Changes in the integrity of thalamocortical connections are associated with sensorimotor deficits in children with congenital hemiplegia
Preservation of thalamocortical projections to the sensorimotor cortex is related to improved hand function in children with cerebral palsy (CP). Whether CP is associated with altered microstructure of these sensorimotor projections or other thalamocortical pathways remains unclear. Forty-two childr...
Gespeichert in:
| Veröffentlicht in: | Brain Structure and Function 2015-01, Vol.220 (1), p.307-318 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 318 |
|---|---|
| container_issue | 1 |
| container_start_page | 307 |
| container_title | Brain Structure and Function |
| container_volume | 220 |
| creator | Tsao, Henry Pannek, Kerstin Boyd, Roslyn N. Rose, Stephen E. |
| description | Preservation of thalamocortical projections to the sensorimotor cortex is related to improved hand function in children with cerebral palsy (CP). Whether CP is associated with altered microstructure of these sensorimotor projections or other thalamocortical pathways remains unclear. Forty-two children with congenital hemiplegia and fifteen typically developing children (TDC) underwent structural and diffusion-weighted imaging (high-angular-resolution diffusion imaging) using a 3T MRI. Structural T1-images were parcellated into 34 cortical regions and the thalamus per hemisphere. Thalamocortical projections were extracted using probabilistic tractography and the top tan cortical regions with the greatest number of thalamocortical streamlines for the TDC group were selected for further analysis. The thalamus was parcellated based on its cortical connections. Differences between hemispheres for thalamocortical streamline numbers to each cortical region [asymmetry index (AI)], tract volume and tract microstructure [weighted mean fractional anisotropy (FA) and mean diffusivity (MD)] were calculated. Correlations between these measures (AI, FA and MD) and sensorimotor function were performed. Thalamocortical projections showed topographical organisation based on cortical connectivity. Projections to paracentral lobule, pre-central and post-central gyri showed greater AI in CP group, which indicates reduced streamlines on the ipsilesioned hemisphere. Reduced FA, reduced tract volume and increased MD were also found for these thalamocortical projections on the ipsilesioned hemisphere in children with CP. Changes in AI and tract microstructure of these projections were associated with poorer sensorimotor function. The findings suggest CP is associated with reorganisation of thalamocortical projections to the sensorimotor cortex. Integrity in these projections may underpin deficits in sensorimotor function. |
| doi_str_mv | 10.1007/s00429-013-0656-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1654665309</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1645778642</sourcerecordid><originalsourceid>FETCH-LOGICAL-c475t-bec99842c173e74d2d8a4edbf174bf3778b6b20777cd555b6ae3e70faf29d5733</originalsourceid><addsrcrecordid>eNqNkU1rFTEUhkNR-mV_QDcl4MbNaJLJx8yyXNQKBTe6DpnkzJ2UmeSa5NL2H_izzXXaIoLg6oTkOc8h50XokpL3lBD1IRPCWd8Q2jZECtk8HKFT2sm2YVLSVy9n0Z6gs5zvCBF9R_tjdMI45ZK27BT93EwmbCFjH3CZoJYC2-TLI45jvTCzWaKNqXhrZmxjCGCLjyFjkwCbnKP1poDD975MOEPIMfkllpiwg9FbX36b7eRnlyCsWNVsIfhSjRMsfjfD1ps36PVo5gwXT_Ucff_08dvmprn9-vnL5vq2sVyJ0gxg-77jzFLVguKOuc5wcMNIFR_GVqlukAMjSinrhBCDNFA5MpqR9U6otj1H71bvLsUfe8hFLz5bmGcTIO6zplJwWVdG-v9AuagDJWcVffsXehf3KdSPHKgq6ySllaIrZVPMOcGod3VbJj1qSvQhUb0mqmui-pCofqg9V0_m_bCAe-l4jrACbAVyfaqLTX-M_qf1F9k8rtI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1643098611</pqid></control><display><type>article</type><title>Changes in the integrity of thalamocortical connections are associated with sensorimotor deficits in children with congenital hemiplegia</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Tsao, Henry ; Pannek, Kerstin ; Boyd, Roslyn N. ; Rose, Stephen E.</creator><creatorcontrib>Tsao, Henry ; Pannek, Kerstin ; Boyd, Roslyn N. ; Rose, Stephen E.