Case Reports in Neurological Medicine最新文献

{"title":"Acute Confusional Migraine: Case Reports and Discussion as a Distinct Entity.","authors":"Karen Dos Santos Ferreira, Ana Miriam Velly","doi":"10.1155/crnm/5382669","DOIUrl":"10.1155/crnm/5382669","url":null,"abstract":"<p><p><b>Background:</b> Acute confusional migraine (ACM) is a migraine variant manifesting with confusion, agitation, disorientation, altered mental status, and/or memory deficits. ACM has notably been excluded from the International Classification of Headache Disorders (ICHD-3 β), despite previous literature describing 120 cases and proposing a standardized classification. Considering these findings, clinicians must be aware of this condition as it can be confounded with other serious health conditions (e.g., stroke, encephalitis, and epilepsy). <b>Objective:</b> Herein, we describe three cases with altered consciousness during a migraine attack, discussing diagnostic criteria, treatment, prognostic implications, and future perspectives. <b>Results:</b> The first case, an 18-year-old male, presented to the emergency room with migraine with visual aura, followed by confusion and torpor. After 24 h, he was completely recovered without deficits. In the second case, a 30-year-old woman in puerperium presented with a visual aura followed by headache, confusion, and disorientation. She recovered her conscience without deficits. The third patient, a 36-year-old woman, showed up in the emergency room presenting migraine, hemiplegia, and confusion. She recovered without deficits after 8 days. Finally, the genetic panel confirmed familial hemiplegic migraine (for the third patient). All the tests, including brain computed tomography (CT) scan, angioscan, brain magnetic resonance imaging (MRI), lumbar puncture (LP), and toxicological workup, had normal results for all three patients. They were treated for migraine with long-term control. <b>Conclusion:</b> ACM is a significant condition that can be mistaken for other serious health issues. Health professionals need to be better informed about their diagnosis and management strategies. Therefore, we proposed criteria to include ACM in the ICHD-3 β classification, and we emphasize the need for future studies to improve understanding and treatment of this condition.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"5382669"},"PeriodicalIF":0.9,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12390517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144943216","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":"Administration of Cilostazol Prior to Intravenous Alteplase for Acute Branch Atheromatous Disease: A Report of Three Cases.","authors":"Eijirou Tanaka, Yoshinari Nagakane, Daiki Fukunaga, Daisuke Nakashima, Takehiro Yamada","doi":"10.1155/crnm/3508206","DOIUrl":"10.1155/crnm/3508206","url":null,"abstract":"<p><p>Patients with acute branch atheromatous disease often experience early neurological deterioration (END) in the first 24-h period, even after intravenous alteplase. Three cases treated with cilostazol, a phosphodiesterase 3-inhibitor, prior to intravenous alteplase with the aim of mitigating END are described. All three patients had no bleeding complications and good outcomes at 3 months, although two patients showed END within 24 h after intravenous alteplase.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"3508206"},"PeriodicalIF":0.9,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882275","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":"Symmetric Pseudoathetosis of Hands and Feet: A Rare Manifestation of Subacute Combined Cord Degeneration With Life-Threatening Thromboembolic Risk.","authors":"Ramsha Siddiqui, Johanna Canenguez, Nithisha Thatikonda, Awab Elaneem, Fernandez Jorge Rodriguez","doi":"10.1155/crnm/1862715","DOIUrl":"10.1155/crnm/1862715","url":null,"abstract":"<p><p>Vitamin B12 deficiency can cause subacute combined degeneration (SACD) by disrupting myelin synthesis, leading to spinal cord degeneration. We present a unique case of SACD featuring symmetrical pseudoathetosis characterized by involuntary, slow, and writhing movements resulting from proprioceptive sensory impairment, which disrupts the brain's ability to accurately perceive limb position and movement and pulmonary embolism due to elevated homocysteine levels. A 34-year-old male presented with chest pain, generalized weakness, and numbness in his hands and feet. Two months prior, he experienced sharp chest pain, followed by progressive numbness and weakness in his upper and lower extremities. Neurological examination revealed no nuchal stiffness, normal cranial nerve function, and impaired light touch and vibration sensation in the lower extremities. Tremulousness in the hands and feet, suggestive of pseudoathetosis, had been present for 6 months. Laboratory tests confirmed severe vitamin B12 deficiency (< 159 pg/mL), elevated homocysteine, and pancytopenia. MRI of the spine showed hyperintense signals consistent with SACD, and a chest CT revealed a large saddle pulmonary embolus. Pernicious anemia was confirmed as the cause of vitamin B12 deficiency. The patient was treated with intravenous vitamin B12, leading to significant neurological improvement. This case is the first documented instance of SACD presenting with symmetrical pseudoathetosis in all four extremities. Recognizing this rare clinical sign is essential, as it can guide early diagnosis and treatment. In addition, hyperhomocysteinemia associated with vitamin B12 deficiency is a significant risk factor for thromboembolism, underscoring the need for screening in patients with unexplained thrombotic events.