Neuromuscular Disorders最新文献

{"title":"Longitudinal assessment of respiratory status utilising the amended Great Ormond Street Respiratory Score in treated spinal muscular atrophy type 1 children","authors":"Lisa Edel ,&nbsp;Georgia Stimpson ,&nbsp;Vasileios Patelis ,&nbsp;Elaine Chan ,&nbsp;Mariacristina Scoto ,&nbsp;Francesco Muntoni ,&nbsp;Giovanni Baranello","doi":"10.1016/j.nmd.2026.106368","DOIUrl":"10.1016/j.nmd.2026.106368","url":null,"abstract":"<div><div>Spinal muscular atrophy type 1 phenotypes have changed since the introduction of disease modifying therapies. The Great Ormond Respiratory Score has been used to assess respiratory function in children with spinal muscular atrophy. This paper presents an updated version of the score and aims to describe preliminary data reviewing the two-year changes of respiratory status in a cohort of spinal muscular atrophy type 1 patients treated with monotherapy or sequential disease modifying treatments. Patients were assessed using the amended Great Ormond Respiratory score at baseline, 6 months, 12 months and 24 months. 59 patients were reviewed. In total, 32 first initiated nusinersen therapy, 16 first initiated onasemnogene abeparvovec and 11 first initiated risdiplam therapy. There was a significant difference in baseline Great Ormond Respiratory Score between the nusinersen group and the onasemnogene abeparvovec group (<em>p</em> = 0.002). Risdiplam data is limited and is identified as preliminary. The data identifies treatment prior to 6 weeks of age stabilise at a lower score, with this being impacted by age of treatment. Those treated after one year show worse scores but stabilise. Despite the switching between disease modifying treatments, the Great Ormond Respiratory Score is a useful and easy-to-use clinical outcome measure which can demonstrate change in respiratory status over longitudinal review.</div></div>","PeriodicalId":19135,"journal":{"name":"Neuromuscular Disorders","volume":"61 ","pages":"Article 106368"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of tamoxifen in patients with duchenne muscular dystrophy: open label extension of TAMDMD trial","authors":"Gaëtan Zwingli ,&nbsp;Niveditha Putananickal ,&nbsp;Simone Schmidt ,&nbsp;Sara Nagy ,&nbsp;Daniela Rubino–Nacht ,&nbsp;Sabine Schaedelin ,&nbsp;Helge Amthor ,&nbsp;Anne–Marie Childs ,&nbsp;Nicolas Deconinck ,&nbsp;Iain Horrocks ,&nbsp;Saskia Houwen–van Opstal ,&nbsp;Vincent Laugel ,&nbsp;Mercedes Lopez Lobato ,&nbsp;Andrés Nascimento Osorio ,&nbsp;Ulrike Schara–Schmidt ,&nbsp;Stefan Spinty ,&nbsp;Arpad von Moers ,&nbsp;Fiona Lawrence ,&nbsp;Patricia Hafner ,&nbsp;Olivier M. Dorchies ,&nbsp;Bettina C. Henzi","doi":"10.1016/j.nmd.2026.106366","DOIUrl":"10.1016/j.nmd.2026.106366","url":null,"abstract":"<div><div>Safety and efficacy of tamoxifen in boys with Duchenne muscular dystrophy was assessed in the double-blind, randomised, placebo-controlled, multicenter phase 3 trial (TAMDMD), which was followed by an 48 weeks open label extension study. The aim of the open label extension study was to investigate if earlier initiation of tamoxifen could reduce the progression of the disease compared to delayed initiation of tamoxifen. Of the initial TAMDMD trial participants, 66 patients were enrolled in the open label extension (OLE). The objective was to investigate the efficacy of prolonged treatment with tamoxifen 20 mg daily, adjunct to corticosteroids, in individuals with DMD over 48 weeks. We aimed to analyse the sustained effect and the timing effect of tamoxifen in patients with DMD on the basis of a set of motor function tests. The sustained effect corresponds to the treatment effect seen in the tamoxifen treatment arm of the RCT phase of the trial being sustained after all patients got the treatment in the OLE phase. The timing effect addresses if patients with earlier tamoxifen initiation show more favourable disease trajectory than patients with delayed tamoxifen initiation. This study was registered with ClinicalTrials.gov (NCT03354039). Between May 28th 2019 and July 28th 2021, 66 patients in 10 study centres in seven European countries could be enrolled into the OLE phase. Of those, 32 had previously been treated with tamoxifen and 34 had been assigned to placebo. The efficacy outcome defined as the change in the motor function did not differ significantly between the early tamoxifen treatment group and the delayed tamoxifen treatment group. There was neither a sustained nor a timing effect of tamoxifen. Overall tamoxifen was well tolerated. No deaths or life-threatening serious adverse events occurred. The OLE phase of the TAMDMD trial showed that treatment with tamoxifen continued to be well tolerated overall; however, there was neither a sustained nor a timing effect of tamoxifen treatment in patients with DMD. We cannot provide statistical nor clinical evidence that prolonged treatment with tamoxifen is effective in delaying disease progression in DMD when used as an adjunct to corticosteroids.</div></div>","PeriodicalId":19135,"journal":{"name":"Neuromuscular Disorders","volume":"61 ","pages":"Article 106366"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146172993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence on ‘Cardiac MRI for early detection of subclinical cardiac dysfunction in dysferlinopathy’ by Thomas et al.","authors":"Holly Borland,&nbsp;John Bourke,&nbsp;Volker Straub","doi":"10.1016/j.nmd.2026.106357","DOIUrl":"10.1016/j.nmd.2026.106357","url":null,"abstract":"","PeriodicalId":19135,"journal":{"name":"Neuromuscular Disorders","volume":"61 ","pages":"Article 106357"},"PeriodicalIF":2.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-onset facioscapulohumeral muscular dystrophy defines a distinct clinical subgroup.","authors":"Giulia Tammam, Sandra Dhifallah, Hongmei Yang, Manuela Gambella, Jonathan Pini, Russell J Butterfield, Elena Carraro, Katy Eichinger, Bakri Elsheikh, Nicholas E Johnson, Doris G Leung, Leann Lewis, William B Martens, Karlien Mul, Valeria A Sansone, Perry B Shieh, Kathryn R Wagner, Leo H Wang, Michaela Walker, Rabi Tawil, Jeffrey M Statland, Sabrina Sacconi","doi":"10.1016/j.nmd.2026.106410","DOIUrl":"https://doi.org/10.1016/j.nmd.2026.106410","url":null,"abstract":"<p><p>Facioscapulohumeral muscular dystrophy type 1 (FSHD1) shows marked clinical heterogeneity, partly related to age at onset. We analysed baseline, 12- and 24-month follow-up data from 231 FSHD1 patients enrolled in the ReSolve study (NCT03458832) to compare clinical, genetic, and epidemiological features between adult-onset (n = 190) and late-onset (n = 41) patients. Differences were assessed using generalized linear models and repeated-measures covariance analyses adjusting for demographics and disease duration. Late-onset patients were predominantly female (58.5%, p = 0.039), older (64.8 ± 6.3 vs 47.6 ± 13.5 years; p < 0.001), and carried longer D4Z4 repeats (6.5 ± 1.6 vs 5.7 ± 1.8; p = 0.01). They showed milder facial and upper limb involvement but greater lower limb impairment, evaluated with TUG (2.37 vs 2.11 s, p = 0.001) and 6MWT (329.16 vs 415.22 meters, p = 0.002), despite shorter disease duration. Lower limb weakness was the most frequent initial symptom (30% vs 10.7%, p = 0.0029). After one year, late-onset patients maintained similar characteristics, while facial differences were no longer significant at two years. Disease progression was similar across outcome measures except for the FSHD clinical score, which worsened more in late-onset patients at two years. These findings indicate that late-onset FSHD1 represents a distinct clinical phenotype relevant for outcome measure selection and personalized management strategies.