Biological Psychiatry最新文献

{"title":"Lower Muscarinic M₁ Receptor Availability in Schizophrenia: In Vivo Positron Emission Tomography Evidence.","authors":"Tommaso Volpi, Rajiv Radhakrishnan, Rachel Hird, Mika Naganawa, Nabeel Nabulsi, Soheila Najafzadeh, Swanee Jacutin-Porte, David Labaree, Richard E Carson, Yiyun Huang, Deepak C D'Souza","doi":"10.1016/j.biopsych.2026.06.002","DOIUrl":"10.1016/j.biopsych.2026.06.002","url":null,"abstract":"<p><strong>Background: </strong>There is growing interest in the contributions of brain muscarinic M₁ receptors to the neurobiology of schizophrenia (SZ). Postmortem evidence strongly indicates M₁ deficits in patients with SZ. Recently, the U.S. Food and Drug Administration approved xanomeline and trospium chloride, which contains the M₁/M₄ agonist xanomeline, as the first nondopaminergic medication for SZ. The development of the positron emission tomography ligand ¹¹C-LSN3172176 enables in vivo quantification of brain M₁ availability in SZ and its relationship to clinical features.</p><p><strong>Methods: </strong>M₁ availability in patients with SZ (n = 16) was compared with age- and sex-matched healthy control (HC) participants (n = 16) using ¹¹C-LSN3172176 and high-resolution research tomography. Distribution volume ratio relative to the centrum semiovale (DVR_CS) and distribution volume (V_T) were measured. Regional variation in percent gray matter fraction was included as a covariate to account for potential atrophy.</p><p><strong>Results: </strong>Compared with HCs, patients with SZ showed significantly lower M₁ availability across several cortical and subcortical regions, with large effect sizes: frontal (DVR_CS: -13%), temporal (DVR_CS: -15%, V_T: -12%), parietal (DVR_CS: -14%, V_T: -11%), and occipital (DVR_CS: -16%, V_T: -13%) cortices; caudate (DVR_CS: -19%, V_T: -15%); putamen (DVR_CS: -19%, V_T: -17%); hippocampus (DVR_CS: -13%); and amygdala (DVR_CS: -19%, V_T: -16%). A subgroup of patients (DVR_CS: 44%, V_T: 27%) showed larger whole-brain M₁ deficits (>20% from the mean of HCs). Exploratory analyses suggested associations between M₁ availability and selected clinical measures.</p><p><strong>Conclusions: </strong>Together with postmortem data, these in vivo findings warrant further characterization of M₁ deficits in SZ and highlight M₁ as a therapeutic target and potential biomarker for muscarinic-based treatments.</p>","PeriodicalId":8918,"journal":{"name":"Biological Psychiatry","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13507943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148238719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing Clinical Translational Research for Profound Autism.","authors":"Matthew W State, Robert C Malenka","doi":"10.1016/j.biopsych.2026.05.020","DOIUrl":"10.1016/j.biopsych.2026.05.020","url":null,"abstract":"","PeriodicalId":8918,"journal":{"name":"Biological Psychiatry","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148194374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focused Ultrasound Ablation for Psychiatric Disorders.","authors":"Kristiana Xhima, Benjamin Davidson, Jennifer Rabin, Rahat Hossain, Margaret Anne Richter, Sean Nestor, Clement Hamani, Peter Giacobbe, Nir Lipsman","doi":"10.1016/j.biopsych.2026.05.018","DOIUrl":"10.1016/j.biopsych.2026.05.018","url":null,"abstract":"<p><p>Modern circuit-based neurosurgical interventions address a critical unmet need for patients with treatment-resistant psychiatric illness. Magnetic resonance-guided high-intensity focused ultrasound (HIFU) enables incisionless, millimeter-precision thermoablation via staged sonications with real-time monitoring, reshaping the risk-benefit profile of traditional neurosurgical interventions for psychiatric disorders. Here, we review the clinical evidence for HIFU ablation and contrast it with alternative platforms, including radiofrequency ablation, radiosurgery, laser interstitial thermal therapy, and deep brain stimulation. Early-phase clinical trials with long-term follow-up have demonstrated that HIFU ablation produces clinically meaningful symptom reduction and sustained quality of life improvements in severe treatment-resistant obsessive-compulsive disorder and major depressive disorder, with a favorable safety profile and stable neurocognitive performance. Current challenges include patient-specific skull characteristics that can constrain transcranial energy delivery and limit lesion creation. Clinical outcomes are heterogeneous, and the field lacks both treatment predictors and consensus on optimal lesion morphology. Tractography-informed targeting, functional network mapping, and electrophysiologic signatures represent converging approaches to further optimize circuit engagement. Key questions remain about treatment durability, retreatment strategies, and integration into longitudinal psychiatric care pathways alongside psychotherapy, pharmacotherapy, and other neuromodulation therapies. A translational roadmap should prioritize multicenter trials, standardized reporting of lesion metrics, and international registries. Promising directions include strategic use of low-intensity focused ultrasound to probe circuit responsiveness prior to ablation and the use of microbubble-mediated ablation to overcome limitations of skull penetration. Moving forward, systems-level frameworks for patient-centered outcomes, equitable access, and ongoing trials will define the potential of HIFU treatments to meet broader psychiatric care needs.