Loading…
Brain functional connectivity and cognition in mild traumatic brain injury
Introduction The aim of this study was to analyze brain functional connectivity and its relationship to cognition in patients with mild traumatic brain injury (mTBI). Methods Twenty-five patients with mTBI and 25 healthy control subjects were studied using resting-state functional MRI (rs-fMRI). Amp...
Saved in:
Published in: | Neuroradiology 2016-07, Vol.58 (7), p.733-739 |
---|---|
Main Authors: | , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
cited_by | cdi_FETCH-LOGICAL-c405t-8c4544ed919041b045ff8b9b024dff6f7b11bbba7903bd2b632d3a1d7ea83d6e3 |
---|---|
cites | cdi_FETCH-LOGICAL-c405t-8c4544ed919041b045ff8b9b024dff6f7b11bbba7903bd2b632d3a1d7ea83d6e3 |
container_end_page | 739 |
container_issue | 7 |
container_start_page | 733 |
container_title | Neuroradiology |
container_volume | 58 |
creator | Xiong, K.L. Zhang, J.N. Zhang, Y.L. Zhang, Y. Chen, H. Qiu, M.G. |
description | Introduction
The aim of this study was to analyze brain functional connectivity and its relationship to cognition in patients with mild traumatic brain injury (mTBI).
Methods
Twenty-five patients with mTBI and 25 healthy control subjects were studied using resting-state functional MRI (rs-fMRI). Amplitudes of low-frequency fluctuations (ALFFs) and functional connectivity (FC) were calculated and correlated with cognition.
Results
Compared with the normal control group, the mTBI patients showed a significant decrease in working memory index (WMI) and processing speed index (PSI), as well as significantly decreased ALFFs in the cingulate gyrus, the middle frontal gyrus and superior frontal gyrus. In contrast, the mTBI patients’ ALFFs in the left middle occipital gyrus, the left precuneus, and lingual gyrus increased. Additionally, FC significantly decreased in the thalamus, caudate nucleus, and right hippocampus in the mTBI patients. Statistical analysis further showed a significant positive correlation between the ALFF in the cingulate gyrus and the WMI (
R
2
= 0.423,
P
|
doi_str_mv | 10.1007/s00234-016-1675-0 |
format | article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1811900966</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1811900966</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-8c4544ed919041b045ff8b9b024dff6f7b11bbba7903bd2b632d3a1d7ea83d6e3</originalsourceid><addsrcrecordid>eNqNkc1q3DAUhUVpaCbTPkA2wdBNNm7ulWTJXqZD0jQMZJOshWTJQYMtp5JdmLePJk5LKBSy0s_5zrlwDyGnCN8QQF4kAMp4CShKFLIq4QNZIWe0xIbCR7LKcl2yhsMxOUlpBwBMMvmJHFOZ77KRK3L7PWofim4O7eTHoPuiHUNw-fHbT_tCB5s_HoM_iEUGB9_bYop6HvTk28K8uH3YzXH_mRx1uk_uy-u5Jg_XV_ebm3J79-Pn5nJbthyqqaxbXnHubIMNcDTAq66rTWOActt1opMG0RijZQPMWGoEo5ZptNLpmlnh2JqcL7lPcfw1uzSpwafW9b0ObpyTwhpzNDRCvAMFIThSyjL69R90N84xL2QJRGR1Xu2a4EK1cUwpuk49RT_ouFcI6tCJWjpRuRN16ERB9py9Js9mcPav408JGaALkLIUHl18M_q_qc9wYpXb</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1811113814</pqid></control><display><type>article</type><title>Brain functional connectivity and cognition in mild traumatic brain injury</title><source>Springer Nature</source><creator>Xiong, K.L. ; Zhang, J.N. ; Zhang, Y.L. ; Zhang, Y. ; Chen, H. ; Qiu, M.G.</creator><creatorcontrib>Xiong, K.L. ; Zhang, J.N. ; Zhang, Y.L. ; Zhang, Y. ; Chen, H. ; Qiu, M.G.</creatorcontrib><description>Introduction
The aim of this study was to analyze brain functional connectivity and its relationship to cognition in patients with mild traumatic brain injury (mTBI).