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"1862715"},"PeriodicalIF":0.9,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820673","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":"Bilateral Parsonage-Turner Syndrome in a Patient With Hemophagocytic Lymphohistiocytosis.","authors":"Nader Pahlevan, Delora E Denney, Ezekiel Gonzalez-Fernandez, Oriana Sanchez, Mark Anderson","doi":"10.1155/crnm/6652600","DOIUrl":"10.1155/crnm/6652600","url":null,"abstract":"<p><p><b>Introduction:</b> Parsonage-Turner syndrome (PTS), also known as idiopathic brachial plexopathy, is an uncommon peripheral neuropathy, and the presentation of bilateral PTS is even rarer. Hemophagocytic lymphohistiocytosis (HLH) is a hyperinflammatory disorder that is normally considered hematologic but can involve the nervous system in up to 70% of cases. <b>Case Presentation:</b> A 56-year-old Caucasian female with a history of SLE, rheumatoid arthritis, Sjogren's disease, and Hashimoto's thyroiditis, but no prior neurologic history, was admitted for the management of isolated thrombocytopenia, diagnosed with HLH, and then developed bilateral upper extremity pain, weakness, and numbness. A diagnosis of bilateral PTS was supported by magnetic resonance imaging (MRI) findings of mild symmetric increased enhancement in the bilateral shoulder muscles, and electromyography/nerve conduction study (EMG/NCS) revealed active denervation in the shoulder muscles bilaterally. The patient was started on methylprednisolone 1000 mg for three days, followed by a long steroid taper along with physical/occupational therapy with significant improvement of her symptoms. <b>Conclusion:</b> It is important to maintain a high index of suspicion for PTS in patients with new-onset shoulder or upper arm pain, weakness, and sensory deficits, even if findings are bilateral. Concomitant inflammatory disorders, infection, and recent surgeries/procedures should prompt a high degree of suspicion of this disorder, and the use of relevant diagnostics, such as MRI brachial plexus and EMG/NCS, should help guide diagnosis, as this condition is very responsive to treatment.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"6652600"},"PeriodicalIF":0.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728133","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":"Brainstem Encephalitis as an Atypical Neurologic Complication Following Kikuchi-Fujimoto Disease.","authors":"Youjiang Tan, Tyngyu Chuah","doi":"10.1155/crnm/3086387","DOIUrl":"10.1155/crnm/3086387","url":null,"abstract":"<p><p>We report an uncommon and peculiar case of a patient who developed brainstem encephalitis between three and four months after recovering from an episode of Kikuchi-Fujimoto disease (KFD). She presented acutely with oscillopsia and persistent irrepressible hiccups, for which brainstem stroke was initially suspected. Brain magnetic resonance imaging was negative for ischemic strokes but demonstrated an enhancing T2-hyperintense lesion within the area postrema of the medulla oblongata extending into the upper cervical cord. Workup for infections etiologies and demyelinating disorders of the central nervous system including neuromyelitis optica, multiple sclerosis, and antimyelin oligodendrocyte glycoprotein antibody disease, were unremarkable. Prior to the administration of immunosuppressive treatment, she spontaneously and rapidly recovered, remaining well over a 3-year period of follow-up. We reviewed prevailing scientific literature and identified similar, albeit rare, cases of encephalitis which were attributed to KFD, which we added to our discussion.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"3086387"},"PeriodicalIF":0.9,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12279417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682103","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":"Radial Nerve Palsy as an Iatrogenic Complication of Shoulder Replacement Surgery With Significant Bone Loss of the Humerus Resembling Gorham-Stout Disease: Case Report and Review of the Literature.","authors":"Lisa B E Shields, Vasudeva G Iyer, Yi Ping Zhang, Christopher B Shields","doi":"10.1155/crnm/9969463","DOIUrl":"10.1155/crnm/9969463","url":null,"abstract":"<p><p>Gorham-Stout disease (GSD), also known as vanishing bone disease or massive osteolysis, is a rare entity characterized by destruction of the osseous matrix and proliferation of vascular structures resulting in bone resorption. While