</p>","PeriodicalId":8918,"journal":{"name":"Biological Psychiatry","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major Depressive Disorder From a Brain-Body Perspective: Reproducible Central Cardiac Interoception Deficits and Peripheral Autonomic Dysfunctions Dissociate.","authors":"Hongliang Zhou, Yucheng Yuan, Jing Zhang, Yuqing Wu, Hui Deng, Yaqing Wang, Xuezheng Gao, Xiaohong Liu, Xinyu Wang, Danting Yang, Yu Li, Luoan Wu, Zhenhe Zhou, Wenhao Jiang, Yonggui Yuan, Chenguang Jiang","doi":"10.1016/j.biopsych.2026.05.015","DOIUrl":"10.1016/j.biopsych.2026.05.015","url":null,"abstract":"<p><strong>Introduction: </strong>Brain-heart interaction (BHI) offers a systems-level framework for understanding major depressive disorder (MDD), but reproducible cross-system markers remain unclear. We aimed to identify reproducible BHI impairments in MDD and clarify their physiological and clinical correlates.</p><p><strong>Methods: </strong>In this cross-sectional electroencephalography-electrocardiography study, we analyzed 3 independent resting-state datasets (total N = 693) and an acute stress dataset (n = 140) under strict medication control. BHI was assessed across cardiac (heart rate [HR], RR intervals), autonomic (heart rate variability [HRV]: root mean square of successive differences [RMSSD], pNN50, SD1, low-to-high frequency power ratio, etc.), and cortical (heartbeat-evoked potential [HEP]) domains.</p><p><strong>Results: </strong>MDD cases consistently showed elevated HR, reduced vagal HRV, and attenuated HEP amplitude at the left centroparietal region (pooled Cohen's d [95% CI] for HEP = -0.35 [-0.51 to -0.20], p = 4.3 × 10^-6, I² = 0%). Under acute stress, peripheral indices were responsive whereas the central HEP marker remained stable. Only pNN50 exhibited a significant group × condition interaction, indicating blunted vagal reactivity in MDD. The central BHI marker (HEP) was linked to fatigue, hopelessness, and concentration deficits across somatic, affective, and cognitive domains, whereas peripheral indices showed domain-specific associations with sleep disturbance and psychomotor retardation. Antidepressant dose correlated with RMSSD.</p><p><strong>Conclusions: </strong>We identified a reproducible central-peripheral BHI impairment model in MDD, suggesting partially distinct pathophysiological contributions of central and peripheral features. This model challenges the view that BHI abnormalities in MDD reflect a unitary hierarchical mechanism and provides a stratified framework that supports conceptualizing MDD as a brain-body disorder.</p>","PeriodicalId":8918,"journal":{"name":"Biological Psychiatry","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148100951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting Mu Opioid Receptor Neurons of the Habenula to Limit Naloxone Aversion.","authors":"Dersu Ozdemir, Chiara Ebner, Judith Meyer, Florian Pons, Cedric Champagnol-Di Liberti, Isabella Guimaraes-Olmo, Md Toufiqur Rahman, Ann M Decker, Olivia Wendling, Eric Schwartz, Sylvie Dumas, Aliza T Ehrlich, Gilles Laverny, Marco A Diana, Chunyang Jin, Brigitte L Kieffer, Emmanuel Darcq","doi":"10.1016/j.biopsych.2026.05.014","DOIUrl":"10.1016/j.biopsych.2026.05.014","url":null,"abstract":"<p><strong>Background: </strong>Opioid use disorder is a chronic relapsing condition that continues to rise worldwide. Naloxone, an opioid antagonist, reverses overdose but triggers strong negative affect. The neuronal circuits underlying these aversive effects remain unclear. We previously identified mu opioid receptor-expressing habenular neurons (Hb-MOR) as key encoders of negative emotional states and hypothesized that they also mediate naloxone aversion.</p><p><strong>Methods: </strong>We combined behavioral models of naloxone aversion with in vivo fiber photometry to monitor Hb-MOR activity in opioid-naïve and -dependent mice. Causality was tested through chemogenetic silencing of Hb-MOR neurons. Finally, we targeted GPR139, an anti-opioid orphan receptor enriched in the habenula, to pharmacologically modulate naloxone responses.</p><p><strong>Results: </strong>In opioid-naïve mice, high-dose naloxone induced conditioned place aversion (CPA) and increased Hb-MOR neuron activity, both of which were prevented by chemogenetic inhibition. In dependent animals, low-dose naloxone was sufficient to activate Hb-MOR neurons and produce CPA. Silencing Hb-MOR neurons abolished these effects and alleviated somatic withdrawal signs, indicating enhanced sensitivity of these neurons in dependence. Targeting GPR139 provided a therapeutic approach: The GPR139 antagonist JD-1 reduced Hb-MOR responses to naloxone and attenuated both somatic and affective withdrawal symptoms in morphine-dependent mice.