Methods
Twenty-five patients with mTBI and 25 healthy control subjects were studied using resting-state functional MRI (rs-fMRI). Amplitudes of low-frequency fluctuations (ALFFs) and functional connectivity (FC) were calculated and correlated with cognition.
Results
Compared with the normal control group, the mTBI patients showed a significant decrease in working memory index (WMI) and processing speed index (PSI), as well as significantly decreased ALFFs in the cingulate gyrus, the middle frontal gyrus and superior frontal gyrus. In contrast, the mTBI patients’ ALFFs in the left middle occipital gyrus, the left precuneus, and lingual gyrus increased. Additionally, FC significantly decreased in the thalamus, caudate nucleus, and right hippocampus in the mTBI patients. Statistical analysis further showed a significant positive correlation between the ALFF in the cingulate gyrus and the WMI (
R
2
= 0.423,
P
< 0.05) and a significant positive correlation between the FC in the left thalamus and left middle frontal gyrus and the WMI (
R
2
= 0.381,
P
< 0.05).
Conclusion
rs-fMRI can reveal the functional state of the brain in patients with mTBI. This finding differed from observations of the normal control group and was significantly associated with clinical cognitive dysfunction. Therefore, rs-fMRI offers an objective imaging modality for treatment planning and prognosis assessment in patients with mTBI.</description><identifier>ISSN: 0028-3940</identifier><identifier>EISSN: 1432-1920</identifier><identifier>DOI: 10.1007/s00234-016-1675-0</identifier><identifier>PMID: 27000797</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Adult ; Brain - diagnostic imaging ; Brain - physiopathology ; Brain damage ; Brain Injuries, Traumatic - complications ; Brain Injuries, Traumatic - diagnostic imaging ; Brain Injuries, Traumatic - physiopathology ; Cognition ; Cognition Disorders - diagnostic imaging ; Cognition Disorders - etiology ; Cognition Disorders - physiopathology ; Cognitive ability ; Connectome - methods ; Female ; Functional Neuroradiology ; Humans ; Imaging ; Magnetic Resonance Imaging - methods ; Male ; Medical imaging ; Medicine ; Medicine & Public Health ; Middle Aged ; Nerve Net - diagnostic imaging ; Nerve Net - physiopathology ; Neurology ; Neuroradiology ; Neurosciences ; Neurosurgery ; NMR ; Nuclear magnetic resonance ; Radiology ; Reproducibility of Results ; Sensitivity and Specificity ; Young Adult</subject><ispartof>Neuroradiology, 2016-07, Vol.58 (7), p.733-739</ispartof><rights>Springer-Verlag Berlin Heidelberg 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-8c4544ed919041b045ff8b9b024dff6f7b11bbba7903bd2b632d3a1d7ea83d6e3</citedby><cites>FETCH-LOGICAL-c405t-8c4544ed919041b045ff8b9b024dff6f7b11bbba7903bd2b632d3a1d7ea83d6e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27000797$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xiong, K.L.</creatorcontrib><creatorcontrib>Zhang, J.N.</creatorcontrib><creatorcontrib>Zhang, Y.L.</creatorcontrib><creatorcontrib>Zhang, Y.</creatorcontrib><creatorcontrib>Chen, H.</creatorcontrib><creatorcontrib>Qiu, M.G.</creatorcontrib><title>Brain functional connectivity and cognition in mild traumatic brain injury</title><title>Neuroradiology</title><addtitle>Neuroradiology</addtitle><addtitle>Neuroradiology</addtitle><description>Introduction
The aim of this study was to analyze brain functional connectivity and its relationship to cognition in patients with mild traumatic brain injury (mTBI).
Methods
Twenty-five patients with mTBI and 25 healthy control subjects were studied using resting-state functional MRI (rs-fMRI). Amplitudes of low-frequency fluctuations (ALFFs) and functional connectivity (FC) were calculated and correlated with cognition.
Results
Compared with the normal control group, the mTBI patients showed a significant decrease in working memory index (WMI) and processing speed index (PSI), as well as significantly decreased ALFFs in the cingulate gyrus, the middle frontal gyrus and superior frontal gyrus. In contrast, the mTBI patients’ ALFFs in the left middle occipital gyrus, the left precuneus, and lingual gyrus increased. Additionally, FC significantly decreased in the thalamus, caudate nucleus, and right hippocampus in the mTBI patients. Statistical analysis further showed a significant positive correlation between the ALFF in the cingulate gyrus and the WMI (
R
2
= 0.423,
P
< 0.05) and a significant positive correlation between the FC in the left thalamus and left middle frontal gyrus and the WMI (
R
2
= 0.381,
P
< 0.05).