</creatorcontrib><description>Preservation of thalamocortical projections to the sensorimotor cortex is related to improved hand function in children with cerebral palsy (CP). Whether CP is associated with altered microstructure of these sensorimotor projections or other thalamocortical pathways remains unclear. Forty-two children with congenital hemiplegia and fifteen typically developing children (TDC) underwent structural and diffusion-weighted imaging (high-angular-resolution diffusion imaging) using a 3T MRI. Structural T1-images were parcellated into 34 cortical regions and the thalamus per hemisphere. Thalamocortical projections were extracted using probabilistic tractography and the top tan cortical regions with the greatest number of thalamocortical streamlines for the TDC group were selected for further analysis. The thalamus was parcellated based on its cortical connections. Differences between hemispheres for thalamocortical streamline numbers to each cortical region [asymmetry index (AI)], tract volume and tract microstructure [weighted mean fractional anisotropy (FA) and mean diffusivity (MD)] were calculated. Correlations between these measures (AI, FA and MD) and sensorimotor function were performed. Thalamocortical projections showed topographical organisation based on cortical connectivity. Projections to paracentral lobule, pre-central and post-central gyri showed greater AI in CP group, which indicates reduced streamlines on the ipsilesioned hemisphere. Reduced FA, reduced tract volume and increased MD were also found for these thalamocortical projections on the ipsilesioned hemisphere in children with CP. Changes in AI and tract microstructure of these projections were associated with poorer sensorimotor function. The findings suggest CP is associated with reorganisation of thalamocortical projections to the sensorimotor cortex. Integrity in these projections may underpin deficits in sensorimotor function.</description><identifier>ISSN: 1863-2653</identifier><identifier>EISSN: 1863-2661</identifier><identifier>EISSN: 0340-2061</identifier><identifier>DOI: 10.1007/s00429-013-0656-x</identifier><identifier>PMID: 24146132</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Anatomy & physiology ; Biomedical and Life Sciences ; Biomedicine ; Brain ; Brain Mapping ; Cell Biology ; Cerebral palsy ; Cerebral Palsy - complications ; Cerebral Palsy - pathology ; Child ; Child, Preschool ; Children & youth ; Developmental Disabilities - etiology ; Developmental Disabilities - pathology ; Diffusion Magnetic Resonance Imaging ; Female ; Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging ; Male ; Medical imaging ; Neural Pathways - growth & development ; Neural Pathways - pathology ; Neurology ; Neurosciences ; Original Article ; Sensorimotor Cortex - pathology ; Severity of Illness Index ; Thalamus - growth & development ; Thalamus - pathology</subject><ispartof>Brain Structure and Function, 2015-01, Vol.220 (1), p.307-318</ispartof><rights>Springer-Verlag Berlin Heidelberg 2013</rights><rights>Springer-Verlag Berlin Heidelberg 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c475t-bec99842c173e74d2d8a4edbf174bf3778b6b20777cd555b6ae3e70faf29d5733</citedby><cites>FETCH-LOGICAL-c475t-bec99842c173e74d2d8a4edbf174bf3778b6b20777cd555b6ae3e70faf29d5733</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00429-013-0656-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00429-013-0656-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24146132$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tsao, Henry</creatorcontrib><creatorcontrib>Pannek, Kerstin</creatorcontrib><creatorcontrib>Boyd, Roslyn N.</creatorcontrib><creatorcontrib>Rose, Stephen E.</creatorcontrib><title>Changes in the integrity of thalamocortical connections are associated with sensorimotor deficits in children with congenital hemiplegia</title><title>Brain Structure and Function</title><addtitle>Brain Struct Funct</addtitle><addtitle>Brain Struct Funct</addtitle><description>Preservation of thalamocortical projections to the sensorimotor cortex is related to improved hand function in children with cerebral palsy (CP). Whether CP is associated with altered microstructure of these sensorimotor projections or other thalamocortical pathways remains unclear. Forty-two children with congenital hemiplegia and fifteen typically developing children (TDC) underwent structural and diffusion-weighted imaging (high-angular-resolution diffusion imaging) using a 3T MRI. Structural T1-images were parcellated into 34 cortical regions and the thalamus per hemisphere. Thalamocortical projections were extracted using probabilistic tractography and the top tan cortical regions with the greatest number of thalamocortical streamlines for the TDC group were selected for further analysis. The thalamus was parcellated based on its cortical connections. Differences between hemispheres for thalamocortical streamline numbers to each cortical region [asymmetry index (AI)], tract volume and tract microstructure [weighted mean fractional anisotropy (FA) and mean diffusivity (MD)] were calculated. Correlations between these measures (AI, FA and MD) and sensorimotor function were performed. Thalamocortical