</p><p><strong>Conclusions: </strong>Hb-MOR neurons are key to naloxone-induced aversion and withdrawal. Pharmacological modulation of GPR139 represents a promising strategy to limit adverse effects associated with naloxone and opioid withdrawal.</p>","PeriodicalId":8918,"journal":{"name":"Biological Psychiatry","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148100994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focused Ultrasound Neuromodulation for Substance Use Disorder.","authors":"James J Mahoney Iii, Daisy G Y Thompson-Lake, Lucas Johnson, Nassima Ait-Daoud, Wendy J Lynch, Greatness Olaitan, Victor Finomore, Manish Ranjan, Tasneem Arsiwala, Ali Rezai","doi":"10.1016/j.biopsych.2026.05.012","DOIUrl":"10.1016/j.biopsych.2026.05.012","url":null,"abstract":"<p><p>Given the prevalence of substance use disorder (SUD), elevated overdose death rates, and limited approved pharmacotherapies for SUD, new treatment approaches are necessary. Neuromodulation is a potential adjunctive treatment for SUD to reduce substance use and risk factors associated with drug use recurrence, such as craving. One form of neuromodulation, focused ultrasound (FUS), has significant potential given that it is noninvasive and capable of precisely targeting subcortical structures implicated in the brain's reward circuity. Both preclinical and clinical findings support FUS as a treatment for SUD, and several ongoing or planned studies are investigating its utility further. Preclinical studies using both FUS neuromodulation and blood-brain barrier opening approaches have demonstrated that FUS reduces drug-associated reward and behaviors by modulating critical components of the reward neurocircuitry. Key preclinical evidence suggests sex differences in these modulation mechanisms. Clinical findings suggest that FUS can reduce craving and use for several substances and improve emotional/behavioral symptoms, but these findings should be interpreted with caution given the open-label design and very limited number of treated cases. Given this, sham-controlled trials in larger cohorts are necessary before any conclusions can be drawn. Expanding research to incorporate a broader range of substances and brain targets while systematically refining FUS parameters is essential to fully realize the therapeutic potential of FUS as a treatment for SUD.</p>","PeriodicalId":8918,"journal":{"name":"Biological Psychiatry","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Marmoset Models for the Study of Autism Spectrum Disorder.","authors":"William Menegas, Qiangge Zhang, Guoping Feng","doi":"10.1016/j.biopsych.2026.05.013","DOIUrl":"10.1016/j.biopsych.2026.05.013","url":null,"abstract":"","PeriodicalId":8918,"journal":{"name":"Biological Psychiatry","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2026-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric Risk Implications From Behavioral and Neural Effects of Adolescent Exposure to Environmental Insecticides: A Systematic Review of Rodent Studies.","authors":"Michelle X Chen, Benjamin Hing, Robert J Taylor, Hanna E Stevens","doi":"10.1016/j.biopsych.2026.05.003","DOIUrl":"10.1016/j.biopsych.2026.05.003","url":null,"abstract":"<p><p>Adolescence is a sensitive neurodevelopmental period marked by remodeling of brain circuits that support cognitive development and emotion and behavior regulation. These maturation processes heighten psychiatric vulnerability to environmental exposures, including to toxicants such as insecticides. Epidemiological studies show widespread adolescent insecticide exposure and increasingly link this to psychiatric outcomes, but underlying neural mechanisms remain poorly understood. Preclinical studies can clarify these associations and identify insecticide-induced mechanisms that may disrupt neurodevelopment and produce consequent long-term behavioral outcomes. Here, we performed a systematic review of rodent studies following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Fifty articles met inclusion criteria, examining neurotoxic outcomes following insecticide exposure during early (juvenile), middle, and late adolescent ages (postnatal days 21-60). Outcomes were categorized into 4 domains: neurocognitive, neuropsychiatric, neurobiological, and general neurotoxicity. Risk of bias was assessed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) Risk of Bias tool. Across studies, adolescent insecticide exposure led to learning and memory impairments and tended to increase depression-relevant behaviors, alter locomotor activity, and produce general neurotoxic effects. Mechanistic findings highlighted disruptions in cholinergic and monoaminergic signaling, oxidative stress, neuroimmune changes, and cell death and other neurodegenerative processes. Together, the findings indicate that adolescent insecticide exposure disrupts multiple neural systems, with behavioral consequences relevant to adolescent development and psychiatric risk. Future research should model real-world exposures (e.g., dose, timing) to better inform translational understanding of adolescent psychiatric vulnerability. Because many life-long neuropsychiatric disorders emerge during adolescence, identifying how modifiable environmental exposures shape risk offers an opportunity for prevention and intervention strategies to alter the course of disease across the lifespan.