Dystonia最新文献

{"title":"Validation of a torsinA cerebellar knockdown model of DYT1 dystonia.","authors":"Yuning Liu, Hong Xing, Fumiaki Yokoi, Ariel Luz Walker, Duo Chen, Edgardo Rodriguez-Lebron, Yuqing Li","doi":"10.3389/dyst.2026.14631","DOIUrl":"10.3389/dyst.2026.14631","url":null,"abstract":"<p><p>Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both. DYT1 dystonia is an early-onset dystonia caused by <i>DYT1/TOR1A</i> gene mutations with reduced penetrance. It is believed that dystonia is produced by abnormal brain networks, but details remain unknown. Recent studies have shown that acute cerebellar knockdown of torsinA using small hairpin RNAs (shRNAs) can induce overt dystonia in adult mice. However, shRNAs have off-target effects that may alter the expression of unintended genes. To avoid this issue, we generated an alternate acute torsinA knockdown model using cre-loxP technology by injecting AAV-<i>cre</i> into the cerebellum of the <i>Dyt1</i> ^{<i>loxP/loxP</i>} mouse. These knockdown mice exhibited overt dystonia and displayed a spinning behavior, characterized by bidirectional circling or spinning during tail suspension. The overt dystonia and spin behavior were not observed in control mice injected with the AAV-GFP virus. Additionally, the knockdown mice showed decreased spontaneous firing and reduced intrinsic excitability of Purkinje cells. These findings confirmed that the acute cerebellar knockdown of torsinA can produce overt dystonia and further support the cerebellum's role in the pathogenesis of DYT1 dystonia. However, the emergence of a spinning phenotype raises questions about the validity of the acute knockdown models as accurate representations of human dystonia.</p>","PeriodicalId":72853,"journal":{"name":"Dystonia","volume":"5 ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13186440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebellar motor and non-motor contributions to dystonia pathophysiology and treatment.","authors":"Linda H Kim, Cheryl Brandenburg, Roy V Sillitoe","doi":"10.3389/dyst.2026.15082","DOIUrl":"10.3389/dyst.2026.15082","url":null,"abstract":"<p><p>Dystonia is a complex neurological disorder characterized by sustained or intermittent abnormal movements and/or postures. However, dystonia's non-motor symptoms, particularly the sleep disturbances, are critical yet underexplored concerns that affect all ages. Here, we synthesize current knowledge on the motor and non-motor domains of dystonia, emphasizing the functional interconnections and plasticity within cerebellar motor, cognitive, and sleep-associated circuits to motivate more comprehensive and effective treatments that improve overall quality of life.</p>","PeriodicalId":72853,"journal":{"name":"Dystonia","volume":"5 ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13465952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148723028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Neck: Long-Term Motor and Non-motor Outcomes of Pallidal DBS in Craniocervical Dystonia.","authors":"Matthew Remz, Pamela Zeilman, Samyukta Senthil, Rohini Kumar, Isabelle Gerzenshtein, Hikaru Kamo, Aparna Wagle Shukla","doi":"10.3389/dyst.2026.16756","DOIUrl":"10.3389/dyst.2026.16756","url":null,"abstract":"<p><p>Pallidal deep brain stimulation (DBS) is effective for treating cranial or craniocervical dystonia, a disorder characterized by abnormal facial expressions, impaired eyelid opening, speech and chewing difficulties, and abnormal head posture, leading to physical disability and functional impairment. However, long-term data on motor, non-motor, and quality-of-life outcomes remain limited with less robust available data than cervical dystonia. In 19 patients with craniocervical dystonia, the Unified Dystonia Rating Scale (UDRS) scores improved by 34.5% at 3-6 months, 51.0% at 1-2 years, 33.3% at 3-5 years, and 43.4% at the most recent follow-up (median of individual improvements). Body region analysis showed that the proportion of patients classified as DBS responders, defined by a ≥ 25-30% improvement in UDRS scores, ranged from 31.2% to 43.8% at 3-6 months, increasing to a range of 50% to 83.3% by the 6-9-year follow-up. Alongside motor improvements, trends in depression and social quality-of-life domain improvements were noted with more robust changes likely limited by sample size and the lack of disease specific metrics. Longer therapy duration appeared to enhance the magnitude of gains. Overall, pallidal DBS improves motor function and daily activities in craniocervical dystonia, with durable and potentially progressive long-term benefits.