Neurologia最新文献

{"title":"The discriminative linguistic profiles of progressive supranuclear palsy and Parkinson's disease","authors":"L. Busteed ,&nbsp;A. Horta-Barba ,&nbsp;A. Reig ,&nbsp;C. García-Sánchez ,&nbsp;B. Pascual-Sedano ,&nbsp;I. Gich ,&nbsp;P. Roy Ciffone ,&nbsp;J. Kulisevsky ,&nbsp;J. Pagonabarraga","doi":"10.1016/j.nrleng.2025.08.001","DOIUrl":"10.1016/j.nrleng.2025.08.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Speech and language disturbances are very frequent in progressive supranuclear palsy (PSP). Therefore, they are part of the diagnostic criteria set forth by the International Parkinson and Movement Disorder Society (MDS) for the disease and are considered a core clinical feature. However, more studies are needed to characterize the linguistic profile of PSP, thus being able to assist in the differential diagnosis. Additionally, studies assessing linguistic differences among PSP phenotypes are needed. The objective of this study is to analyze the language alterations presented by patients with PSP, as well as its different phenotypes, and differentiate them from those presented in patients with Parkinson's disease (PD).</div></div><div><h3>Methods</h3><div>An extensive cognitive and linguistic assessment was administered to 13 PSP patients, 19 PD patients and 19 healthy controls (HC) with similar sociodemographic features. Language assessment included evaluation of: syntactic processing, object naming, and phonetic and semantic fluencies. We included a subgroup of 6 PSP patients, 19 PD patients and 19 HC for further analysis of language. This analysis included, in addition to the general evaluation, the assessment of alternating fluency, comprehension, naming, automatic speech, repetition, object recognition, verbal and written instructions, writing to dictation, and oral expression.</div></div><div><h3>Results</h3><div>We found greater impairment on phonetic, semantic, and alternating fluencies, following verbal instructions, repetition, syntactic processing and writing (without phonetic paragraphia) in the PSP group compared to patients with PD and HC. Distinguishing linguistic features of PSP with a less marked reduction than the previously mentioned features were automatic speech, fluency of speech, and naming. Language analysis did not distinguish between PSP phenotypes.</div></div><div><h3>Conclusions</h3><div>Language disturbances distinguish PSP from PD and HC but were not able to discriminate PSP phenotypes.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 830-839"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145435248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychological differential diagnosis of Alzheimer’s disease and Lewy body dementia: A systematic review","authors":"T. Julio-Ramos ,&nbsp;V. Mora-Castelleto ,&nbsp;C. Foncea-González ,&nbsp;C. Adames-Valencia ,&nbsp;I. Cigarroa ,&nbsp;C. Méndez-Orellana ,&nbsp;D. Toloza-Ramirez","doi":"10.1016/j.nrleng.2025.10.001","DOIUrl":"10.1016/j.nrleng.2025.10.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Alzheimer's disease (AD) reports heterogeneity of neuropsychological symptoms misleading the differential diagnosis with other forms of dementia, such as dementia with Lewy bodies (DLB). About 50% of DLB patients are misdiagnosed as AD cases. Likewise, the diagnosis of both diseases is mainly based on clinical characteristics. However, differentiating AD of those with DLB based on neuropsychological symptoms and anatomical and functional brain changes remains challenging.</div></div><div><h3>Aim</h3><div>To establish the main neuropsychological, anatomical, and functional similarities and differences in patients with AD and DLB.</div></div><div><h3>Methods</h3><div>The present study followed the PRISMA guidelines and included studies from the PubMed, Scopus, and Web of Sciences databases, published between January 2000 and July 2022.</div></div><div><h3>Results</h3><div>41 articles were included in this systematic review for critical analysis. Our results suggest that the cognitive key domains to consider in the differential diagnosis are memory, executive function, attention, visuospatial/visuoconstructive skills, and verbal fluency (both semantic and phonological). The stage and severity of both diseases would be essential for differential diagnosis. On the other hand, the anatomical and functional changes suggest a similar atrophy pattern between AD and DLB in the frontal, parietal, temporal, hippocampal, and precuneus regions.</div></div><div><h3>Conclusion</h3><div>The differential diagnosis between AD and DLB is challenging in clinical practice. Therefore, our results suggest exploring cognitive linguistic markers along with correlating these markers with anatomical and functional brain changes.