neurological complications such as cerebrospinal rhinorrhea secondary to cranial involvement and paraplegia from spinal involvement have been reported, peripheral nerve complications are not known. We describe a case of radial nerve palsy that was an iatrogenic complication of shoulder replacement surgery with bone loss of the humerus resembling GSD. A 71-year-old male with a history of left total shoulder arthroplasty followed by a revision reverse total shoulder arthroplasty noted a \"bone protruding\" and pain in the left upper arm 12 years later. X-rays showed that the proximal portion of the humerus was not detectable. CT scan of the left upper extremity revealed loosening of the humeral component with prominent osteolysis most pronounced around the distal stem. The patient underwent a revision of the reverse total shoulder arthroplasty with replacement of the humeral head and shaft. He experienced numbness, pain, and weakness of the left shoulder and arm with wrist drop postoperatively. Physical exam revealed marked weakness of the dorsiflexors of the wrist and digits, wasting and weakness of the brachioradialis muscle, and loss of pinprick sensation of the superficial radial nerve distribution. Needle EMG showed denervation changes in the extensor digitorum communis, brachioradialis, and extensor carpi radialis longus muscles. An ultrasound (US) study showed enlargement of the left radial nerve at the spiral groove. The EDX and US findings suggested a left radial nerve palsy at the spiral groove. There were minimal EMG abnormalities in the deltoid and triceps muscles suggesting additional involvement of the posterior cord of the brachial plexus. This case illustrates the potential for iatrogenic radial nerve palsy following shoulder replacement surgery with significant bone loss of the humerus resembling GSD.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"9969463"},"PeriodicalIF":0.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504917","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":"Hemichorea Associated With Nigrostriatal Dysfunction: Case Report of a Patient With an Ipsilateral Infarct in the Lenticular Nucleus and Internal Capsule.","authors":"Makoto Kobayashi","doi":"10.1155/crnm/6054686","DOIUrl":"10.1155/crnm/6054686","url":null,"abstract":"<p><p>Hemichorea is a rare manifestation of ischemic stroke whose lesion is typically located in the contralateral basal ganglia. Its pathomechanism has not been elucidated completely; however, it may be related to nigrostriatal dysfunction. In patients with hemichorea, dopamine transporter-single photon emission computed tomography (DAT-SPECT) reportedly displayed decreased tracer accumulation in the contralateral striatum. Moreover, in exceptional cases, responsible lesions were located in the ipsilateral cerebral hemisphere. This case report describes an 84-year-old man who presented with three weeks of intermittent, involuntary, and twisting movements in his right limbs. On physical examination, the patient had right-sided hemichorea without other neurological deficits. The choreic movements were more frequent in the lower limb than in the upper and provoked when he tried to take a certain posture or engaged in mental arithmetic. Magnetic resonance imaging performed on suspicion of stroke detected a right hemispheric subacute infarct in the posterior part of the lenticular nucleus and posterior limb of the internal capsule. Furthermore, DAT-SPECT revealed decreased tracer accumulation in the right striatum. He was administered oral antiplatelet medication after being diagnosed with lacunar infarction. The choreic movements gradually reduced over the next 8 months and eventually disappeared. The lesion in the lenticular nucleus and internal capsule was considered to have induced ipsilesional hemichorea, considering the temporal proximity between the hemichorea and ischemic stroke. Although DAT-SPECT findings in patients with ipsilesional hemichorea have not been reported, this case suggests that nigrostriatal dopamine dysfunction can contribute to the pathogenesis of ipsilesional hemichorea.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"6054686"},"PeriodicalIF":0.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483260","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":"Posterior Reversible Encephalopathy Syndrome Induced by Mirtazapine Overdose: A Case Report.","authors":"Min-Chiao Tsai, Wei-Hao Lin","doi":"10.1155/crnm/4690032","DOIUrl":"10.1155/crnm/4690032","url":null,"abstract":"<p><p><b>Introduction:</b> Posterior reversible encephalopathy syndrome (PRES) is a neurological emergency typically associated with hypertension or drug toxicity. Although mirtazapine is not a classical serotonergic agent, overdose may induce serotonin syndrome, which can contribute to PRES. <b>Case Presentation:</b> A 50-year-old woman presented with seizures, impaired consciousness, and autonomic instability following ingestion of > 300 mg mirtazapine. Magnetic resonance image (MRI) revealed vasogenic edema in the parieto-occipital and frontal lobes. Her clinical features fulfilled the Hunter criteria for serotonin syndrome. Treatment with cyproheptadine led to full clinical and radiological recovery. <b>Discussion:</b> Serotonin syndrome may disrupt cerebral autoregulation and impair endothelial integrity, contributing to PRES. Although rare, similar cases have been reported with other serotonergic agents. This is the first reported case of mirtazapine overdose resulting in serotonin syndrome-associated PRES. <b>Conclusion:</b> Clinicians should recognize that mirtazapine overdose can cause serotonin syndrome and secondary PRES. Early identification and serotonin antagonism are crucial for recovery and prevention of sequelae.