Loading…

Differential effects of withdrawal from intermittent and continuous nicotine exposure on reward deficit and somatic aspects of nicotine withdrawal and expression of α4β2 nAChRs in Wistar male rats

Chronic nicotine exposure produces neuroadaptations in brain reward systems and α4β2 nicotinic acetylcholine receptors (nAChRs) in the corticolimbic brain areas. We previously demonstrated opposite effects of nicotine exposure delivered by self-administration or pumps on brain reward thresholds that...

Full description

Saved in:
Bibliographic Details
Published in:Pharmacology, biochemistry and behavior biochemistry and behavior, 2018-08, Vol.171, p.54-65
Main Authors: Semenova, Svetlana, Jin, Xinchun, McClure-Begley, Tristan D., Tadman, Matthew Philip, Marks, Michael J., Markou, Athina
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-c3662-c71fd6c69c9c697e53e824175f5b73bd34cbbf6487e29e299ba3f03b708a51b73
cites cdi_FETCH-LOGICAL-c3662-c71fd6c69c9c697e53e824175f5b73bd34cbbf6487e29e299ba3f03b708a51b73
container_end_page 65
container_issue
container_start_page 54
container_title Pharmacology, biochemistry and behavior
container_volume 171
creator Semenova, Svetlana
Jin, Xinchun
McClure-Begley, Tristan D.
Tadman, Matthew Philip
Marks, Michael J.
Markou, Athina
description Chronic nicotine exposure produces neuroadaptations in brain reward systems and α4β2 nicotinic acetylcholine receptors (nAChRs) in the corticolimbic brain areas. We previously demonstrated opposite effects of nicotine exposure delivered by self-administration or pumps on brain reward thresholds that can be attributed to the different temporal pattern and contingency of nicotine exposure. We investigated the effects of these two factors on reward thresholds and somatic signs during nicotine withdrawal, and on nAChRs binding in corticolimbic brain areas. The intracranial self-stimulation procedure was used to assess reward thresholds in rats prepared with pumps delivering various doses of nicotine continuously or intermittently. Separate group of rats were randomly exposed to nicotine via pumps (non-contingent) or nicotine self-administration (contingent) to determine [125I]-epibatidine binding at α4β2* nAChRs. Withdrawal from continuous non-contingent nicotine exposure led to significant elevations in thresholds and increases in somatic signs in rats, while there was no significant effect of withdrawal from intermittent non-contingent nicotine exposure at the same doses. nAChRs were upregulated during withdrawal from continuous non-contingent nicotine exposure. α4β2* nAChRs were upregulated in the ventral tegmental area and prelimbic cortex during withdrawal from non-contingent intermittent exposure and in the nucleus accumbens during withdrawal from contingent intermittent nicotine exposure to the same dose. During non-contingent nicotine exposure, the temporal pattern of nicotine delivery differentially affected thresholds and somatic signs of withdrawal. Upregulation of α4β2* nAChRs was brain site-specific and depended on both temporal pattern and contingency of nicotine exposure. •Non-contingent continuous nicotine produced withdrawal and upregulated α4β2 nAChRs.•Non-contingent intermittent nicotine exposure did not produce nicotine withdrawal.•Non-contingent intermittent nicotine upregulated α4β2 nAChRs in the VTA and PLC.•Contingent intermittent nicotine exposure upregulated α4β2* nAChRs in the Acb.
