Ayyad, Ram Saha","doi":"10.1007/s13760-025-02872-2","DOIUrl":"https://doi.org/10.1007/s13760-025-02872-2","url":null,"abstract":"<p><strong>Background: </strong>Loeys-Dietz syndrome (LDS) is a rare genetic disorder characterized by profound systemic vascular vulnerability, with complex neurovascular manifestations that remain incompletely understood. This systematic review aimed to comprehensively map the spectrum of neurovascular complications in LDS, synthesize existing literature, identify potential genetic and phenotypic correlations contributing to disease severity, and present our case report to illustrate real-world clinical challenges and management complexities.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Cochrane Library from database inception to March 2025. Studies were systematically screened using predefined inclusion/exclusion criteria. The Joanna Briggs Institute Critical Appraisal Checklists were employed for quality assessment.</p><p><strong>Results: </strong>Twenty-five studies, including 13 retrospective cohort studies and 12 case reports, were ultimately included. The review revealed a significant neurovascular disease burden in LDS. Intracranial aneurysm prevalence ranged from 19.4 to 30%, with an average size of 3.6 mm. Genetic mutations in TGFBR1, TGFBR2, and SMAD3 genes were strongly associated with vascular complications. Arterial dissections were documented in 22.2% of patients, with neurovascular events spanning pediatric to adult populations. Our case report illustrated the syndrome's complex multisystemic manifestations, demonstrating bilateral embolic infarcts with hemorrhagic components.</p><p><strong>Conclusions: </strong>This systematic review provides a comprehensive characterization of neurovascular complications in LDS, emphasizing the critical need for specialized, genetic-specific risk stratification and longitudinal monitoring. The findings underscore the complex relationship between genetic mutations and vascular pathophysiology, highlighting potential molecular intervention strategies.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815477","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":"Seizure self-efficacy and psychosocial outcomes in pediatric epilepsy: a cross-sectional study on quality of life and stigma.","authors":"Unal Akca, Gulfer Akca","doi":"10.1007/s13760-025-02867-z","DOIUrl":"https://doi.org/10.1007/s13760-025-02867-z","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate seizure self-efficacy and its association with perceived stigma and quality of life in children with epilepsy, integrating both child and parent perspectives.</p><p><strong>Methods: </strong>A total of 155 children with epilepsy (aged 9-17 years) and their parents were included in this cross-sectional study. Standardized instruments were used: the Seizure Self-Efficacy Scale for Children (SSES-C), the Pediatric Quality of Life Inventory (PedsQL 4.0), and validated stigma scales for both children and parents. Sociodemographic and clinical variables (e.g., number of antiepileptic drugs, disease duration, parental education, and income) were also recorded and analyzed.</p><p><strong>Results: </strong>Higher self-efficacy scores were significantly associated with improved quality of life and lower stigma perception in both children and parents (p < 0.001). Multivariate regression revealed that self-efficacy positively predicted child-reported quality of life, while perceived stigma had a significant negative effect. Additional findings indicated that polytherapy, longer disease duration, lower parental education, and low household income were related to lower self-efficacy and higher stigma.</p><p><strong>Conclusion: </strong>Seizure self-efficacy is a modifiable psychological factor strongly linked to psychosocial well-being in pediatric epilepsy. The dual-perspective approach adopted in this study provides a more comprehensive understanding of disease burden. Targeted interventions that enhance self-efficacy and reduce stigma may lead to improved quality of life outcomes for both children and their families.