{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:53:42Z","timestamp":1791305622181,"version":"4.3.1"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"NIH NINDS","award":["R01NS122119"],"award-info":[{"award-number":["R01NS122119"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurocrit Care"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Neurologic complications are a leading cause of morbidity and mortality in children supported with extracorporeal membrane oxygenation (ECMO). Antemortem neuroimaging is limited, while postmortem neuropathology provides definitive but rarely available assessment. Correlating imaging with pathology may improve diagnostic accuracy and monitoring strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We performed a retrospective, single-center cohort study of neonates and children (0\u201318\u00a0years) supported with ECMO (2009\u20132024) who underwent cerebral autopsy. Standardized neuropathologic sampling across six brain regions classified injuries as mild, moderate, or severe. Antemortem imaging (computed tomography [CT] or head ultrasound [HUS]) within 7\u00a0days of death was reviewed by a blinded neuroradiologist and scored using a Neurologic Injury Severity (NIS) framework. Imaging\u2013pathology correlation was assessed in patients with both datasets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>A total of 54 patients underwent neuropathologic evaluation; 26 had qualifying neuroimaging. Neuropathology revealed frequent ischemic and hemorrhagic injuries, most commonly in the frontal lobes, deep grey matter, and temporal lobes. Severe injury was more frequent in venoarterial ECMO and in infants\/toddlers. NIS scores strongly correlated with global and regional histopathologic severity, particularly in frontal, temporal, and deep grey regions. Discordance was observed in parieto-occipital, pontine, and cerebellar regions, where immunohistochemistry (GFAP, CD68) detected subtle injuries not visible with hematoxylin and eosin (H&amp;E). Severe pathology consistently corresponded to NIS\u2009\u2265\u200910, while mild pathology aligned with low scores and limited involvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Structured imaging severity scoring, especially with CT, correlates strongly with neuropathology in pediatric decedents of ECMO. Findings support NIS scoring as a surrogate for underlying pathology, while underscoring the need for refined histologic methods and adjunctive neuromonitoring to optimize neurologic surveillance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12028-026-02545-9","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T18:40:27Z","timestamp":1779820827000},"page":"787-797","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neuroimaging and Neuropathologic Findings in Pediatric Patients with ECMO: An Imaging\u2013Pathology Comparison"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0595-8480","authenticated-orcid":false,"given":"Margherita","family":"Tabet","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bill","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chasity","family":"Custer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Craig","family":"Morriss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumit","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aliya","family":"Abioye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscilla","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan","family":"Sanford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshmi","family":"Raman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veena","family":"Rajaram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Busch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"issue":"2","key":"2545_CR1","first-page":"287","volume":"17","author":"DI Bulas","year":"1996","unstructured":"Bulas DI, Taylor GA, O\u2019Donnell RM, Short BL, Fitz CR, Vezina G. Intracranial abnormalities in infants treated with extracorporeal membrane oxygenation: update on sonographic and CT findings. AJNR Am J Neuroradiol. 