</p>","PeriodicalId":72853,"journal":{"name":"Dystonia","volume":"5 ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13618971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing vocal changes through spectral analyses of vocalizations in a cerebellar-specific dystonia mouse model.","authors":"Austin L Fitzgerald, Jonathan A Coello, Alyssa M Lyon, Breanne L Dao, Meike E van der Heijden","doi":"10.3389/dyst.2026.15530","DOIUrl":"10.3389/dyst.2026.15530","url":null,"abstract":"<p><p>Vocal impairments are a debilitating but understudied feature of several dystonias, including generalized and early-onset genetic forms. Despite growing recognition that cerebellar dysfunction contributes to dystonic pathophysiology, the circuit mechanisms underlying vocal-motor abnormalities remain poorly understood, and effective treatments remain limited, in part due to the lack of a preclinical model that captures specific vocal features. Our experiment evaluates ultrasonic vocalizations (USVs) in <i>Ptf1a</i> ^<i>Cre/+</i> <i>;Vglut2</i> ^<i>fl/fl</i> mice, a cerebellum-specific generalized dystonia model, to assess cerebellar contributions to phonation and explore translational relevance for vocal features. At postnatal day 9, dystonic mice demonstrated statistically significant reductions in total USV count, relative count of complex calls, and key spectral parameters-especially frequency modulation and power-mirroring general phonatory abnormalities seen in dystonia. Cluster analyses further revealed impaired vocal burst initiation, suggesting disrupted cerebellar coordination of temporal vocal-motor output. These findings support the model's construct and face validity for studying cerebellar mechanisms of vocal impairment. By identifying quantifiable acoustic disruptions, our study establishes a foundational platform for future circuit-targeted investigations of vocal-motor dysfunction in dystonia.</p>","PeriodicalId":72853,"journal":{"name":"Dystonia","volume":"5 ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13256318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain localization and response to botulinum toxin in cervical dystonia.","authors":"Alexander S Wang, Hanieh Agharazi, Aetan Parmar, Camilla W Kilbane, Lauren Cameron, Aasef G Shaikh, Steven A Gunzler","doi":"10.3389/dyst.2025.14652","DOIUrl":"10.3389/dyst.2025.14652","url":null,"abstract":"<p><strong>Introduction: </strong>Pain is a common symptom of cervical dystonia (CD). The mainstay of treatment of CD is botulinum toxin, which is known to have benefits in relieving pain. We aimed to characterize the locations of pain in patients with CD, and to assess what factors may predict pain reduction following botulinum toxin injection.</p><p><strong>Methods: </strong>We conducted a single-center observational study of CD patients who reported pain and who received botulinum toxin treatment. On the day of their toxin injection (in the untreated state), they filled out a survey evaluating primary and secondary sites of pain as indicated on a diagram, as well as Pain Numeric Rating Scale assessing average pain over the past 24 h. Two weeks later, they filled out a follow-up survey (in the treated state) to evaluate whether location and pain intensity changed.</p><p><strong>Results: </strong>55 people with CD participated in the study, and 40 of them completed both surveys. Most patients reported pain localization over the posterior musculature, especially in the areas overlying superior trapezius and levator scapulae. 21 of 40 (52.5%) patients reported improvement of pain intensity by ≥ 30% in the primary site of pain. The mean improvement in pain intensity was 30.4% (SD = 32.4%), with a mean improvement on Numeric Rating Scale of 2.13 (SD = 2.02). 68% of patients received injections into or close to their primary site of pain. Using univariate linear regression, there was no clear effect of age, sex, muscles injected, or TWSTRS motor subscale on the degree of pain improvement. The locations of pain remained relatively stable in the post-treatment state.</p><p><strong>Conclusion: </strong>We confirmed that botulinum toxin is effective for treatment of pain related to CD. We also gained insight into the typical locations of pain in CD by generating a heat map, showing pain most often in the regions of upper trapezius, levator scapulae, and splenius cervicus and capitis. Although there was not a significant correlation between the site of botulinum toxin injection and pain improvement, larger studies are needed to better determine optimal treatment strategies.