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 884-914"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex dystonia in an adolescent male with a MECP2 variant","authors":"R. Baviera-Muñoz ,&nbsp;T. Jaijo ,&nbsp;M. Campins-Romeu ,&nbsp;I. Martínez-Torres ,&nbsp;I. Sastre-Bataller","doi":"10.1016/j.nrleng.2025.08.004","DOIUrl":"10.1016/j.nrleng.2025.08.004","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 924-925"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145435362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple sclerosis mortality trends by sex in Chile, 1997–2019","authors":"J. Arriagada Opazo ,&nbsp;V. Farah González ,&nbsp;M. González Delgadillo ,&nbsp;L. Núñez-Franz ,&nbsp;C. Morales Garcia ,&nbsp;P. Jiménez Rodríguez","doi":"10.1016/j.nrleng.2025.10.003","DOIUrl":"10.1016/j.nrleng.2025.10.003","url":null,"abstract":"<div><h3>Background</h3><div>An increasing trend has been observed in the prevalence of Multiple Sclerosis (MS) globally. It is estimated that a total of 2.8 million people live with MS worldwide. In 2008, Chile started a pilot program for the Modifying Therapy of MS, and its clinical practice guideline.</div></div><div><h3>Aim</h3><div>This study aims to analyse the trend of the MS mortality rate in Chile from 1997 to 2019 disaggregated by sex and latitude.</div></div><div><h3>Methods</h3><div>MS mortality data (ICD-10, G35) from 1997−2019 were extracted from the Department of Health Statistical Information and population data from the National Institute of Statistics. Standardized mortality rates (SMRs) by age were calculated. The trend of the SMR was analysed using Joinpoint and with RiskDiff the effect of the risk of dying, the structure, and the size of the population on the crude mortality rate was evaluated.</div></div><div><h3>Results</h3><div>The trend of the TME has been decreasing significantly since 2005. When disaggregating by sex the decrease was not significant. According to latitude, the north and center south have a significant decreasing trend; in the south, the decreasing trend is not significant. There is an increase of 25% in the crude mortality rate due to the change in the structure of the population and a decrease of 25.46% is attributed to the risk of dying.</div></div><div><h3>Conclusion</h3><div>The SMR due to MS in Chile during 1997−2019 has decreased, in addition, a decreasing SMR is evidenced only in the northern zone. The crude rate has increased as a consequence of changes in the population, however, the risk of dying has decreased, especially in men.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 840-848"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case series of epilepsy with eyelid myoclonia","authors":"M. Henao-Pérez ,&nbsp;D.C. López-Medina ,&nbsp;A. Arboleda-Ramírez ,&nbsp;N.L. Patiño-Jaramillo ,&nbsp;J.F. Zapata-Berruecos ,&nbsp;R. Andrade","doi":"10.1016/j.nrleng.2025.10.005","DOIUrl":"10.1016/j.nrleng.2025.10.005","url":null,"abstract":"<div><h3>Introduction</h3><div>epilepsy with palpebral myoclonus is an idiopathic generalised childhood epilepsy, which is underdiagnosed because it is confused with tics or behavioral actions. Patients and Methods: quantitative, observational, descriptive of 16 patients with epilepsy and myoclonic eyelids treated at an institution specialised in neurology, between the years 2017 and 2022. Clinical histories and videoelectroencephalograms were evaluated.</div></div><div><h3>Results</h3><div>of 16 patients, 11 were women (68.8%), the median age was 17.5 years (IQR 12.5). The first diagnosis most frequently received by patients was idiopathic generalised epilepsy. Stressful situations were the most reported precipitant. 93.75% of the patients initially presented palpebral myoclonic seizures and after several years presented generalised tonic-clonic seizures. The time elapsed between the first seizure and the diagnosis varied between 1 and more than 40 years, being greater among patients with a subsidised health system. Men had a high frequency of family history of epilepsy in the first and second degrees of consanguinity, had a longer delay in diagnosis and reported greater drug resistance. In both women and men, the posterior regions (occipital, temporoccipital and parietoccipital) presented a greater focal epileptiform activity. The photoparoxysmal response occurred with greater predominance in women, with the Waltz type III and IV responses being the most frequent.</div></div><div><h3>Conclusion</h3><div>the importance of suspecting this pathology before palpebral myoclonus in children should be highlighted, guaranteeing quality and timely management.