{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:44:24Z","timestamp":1791996264135,"version":"4.4.0"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,12,26]],"date-time":"2020-12-26T00:00:00Z","timestamp":1608940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"The Medical Research Council","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"crossref"}]},{"name":"The Imperial Health Charity"},{"DOI":"10.13039\/501100013342","name":"NIHR Imperial Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013342","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NIHR Clinical Doctoral Research Fellowship"},{"name":"The US Department of Defense - Congressionally Directed Medical Research Program"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Vestibular dysfunction, causing dizziness and imbalance, is a common yet poorly understood feature in patients with TBI. Damage to the inner ear, nerve, brainstem, cerebellum and cerebral hemispheres may all affect vestibular functioning, hence, a multi-level assessment\u2014from reflex to perception\u2014is required. In a previous report, postural instability was the commonest neurological feature in ambulating acute patients with TBI. During ward assessment, we also frequently observe a loss of vertigo sensation in patients with acute TBI, common inner ear conditions and a related vigorous vestibular-ocular reflex nystagmus, suggesting a \u2018vestibular agnosia\u2019. Patients with vestibular agnosia were also more unbalanced; however, the link between vestibular agnosia and imbalance was confounded by the presence of inner ear conditions. We investigated the brain mechanisms of imbalance in acute TBI, its link with vestibular agnosia, and potential clinical impact, by prospective laboratory assessment of vestibular function, from reflex to perception, in patients with preserved peripheral vestibular function. Assessment included: vestibular reflex function, vestibular perception by participants\u2019 report of their passive yaw rotations in the dark, objective balance via posturography, subjective symptoms via questionnaires, and structural neuroimaging. We prospectively screened 918 acute admissions, assessed 146 and recruited 37. Compared to 37 matched controls, patients showed elevated vestibular-perceptual thresholds (patients 12.92\u00b0\/s versus 3.87\u00b0\/s) but normal vestibular-ocular reflex thresholds (patients 2.52\u00b0\/s versus 1.78\u00b0\/s). Patients with elevated vestibular-perceptual thresholds [3 standard deviations (SD) above controls\u2019 average], were designated as having vestibular agnosia, and displayed worse posturography than non-vestibular-agnosia patients, despite no difference in vestibular symptom scores. Only in patients with impaired postural control (3 SD above controls\u2019 mean), whole brain diffusion tensor voxel-wise analysis showed elevated mean diffusivity (and trend lower fractional anisotropy) in the inferior longitudinal fasciculus in the right temporal lobe that correlated with vestibular agnosia severity. Thus, impaired balance and vestibular agnosia are co-localized to the inferior longitudinal fasciculus in the right temporal lobe. Finally, a clinical audit showed a sevenfold reduction in clinician recognition of a common peripheral vestibular condition (benign paroxysmal positional vertigo) in acute patients with clinically apparent vestibular agnosia. That vestibular agnosia patients show worse balance, but without increased dizziness symptoms, explains why clinicians may miss treatable vestibular diagnoses in these patients. In conclusion, vestibular agnosia mediates imbalance in traumatic brain injury both directly via white matter tract damage in the right temporal lobe, and indirectly via reduced clinical recognition of common, treatable vestibular diagnoses.