</p>","PeriodicalId":72853,"journal":{"name":"Dystonia","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Dystonia and tremor.","authors":"Pattamon Panyakaew, Aparna Wagle Shukla","doi":"10.3389/dyst.2025.14589","DOIUrl":"10.3389/dyst.2025.14589","url":null,"abstract":"","PeriodicalId":72853,"journal":{"name":"Dystonia","volume":"4 ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain network pathophysiology in dystonia.","authors":"David A Peterson, Myungjoo Kim, Robert Chen, David Eidelberg, Cecile Gallea, Andreas G Horn, Stephane Lehericy, Anthony R McIntosh, Joel S Perlmutter, Anna Sadnicka, Terrence D Sanger, Emiliano Santarnecchi, Philip A Starr, Jan K Teller, Mark Hallett, Kristina Simonyan","doi":"10.3389/dyst.2025.15446","DOIUrl":"10.3389/dyst.2025.15446","url":null,"abstract":"<p><p>Dystonia is increasingly recognized as a disorder of brain networks. This review integrates multimodal evidence from human studies to characterize the network-level pathophysiology of dystonia. Structural MRI studies using voxel-based morphometry and diffusion imaging reveal alterations in gray matter volume and white matter connectivity across the sensorimotor cortex, basal ganglia, cerebellum, and thalamus. Functional imaging modalities, including PET, fMRI, EEG, MEG, and fNIRS, demonstrate aberrant activity and connectivity in cortico-striato-pallido-thalamocortical and cerebello-thalamocortical loops. Invasive electrophysiological recordings from deep brain stimulation (DBS) provide high-resolution insights into abnormal oscillatory activity and effective connectivity within these circuits. Non-invasive brain stimulation (NIBS) techniques such as TMS, TES, and TUS provide a means of actively interrogating those networks through transient perturbation. They also provide an avenue for personalized neuromodulation. Computational models, including The Virtual Brain platform, enable integration of multimodal data to simulate dynamic network behavior. Across focal, generalized, and genetic forms of dystonia, shared patterns of network dysfunction are observed, though phenotypic and genotypic subtypes exhibit distinct topographies and circuit-level alterations. These findings underscore the importance of network dysfunction underlying dystonia. This network perspective informs the development of more targeted and individualized diagnostic and therapeutic approaches, including circuit-guided neuromodulation and closed-loop brain stimulation. Advancing multimodal and integrative methodologies will be essential to unraveling the complex dynamics underlying dystonia and translating mechanistic insights into precision interventions.</p>","PeriodicalId":72853,"journal":{"name":"Dystonia","volume":"4 ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13348815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subtle changes in Purkinje cell firing in Purkinje cell-specific <i>Dyt1 ΔGAG</i> knock-in mice.","authors":"Hong Xing, Pallavi Girdhar, Yuning Liu, Fumiaki Yokoi, David E Vaillancourt, Yuqing Li","doi":"10.3389/dyst.2025.14148","DOIUrl":"10.3389/dyst.2025.14148","url":null,"abstract":"<p><p>DYT1 dystonia is an inherited early-onset generalized dystonia characterized by sustained muscle contractions causing abnormal, repetitive movements or postures. Most DYT1 patients have a heterozygous trinucleotide GAG deletion (<i>ΔGAG</i>) in <i>DYT1/TOR1A</i>, coding for torsinA. <i>Dyt1</i> heterozygous ΔGAG knock-in (KI) mice or global KI mice show motor deficits and abnormal Purkinje cell firing. However, Purkinje cell-specific heterozygous ΔGAG conditional KI mice (Pcp2-KI) show improved motor performance, reduced sensory-evoked brain activation in the striatum and midbrain, and reduced functional connectivity of the striatum with the anterior medulla. Whether Pcp2-KI mice show similar abnormal Purkinje cell firing as the global KI mice, suggesting a cell-autonomous effect causes the abnormal Purkinje cell firing in the global KI mice, is unknown. We used acute cerebellar slice recording in Pcp2-KI mice to address this issue. The Pcp2-KI mice exhibited no changes in spontaneous firing and intrinsic excitability compared to the control mice. While membrane properties were largely unchanged, the resting membrane potential was slightly hyperpolarized, which was associated with decreased baseline excitability. Our results suggest that the abnormal Purkinje cell firing in the global KI mice was not cell-autonomous and was caused by physiological changes elsewhere in the brain circuits. Our results also contribute to the ongoing research of how basal ganglia and cerebellum interact to influence motor control in normal states and movement disorders.</p>","PeriodicalId":72853,"journal":{"name":"Dystonia","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social determinants of health and health-related quality of life in individuals with isolated dystonia.","authors":"Caroline Nelson, Christopher D Stephen, Ellen B Penney, Hang Lee, Elyse R Park, Nutan Sharma, Marisela E Dy-Hollins","doi":"10.3389/dyst.2025.13711","DOIUrl":"10.3389/dyst.2025.13711","url":null,"abstract":"<p><strong>Background and objectives: </strong>Dystonia is the third most common movement disorder. Motor and non-motor manifestations of dystonia may impact Health Related Quality of Life (HRQoL), with lower HRQoL scores compared to the healthy population. People with generalized dystonia report worse HRQoL scores (vs. people with focal distributions). Social determinants of health (SDOH) may play a role in HRQoL outcomes in dystonia, but scant data exists. We aimed to examine differences in HRQoL scores in people with focal vs. non-focal (e.g., segmental, multifocal, generalized) dystonia and the association with SDOH.