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"4690032"},"PeriodicalIF":0.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12165748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301179","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":"Pudendal Nerve Irritation as Unique Symptom of Pelvic Congestion Syndrome.","authors":"Christos Dimopoulos, Sotirios Bisdas, Theodosios Bisdas","doi":"10.1155/crnm/7952359","DOIUrl":"10.1155/crnm/7952359","url":null,"abstract":"<p><p>Pelvic congestion syndrome (PCS) is an underdiagnosed but not rare cause of chronic pelvic pain, affecting approximately 10%-30% of women of reproductive age. It is characterized by venous insufficiency and dilation of the ovarian and pelvic veins, often presenting with symptoms that worsen during menstruation or prolonged standing, and improve in the supine position. Dyspareunia and a sensation of pelvic heaviness are also frequently reported. Neurological manifestations-such as pudendal or femoral nerve irritation-are rare but may offer key diagnostic clues. We present a case of a 30-year-old woman with right-sided pelvic pain radiating to the groin and proximal thigh, consistent with neural irritation. Magnetic neurography revealed dilated pelvic veins in close proximity to the right psoas muscle and the L5 nerve root, suggesting perineural venous engorgement. Selective venography confirmed bilateral ovarian vein insufficiency, and the patient underwent successful embolization with Ruby coils and adjunct sclerotherapy. Postoperative recovery was uneventful, with complete resolution of symptoms. Follow-up at 1 year showed no recurrence, and the patient later achieved a successful pregnancy. This case highlights the potential for pelvic venous congestion to mimic or cause neural symptoms and emphasizes the diagnostic value of magnetic neurography in complex pain presentations. Endovascular treatment proved safe and effective, even in cases with neurological involvement.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"7952359"},"PeriodicalIF":0.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265323","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":"Anti-NMDAR Encephalitis With Serial Negative MRI Findings: An Evaluation Using Autoimmune Psychosis Criteria.","authors":"Satoshi Saito, Go Taniguchi, Chihiro Nakata, Hideo Kato, Mao Otake, Masahiro Umeda, Yuichiro Fuji, Eiji Nakagawa","doi":"10.1155/crnm/4561447","DOIUrl":"10.1155/crnm/4561447","url":null,"abstract":"<p><p>Autoimmune psychosis criteria have been proposed for autoimmune encephalitis with prominent psychiatric symptoms as an alternative to biomarker-based diagnostic approaches such as the Graus criteria. We present a case of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis that was initially misdiagnosed as a psychiatric disorder due to serial negative MRI findings and subsequently re-evaluated correctly using autoimmune psychosis criteria. A 15-year-old male developed sudden-onset generalized convulsive seizures that increased progressively in frequency and fluctuating psychiatric symptoms that gradually worsened to include reduced reactivity, language deterioration, and catatonia. On admission, both brain MRI and cerebral spinal fluid (CSF) findings were unremarkable; however, autoimmune encephalitis was strongly suspected based on autoimmune psychosis criteria and subsequently confirmed by detection of oligoclonal bands (OCBs) and anti-NMDAR antibodies in the serum and CSF. Repeated steroid pulse therapy resulted in significant clinical improvement. The patient met multiple autoimmune psychosis criteria, including subacute onset of psychiatric symptoms, catatonia, disproportionate cognitive dysfunction, decreased level of consciousness, and the emergence of seizures. These features are not typically present in primary psychiatric disorders. Anti-NMDAR encephalitis can present with a variety of symptoms, complicating its differentiation from primary psychiatric conditions. The application of autoimmune psychosis criteria may serve as a valuable diagnostic aid, particularly when MRI findings are repeatedly negative.</p>","PeriodicalId":9615,"journal":{"name":"Case Reports in Neurological Medicine","volume":"2025 ","pages":"4561447"},"PeriodicalIF":0.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265322","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}