1996;17(2):287\u201394 ((In English)).","journal-title":"AJNR Am J Neuroradiol"},{"key":"2545_CR2","unstructured":"Organization ELS. ELSO Registry International Summary Report. ELSO. (https:\/\/www.elso.org\/registry\/internationalsummaryandreports\/internationalsummary.aspx)."},{"issue":"6","key":"2545_CR3","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1097\/PCC.0000000000000415","volume":"16","author":"MM Bembea","year":"2015","unstructured":"Bembea MM, Felling R, Anton B, Salorio CF, Johnston MV. Neuromonitoring during extracorporeal membrane oxygenation: a systematic review of the literature. Pediatr Crit Care Med. 2015;16(6):558\u201364. https:\/\/doi.org\/10.1097\/PCC.0000000000000415.","journal-title":"Pediatr Crit Care Med"},{"issue":"10","key":"2545_CR4","doi-asserted-by":"publisher","first-page":"2336","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.05.022","volume":"26","author":"JF Rilinger","year":"2017","unstructured":"Rilinger JF, Smith CM, de Regnier RAO, et al. Transcranial Doppler identification of neurologic injury during pediatric extracorporeal membrane oxygenation therapy. J Stroke Cerebrovasc Dis. 2017;26(10):2336\u201345. https:\/\/doi.org\/10.1016\/j.jstrokecerebrovasdis.2017.05.022.","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"2","key":"2545_CR5","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1097\/PCC.0000000000001778","volume":"20","author":"NF O'Brien","year":"2019","unstructured":"O\u2019Brien NF, Buttram SDW, Maa T, et al. Cerebrovascular physiology during pediatric extracorporeal membrane oxygenation: a multicenter study using transcranial Doppler ultrasonography. Pediatr Crit Care Med. 2019;20(2):178\u201386. https:\/\/doi.org\/10.1097\/PCC.0000000000001778.","journal-title":"Pediatr Crit Care Med"},{"issue":"2","key":"2545_CR6","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1053\/j.semperi.2017.12.007","volume":"42","author":"N Lin","year":"2018","unstructured":"Lin N, Flibotte J, Licht DJ. Neuromonitoring in the neonatal ECMO patient. Semin Perinatol. 2018;42(2):111\u201321. https:\/\/doi.org\/10.1053\/j.semperi.2017.12.007.","journal-title":"Semin Perinatol"},{"key":"2545_CR7","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9082512","author":"J Fox","year":"2020","unstructured":"Fox J, Jenks CL, Farhat A, et al. EEG is a predictor of neuroimaging abnormalities in pediatric extracorporeal membrane oxygenation. J Clin Med. 2020. https:\/\/doi.org\/10.3390\/jcm9082512.","journal-title":"J Clin Med"},{"issue":"2","key":"2545_CR8","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1016\/0022-3468(94)90315-8","volume":"29","author":"EL Lazar","year":"1994","unstructured":"Lazar EL, Abramson SJ, Weinstein S, Stolar CJ. Neuroimaging of brain injury in neonates treated with extracorporeal membrane oxygenation: lessons learned from serial examinations. J Pediatr Surg. 1994;29(2):186\u201390. https:\/\/doi.org\/10.1016\/0022-3468(94)90315-8. (discussion 190-1).","journal-title":"J Pediatr Surg"},{"issue":"1","key":"2545_CR9","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-024-05082-z","volume":"28","author":"SM Cho","year":"2024","unstructured":"Cho SM, Hwang J, Chiarini G, et al. Neurological monitoring and management for adult extracorporeal membrane oxygenation patients: Extracorporeal Life Support Organization consensus guidelines. Crit Care. 2024;28(1):296. https:\/\/doi.org\/10.1186\/s13054-024-05082-z.","journal-title":"Crit Care"},{"issue":"4","key":"2545_CR10","doi-asserted-by":"publisher","first-page":"338","DOI":"10.3171\/2011.1.Peds10443","volume":"7","author":"SL Hervey-Jumper","year":"2011","unstructured":"Hervey-Jumper SL, Annich GM, Yancon AR, Garton HJ, Muraszko KM, Maher CO. Neurological complications of extracorporeal membrane oxygenation in children. J Neurosurg Pediatr. 2011;7(4):338\u201344. https:\/\/doi.org\/10.3171\/2011.1.Peds10443.","journal-title":"J Neurosurg Pediatr"},{"issue":"11","key":"2545_CR11","doi-asserted-by":"publisher","DOI":"10.3390\/cells12111546","volume":"12","author":"S Khanduja","year":"2023","unstructured":"Khanduja S, Kim J, Kang JK, et al. Hypoxic-ischemic brain injury in ECMO: pathophysiology, neuromonitoring, and therapeutic opportunities. Cells. 