</p><p><strong>Methods: </strong>129 participants with isolated dystonia, who were recruited through Mass General Brigham movement disorders clinic and enrolled in the Dystonia Partners Research Bank, completed a follow-up survey on SDOH and HRQoL: Quality of Life in Neurological Disorders Version 2.0 Short Form (Neuro- QoL-SF) and the EuroGroup 5-level (Euro-QoL). Linear regression analyses were performed.</p><p><strong>Results: </strong>Participants with isolated dystonia were predominantly female (72.1%), non-Hispanic white (79.8%), and highly educated (79.8%; ≥ bachelor's degree). 71.3% of the participants had focal dystonia and 28.7% of the participants had non-focal dystonia. Participants with focal dystonia (vs. non-focal dystonia) reported older age at diagnosis (49.2 ± 11.7 vs. 40.6 ± 19.2, p = 0.004). Participants with focal dystonia (vs. non-focal dystonia) reported higher (i.e., better) overall health scores (80.4 ± 13.9 vs. 72.8 ± 13.5, p = 0.005), higher ability to participate in social activities (51.3 ± 7.7 vs. 47.2 ± 6.0, p = 0.003), lower fatigue (44.7 ± 8.4 vs. 49.8 ± 7.2, p = 0.001), and lower sleep disturbance (48.0 ± 8.2 vs. 53.0 ± 7.9, p = 0.002). Independent predictors of higher overall health ratings included focal distribution of dystonia (b = 7.5; p = 0.01), a higher level of education (b = 9.2; p = 0.04) and not having a mental health diagnosis (b = 7.5; p = 0.01).</p><p><strong>Conclusion: </strong>Participants with focal dystonia were diagnosed later and had higher (i.e., better) HRQoL measures vs. participants with non-focal dystonia. Predictors of better HRQoL were having focal dystonia and higher level of education, whereas the presence of a mental health diagnosis was associated with lower HRQoL (i.e., worse) scores. SDOH such as employment status, medical literacy, and ability to afford basic needs may influence HRQoL ratings for participants with isolated dystonia. Our findings may not be generalizable to the general population of patients with isolated dystonia. We highlight areas for further research and development.</p>","PeriodicalId":72853,"journal":{"name":"Dystonia","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12393166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurorehabilitation in Dystonia Care: Key Questions of Who Benefits, What Modalities, and When to Intervene.","authors":"Hikaru Kamo, Koichi Nagaki, Alison R Kraus, Lisa Warren, Aparna Wagle Shukla","doi":"10.3389/dyst.2025.14695","DOIUrl":"https://doi.org/10.3389/dyst.2025.14695","url":null,"abstract":"<p><p>Dystonia causes involuntary, patterned movements and posturing, often leading to disability, pain, and reduced quality-of-life. Despite standard treatments such as botulinum toxin (BoNT) injections, oral medications, and deep brain stimulation therapy, many patients continue to experience persistent symptoms. There is growing evidence supporting the use of rehabilitation-based therapies in the management of certain forms of dystonia. This review summarizes the current body of evidence, which primarily focuses on cervical dystonia (CD) and task-specific dystonia (TSD). The greatest therapeutic potential appears to lie in using these interventions as adjuncts to BoNT therapy. In CD, physical therapy has shown effectiveness when aimed at reducing overactivity in the affected neck muscles through techniques such as stretching, massage, and biofeedback. Concurrently, strengthening the opposing muscle groups helps promote improved posture, reduce pain, and enhance range of motion. In TSD, many studies applied splinting of unaffected body parts (sensory-motor retuning) to encourage adaptive retraining of affected body parts (principles of constraint-induced movement therapy), or alternatively restricting movements of affected body parts to promote sensory reorganization. Although there is high risk of bias, neuroplasticity-based strategies like motor and sensorimotor training appear to be promising for TSD. Use of kinesiotaping, vibrotactile stimulation, TENS, and orthotics can help modify movement patterns, while biofeedback can reinforce and sustain motor control improvements. Emerging evidence for functional dystonia supports the role of multimodal approach, combining PT with cognitive behavioral therapy or mind-body strategies. The focus is movement retraining to shift attention away from abnormal movements and restore confidence in normal movement to improve outcomes. Regardless of dystonia type, individualized therapy plans are essential. Home-based exercises play a critical role in maintaining the gains achieved during supervised sessions, supporting ongoing progress, and preventing regression.</p>","PeriodicalId":72853,"journal":{"name":"Dystonia","volume":"4 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144981022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}