Conclusion
rs-fMRI can reveal the functional state of the brain in patients with mTBI. This finding differed from observations of the normal control group and was significantly associated with clinical cognitive dysfunction. Therefore, rs-fMRI offers an objective imaging modality for treatment planning and prognosis assessment in patients with mTBI.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Brain - diagnostic imaging</subject><subject>Brain - physiopathology</subject><subject>Brain damage</subject><subject>Brain Injuries, Traumatic - complications</subject><subject>Brain Injuries, Traumatic - diagnostic imaging</subject><subject>Brain Injuries, Traumatic - physiopathology</subject><subject>Cognition</subject><subject>Cognition Disorders - diagnostic imaging</subject><subject>Cognition Disorders - etiology</subject><subject>Cognition Disorders - physiopathology</subject><subject>Cognitive ability</subject><subject>Connectome - methods</subject><subject>Female</subject><subject>Functional Neuroradiology</subject><subject>Humans</subject><subject>Imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nerve Net - diagnostic imaging</subject><subject>Nerve Net - physiopathology</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Radiology</subject><subject>Reproducibility of Results</subject><subject>Sensitivity and Specificity</subject><subject>Young Adult</subject><issn>0028-3940</issn><issn>1432-1920</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNqNkc1q3DAUhUVpaCbTPkA2wdBNNm7ulWTJXqZD0jQMZJOshWTJQYMtp5JdmLePJk5LKBSy0s_5zrlwDyGnCN8QQF4kAMp4CShKFLIq4QNZIWe0xIbCR7LKcl2yhsMxOUlpBwBMMvmJHFOZ77KRK3L7PWofim4O7eTHoPuiHUNw-fHbT_tCB5s_HoM_iEUGB9_bYop6HvTk28K8uH3YzXH_mRx1uk_uy-u5Jg_XV_ebm3J79-Pn5nJbthyqqaxbXnHubIMNcDTAq66rTWOActt1opMG0RijZQPMWGoEo5ZptNLpmlnh2JqcL7lPcfw1uzSpwafW9b0ObpyTwhpzNDRCvAMFIThSyjL69R90N84xL2QJRGR1Xu2a4EK1cUwpuk49RT_ouFcI6tCJWjpRuRN16ERB9py9Js9mcPav408JGaALkLIUHl18M_q_qc9wYpXb</recordid><startdate>20160701</startdate><enddate>20160701</enddate><creator>Xiong, K.L.</creator><creator>Zhang, J.N.</creator><creator>Zhang, Y.L.</creator><creator>Zhang, Y.</creator><creator>Chen, H.</creator><creator>Qiu, M.G.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TK</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20160701</creationdate><title>Brain functional connectivity and cognition in mild traumatic brain injury</title><author>Xiong, K.L. ; Zhang, J.N. ; Zhang, Y.L. ; Zhang, Y. ; Chen, H. ; Qiu, M.G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-8c4544ed919041b045ff8b9b024dff6f7b11bbba7903bd2b632d3a1d7ea83d6e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Brain - diagnostic imaging</topic><topic>Brain - physiopathology</topic><topic>Brain damage</topic><topic>Brain Injuries, Traumatic - complications</topic><topic>Brain Injuries, Traumatic - diagnostic imaging</topic><topic>Brain Injuries, Traumatic - physiopathology</topic><topic>Cognition</topic><topic>Cognition Disorders - diagnostic imaging</topic><topic>Cognition Disorders - etiology</topic><topic>Cognition Disorders - physiopathology</topic><topic>Cognitive ability</topic><topic>Connectome - methods</topic><topic>Female</topic><topic>Functional Neuroradiology</topic><topic>Humans</topic><topic>Imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nerve Net - diagnostic imaging</topic><topic>Nerve Net - physiopathology</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Radiology</topic><topic>Reproducibility of Results</topic><topic>Sensitivity and Specificity</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xiong, K.L.</creatorcontrib><creatorcontrib>Zhang, J.N.</creatorcontrib><creatorcontrib>Zhang, Y.L.</creatorcontrib><creatorcontrib>Zhang, Y.</creatorcontrib><creatorcontrib>Chen, H.</creatorcontrib><creatorcontrib>Qiu, M.G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Research Library</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest advanced technologies & aerospace journals</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Neuroradiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xiong, K.L.</au><au>Zhang, J.N.</au><au>Zhang, Y.L.</au><au>Zhang, Y.</au><au>Chen, H.</au><au>Qiu, M.G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Brain functional connectivity and cognition in mild traumatic brain injury</atitle><jtitle>Neuroradiology</jtitle><stitle>Neuroradiology</stitle><addtitle>Neuroradiology</addtitle><date>2016-07-01</date><risdate>2016</risdate><volume>58</volume><issue>7</issue><spage>733</spage><epage>739</epage><pages>733-739</pages><issn>0028-3940</issn><eissn>1432-1920</eissn><abstract>Introduction
The aim of this study was to analyze brain functional connectivity and its relationship to cognition in patients with mild traumatic brain injury (mTBI).