<\/jats:p>","DOI":"10.1093\/brain\/awaa386","type":"journal-article","created":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T15:21:06Z","timestamp":1602688866000},"page":"128-143","source":"Crossref","is-referenced-by-count":87,"title":["Vestibular agnosia in traumatic brain injury and its link to imbalance"],"prefix":"10.1093","volume":"144","author":[{"given":"Elena","family":"Calzolari","sequence":"first","affiliation":[{"name":"Brain and Vestibular Group, Neuro-Otology Unit, Department of Brain Sciences, Charing Cross Hospital, Imperial College London, London, W6 8RF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariya","family":"Chepisheva","sequence":"additional","affiliation":[{"name":"Brain and Vestibular Group, Neuro-Otology Unit, Department of Brain Sciences, Charing Cross Hospital, Imperial College London, London, W6 8RF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca M","family":"Smith","sequence":"additional","affiliation":[{"name":"Brain and Vestibular Group, Neuro-Otology Unit, Department of Brain Sciences, Charing Cross Hospital, Imperial College London, London, W6 8RF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2060-5093","authenticated-orcid":false,"given":"Mohammad","family":"Mahmud","sequence":"additional","affiliation":[{"name":"Brain and Vestibular Group, Neuro-Otology Unit, Department of Brain Sciences, Charing Cross Hospital, Imperial College London, London, W6 8RF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J","family":"Hellyer","sequence":"additional","affiliation":[{"name":"Centre for Neuroimaging Sciences, King\u2019s College London, London WC2R 2LS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vassilios","family":"Tahtis","sequence":"additional","affiliation":[{"name":"Brain and Vestibular Group, Neuro-Otology Unit, Department of Brain Sciences, Charing Cross Hospital, Imperial College London, London, W6 8RF, UK"},{"name":"King\u2019s College Hospital NHS Foundation Trust, SE5 9RS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qadeer","family":"Arshad","sequence":"additional","affiliation":[{"name":"InAmind Laboratory, Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, LE1 7RH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7413-9772","authenticated-orcid":false,"given":"Amy","family":"Jolly","sequence":"additional","affiliation":[{"name":"C3NL, Department of Brain Sciences, Hammersmith Hospital, Imperial College London, London, W12 0NN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Wilson","sequence":"additional","affiliation":[{"name":"St Mary\u2019s Hospital Major Trauma Centre, Imperial College Healthcare NHS Trust, London, W2 1NY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiko","family":"Rust","sequence":"additional","affiliation":[{"name":"Brain and Vestibular Group, Neuro-Otology Unit, Department of Brain Sciences, Charing Cross Hospital, Imperial College London, London, W6 8RF, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Sharp","sequence":"additional","affiliation":[{"name":"C3NL, Department of Brain Sciences, Hammersmith Hospital, Imperial College London, London, W12 0NN, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6578-0904","authenticated-orcid":false,"given":"Barry M","family":"Seemungal","sequence":"additional","affiliation":[{"name":"Brain and Vestibular Group, Neuro-Otology Unit, Department of Brain Sciences, Charing Cross Hospital, Imperial College London, London, W6 8RF, UK"},{"name":"St Mary\u2019s Hospital Major Trauma Centre, Imperial College Healthcare NHS Trust, London, W2 1NY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,26]]},"reference":[{"key":"2021021221073849500_awaa386-B1","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1007\/s00415-014-7301-3","article-title":"Clinical, cognitive, and behavioural correlates of white matter damage in progressive supranuclear palsy","volume":"261","author":"Agosta","year":"2014","journal-title":"J Neurol"},{"key":"2021021221073849500_awaa386-B2","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1002\/mrm.10609","article-title":"Characterization and propagation of uncertainty in diffusion-weighted MR imaging","volume":"50","author":"Behrens","year":"2003","journal-title":"Magn Reson Med"},{"key":"2021021221073849500_awaa386-B3","doi-asserted-by":"crossref","first-page":"13442","DOI":"10.1523\/JNEUROSCI.1163-11.2011","article-title":"Default mode network connectivity predicts sustained attention deficits after traumatic brain injury","volume":"31","author":"Bonnelle","year":"2011","journal-title":"J Neurosci"},{"key":"2021021221073849500_awaa386-B4","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1016\/S0140-6736(99)03179-7","article-title":"You are better off running than walking with acute vestibulopathy","volume":"354","author":"Brandt","year":"1999","journal-title":"Lancet"},{"key":"2021021221073849500_awaa386-B5","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1016\/j.apmr.2004.02.012","article-title":"Outcome after mild to moderate traumatic brain injury: the role of dizziness","volume":"85","author":"Chamelian","year":"2004","journal-title":"Arch