2023;12(11):1546.","journal-title":"Cells"},{"issue":"1","key":"2545_CR12","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-019-2671-7","volume":"23","author":"CM Veraar","year":"2019","unstructured":"Veraar CM, Rin\u00f6sl H, K\u00fchn K, et al. Non-pulsatile blood flow is associated with enhanced cerebrovascular carbon dioxide reactivity and an attenuated relationship between cerebral blood flow and regional brain oxygenation. Crit Care. 2019;23(1):426. https:\/\/doi.org\/10.1186\/s13054-019-2671-7.","journal-title":"Crit Care"},{"issue":"1","key":"2545_CR13","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/j.jpedsurg.2011.10.017","volume":"47","author":"MD Rollins","year":"2012","unstructured":"Rollins MD, Hubbard A, Zabrocki L, Barnhart DC, Bratton SL. Extracorporeal membrane oxygenation cannulation trends for pediatric respiratory failure and central nervous system injury. J Pediatr Surg. 2012;47(1):68\u201375. https:\/\/doi.org\/10.1016\/j.jpedsurg.2011.10.017.","journal-title":"J Pediatr Surg"},{"issue":"5","key":"2545_CR14","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1352\/1944-7558-129.5.377","volume":"129","author":"OS Nakip","year":"2024","unstructured":"Nakip OS, Kesici S, Konuskan GD, Yazici MU, Konuskan B, Bayrakci B. Neurodevelopmental outcomes of pediatric cardiac extracorporeal membrane oxygenation survivors with central cannulation. Am J Intellect Dev Disabil. 2024;129(5):377\u201386. https:\/\/doi.org\/10.1352\/1944-7558-129.5.377.","journal-title":"Am J Intellect Dev Disabil"},{"issue":"9","key":"2545_CR15","doi-asserted-by":"publisher","first-page":"e1278","DOI":"10.1212\/wnl.0000000000011525","volume":"96","author":"IR Khan","year":"2021","unstructured":"Khan IR, Gu Y, George BP, et al. Brain histopathology of adult decedents after extracorporeal membrane oxygenation. Neurology. 2021;96(9):e1278\u201389. https:\/\/doi.org\/10.1212\/wnl.0000000000011525.","journal-title":"Neurology"},{"issue":"Suppl 15","key":"2545_CR16","doi-asserted-by":"publisher","first-page":"S1865","DOI":"10.21037\/jtd.2019.08.121","volume":"11","author":"C Aludaat","year":"2019","unstructured":"Aludaat C, Sarsam M, Doguet F, Baste JM. Autopsy and clinical discrepancies in patients undergoing extracorporeal membrane oxygenation: a case series-a step towards understanding \u201cWhy\u201d? J Thorac Dis. 2019;11(Suppl 15):S1865-s1868. https:\/\/doi.org\/10.21037\/jtd.2019.08.121.","journal-title":"J Thorac Dis"},{"issue":"4","key":"2545_CR17","doi-asserted-by":"publisher","first-page":"820","DOI":"10.3174\/ajnr.A5092","volume":"38","author":"MA Wien","year":"2017","unstructured":"Wien MA, Whitehead MT, Bulas D, et al. Patterns of brain injury in newborns treated with extracorporeal membrane oxygenation. AJNR Am J Neuroradiol. 2017;38(4):820\u20136. https:\/\/doi.org\/10.3174\/ajnr.A5092.","journal-title":"AJNR Am J Neuroradiol"},{"key":"2545_CR18","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.713333","volume":"8","author":"H Zhang","year":"2021","unstructured":"Zhang H, Xu J, Yang X, et al. Narrative review of neurologic complications in adults on ECMO: prevalence, risks, outcomes, and prevention strategies. Front Med (Lausanne). 2021;8:713333. https:\/\/doi.org\/10.3389\/fmed.2021.713333.","journal-title":"Front Med (Lausanne)"},{"issue":"6","key":"2545_CR19","doi-asserted-by":"publisher","first-page":"e532","DOI":"10.1097\/ccm.0000000000004289","volume":"48","author":"SM Cho","year":"2020","unstructured":"Cho SM, Geocadin RG, Caturegli G, et al. Understanding characteristics of acute brain injury in adult extracorporeal membrane oxygenation: an autopsy study. Crit Care Med. 2020;48(6):e532\u20136. https:\/\/doi.org\/10.1097\/ccm.0000000000004289.","journal-title":"Crit Care Med"},{"issue":"3","key":"2545_CR20","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1097\/pcc.0000000000002573","volume":"22","author":"G Caturegli","year":"2021","unstructured":"Caturegli G, Cho S-M, White B, Chen LL. Acute brain injury in infant venoarterial extracorporeal membrane oxygenation: an autopsy study*. Pediatr Crit Care Med. 2021;22(3):297\u2013302. https:\/\/doi.org\/10.1097\/pcc.0000000000002573.","journal-title":"Pediatr Crit Care Med"},{"issue":"1","key":"2545_CR21","doi-asserted-by":"publisher","first-page":"121","DOI":"10.2214\/ajr.153.1.121","volume":"153","author":"GA Taylor","year":"1989","unstructured":"Taylor GA, Fitz CR, Glass P, Short BL. CT of cerebrovascular injury after neonatal extracorporeal membrane oxygenation: implications for neurodevelopmental outcome. AJR Am J Roentgenol. 