Methods
Twenty-five patients with mTBI and 25 healthy control subjects were studied using resting-state functional MRI (rs-fMRI). Amplitudes of low-frequency fluctuations (ALFFs) and functional connectivity (FC) were calculated and correlated with cognition.
Results
Compared with the normal control group, the mTBI patients showed a significant decrease in working memory index (WMI) and processing speed index (PSI), as well as significantly decreased ALFFs in the cingulate gyrus, the middle frontal gyrus and superior frontal gyrus. In contrast, the mTBI patients’ ALFFs in the left middle occipital gyrus, the left precuneus, and lingual gyrus increased. Additionally, FC significantly decreased in the thalamus, caudate nucleus, and right hippocampus in the mTBI patients. Statistical analysis further showed a significant positive correlation between the ALFF in the cingulate gyrus and the WMI (
R
2
= 0.423,
P
< 0.05) and a significant positive correlation between the FC in the left thalamus and left middle frontal gyrus and the WMI (
R
2
= 0.381,
P
< 0.05).
Conclusion
rs-fMRI can reveal the functional state of the brain in patients with mTBI. This finding differed from observations of the normal control group and was significantly associated with clinical cognitive dysfunction. Therefore, rs-fMRI offers an objective imaging modality for treatment planning and prognosis assessment in patients with mTBI.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27000797</pmid><doi>10.1007/s00234-016-1675-0</doi><tpages>7</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0028-3940 |
ispartof | Neuroradiology, 2016-07, Vol.58 (7), p.733-739 |
issn | 0028-3940 1432-1920 |
language | eng |
recordid | cdi_proquest_miscellaneous_1811900966 |
source | Springer Nature |
subjects | Adolescent Adult Brain - diagnostic imaging Brain - physiopathology Brain damage Brain Injuries, Traumatic - complications Brain Injuries, Traumatic - diagnostic imaging Brain Injuries, Traumatic - physiopathology Cognition Cognition Disorders - diagnostic imaging Cognition Disorders - etiology Cognition Disorders - physiopathology Cognitive ability Connectome - methods Female Functional Neuroradiology Humans Imaging Magnetic Resonance Imaging - methods Male Medical imaging Medicine Medicine & Public Health Middle Aged Nerve Net - diagnostic imaging Nerve Net - physiopathology Neurology Neuroradiology Neurosciences Neurosurgery NMR Nuclear magnetic resonance Radiology Reproducibility of Results Sensitivity and Specificity Young Adult |
title | Brain functional connectivity and cognition in mild traumatic brain injury |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-18T14%3A36%3A56IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Brain%20functional%20connectivity%20and%20cognition%20in%20mild%20traumatic%20brain%20injury&rft.jtitle=Neuroradiology&rft.au=Xiong,%20K.L.&rft.date=2016-07-01&rft.volume=58&rft.issue=7&rft.spage=733&rft.epage=739&rft.pages=733-739&rft.issn=0028-3940&rft.eissn=1432-1920&rft_id=info:doi/10.1007/s00234-016-1675-0&rft_dat=%3Cproquest_cross%3E1811900966%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c405t-8c4544ed919041b045ff8b9b024dff6f7b11bbba7903bd2b632d3a1d7ea83d6e3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1811113814&rft_id=info:pmid/27000797&rfr_iscdi=true |