projections showed topographical organisation based on cortical connectivity. Projections to paracentral lobule, pre-central and post-central gyri showed greater AI in CP group, which indicates reduced streamlines on the ipsilesioned hemisphere. Reduced FA, reduced tract volume and increased MD were also found for these thalamocortical projections on the ipsilesioned hemisphere in children with CP. Changes in AI and tract microstructure of these projections were associated with poorer sensorimotor function. The findings suggest CP is associated with reorganisation of thalamocortical projections to the sensorimotor cortex. Integrity in these projections may underpin deficits in sensorimotor function.</description><subject>Adolescent</subject><subject>Anatomy & physiology</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Brain</subject><subject>Brain Mapping</subject><subject>Cell Biology</subject><subject>Cerebral palsy</subject><subject>Cerebral Palsy - complications</subject><subject>Cerebral Palsy - pathology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children & youth</subject><subject>Developmental Disabilities - etiology</subject><subject>Developmental Disabilities - pathology</subject><subject>Diffusion Magnetic Resonance Imaging</subject><subject>Female</subject><subject>Humans</subject><subject>Image Processing, Computer-Assisted</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Neural Pathways - growth & development</subject><subject>Neural Pathways - pathology</subject><subject>Neurology</subject><subject>Neurosciences</subject><subject>Original Article</subject><subject>Sensorimotor Cortex - pathology</subject><subject>Severity of Illness Index</subject><subject>Thalamus - growth & development</subject><subject>Thalamus - pathology</subject><issn>1863-2653</issn><issn>1863-2661</issn><issn>0340-2061</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkU1rFTEUhkNR-mV_QDcl4MbNaJLJx8yyXNQKBTe6DpnkzJ2UmeSa5NL2H_izzXXaIoLg6oTkOc8h50XokpL3lBD1IRPCWd8Q2jZECtk8HKFT2sm2YVLSVy9n0Z6gs5zvCBF9R_tjdMI45ZK27BT93EwmbCFjH3CZoJYC2-TLI45jvTCzWaKNqXhrZmxjCGCLjyFjkwCbnKP1poDD975MOEPIMfkllpiwg9FbX36b7eRnlyCsWNVsIfhSjRMsfjfD1ps36PVo5gwXT_Ucff_08dvmprn9-vnL5vq2sVyJ0gxg-77jzFLVguKOuc5wcMNIFR_GVqlukAMjSinrhBCDNFA5MpqR9U6otj1H71bvLsUfe8hFLz5bmGcTIO6zplJwWVdG-v9AuagDJWcVffsXehf3KdSPHKgq6ySllaIrZVPMOcGod3VbJj1qSvQhUb0mqmui-pCofqg9V0_m_bCAe-l4jrACbAVyfaqLTX-M_qf1F9k8rtI</recordid><startdate>20150101</startdate><enddate>20150101</enddate><creator>Tsao, Henry</creator><creator>Pannek, Kerstin</creator><creator>Boyd, Roslyn N.</creator><creator>Rose, Stephen E.</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>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20150101</creationdate><title>Changes in the integrity of thalamocortical connections are associated with sensorimotor deficits in children with congenital hemiplegia</title><author>Tsao, Henry ; Pannek, Kerstin ; Boyd, Roslyn N. ; Rose, Stephen E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c475t-bec99842c173e74d2d8a4edbf174bf3778b6b20777cd555b6ae3e70faf29d5733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adolescent</topic><topic>Anatomy & physiology</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Brain</topic><topic>Brain Mapping</topic><topic>Cell Biology</topic><topic>Cerebral palsy</topic><topic>Cerebral Palsy - complications</topic><topic>Cerebral Palsy - pathology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children & youth</topic><topic>Developmental Disabilities - etiology</topic><topic>Developmental Disabilities - pathology</topic><topic>Diffusion Magnetic Resonance Imaging</topic><topic>Female</topic><topic>Humans</topic><topic>Image Processing, Computer-Assisted</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Neural Pathways - growth & development</topic><topic>Neural Pathways - pathology</topic><topic>Neurology</topic><topic>Neurosciences</topic><topic>Original Article</topic><topic>Sensorimotor Cortex - pathology</topic><topic>Severity of Illness Index</topic><topic>Thalamus - growth & development</topic><topic>Thalamus - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tsao, Henry</creatorcontrib><creatorcontrib>Pannek, Kerstin</creatorcontrib><creatorcontrib>Boyd, Roslyn N.</creatorcontrib><creatorcontrib>Rose, Stephen E.</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>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech 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>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</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>Medical Database</collection><collection>Psychology Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</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 One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Brain Structure and Function</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tsao, Henry</au><au>Pannek, Kerstin</au><au>Boyd, Roslyn N.