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815478","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":"Role of hippocampus in epileptogenesis: new insights in the cross-talks between the underlying mechanisms.","authors":"Mennatullah A M Hussein, Nedaa A Kiwan, Yahya Raafat Aly, Abdelnaser A Badawy, Abdelaziz M Hussein","doi":"10.1007/s13760-025-02857-1","DOIUrl":"https://doi.org/10.1007/s13760-025-02857-1","url":null,"abstract":"<p><p>As a component of the limbic system, the hippocampal region, one of the deep structures of the medial temporal lobe, is a complex structure involved in a wide range of cognitive processes, including declarative memory, spatial memory, and emotional reactions. The subiculum, the dentate gyrus (DG), and the cornu of Ammonis (CA)-which includes the four subfields CA4, CA3, CA2, and CA1-make up the hippocampus. The hippocampus is known to have the lowest seizure threshold. Therefore, the hippocampus is relatively more prone to seizures, and plays a significant role in epilepsy. Also, it has been reported that seizures can result in abnormal hippocampal neurogenesis and malfunctioning circuits that impair hippocampal function. Several mechanisms have been suggested for the process of epileptogenesis including gliosis, neuronal degeneration, neurotransmitter disturbances, channelopathy, neuroinflammations, and axonal plasticity. In this review, we will focus on the role of the hippocampus in the process of epileptogenesis, as well as on the morphological changes in hippocampal structure, neuronal circuits, neurotransmitters and neurosteroids in epilepsy.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811607","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":"Scorpion sting as a trigger factor for stroke: a case report.","authors":"Saliha Yarimoglu, Rafet Yarimoglu, Merve Akgul Gunay, Zeliha Yucel","doi":"10.1007/s13760-025-02862-4","DOIUrl":"https://doi.org/10.1007/s13760-025-02862-4","url":null,"abstract":"","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803247","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":"Tremor, sensory-motor polyneuropathy and cerebral gliosis in klinefelter's syndrome.","authors":"Donato Melchionda, Giovanni Martire, Carlo Avolio","doi":"10.1007/s13760-025-02869-x","DOIUrl":"https://doi.org/10.1007/s13760-025-02869-x","url":null,"abstract":"<p><p>Klinefelter's syndrome (KS) represents one of the most frequent sexual chromosome abnormalities, with an extra-X chromosome added to the normal karyotype (XXY). Clinically, it is characterized by tall body habitus, infertility, gynecomastia, small penis and testes. Neurological involvement is usually present and tremor is frequently described as postural and kinetic tremor that resembles an essential tremor. Polyneuropathy is another neurological problem described in KS. It is an axonal neuropathy with the involvement of sensory-motor fibers. It may represent a complication or alternatively a coexisting morbidity. Cerebral gliosis in magnetic resonance images (MRI) was also described, with lesions in deep white matter (white matter lesions -WMLs). Sexual chromosome alterations with an increased number of chromosomes (XXXY, XXYY, etc.) more often present these MRI abnormalities. We describe three cases of KS patients carrying these alterations: tremor, sensory-motor polyneuropathy and leukoencephalopathy. These three abnormalities should be considered in all patients with KS.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803248","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":"Uncovering the CLCN1 Y150* nonsense variant in myotonia congenita: genetic evidence from segregation analysis.","authors":"Betül Okur Altındaş, Ayse Gul Zamani, Figen Güney, Mahmut Selman Yildirim","doi":"10.1007/s13760-025-02861-5","DOIUrl":"https://doi.org/10.1007/s13760-025-02861-5","url":null,"abstract":"<p><p>Myotonia congenita is a rare genetic disorder characterized by skeletal muscle membrane hyperexcitability due to CLCN1 mutations. It can be inherited in either an autosomal dominant (Thomsen disease) or autosomal recessive (Becker disease) manner. This study describes a homozygous null alteration and its segregation analysis, confirming its pathogenicity. A 30-year-old male, presenting with myotonia since the age of five, was referred to the Medical Genetics clinic. His parents were from the same village, and two of his siblings exhibited similar symptoms. Clinical evaluation was consistent with Becker's myotonia. Next-generation sequencing revealed a homozygous nonsense variant in CLCN1 (NM_000083.2:c.450 C > A, p.Tyr150Ter [Y150*]), which was confirmed by Sanger sequencing in both the proband and his affected brother. This variant has been reported in only five patients. Given that all cases were of Turkish origin and exhibited Becker-type myotonia, our findings support a potential genotype-phenotype association and raise the possibility that this variant may be relatively more prevalent in patients from Türkiye.