Phys Med Rehabil"},{"key":"2021021221073849500_awaa386-B6","doi-asserted-by":"crossref","first-page":"4","DOI":"10.3389\/fneur.2016.00004","article-title":"Absence of rotation perception during warm water caloric irrigation in some seniors with postural instability","volume":"7","author":"Chiarovano","year":"2016","journal-title":"Front Neurol"},{"key":"2021021221073849500_awaa386-B7","article-title":"Vestibular deficits in neurodegenerative disorders: balance, dizziness, and spatial disorientation","volume":"8","author":"Cronin","year":"2017","journal-title":"Front Neurol"},{"key":"2021021221073849500_awaa386-B8","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1093\/cercor\/13.9.994","article-title":"Dominance for vestibular cortical function in the non-dominant hemisphere","volume":"13","author":"Dieterich","year":"2003","journal-title":"Cereb Cortex"},{"key":"2021021221073849500_awaa386-B9","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1590\/S1808-86942010000100019","article-title":"Elderly falls associated with benign paroxysmal positional vertigo","volume":"76","author":"Ganan\u00e7a","year":"2010","journal-title":"Braz J Otorhinolaryngol (Impr)"},{"key":"2021021221073849500_awaa386-B10","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.1001\/archneur.61.10.1590","article-title":"Is posttraumatic benign paroxysmal positional vertigo different from the idiopathic form?","volume":"61","author":"Gordon","year":"2004","journal-title":"Arch Neurol"},{"key":"2021021221073849500_awaa386-B11","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1097\/WCO.0b013e328359488f","article-title":"How can investigation of network function inform rehabilitation after traumatic brain injury?","volume":"25","author":"Ham","year":"2012","journal-title":"Curr Opin Neurol"},{"key":"2021021221073849500_awaa386-B12","first-page":"69","article-title":"Posttraumatic balance disorders","volume":"13","author":"Hoffer","year":"2007","journal-title":"Int Tinnitus J"},{"key":"2021021221073849500_awaa386-B13","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.aorl.2007.04.003","article-title":"Vertigo, dizziness and falls in the elderly","volume":"124","author":"Imbaud Genieys","year":"2007","journal-title":"Ann Otolaryngol Chir Cervicofac"},{"key":"2021021221073849500_awaa386-B14","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1001\/archotol.1990.01870040046011","article-title":"The development of the dizziness handicap inventory","volume":"116","author":"Jacobson","year":"1990","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"2021021221073849500_awaa386-B15","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1002\/ana.10726","article-title":"Reappraisal of the human vestibular cortex by cortical electrical stimulation study","volume":"54","author":"Kahane","year":"2003","journal-title":"Ann Neurol"},{"key":"2021021221073849500_awaa386-B16","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1093\/brain\/awv370","article-title":"Temporoparietal encoding of space and time during vestibular-guided orientation","volume":"139","author":"Kaski","year":"2016","journal-title":"Brain"},{"key":"2021021221073849500_awaa386-B17","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1093\/brain\/awq347","article-title":"White matter damage and cognitive impairment after traumatic brain injury","volume":"134","author":"Kinnunen","year":"2011","journal-title":"Brain"},{"key":"2021021221073849500_awaa386-B18","doi-asserted-by":"crossref","first-page":"1291","DOI":"10.1007\/s00429-014-0971-x","article-title":"Structural and functional connectivity mapping of the vestibular circuitry from human brainstem to cortex","volume":"221","author":"Kirsch","year":"2016","journal-title":"Brain Struct Funct"},{"key":"2021021221073849500_awaa386-B19","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1177\/0031512518809203","article-title":"Physical performance and fall risk in persons with traumatic brain injury","volume":"126","author":"Klima","year":"2019","journal-title":"Percept Mot Skills"},{"key":"2021021221073849500_awaa386-B20","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1097\/00001199-200609000-00001","article-title":"The epidemiology and impact of traumatic brain injury","volume":"21","author":"Langlois","year":"2006","journal-title":"J Head Trauma Rehabi"},{"key":"2021021221073849500_awaa386-B21","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1089\/neu.2006.0245","article-title":"The