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 855-863"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary headaches as the reason for consultation in Primary Care: a prospective study","authors":"I. Rivera ,&nbsp;N. Fontanillas ,&nbsp;L. Cadelo ,&nbsp;J. Pascual","doi":"10.1016/j.nrleng.2025.10.004","DOIUrl":"10.1016/j.nrleng.2025.10.004","url":null,"abstract":"<div><h3>Objectives</h3><div>To prospectively study the rate of consultation, diagnoses, burden and historical management patterns of those patients attending due to primary headache in Primary Care.</div></div><div><h3>Patients and methods</h3><div>We included 200 patients with primary headache in a semi-urban Health Center. To study the consultation impact, 100 patients were consecutively recruited in one primary care quota. For every patient we obtained demographic data, comorbidities, rate of consultation, absenteeism, impact in quality of life (MIDAS and HIT-6 scales) and previous patterns of referral and treatment.</div></div><div><h3>Results</h3><div>A total of 2.2% of the demand consultations were due to primary headache. Migraine (60%) was the most frequent reason, followed by tension-type headache (38.5%) and trigeminal autonomic headaches (1.5%). In 58% of cases the diagnosis was incomplete or incorrect. Between 33% (MIDAS) and 50.8% (HIT-6) of cases showed at least a moderate decrease in their quality of life, which was higher for migraine (40.8% and 72.5%, respectively). There was absenteeism in 12% of patients the last year (in 87.5% of cases due to migraine). More than half (58%) of cases had been referred to Neurology and preventive treatments had been initiated in Primary Care in only 5.5% of patients.</div></div><div><h3>Conclusions</h3><div>Primary headaches, and mainly migraine, are a frequent reason for consultation in Primary Care. Even though migraine induces a significant absenteeism and damages quality of life, there is a clear room for improvement in their management. Primary headaches should be included in the health plans of Primary Care.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 849-854"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of autonomic dysfunction in hereditary transthyretin amyloidosis","authors":"F. Martínez-Valle ,&nbsp;C. Casasnovas-Pons ,&nbsp;M. Romero-Acebal ,&nbsp;L. Galán-Dávila","doi":"10.1016/j.nrleng.2025.08.002","DOIUrl":"10.1016/j.nrleng.2025.08.002","url":null,"abstract":"<div><h3>Background</h3><div>Autonomic dysfunction is a common manifestation of hereditary transthyretin (ATTRv) amyloidosis that frequently appears early and has a major impact on disease severity, survival, and quality of life. Early detection of autonomic symptoms is paramount to avoid delayed diagnosis or misdiagnosis of ATTRv amyloidosis and thereby achieve timely interventions with novel therapies. We thus require a better understanding and recognition of the warning signs of autonomic nervous system involvement in patients with ATTRv amyloidosis.</div></div><div><h3>Development</h3><div>According to the literature and the expertise of key opinion leaders on ATTRv amyloidosis, early signs and symptoms of autonomic dysfunction often include orthostatic hypotension, gastrointestinal disturbances, and cardiac and sudomotor sympathetic denervation. Assessment methods for a rapid and accurate diagnostic thus comprise blood pressure monitoring, nutritional status evaluation, cardiac imaging techniques, and pathological and neurophysiological tests assessing small fiber function. The COMPASS-31 and Norfolk QOL-DN tests allow assessment of the severity of autonomic dysfunction and its impact on quality of life, respectively.</div></div><div><h3>Conclusion</h3><div>The screening strategy for autonomic dysfunction should involve diverse neurological and non-neurological tests to encompass the wide variety of potential manifestations of autonomic dysfunction in ATTRv amyloidosis. Further studies addressing the correlations among different tests and their prognostic value in different TTR variants are required to establish a single standardized method or the minimum set of tests needed to assess autonomic dysfunction in ATTRv amyloidosis patients.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 915-923"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145435361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of dehydration on collateral circulation and clinical outcome after endovascular therapy in patients with acute ischemic stroke","authors":"M. Guasch-Jiménez ,&nbsp;P. Camps-Renom ,&nbsp;C. Toscano-Prat ,&nbsp;D. Guisado-Alonso ,&nbsp;A. Martínez-Domeño ,&nbsp;L. Prats-Sánchez ,&nbsp;A. Ramos-Pachón ,&nbsp;I. Fernández-Cadenas ,&nbsp;J.P. Martínez-González ,&nbsp;I. Fernández-Pérez ,&nbsp;C. Avellaneda-Gómez ,&nbsp;E. de Celis-Ruiz ,&nbsp;J. Rodríguez-Pardo ,&nbsp;M. del Mar Freijo ,&nbsp;A. Luna ,&nbsp;F. Moniche ,&nbsp;B. Pardo-Galiana ,&nbsp;J. Ortega-Quintanilla ,&nbsp;J.F. Arenillas ,&nbsp;E. Cortijo ,&nbsp;J. Martí-Fàbregas","doi":"10.1016/j.nrleng.2025.10.007","DOIUrl":"10.1016/j.nrleng.2025.10.