</p>","PeriodicalId":19135,"journal":{"name":"Neuromuscular Disorders","volume":"62 ","pages":"106410"},"PeriodicalIF":2.8,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital skeletal muscle myopathy due to the recently described digenic inheritance of TTN and SRPK3 genetic variants: a case study.","authors":"Dominic Spicer, Lucas Dejong, Abhi Kulkarni, Karin S Kassahn, Roula Ghaoui","doi":"10.1016/j.nmd.2026.106390","DOIUrl":"https://doi.org/10.1016/j.nmd.2026.106390","url":null,"abstract":"<p><p>The recently described skeletal myopathy from dual inheritance of TTN and SRPK3 genetic variants has demonstrated digenic inheritance constitutes an under-recognised burden amongst inherited neuromuscular disorders. Neuromuscular specialist input is essential to guide appropriate genetic testing for these elusive diagnoses. Here we present the first case since the initial discovery of this condition, of an adult age diagnosis of TTN/SRPK3 congenital myopathy. Our proband achieved an adult age diagnosis but had congenital symptoms previously diagnosed 'minimal change myopathy' from a childhood muscle biopsy. Their presentation was phenotypically consistent with the initial cohort. He exhibited congenital limb-girdle weakness/wasting, delayed motor developmental milestones, restrictive ventilatory deficit, Achilles tendon contractures and hyperCKaemia but no evidence of cardiomyopathy. Genetic diagnosis was achieved through research-based whole-genome sequencing and targeted SRPK3 gene review, after finding a TTN variant. Knowledge of these specific variants and inheritance pattern enabled diagnosis, where standard panel testing had missed it.</p>","PeriodicalId":19135,"journal":{"name":"Neuromuscular Disorders","volume":" ","pages":"106390"},"PeriodicalIF":2.8,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147369869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary glucose tetrasaccharide tracks disease activity in late-onset Pompe disease","authors":"Cristina Domínguez-González ,&nbsp;Domenico Iannucci ,&nbsp;James Clark ,&nbsp;Paloma Martín-Jiménez ,&nbsp;Stephan Hold ,&nbsp;Petra Oliva ,&nbsp;Anita Bischinger ,&nbsp;Eduard Gallardo ,&nbsp;Jordi Díaz-Manera","doi":"10.1016/j.nmd.2026.106359","DOIUrl":"10.1016/j.nmd.2026.106359","url":null,"abstract":"<div><div>Late-onset Pompe disease (LOPD) is a progressive metabolic myopathy caused by acid α-glucosidase deficiency, leading to glycogen accumulation in skeletal muscle. Reliable biomarkers for monitoring disease progression and treatment response are lacking. Urinary glucose tetrasaccharide (Glc4), a marker of glycogen turnover, is well established in infantile-onset Pompe disease, but its prognostic value in LOPD under longitudinal real-world conditions remains uncertain. Urinary Glc4 was evaluated in 35 genetically confirmed LOPD patients followed for four years with annual functional assessments, spirometry, and quantitative muscle MRI. Glc4 was measured by liquid chromatography–tandem mass spectrometry and normalized to creatinine. Associations with changes in six-minute walk test (6MWT), forced vital capacity (FVC), and thigh fat fraction (FF) were analyzed. Receiver operating characteristic (ROC) analysis assessed the ability of baseline Glc4 to predict clinically meaningful motor decline (&gt;30 m reduction in 6MWT). Multivariate linear regression evaluated whether baseline Glc4 independently predicted 6MWT decline. Glc4 levels were elevated in all patients and showed considerable intra-individual variability. Higher baseline Glc4 was associated with greater functional decline and increased muscle fat replacement. ROC analysis showed good predictive performance (AUC 0.78), with an optimal threshold of approximately 13 mmol/mol creatinine. Baseline Glc4 remained an independent predictor of 6MWT decline in multivariate analysis (<em>p</em> = 0.042). Baseline urinary Glc4 provides relevant prognostic information in LOPD and may serve as a complementary biomarker for routine disease monitoring.