</p>","PeriodicalId":8918,"journal":{"name":"Biological Psychiatry","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13216887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Theta Burst Stimulation Improves Long-Term Outcomes in Alcohol Use Disorder by Modulating a Craving-Related Dynamic Network.","authors":"Liang-Jie-Cheng Huang, Ning-Ning Zeng, Jing-Nan Zhao, Zhou-Kang Wu, Ying-Ying Li, Tian-Zhen Chen, Lei Guo, Wen-Wen Shen, Hui Zheng, Jian-Zhong Di, Jun Yin, Min Wang","doi":"10.1016/j.biopsych.2026.05.004","DOIUrl":"10.1016/j.biopsych.2026.05.004","url":null,"abstract":"<p><strong>Background: </strong>Alcohol use disorder (AUD) is a chronic relapsing disorder characterized by craving. While continuous theta burst stimulation (cTBS) shows promise for AUD, its long-term effects on drinking reduction and underlying mechanisms remain unclear. We evaluated the 12-month efficacy of right dorsolateral prefrontal cortex (DLPFC) cTBS for reducing alcohol consumption and identified associated neural and molecular mechanisms.</p><p><strong>Methods: </strong>Fifty-five patients with alcohol dependence were randomized to receive 20 sessions of active cTBS targeting the right DLPFC or sham cTBS over 2 weeks. Clinical outcomes were evaluated through 5 follow-up assessments over a 12-month period. A functional magnetic resonance imaging cue-reactivity task was used to investigate craving-related neuroplasticity.</p><p><strong>Results: </strong>Compared with a sham treatment, active cTBS significantly reduced the risk of returning to baseline or higher drinking over 12 months (hazard ratio = 0.488, 95% CI [0.245-0.971]). At the conclusion of treatment, significant group × time interactions were observed for both the Alcohol Use Disorders Identification Test and subjective craving scores. We identified a craving-related network characterized by hyperconnectivity between frontoparietal and subcortical networks alongside hypoconnectivity between visual and ventral attention systems. Network weight changes correlated with immediate and long-term clinical improvements. Transcriptome association analysis revealed that this network's spatial pattern was linked to genes enriched for synaptic transmission and myelination.</p><p><strong>Conclusions: </strong>This study provides evidence for the long-term clinical efficacy of cTBS in reducing drinking among individuals with AUD. The identified multiscale biomarker offers new insights into the hierarchical mechanisms by which cTBS achieves this efficacy, highlighting its potential as a circuit-based therapy for addiction.</p>","PeriodicalId":8918,"journal":{"name":"Biological Psychiatry","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focused Ultrasound Ablation for Neurological Disorders.","authors":"Haiden S Berton, Haden D Ray, Nicole Silva, Varina L Boerwinkle, Paul Dayton, Daniel Roque, Vibhor Krishna","doi":"10.1016/j.biopsych.2026.04.027","DOIUrl":"10.1016/j.biopsych.2026.04.027","url":null,"abstract":"<p><p>Focused ultrasound (FUS) was explored for neurological indications more than half a century ago, but only recent technological advances have enabled its practical transcranial use for movement and neuropsychiatric disorders. FUS can produce stereotactic thermal lesions via FUS ablation (FUSA), while nonthermal lesioning (e.g., FUS histotripsy) and nonablative approaches such as neuromodulation and blood-brain barrier opening are under active clinical investigation. FUSA is approved by the Food and Drug Administration for essential tremor and Parkinson's disease (PD) and is now being evaluated for additional syndromes, including epilepsy, dystonia, and treatment-resistant psychiatric disorders. Neuroimaging, particularly magnetic resonance (MR) imaging and MR thermometry, is central to feasibility, targeting, intraprocedural monitoring, and posttreatment assessment. Clinical studies demonstrate substantial and durable motor symptom reduction in essential tremor and PD, with growing evidence for emerging indications. The goal of this review was to integrate mechanistic concepts with the current clinical evidence for FUSA and to define priorities that can improve patient selection, optimize targeting, and guide expansion across neurological and neuropsychiatric disorders.</p>","PeriodicalId":8918,"journal":{"name":"Biological Psychiatry","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147866634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}