doi_str_mv 10.1016/j.pbb.2018.06.002
format article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6170027</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0091305718301047</els_id><sourcerecordid>2056392309</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3662-c71fd6c69c9c697e53e824175f5b73bd34cbbf6487e29e299ba3f03b708a51b73</originalsourceid><addsrcrecordid>eNp9kd-K1DAUxoso7rj6AN5ILr1pPUnbpEUQlvEvLAiieBnS9MTJ0DZj0u7oY-lDeLnP5Blmd1hvhJAckt_3nXC-LHvKoeDA5Yttseu6QgBvCpAFgLiXrXijyrzmSt3PVgAtz0uo1Vn2KKUtAFRCqofZmWhbaATAKvvz2juHEafZm4Eh1XZOLDi29_Omj2ZPty6Gkflpxjj6eSaUmalnNpBmWsKS2ORtoBoZ_tiFtERkYWIR9yb2rEfnrT9KUhjN7C0zaXfb5iS90--AklPElDwZEXX9q7r-Ldh0sd58SvQV9tWn2UQ2mgFZNHN6nD1wZkj45OY8z768ffN5_T6__Pjuw_riMrellCK3irteWtnaljaFdYmNqLiqXd2psuvLynadk1WjULS02s6UDspOQWNqTsh59urou1u6EXtLw4hm0LvoRxN_6mC8_vdl8hv9LVxpyRXlczB4fmMQw_cF06xHnywOg5mQRqkF1LJsRQktofyI2hhSiuhObTjoQ_56qyl_fchfg9TkT5pnd_93UtwGTsDLI4A0pSuPUSfrcbLY-0iZ6D74_9j_BSZwyGw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2056392309</pqid></control><display><type>article</type><title>Differential effects of withdrawal from intermittent and continuous nicotine exposure on reward deficit and somatic aspects of nicotine withdrawal and expression of α4β2 nAChRs in Wistar male rats</title><source>ScienceDirect Journals</source><creator>Semenova, Svetlana ; Jin, Xinchun ; McClure-Begley, Tristan D. ; Tadman, Matthew Philip ; Marks, Michael J. ; Markou, Athina</creator><creatorcontrib>Semenova, Svetlana ; Jin, Xinchun ; McClure-Begley, Tristan D. ; Tadman, Matthew Philip ; Marks, Michael J. ; Markou, Athina</creatorcontrib><description>Chronic nicotine exposure produces neuroadaptations in brain reward systems and α4β2 nicotinic acetylcholine receptors (nAChRs) in the corticolimbic brain areas. We previously demonstrated opposite effects of nicotine exposure delivered by self-administration or pumps on brain reward thresholds that can be attributed to the different temporal pattern and contingency of nicotine exposure. We investigated the effects of these two factors on reward thresholds and somatic signs during nicotine withdrawal, and on nAChRs binding in corticolimbic brain areas. The intracranial self-stimulation procedure was used to assess reward thresholds in rats prepared with pumps delivering various doses of nicotine continuously or intermittently. Separate group of rats were randomly exposed to nicotine via pumps (non-contingent) or nicotine self-administration (contingent) to determine [125I]-epibatidine binding at α4β2* nAChRs. Withdrawal from continuous non-contingent nicotine exposure led to significant elevations in thresholds and increases in somatic signs in rats, while there was no significant effect of withdrawal from intermittent non-contingent nicotine exposure at the same doses. nAChRs were upregulated during withdrawal from continuous non-contingent nicotine exposure. α4β2* nAChRs were upregulated in the ventral tegmental area and prelimbic cortex during withdrawal from non-contingent intermittent exposure and in the nucleus accumbens during withdrawal from contingent intermittent nicotine exposure to the same dose. During non-contingent nicotine exposure, the temporal pattern of nicotine delivery differentially affected thresholds and somatic signs of withdrawal. Upregulation of α4β2* nAChRs was brain site-specific and depended on both temporal pattern and contingency of nicotine exposure. •Non-contingent continuous nicotine produced withdrawal and upregulated α4β2 nAChRs.•Non-contingent intermittent nicotine exposure did not produce nicotine withdrawal.•Non-contingent intermittent nicotine upregulated α4β2 nAChRs in the VTA and PLC.•Contingent intermittent nicotine exposure upregulated α4β2* nAChRs in the Acb.