</div></div>","PeriodicalId":19135,"journal":{"name":"Neuromuscular Disorders","volume":"60 ","pages":"Article 106359"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meeting report: Expanding access to advanced cardiac therapies, including ventricular assist devices (VADs) and heart transplantation in muscular dystrophy","authors":"Seth A. Hollander,&nbsp;David Rosenthal","doi":"10.1016/j.nmd.2026.106338","DOIUrl":"10.1016/j.nmd.2026.106338","url":null,"abstract":"<div><div>Cardiomyopathy remains a leading cause of mortality in Duchenne muscular dystrophy (DMD), yet advanced therapies such as ventricular assist devices (VAD) and heart transplantation are rarely considered. In September 2024, a multidisciplinary group of neuromuscular specialists, cardiologists, intensivists, anesthesiologists, surgeons, respiratory therapists, rehabilitation specialists, and patient advocates convened to challenge the clinical challenges and institutional barriers that have historically excluded individuals with DMD from these life-prolonging interventions. The charge of the meeting was to develop a practical roadmap to guide the timely referral, evaluation, and management of DMD patients with advanced heart failure. Presentations focused on the evolving treatment landscape and reviewed limitations of standard heart failure assessments—including ejection fraction and symptomatology—while exploring alternative evaluation tools such as cardiac MRI, biomarkers, adapted exercise testing, and patient-reported outcomes. Discussions addressed candidacy, surgical considerations, respiratory and nutritional optimization, and psychosocial supports. Participants determined that VAD and transplant should be offered to appropriate candidates and began collaborative development of clinical protocols, which were then completed and published online approximately one year after the meeting concluded.</div></div>","PeriodicalId":19135,"journal":{"name":"Neuromuscular Disorders","volume":"60 ","pages":"Article 106338"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146024597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"277th ENMC international workshop: Congenital myopathies: revising and revisiting nomenclature and diagnostic guidelines, 21–23 June 2024, Hoofddorp, The Netherlands","authors":"RN Villar-Quiles ,&nbsp;LH Hayes ,&nbsp;S Raga ,&nbsp;C Bönnemann ,&nbsp;E Oates ,&nbsp;J Dowling ,&nbsp;A Ferreiro ,&nbsp;277th ENMC workshop participants","doi":"10.1016/j.nmd.2025.106328","DOIUrl":"10.1016/j.nmd.2025.106328","url":null,"abstract":"<div><div>The 277th ENMC workshop on Congenital Myopathies was held in Amsterdam, The Netherlands, on 21–23 June, with 26 clinical, research, and curation experts and patient representatives from five continents. The workshop aimed to 1) establish an updated nomenclature and 2) update recommendations for their diagnostic evaluation. It was agreed that the preferred acronym for congenital myopathies is CMYO. Consensus defined CMYOs as a heterogeneous group of genetic muscle disorders typically presenting perinatally or in infancy with hypotonia and muscle weakness, usually non- or slowly progressive, with distinctive structural, non-dystrophic histopathological features. A nomenclature framework integrating gene, mode of inheritance, and histopathology was proposed, exemplified by “autosomal recessive RYR1-congenital myopathy with cores.” Diagnostic consensus emphasized a genetics-first approach, using targeted massively parallel sequencing panels, exome, or genome sequencing, complemented by electromyography, muscle imaging, and biopsy when indicated and available. The workshop highlighted the need for harmonized classification across databases, patient engagement, and global representation to support precise diagnosis, genotype–phenotype correlation, and equitable access to care and research.