1989;153(1):121\u20136. https:\/\/doi.org\/10.2214\/ajr.153.1.121.","journal-title":"AJR Am J Roentgenol"},{"issue":"3","key":"2545_CR22","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1148\/radiology.165.3.3317499","volume":"165","author":"GA Taylor","year":"1987","unstructured":"Taylor GA, Fitz CR, Miller MK, Garin DB, Catena LM, Short BL. Intracranial abnormalities in infants treated with extracorporeal membrane oxygenation: imaging with US and CT. Radiology. 1987;165(3):675\u20138. https:\/\/doi.org\/10.1148\/radiology.165.3.3317499.","journal-title":"Radiology"},{"issue":"2","key":"2545_CR23","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1136\/archdischild-2020-319063","volume":"106","author":"C Del Rosario","year":"2021","unstructured":"Del Rosario C, Slevin M, Molloy EJ, Quigley J, Nixon E. How to use the Bayley Scales of Infant and Toddler Development. Arch Dis Child Educ Pract Ed. 2021;106(2):108\u201312. https:\/\/doi.org\/10.1136\/archdischild-2020-319063.","journal-title":"Arch Dis Child Educ Pract Ed"},{"issue":"3","key":"2545_CR24","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1097\/CCM.0000000000005308","volume":"50","author":"A Farhat","year":"2022","unstructured":"Farhat A, Li X, Huet B, Tweed J, Morriss MC, Raman L. Routine neuroimaging: understanding brain injury in pediatric extracorporeal membrane oxygenation. Crit Care Med. 2022;50(3):480\u201390. https:\/\/doi.org\/10.1097\/CCM.0000000000005308.","journal-title":"Crit Care Med"},{"issue":"9","key":"2545_CR25","doi-asserted-by":"publisher","first-page":"1594","DOI":"10.1007\/s00134-013-2985-x","volume":"39","author":"A Polito","year":"2013","unstructured":"Polito A, Barrett CS, Wypij D, et al. Neurologic complications in neonates supported with extracorporeal membrane oxygenation. An analysis of ELSO registry data. Intensive Care Med. 2013;39(9):1594\u2013601. https:\/\/doi.org\/10.1007\/s00134-013-2985-x.","journal-title":"Intensive Care Med"},{"issue":"4","key":"2545_CR26","doi-asserted-by":"publisher","DOI":"10.1117\/1.NPh.4.4.041410","volume":"4","author":"F Tian","year":"2017","unstructured":"Tian F, Morriss MC, Chalak L, et al. Impairment of cerebral autoregulation in pediatric extracorporeal membrane oxygenation associated with neuroimaging abnormalities. Neurophotonics. 2017;4(4):041410. https:\/\/doi.org\/10.1117\/1.NPh.4.4.041410.","journal-title":"Neurophotonics"},{"issue":"1","key":"2545_CR27","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurot.2024.e00521","volume":"22","author":"SJ Hong","year":"2025","unstructured":"Hong SJ, De Souza BJ, Penberthy KK, et al. Plasma brain-related biomarkers and potential therapeutic targets in pediatric ECMO. Neurotherapeutics. 2025;22(1):e00521. https:\/\/doi.org\/10.1016\/j.neurot.2024.e00521.","journal-title":"Neurotherapeutics"},{"issue":"5","key":"2545_CR28","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1097\/PCC.0b013e3181fe3ec7","volume":"12","author":"MM Bembea","year":"2011","unstructured":"Bembea MM, Savage W, Strouse JJ, et al. Glial fibrillary acidic protein as a brain injury biomarker in children undergoing extracorporeal membrane oxygenation. Pediatr Crit Care Med. 2011;12(5):572\u20139. https:\/\/doi.org\/10.1097\/PCC.0b013e3181fe3ec7.","journal-title":"Pediatr Crit Care Med"},{"issue":"1","key":"2545_CR29","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-024-05248-9","volume":"29","author":"B Deng","year":"2025","unstructured":"Deng B, Zhao Z, Ruan T, et al. Development and external validation of a machine learning model for brain injury in pediatric patients on extracorporeal membrane oxygenation. Crit Care. 2025;29(1):17. https:\/\/doi.org\/10.1186\/s13054-024-05248-9.","journal-title":"Crit