</au><au>Rose, Stephen E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in the integrity of thalamocortical connections are associated with sensorimotor deficits in children with congenital hemiplegia</atitle><jtitle>Brain Structure and Function</jtitle><stitle>Brain Struct Funct</stitle><addtitle>Brain Struct Funct</addtitle><date>2015-01-01</date><risdate>2015</risdate><volume>220</volume><issue>1</issue><spage>307</spage><epage>318</epage><pages>307-318</pages><issn>1863-2653</issn><eissn>1863-2661</eissn><eissn>0340-2061</eissn><abstract>Preservation of thalamocortical projections to the sensorimotor cortex is related to improved hand function in children with cerebral palsy (CP). Whether CP is associated with altered microstructure of these sensorimotor projections or other thalamocortical pathways remains unclear. Forty-two children with congenital hemiplegia and fifteen typically developing children (TDC) underwent structural and diffusion-weighted imaging (high-angular-resolution diffusion imaging) using a 3T MRI. Structural T1-images were parcellated into 34 cortical regions and the thalamus per hemisphere. Thalamocortical projections were extracted using probabilistic tractography and the top tan cortical regions with the greatest number of thalamocortical streamlines for the TDC group were selected for further analysis. The thalamus was parcellated based on its cortical connections. Differences between hemispheres for thalamocortical streamline numbers to each cortical region [asymmetry index (AI)], tract volume and tract microstructure [weighted mean fractional anisotropy (FA) and mean diffusivity (MD)] were calculated. Correlations between these measures (AI, FA and MD) and sensorimotor function were performed. Thalamocortical projections showed topographical organisation based on cortical connectivity. Projections to paracentral lobule, pre-central and post-central gyri showed greater AI in CP group, which indicates reduced streamlines on the ipsilesioned hemisphere. Reduced FA, reduced tract volume and increased MD were also found for these thalamocortical projections on the ipsilesioned hemisphere in children with CP. Changes in AI and tract microstructure of these projections were associated with poorer sensorimotor function. The findings suggest CP is associated with reorganisation of thalamocortical projections to the sensorimotor cortex. Integrity in these projections may underpin deficits in sensorimotor function.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>24146132</pmid><doi>10.1007/s00429-013-0656-x</doi><tpages>12</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1863-2653 |
| ispartof | Brain Structure and Function, 2015-01, Vol.220 (1), p.307-318 |
| issn | 1863-2653 1863-2661 0340-2061 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1654665309 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Adolescent Anatomy & physiology Biomedical and Life Sciences Biomedicine Brain Brain Mapping Cell Biology Cerebral palsy Cerebral Palsy - complications Cerebral Palsy - pathology Child Child, Preschool Children & youth Developmental Disabilities - etiology Developmental Disabilities - pathology Diffusion Magnetic Resonance Imaging Female Humans Image Processing, Computer-Assisted Magnetic Resonance Imaging Male Medical imaging Neural Pathways - growth & development Neural Pathways - pathology Neurology Neurosciences Original Article Sensorimotor Cortex - pathology Severity of Illness Index Thalamus - growth & development Thalamus - pathology |
| title | Changes in the integrity of thalamocortical connections are associated with sensorimotor deficits in children with congenital hemiplegia |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-05T20%3A27%3A14IST&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=Changes%20in%20the%20integrity%20of%20thalamocortical%20connections%20are%20associated%20with%20sensorimotor%20deficits%20in%20children%20with%20congenital%20hemiplegia&rft.jtitle=Brain%20Structure%20and%20Function&rft.au=Tsao,%20Henry&rft.date=2015-01-01&rft.volume=220&rft.issue=1&rft.spage=307&rft.epage=318&rft.pages=307-318&rft.issn=1863-2653&rft.eissn=1863-2661&rft_id=info:doi/10.1007/s00429-013-0656-x&rft_dat=%3Cproquest_cross%3E1645778642%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1643098611&rft_id=info:pmid/24146132&rfr_iscdi=true |