</description><identifier>ISSN: 0091-3057</identifier><identifier>EISSN: 1873-5177</identifier><identifier>DOI: 10.1016/j.pbb.2018.06.002</identifier><identifier>PMID: 29908200</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Animals ; Autoantigens ; Bridged Bicyclo Compounds, Heterocyclic - metabolism ; Cotinine ; Drug Administration Schedule ; Infusion Pumps, Implantable ; Intracranial self-stimulation ; Iodine Radioisotopes - metabolism ; Limbic Lobe - metabolism ; Male ; Nicotine - administration &amp; dosage ; Nicotine - adverse effects ; Nucleus Accumbens - metabolism ; Pyridines - metabolism ; Radioligand Assay ; Rats ; Rats, Wistar ; Receptors, Nicotinic - metabolism ; Reward ; Reward thresholds ; Somatic signs ; Substance Withdrawal Syndrome - diagnosis ; Substance Withdrawal Syndrome - metabolism ; Up-Regulation ; Ventral Tegmental Area - metabolism ; α4β2 nicotinic acetylcholine receptors</subject><ispartof>Pharmacology, biochemistry and behavior, 2018-08, Vol.171, p.54-65</ispartof><rights>2018</rights><rights>Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3662-c71fd6c69c9c697e53e824175f5b73bd34cbbf6487e29e299ba3f03b708a51b73</citedby><cites>FETCH-LOGICAL-c3662-c71fd6c69c9c697e53e824175f5b73bd34cbbf6487e29e299ba3f03b708a51b73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29908200$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Semenova, Svetlana</creatorcontrib><creatorcontrib>Jin, Xinchun</creatorcontrib><creatorcontrib>McClure-Begley, Tristan D.</creatorcontrib><creatorcontrib>Tadman, Matthew Philip</creatorcontrib><creatorcontrib>Marks, Michael J.</creatorcontrib><creatorcontrib>Markou, Athina</creatorcontrib><title>Differential effects of withdrawal from intermittent and continuous nicotine exposure on reward deficit and somatic aspects of nicotine withdrawal and expression of α4β2 nAChRs in Wistar male rats</title><title>Pharmacology, biochemistry and behavior</title><addtitle>Pharmacol Biochem Behav</addtitle><description>Chronic nicotine exposure produces neuroadaptations in brain reward systems and α4β2 nicotinic acetylcholine receptors (nAChRs) in the corticolimbic brain areas. We previously demonstrated opposite effects of nicotine exposure delivered by self-administration or pumps on brain reward thresholds that can be attributed to the different temporal pattern and contingency of nicotine exposure. We investigated the effects of these two factors on reward thresholds and somatic signs during nicotine withdrawal, and on nAChRs binding in corticolimbic brain areas. The intracranial self-stimulation procedure was used to assess reward thresholds in rats prepared with pumps delivering various doses of nicotine continuously or intermittently. Separate group of rats were randomly exposed to nicotine via pumps (non-contingent) or nicotine self-administration (contingent) to determine [125I]-epibatidine binding at α4β2* nAChRs. Withdrawal from continuous non-contingent nicotine exposure led to significant elevations in thresholds and increases in somatic signs in rats, while there was no significant effect of withdrawal from intermittent non-contingent nicotine exposure at the same doses. nAChRs were upregulated during withdrawal from continuous non-contingent nicotine exposure. α4β2* nAChRs were upregulated in the ventral tegmental area and prelimbic cortex during withdrawal from non-contingent intermittent exposure and in the nucleus accumbens during withdrawal from contingent intermittent nicotine exposure to the same dose. During non-contingent nicotine exposure, the temporal pattern of nicotine delivery differentially affected thresholds and somatic signs of withdrawal. Upregulation of α4β2* nAChRs was brain site-specific and depended on both temporal pattern and contingency of nicotine exposure. •Non-contingent continuous nicotine produced withdrawal and upregulated α4β2 nAChRs.•Non-contingent intermittent nicotine exposure did not produce nicotine withdrawal.•Non-contingent intermittent nicotine upregulated α4β2 nAChRs in the VTA and PLC.•Contingent intermittent nicotine exposure upregulated α4β2* nAChRs in the Acb.