</div></div>","PeriodicalId":19135,"journal":{"name":"Neuromuscular Disorders","volume":"60 ","pages":"Article 106328"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond motor function: cognitive and language impairments in spinal muscular atrophy children treated with modern therapies","authors":"Mathilde Guibert ,&nbsp;Marie Canton ,&nbsp;Delphine Saunier ,&nbsp;Sandra Gharbi ,&nbsp;Melodie Campiglia ,&nbsp;Hélène Vincent ,&nbsp;Mathieu Kuchenbuch ,&nbsp;Cyril Schweitzer ,&nbsp;Clémentine Lambert","doi":"10.1016/j.nmd.2026.106340","DOIUrl":"10.1016/j.nmd.2026.106340","url":null,"abstract":"<div><div>Recent disease-modifying treatments have markedly improved the motor prognosis of spinal muscular atrophy, yet the neurocognitive and language outcomes of treated children remain insufficiently characterized. This monocentric observational study included sixteen children with genetically confirmed Spinal muscular atrophy types I–III (10 males; age 2.6–15.4 years; 5 with type I, 5 type II, and 6 type III) treated with at least one disease-modifying therapy and followed at our center. Participants underwent standardized assessments of intellectual abilities, executive functions, social cognition, memory, and language, complemented by parent questionnaires. Data were analyzed descriptively given the small and heterogeneous sample. Intellectual functioning was preserved (mean IQ = 102 ± 4), with no cases of intellectual disability, although 15% showed executive dysfunctions (e.g., inhibition, cognitive flexibility) not perceived by parents. Oral language disorders were found in 73% of individuals, affecting phonology, lexicon, and morphosyntax, and were more frequent in children with more severe motor phenotypes and fewer SMN2 copies. Written language disorders were identified in 29% of individuals, even without major motor impairment. Routine neuropsychological and speech-language assessments should be integrated into multidisciplinary care to enable earlier detection, targeted interventions, and improved long-term outcomes.</div></div>","PeriodicalId":19135,"journal":{"name":"Neuromuscular Disorders","volume":"60 ","pages":"Article 106340"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146079818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining functional phenotypes in an international cohort of untreated paediatric type 2 and 3 SMA patients using the Revised Hammersmith Scale","authors":"E Milev ,&nbsp;G Stimpson ,&nbsp;D Ramsey ,&nbsp;A Mayhew ,&nbsp;M Scoto ,&nbsp;G Baranello ,&nbsp;R Muni Lofra ,&nbsp;E O’Reilly ,&nbsp;Wolfe Amy ,&nbsp;M Main ,&nbsp;ES Mazzone ,&nbsp;J Montes ,&nbsp;AM Glanzman ,&nbsp;A Pasternak ,&nbsp;T Duong ,&nbsp;M Civitello ,&nbsp;G Coratti ,&nbsp;C Marini-Bettolo ,&nbsp;J Day ,&nbsp;BT Darras ,&nbsp;F Muntoni","doi":"10.1016/j.nmd.2026.106336","DOIUrl":"10.1016/j.nmd.2026.106336","url":null,"abstract":"<div><div>Spinal muscular atrophy types 2 and 3 encompass a wide spectrum of motor abilities ranging from non-sitting to sitting and walking. This study refines a functional group termed high functioning sitter-standers, positioned between traditional categories, and examined in relation to both the Revised Hammersmith Scale and a World Health Organization motor milestone-based framework. Among 178 participants completing 618 assessments, 109 were classified as type 2, 59 as type 3a, and 10 as type 3b, with ages ranging from 1 to 17.5 years. Twenty-seven non-sitters completed 54 assessments, 110 sitters completed 347, and 50 walkers completed 169, while the high functioning sitter-standers accounted for 48 assessments of 21 individuals. This newly defined group scored significantly lower than walkers and higher than both sitters and non-sitters, highlighting a distinct and measurable functional profile. Although no significant differences in age distribution were observed between the high functioning sitter-standers and walkers or non-sitters, sitters were notably younger. This intermediate phenotype captures patients with partial standing and assisted walking abilities, often overlooked in previous analyses. Recognition of this group is important for understanding emerging functional trajectories in treated spinal muscular atrophy and for informing future outcome measures and quality of life assessments.</div></div>","PeriodicalId":19135,"journal":{"name":"Neuromuscular Disorders","volume":"60 ","pages":"Article 106336"},"PeriodicalIF":2.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}