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803249","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":"Restless legs syndrome and hashimoto's thyroiditis.","authors":"Arif Tolga Sönmez, Hüseyin Demirci","doi":"10.1007/s13760-025-02871-3","DOIUrl":"https://doi.org/10.1007/s13760-025-02871-3","url":null,"abstract":"<p><strong>Background: </strong>It has been hypothesized that an imbalance between thyroid hormones and dopaminergic activity may contribute to the development of Restless legs syndrome (RLS). This study aimed to evaluate the incidence and severity of RLS in patients with Hashimoto's thyroiditis compared to healthy controls, with a focus on the potential impact of thyroid hormone replacement therapy.</p><p><strong>Methods: </strong>A total of 120 consecutive patients, 80 with Hashimoto's thyroiditis (40 untreated, 40 under treatment) and 40 healthy controls, were included in the study. RLS symptoms were assessed based on the International Restless Legs Syndrome Study Group (IRLSSG) diagnostic criteria. Symptom severity was evaluated using the Restless Legs Syndrome Severity Rating Scale (RLS-SRS).</p><p><strong>Results: </strong>RLS symptoms and RLS-SRS scores were significantly higher in patients with Hashimoto's thyroiditis compared to healthy controls (p < 0.01). The untreated group showed a significantly higher RLS incidence and symptom severity than both the treated group and controls (p < 0.001). No significant difference was observed between the treated Hashimoto's group and the control group. Additionally, RLS severity was associated with a longer duration of Hashimoto's disease (p = 0.03).</p><p><strong>Conclusion: </strong>The results of our study suggest that RLS is more prevalent and severe in patients with untreated Hashimoto's thyroiditis. Furthermore, thyroid hormone replacement therapy may have a protective role in reducing both the incidence and severity of RLS in this population.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803246","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":"Cervical vestibular evoked myogenic potentials are not disturbed in hemifacial spasm and blepharospasm.","authors":"Mahmut Tarı, Ceyla Ataç, Ayşın Kısabay Ak, Pınar Ortan, Figen Gökçay, Neşe Çelebisoy","doi":"10.1007/s13760-025-02868-y","DOIUrl":"https://doi.org/10.1007/s13760-025-02868-y","url":null,"abstract":"<p><strong>Introduction: </strong>Hemifacial spasm (HFS) and blepharospasm (BS) are movement disorders involving the facial muscles. HFS is linked to facial nerve, nucleus irritation and BS to basal ganglia dysfunction causing hyperexcitability of brainstem interneurons. Cervical vestibular-evoked myogenic potential (cVEMP) responses demonstrate the saccullocollic reflex. This study aimed to evaluate saccullocollic pathways using the cVEMP test in HFS and BS patients with abnormal brainstem activity.</p><p><strong>Methods: </strong>Our study was conducted between July 2022 and December 2023 at Movement Disorders Outpatient Clinic of Neurology Department, including 54 HFS and 32 BS patients and 50 healthy volunteers. Peak p13 and n23 latencies, peak-to-peak p13-n23 amplitudes, and amplitude asymmetry ratios (AAR) of the responses recorded from the sternocleidomastoid muscle ipsilateral to the stimulated ear was recorded and the results gathered from the patients were compared with the results of the healthy controls. Results of the affected and unaffected sides of the HFS patients were also compared.</p><p><strong>Results: </strong>There was no significant difference regarding age between patient and control groups. The female gender was higher in the BS group. No statistically significant differences were observed in terms of right and left p13 and n23 latencies and p13-n23 amplitude parameters in comparison of the patient groups and healthy controls. Comparison of the affected and unaffected sides of the HFS patients did not reveal a significant difference.</p><p><strong>Conclusions: </strong>This study found no evidence of saccullocollic involvement in HFS and BS patients using the cVEMP test. It is important as a guiding study for future research.</p>","PeriodicalId":7042,"journal":{"name":"Acta neurologica Belgica","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144797937","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}