</description><subject>Animals</subject><subject>Autoantigens</subject><subject>Bridged Bicyclo Compounds, Heterocyclic - metabolism</subject><subject>Cotinine</subject><subject>Drug Administration Schedule</subject><subject>Infusion Pumps, Implantable</subject><subject>Intracranial self-stimulation</subject><subject>Iodine Radioisotopes - metabolism</subject><subject>Limbic Lobe - metabolism</subject><subject>Male</subject><subject>Nicotine - administration &amp; dosage</subject><subject>Nicotine - adverse effects</subject><subject>Nucleus Accumbens - metabolism</subject><subject>Pyridines - metabolism</subject><subject>Radioligand Assay</subject><subject>Rats</subject><subject>Rats, Wistar</subject><subject>Receptors, Nicotinic - metabolism</subject><subject>Reward</subject><subject>Reward thresholds</subject><subject>Somatic signs</subject><subject>Substance Withdrawal Syndrome - diagnosis</subject><subject>Substance Withdrawal Syndrome - metabolism</subject><subject>Up-Regulation</subject><subject>Ventral Tegmental Area - metabolism</subject><subject>α4β2 nicotinic acetylcholine receptors</subject><issn>0091-3057</issn><issn>1873-5177</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kd-K1DAUxoso7rj6AN5ILr1pPUnbpEUQlvEvLAiieBnS9MTJ0DZj0u7oY-lDeLnP5Blmd1hvhJAckt_3nXC-LHvKoeDA5Yttseu6QgBvCpAFgLiXrXijyrzmSt3PVgAtz0uo1Vn2KKUtAFRCqofZmWhbaATAKvvz2juHEafZm4Eh1XZOLDi29_Omj2ZPty6Gkflpxjj6eSaUmalnNpBmWsKS2ORtoBoZ_tiFtERkYWIR9yb2rEfnrT9KUhjN7C0zaXfb5iS90--AklPElDwZEXX9q7r-Ldh0sd58SvQV9tWn2UQ2mgFZNHN6nD1wZkj45OY8z768ffN5_T6__Pjuw_riMrellCK3irteWtnaljaFdYmNqLiqXd2psuvLynadk1WjULS02s6UDspOQWNqTsh59urou1u6EXtLw4hm0LvoRxN_6mC8_vdl8hv9LVxpyRXlczB4fmMQw_cF06xHnywOg5mQRqkF1LJsRQktofyI2hhSiuhObTjoQ_56qyl_fchfg9TkT5pnd_93UtwGTsDLI4A0pSuPUSfrcbLY-0iZ6D74_9j_BSZwyGw</recordid><startdate>20180801</startdate><enddate>20180801</enddate><creator>Semenova, Svetlana</creator><creator>Jin, Xinchun</creator><creator>McClure-Begley, Tristan D.</creator><creator>Tadman, Matthew Philip</creator><creator>Marks, Michael J.</creator><creator>Markou, Athina</creator><general>Elsevier Inc</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>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180801</creationdate><title>Differential effects of withdrawal from intermittent and continuous nicotine exposure on reward deficit and somatic aspects of nicotine withdrawal and expression of α4β2 nAChRs in Wistar male rats</title><author>Semenova, Svetlana ; Jin, Xinchun ; McClure-Begley, Tristan D. ; Tadman, Matthew Philip ; Marks, Michael J. ; Markou, Athina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3662-c71fd6c69c9c697e53e824175f5b73bd34cbbf6487e29e299ba3f03b708a51b73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Animals</topic><topic>Autoantigens</topic><topic>Bridged Bicyclo Compounds, Heterocyclic - metabolism</topic><topic>Cotinine</topic><topic>Drug Administration Schedule</topic><topic>Infusion Pumps, Implantable</topic><topic>Intracranial self-stimulation</topic><topic>Iodine Radioisotopes - metabolism</topic><topic>Limbic Lobe - metabolism</topic><topic>Male</topic><topic>Nicotine - administration &amp; dosage</topic><topic>Nicotine - adverse effects</topic><topic>Nucleus Accumbens - metabolism</topic><topic>Pyridines - metabolism</topic><topic>Radioligand Assay</topic><topic>Rats</topic><topic>Rats, Wistar</topic><topic>Receptors, Nicotinic - metabolism</topic><topic>Reward</topic><topic>Reward thresholds</topic><topic>Somatic signs</topic><topic>Substance Withdrawal Syndrome - diagnosis</topic><topic>Substance Withdrawal Syndrome - metabolism</topic><topic>Up-Regulation</topic><topic>Ventral Tegmental Area - metabolism</topic><topic>α4β2 nicotinic acetylcholine receptors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Semenova, Svetlana</creatorcontrib><creatorcontrib>Jin, Xinchun</creatorcontrib><creatorcontrib>McClure-Begley, Tristan D.</creatorcontrib><creatorcontrib>Tadman, Matthew Philip</creatorcontrib><creatorcontrib>Marks, Michael J.</creatorcontrib><creatorcontrib>Markou, Athina</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pharmacology, biochemistry and behavior</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Semenova, Svetlana</au><au>Jin, Xinchun</au><au>McClure-Begley, Tristan D.</au><au>Tadman, Matthew Philip</au><au>Marks, Michael J.