Mayo classification system for traumatic brain injury severity","volume":"24","author":"Malec","year":"2007","journal-title":"J Neurotrauma"},{"key":"2021021221073849500_awaa386-B22","doi-asserted-by":"crossref","first-page":"2430","DOI":"10.1007\/s00415-019-09403-z","article-title":"Vestibular dysfunction in acute traumatic brain injury","volume":"266","author":"Marcus","year":"2019","journal-title":"J Neurol"},{"key":"2021021221073849500_awaa386-B23","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1080\/02699050500488041","article-title":"Dizziness after traumatic brain injury: overview and measurement in the clinical setting","volume":"20","author":"Maskell","year":"2006","journal-title":"Brain Inj"},{"key":"2021021221073849500_awaa386-B24","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1080\/02699050701472109","article-title":"Dizziness after traumatic brain injury: results from an interview study","volume":"21","author":"Maskell","year":"2007","journal-title":"Brain Inj"},{"key":"2021021221073849500_awaa386-B25","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/hbm.1058","article-title":"Nonparametric permutation tests for functional neuroimaging: a primer with examples","volume":"15","author":"Nichols","year":"2002","journal-title":"Hum Brain Mapp"},{"key":"2021021221073849500_awaa386-B26","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1093\/cercor\/bht266","article-title":"The neuroanatomical correlates of training-related perceptuo-reflex uncoupling in dancers","volume":"25","author":"Nigmatullina","year":"2015","journal-title":"Cereb Cortex"},{"key":"2021021221073849500_awaa386-B27","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/S0194-5998(00)70187-2","article-title":"Unrecognized benign paroxysmal positional vertigo in elderly patients","volume":"122","author":"Oghalai","year":"2000","journal-title":"Otolaryngol Head Neck Surg"},{"key":"2021021221073849500_awaa386-B28","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1001\/archneur.57.10.1464","article-title":"Computerized posturography analysis of progressive supranuclear palsy","volume":"57","author":"Ondo","year":"2000","journal-title":"Arch Neurol"},{"key":"2021021221073849500_awaa386-B29","doi-asserted-by":"crossref","first-page":"M28","DOI":"10.1093\/gerona\/50A.1.M28","article-title":"The activities-specific balance confidence (ABC) Scale","volume":"50A","author":"Powell","year":"1995","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2021021221073849500_awaa386-B30","article-title":"The utility of the Sports Concussion Assessment Tool in hospitalized traumatic brain injury patients","author":"Sargeant","year":"2018","journal-title":"Journal of Concussion"},{"key":"2021021221073849500_awaa386-B31","author":"Seemungal","year":"5054"},{"key":"2021021221073849500_awaa386-B32","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1097\/WCO.0000000000000060","article-title":"The cognitive neurology of the vestibular system","volume":"27","author":"Seemungal","year":"2014","journal-title":"Curr Opin Neurol"},{"key":"2021021221073849500_awaa386-B33","doi-asserted-by":"crossref","first-page":"i3004","DOI":"10.1136\/bmj.i3004","article-title":"Screening for BPPV in falls: an easy but big clinical \u2018win\u2019","volume":"353","author":"Seemungal","year":"2016","journal-title":"BMJ"},{"key":"2021021221073849500_awaa386-B34","doi-asserted-by":"crossref","first-page":"461","DOI":"10.3233\/VES-2004-14604","article-title":"Perceptual and nystagmic thresholds of vestibular function in yaw","volume":"14","author":"Seemungal","year":"2004","journal-title":"J Vestib Res"},{"key":"2021021221073849500_awaa386-B35","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1097\/00001199-199810000-00007","article-title":"Impaired awareness and employment outcome after traumatic brain injury","volume":"13","author":"Sherer","year":"1998","journal-title":"J Head Trauma Rehabil"},{"key":"2021021221073849500_awaa386-B36","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1093\/brain\/117.5.1023","article-title":"The brain activity related to residual motion vision in a patient with bilateral lesions of V5","volume":"117 (Pt 5","author":"Shipp","year":"1994","journal-title":"Brain"},{"key":"2021021221073849500_awaa386-B37","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1002\/hbm.10062","article-title":"Fast robust automated brain extraction","volume":"17","author":"Smith","year":"2002","journal-title":"Hum