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Dehydration in patients with acute ischemic stroke (AIS) is associated with poor outcome. Our aim is to investigate whether dehydration is associated with collateral circulation (CC) and functional outcome in patients with AIS treated with mechanical thrombectomy (MT).</div></div><div><h3>Methods</h3><div>Prospective multicenter study of patients with anterior circulation AIS treated with MT (January 2020–June 2021). Dehydration was assessed with two formulas: plasma osmolarity and urea/creatinine (U/C) ratio. CC was quantified with an automated software (Brainomix Ltd.) on baseline computed tomography angiography. The primary outcome was the association between CC (expressed numerically as the percentage of change between hemispheres) and dehydration (osmolarity ≥ 295 mmol/L, U/C ≥ 80). Secondary outcomes included disability at discharge and at three months of follow-up, assessed using the modified Rankin scale (poor outcome: 3–6). Multivariable logistic and ordinal regression analyses were performed.</div></div><div><h3>Results</h3><div>Two hundred sixty patients were included. 65.8% were dehydrated according to osmolarity and 2.9% according to U/C. There was no association between CC score and dehydration [71% in dehydrated vs 73% in non-dehydrated; <em>P</em> = .875]. 64.3% of dehydrated patients vs. 46.7% of non-dehydrated patients had a poor outcome at discharge (<em>P</em> = .026). In multivariable logistic regression analysis, dehydration was an independent predictor of poor outcome at discharge (OR 2.50; <em>P</em> = .011) and at three months of follow-up (OR 2.27; <em>P</em> = .046).</div></div><div><h3>Conclusions</h3><div>Dehydration on admission is associated with poor outcome in patients with AIS treated with MT, but it is not related to CC.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 9","pages":"Pages 822-829"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sensory neuronopathy in a patient with anti-FGFR3 antibodies and lung adenocarcinoma, coincidence or causality?","authors":"L. Fernández-Llarena,&nbsp;A. Moreno-Estébanez,&nbsp;A. González-Eizaguirre,&nbsp;A. Jauregi-Barrutia","doi":"10.1016/j.nrleng.2025.09.001","DOIUrl":"10.1016/j.nrleng.2025.09.001","url":null,"abstract":"","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 8","pages":"Pages 807-810"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare impact of electroencephalography performed during clinical neurophysiology on-call duty in a third-level hospital","authors":"F. Vázquez-Sánchez ,&nbsp;M.C. Lloria-Gil ,&nbsp;B. García-López ,&nbsp;O. Pérez-Gil ,&nbsp;A. Saponaro-González ,&nbsp;E. Rivas-Navas ,&nbsp;A.I. Gómez-Menéndez","doi":"10.1016/j.nrleng.2025.09.006","DOIUrl":"10.1016/j.nrleng.2025.09.006","url":null,"abstract":"<div><h3>Introduction</h3><div>The electroencephalogram (EEG) is a useful tool in the diagnosis of pathologies such as non-convulsive status epilepticus (NCSE) or brain death (BD), cardiac arrest (CA), and status epilepticus (SE) treatment monitoring. In addition, it provides irreplaceable information depending on the time it is performed, as is the case with the diagnosis of epilepsy after a first epileptic seizure (ES) or to differentiate these from non-epileptic paroxysmal events (NEPE). Its usefulness is maintained outside the usual working day, but it is not available in many centers.</div></div><div><h3>Subjects and methods</h3><div>Retrospective observational study based on the clinical history of 86 patients who underwent an on-call EEG (ocEEG) at our hospital during 2020.</div></div><div><h3>Results</h3><div>One hundred two records requested by Intensive Care (41.1%), Neurology (37.3%), Pediatrics (17.6%) or other services (4%) were made. Suspected NCSE represented 56.7%, followed by treatment monitoring in EE (21.6%). The ME accounted for only 6.9% of the total. The ocEEG avoided potential iatrogenesis in a 56.3% of cases with therapeutic implications, allowed to treat 27.58% of patients who would have remained without treatment until the conventional EEG. An increase in the level of care was required in only 22,2% of all cases. The ocEEG was anticipated a mean of 31.6 hours to the next conventional EEG that would have been available.</div></div><div><h3>Conclusions</h3><div>The availability of ocEEG is beneficial in terms of diagnosis, therapy, and hospital management, advancing decision-making and avoiding iatrogenesis. Its availability should become widespread.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"40 8","pages":"Pages 746-752"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}