</au><au>Markou, Athina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Differential effects of withdrawal from intermittent and continuous nicotine exposure on reward deficit and somatic aspects of nicotine withdrawal and expression of α4β2 nAChRs in Wistar male rats</atitle><jtitle>Pharmacology, biochemistry and behavior</jtitle><addtitle>Pharmacol Biochem Behav</addtitle><date>2018-08-01</date><risdate>2018</risdate><volume>171</volume><spage>54</spage><epage>65</epage><pages>54-65</pages><issn>0091-3057</issn><eissn>1873-5177</eissn><abstract>Chronic nicotine exposure produces neuroadaptations in brain reward systems and α4β2 nicotinic acetylcholine receptors (nAChRs) in the corticolimbic brain areas. We previously demonstrated opposite effects of nicotine exposure delivered by self-administration or pumps on brain reward thresholds that can be attributed to the different temporal pattern and contingency of nicotine exposure. We investigated the effects of these two factors on reward thresholds and somatic signs during nicotine withdrawal, and on nAChRs binding in corticolimbic brain areas. The intracranial self-stimulation procedure was used to assess reward thresholds in rats prepared with pumps delivering various doses of nicotine continuously or intermittently. Separate group of rats were randomly exposed to nicotine via pumps (non-contingent) or nicotine self-administration (contingent) to determine [125I]-epibatidine binding at α4β2* nAChRs. Withdrawal from continuous non-contingent nicotine exposure led to significant elevations in thresholds and increases in somatic signs in rats, while there was no significant effect of withdrawal from intermittent non-contingent nicotine exposure at the same doses. nAChRs were upregulated during withdrawal from continuous non-contingent nicotine exposure. α4β2* nAChRs were upregulated in the ventral tegmental area and prelimbic cortex during withdrawal from non-contingent intermittent exposure and in the nucleus accumbens during withdrawal from contingent intermittent nicotine exposure to the same dose. During non-contingent nicotine exposure, the temporal pattern of nicotine delivery differentially affected thresholds and somatic signs of withdrawal. Upregulation of α4β2* nAChRs was brain site-specific and depended on both temporal pattern and contingency of nicotine exposure. •Non-contingent continuous nicotine produced withdrawal and upregulated α4β2 nAChRs.•Non-contingent intermittent nicotine exposure did not produce nicotine withdrawal.•Non-contingent intermittent nicotine upregulated α4β2 nAChRs in the VTA and PLC.•Contingent intermittent nicotine exposure upregulated α4β2* nAChRs in the Acb.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29908200</pmid><doi>10.1016/j.pbb.2018.06.002</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0091-3057
ispartof Pharmacology, biochemistry and behavior, 2018-08, Vol.171, p.54-65
issn 0091-3057
1873-5177
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6170027
source ScienceDirect Journals
subjects Animals
Autoantigens
Bridged Bicyclo Compounds, Heterocyclic - metabolism
Cotinine
Drug Administration Schedule
Infusion Pumps, Implantable
Intracranial self-stimulation
Iodine Radioisotopes - metabolism
Limbic Lobe - metabolism
Male
Nicotine - administration & dosage
Nicotine - adverse effects
Nucleus Accumbens - metabolism
Pyridines - metabolism
Radioligand Assay
Rats
Rats, Wistar
Receptors, Nicotinic - metabolism
Reward
Reward thresholds
Somatic signs
Substance Withdrawal Syndrome - diagnosis
Substance Withdrawal Syndrome - metabolism
Up-Regulation
Ventral Tegmental Area - metabolism
α4β2 nicotinic acetylcholine receptors
title Differential effects of withdrawal from intermittent and continuous nicotine exposure on reward deficit and somatic aspects of nicotine withdrawal and expression of α4β2 nAChRs in Wistar male rats
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-12T20%3A07%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Differential%20effects%20of%20withdrawal%20from%20intermittent%20and%20continuous%20nicotine%20exposure%20on%20reward%20deficit%20and%20somatic%20aspects%20of%20nicotine%20withdrawal%20and%20expression%20of%20%CE%B14%CE%B22%20nAChRs%20in%20Wistar%20male%20rats&rft.jtitle=Pharmacology,%20biochemistry%20and%20behavior&rft.au=Semenova,%20Svetlana&rft.date=2018-08-01&rft.volume=171&rft.spage=54&rft.epage=65&rft.pages=54-65&rft.issn=0091-3057&rft.eissn=1873-5177&rft_id=info:doi/10.1016/j.pbb.2018.06.002&rft_dat=%3Cproquest_pubme%3E2056392309%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c3662-c71fd6c69c9c697e53e824175f5b73bd34cbbf6487e29e299ba3f03b708a51b73%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2056392309&rft_id=info:pmid/29908200&rfr_iscdi=true