Brain Mapp"},{"key":"2021021221073849500_awaa386-B38","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1016\/j.neuroimage.2006.02.024","article-title":"Tract-based spatial statistics: voxelwise analysis of multi-subject diffusion data","volume":"31","author":"Smith","year":"2006","journal-title":"Neuroimage"},{"key":"2021021221073849500_awaa386-B39","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.neuroimage.2004.07.051","article-title":"Advances in functional and structural MR image analysis and implementation as FSL","volume":"23","author":"Smith","year":"2004","journal-title":"Neuroimage"},{"key":"2021021221073849500_awaa386-B40","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.neuroimage.2008.03.061","article-title":"Threshold-free cluster enhancement: addressing problems of smoothing, threshold dependence and localisation in cluster inference","volume":"44","author":"Smith","year":"2009","journal-title":"Neuroimage"},{"key":"2021021221073849500_awaa386-B41","doi-asserted-by":"crossref","first-page":"137","DOI":"10.3758\/BF03203817","article-title":"A rapid technique to assess the resting states of the eyes and other threshold phenomena: the Modified Binary Search (MOBS)","volume":"20","author":"Tyrrell","year":"1988","journal-title":"Behav Res Methods Instruments Comput"},{"key":"2021021221073849500_awaa386-B42","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3389\/fnint.2014.00053","article-title":"Vestibular function in the temporal and parietal cortex: distinct velocity and inertial processing pathways","volume":"8","author":"Ventre-Dominey","year":"2014","journal-title":"Front Integr Neurosci"},{"key":"2021021221073849500_awaa386-B43","doi-asserted-by":"crossref","first-page":"1884","DOI":"10.1016\/S0028-3932(03)00126-X","article-title":"Evidence for interacting cortical control of vestibular function and spatial representation in man","volume":"41","author":"Ventre-Dominey","year":"2003","journal-title":"Neuropsychologia"},{"key":"2021021221073849500_awaa386-B44","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.neurobiolaging.2010.02.009","article-title":"Age-related decline in white matter tract integrity and cognitive performance: a DTI tractography and structural equation modeling study","volume":"33","author":"Voineskos","year":"2012","journal-title":"Neurobiol Aging"},{"key":"2021021221073849500_awaa386-B45","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1136\/jnnp.2006.100420","article-title":"Epidemiology of benign paroxysmal positional vertigo: a population based study","volume":"78","author":"von Brevern","year":"2007","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2021021221073849500_awaa386-B46","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1001\/archneurol.2011.107","article-title":"Clinical correlates of white matter tract degeneration in progressive supranuclear palsy","volume":"68","author":"Whitwell","year":"2011","journal-title":"Arch Neurol"},{"key":"2021021221073849500_awaa386-B47","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1089\/brain.2017.0544","article-title":"White matter connectivity of the visual-vestibular cortex examined by diffusion-weighted imaging","volume":"8","author":"Wirth","year":"2018","journal-title":"Brain Connect"},{"key":"2021021221073849500_awaa386-B48","doi-asserted-by":"crossref","first-page":"S173","DOI":"10.1016\/j.neuroimage.2008.10.055","article-title":"Bayesian analysis of neuroimaging data in FSL","volume":"45","author":"Woolrich","year":"2009","journal-title":"Neuroimage"}],"container-title":["Brain"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/brain\/article-pdf\/144\/1\/128\/36247909\/awaa386.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/brain\/article-pdf\/144\/1\/128\/36247909\/awaa386.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T03:34:12Z","timestamp":1669174452000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/brain\/article\/144\/1\/128\/6050089"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,26]]},"references-count":48,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,12,26]]},"published-print":{"date-parts":[[2021,2,12]]}},"URL":"https:\/\/doi.org\/10.1093\/brain\/awaa386","relation":{},"ISSN":["0006-8950","1460-2156"],"issn-type":[{"value":"0006-8950","type":"print"},{"value":"1460-2156","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,1,1]]},"published":{"date-parts":[[2020,12,26]]}}}