Care"},{"issue":"1","key":"2545_CR30","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-023-04416-7","volume":"27","author":"H Sabir","year":"2023","unstructured":"Sabir H, Kipfmueller F, Bagci S, et al. Feasibility of bedside portable MRI in neonates and children during ECLS. Crit Care. 2023;27(1):134. https:\/\/doi.org\/10.1186\/s13054-023-04416-7.","journal-title":"Crit Care"},{"issue":"11","key":"2545_CR31","doi-asserted-by":"publisher","first-page":"e460","DOI":"10.1097\/mat.0000000000001990","volume":"69","author":"C Custer","year":"2023","unstructured":"Custer C, Singh S, Sanford E, et al. Computed tomography is predictive of significant neurologic injury in children supported on extracorporeal membrane oxygenation. ASAIO J. 2023;69(11):e460\u20132. https:\/\/doi.org\/10.1097\/mat.0000000000001990.","journal-title":"ASAIO J"},{"issue":"4","key":"2545_CR32","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1097\/WNP.0000000000000890","volume":"40","author":"A Chahine","year":"2023","unstructured":"Chahine A, Chenouard A, Joram N, et al. Continuous amplitude-integrated electroencephalography during neonatal and pediatric extracorporeal membrane oxygenation. J Clin Neurophysiol. 2023;40(4):317\u201324. https:\/\/doi.org\/10.1097\/WNP.0000000000000890.","journal-title":"J Clin Neurophysiol"},{"key":"2545_CR33","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.762731","volume":"8","author":"M Zhang","year":"2021","unstructured":"Zhang M, Yang Y, Chen X, et al. Application of near-infrared spectroscopy to monitor perfusion during extracorporeal membrane oxygenation after pediatric heart surgery. Front Med (Lausanne). 2021;8:762731. https:\/\/doi.org\/10.3389\/fmed.2021.762731.","journal-title":"Front Med (Lausanne)"},{"issue":"7","key":"2545_CR34","doi-asserted-by":"publisher","first-page":"e315","DOI":"10.1097\/MAT.0000000000001970","volume":"69","author":"EL Sanford","year":"2023","unstructured":"Sanford EL, Akorede R, Miller I, et al. Association between disrupted cerebral autoregulation and radiographic neurologic injury for children on extracorporeal membrane oxygenation: a prospective pilot study. ASAIO J. 2023;69(7):e315\u201321. https:\/\/doi.org\/10.1097\/MAT.0000000000001970.","journal-title":"ASAIO J"},{"issue":"6","key":"2545_CR35","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1038\/s41390-020-0841-6","volume":"88","author":"DR Busch","year":"2020","unstructured":"Busch DR, Baker WB, Mavroudis CD, et al. Noninvasive optical measurement of microvascular cerebral hemodynamics and autoregulation in the neonatal ECMO patient. Pediatr Res. 2020;88(6):925\u201333. https:\/\/doi.org\/10.1038\/s41390-020-0841-6.","journal-title":"Pediatr Res"}],"container-title":["Neurocritical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12028-026-02545-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12028-026-02545-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12028-026-02545-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:10:41Z","timestamp":1791303041000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12028-026-02545-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,26]]},"references-count":35,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["2545"],"URL":"https:\/\/doi.org\/10.1007\/s12028-026-02545-9","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-8745399\/v1","asserted-by":"object"}]},"ISSN":["1541-6933","1556-0961"],"issn-type":[{"value":"1541-6933","type":"print"},{"value":"1556-0961","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,26]]},"assertion":[{"value":"2 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that they have no conflicts of interest.","order":1,"name":"Ethics","label":"Conflicts of Interest","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"The study protocol (STU-2022-0723) was approved by the Institutional Review Board of the University of Texas Southwestern Medical Center on 12 September 2024. Informed consent was waived due to the retrospective nature of the study.","order":2,"name":"Ethics","label":"Ethical Approval\/Informed Consent","group":{"name":"EthicsHeading","label":"Ethics"}}]}}