{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T17:02:57Z","timestamp":1784566977014,"version":"3.55.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T00:00:00Z","timestamp":1631491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T00:00:00Z","timestamp":1631491200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurol. Res. Pract."],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>More patients with left-hemispheric than right-hemispheric strokes are admitted to hospitals. This is due to the easier recognition of cortical symptoms of the dominant-hemisphere. The thalamus constitutes a \u201cmicro-model\u201d of the brain cortex with structure-function relationships known to be asymmetric, especially for language, memory, and visuo-spatial neurocognitive functions. The goal of this study was to characterize clinical symptoms and lesion distribution patterns of patients with acute isolated thalamic stroke (ITS) and to evaluate whether left-sided lesions are overrepresented in the hospital.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We performed a radiological database search including all brain scans performed in the Center of Neurology and Neurosurgery of the University Hospital Frankfurt between 2010 and 2019. A total of 5733 patients presenting with acute ischemic stroke were screened for ITS. Based on the MRI data, a lesion-overlap map was then generated to visualize the ITS lesion distribution.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Fifty-eight patients with unilateral ITS were identified. A majority of 38 patients (65.5%) showed left-sided ITS, whereas only 20 patients (34.5%) had right-sided ITS (<jats:italic>p<\/jats:italic>\u2009=\u20090.012). A particular difference was found for ITS lesions in the anterior thalamus of the anterolateral (<jats:italic>n<\/jats:italic>\u2009=\u200910) and anteromedian (<jats:italic>n<\/jats:italic>\u2009=\u20093) vascular territory, which were located in the left thalamus in 85% of patients (<jats:italic>p<\/jats:italic>\u2009=\u20090.011). No distribution difference was found for ITS lesions in the inferomedial (<jats:italic>n<\/jats:italic>\u2009=\u20097), central (<jats:italic>n<\/jats:italic>\u2009=\u20098), inferolateral (<jats:italic>n<\/jats:italic>\u2009=\u200923) and posterior (n\u2009=\u20097) vascular territories. The neuropsychological symptoms of thalamic aphasia (<jats:italic>n<\/jats:italic>\u2009=\u20098), neurocognitive impairment (<jats:italic>n<\/jats:italic>\u2009=\u20096), behavioral changes (<jats:italic>n<\/jats:italic>\u2009=\u20092), neglect (n\u2009=\u20092) and memory deficits (<jats:italic>n<\/jats:italic>\u2009=\u20093) were described predominantly in patients with left-sided ITS (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). In contrast, other stroke symptoms (e.g., sensorimotor hemi-syndromes) did not reveal a side preponderance.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The better recognizability of left anterior compared to right anterior thalamic stroke symptoms may have an impact on the frequency in which ITS patients are admitted to the hospital. Clinical characteristics of right anterior thalamic stroke should therefore be further investigated, and diagnostic instruments towards their detection be identified.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s42466-021-00148-7","type":"journal-article","created":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T02:02:48Z","timestamp":1631498568000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Isolated thalamic stroke \u2013 analysis of clinical characteristics and asymmetry of lesion distribution in a retrospective cohort study"],"prefix":"10.1186","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1447-9908","authenticated-orcid":false,"given":"Martin A.","family":"Schaller-Paule","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariane Martinez","family":"Oeckel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-R\u00fcdiger","family":"Sch\u00fcre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fee","family":"Keil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elke","family":"Hattingen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Foerch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Rauch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,9,13]]},"reference":[{"issue":"9483","key":"148_CR1","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1016\/s0140-6736(05)67024-9","volume":"366","author":"C Foerch","year":"2005","unstructured":"Foerch, C., Misselwitz, B., Sitzer, M., Berger, K., Steinmetz, H., & Neumann-Haefelin, T. (2005). Difference in recognition of right and left hemispheric stroke. The Lancet., 366(9483), 392\u2013393. https:\/\/doi.org\/10.1016\/s0140-6736(05)67024-9.","journal-title":"The Lancet."},{"issue":"1","key":"148_CR2","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1161\/STROKEAHA.114.007385","volume":"46","author":"ML Portegies","year":"2015","unstructured":"Portegies, M. L., Selwaness, M., Hofman, A., Koudstaal, P. J., Vernooij, M. W., & Ikram, M. A. (2015). Left-sided strokes are more often recognized than right-sided strokes: The Rotterdam study. Stroke., 46(1), 252\u2013254. https:\/\/doi.org\/10.1161\/STROKEAHA.114.007385.","journal-title":"Stroke."},{"issue":"6","key":"148_CR3","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1212\/wnl.38.6.837","volume":"38","author":"J Bogousslavsky","year":"1988","unstructured":"Bogousslavsky, J., Regli, F., & Uske, A. (1988). Thalamic infarcts: Clinical syndromes, etiology, and prognosis. Neurology., 38(6), 837\u2013848. https:\/\/doi.org\/10.1212\/wnl.38.6.837.","journal-title":"Neurology."},{"issue":"9","key":"148_CR4","doi-asserted-by":"publisher","first-page":"2264","DOI":"10.1161\/01.Str.0000087786.38997.9e","volume":"34","author":"JD Schmahmann","year":"2003","unstructured":"Schmahmann, J. D. (2003). Vascular syndromes of the thalamus. Stroke., 34(9), 2264\u20132278. https:\/\/doi.org\/10.1161\/01.Str.0000087786.38997.9e.","journal-title":"Stroke."},{"issue":"9","key":"148_CR5","doi-asserted-by":"publisher","first-page":"1615","DOI":"10.1007\/s00330-004-2303-7","volume":"14","author":"S Weidauer","year":"2004","unstructured":"Weidauer, S., Nichtweiss, M., Zanella, F. E., & Lanfermann, H. (2004). Assessment of paramedian thalamic infarcts: MR imaging, clinical features and prognosis. European Radiology., 14(9), 1615\u20131626. https:\/\/doi.org\/10.1007\/s00330-004-2303-7.","journal-title":"European Radiology."},{"issue":"2","key":"148_CR6","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1002\/ana.410100204","volume":"10","author":"P Castaigne","year":"1981","unstructured":"Castaigne, P., Lhermitte, F., Buge, A., Escourolle, R., Hauw, J. J., & Lyon-Caen, O. (1981). Paramedian thalamic and midbrain infarct: Clinical and neuropathological study. Annals of Neurology, 10(2), 127\u2013148. https:\/\/doi.org\/10.1002\/ana.410100204.","journal-title":"Annals of Neurology"},{"issue":"10","key":"148_CR7","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1136\/jnnp.2010.239624","volume":"82","author":"Y-M Song","year":"2011","unstructured":"Song, Y.-M. (2011). Topographic patterns of thalamic infarcts in association with stroke syndromes and aetiologies. Journal of Neurology, Neurosurgery & Psychiatry., 82(10), 1083\u20131086. https:\/\/doi.org\/10.1136\/jnnp.2010.239624.","journal-title":"Journal of Neurology, Neurosurgery & Psychiatry."},{"issue":"2","key":"148_CR8","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1002\/1531-8249(200008)48:2<220::Aid-ana12>3.0.Co;2-m","volume":"48","author":"F Ghika-Schmid","year":"2000","unstructured":"Ghika-Schmid, F., & Bogousslavsky, J. (2000). The acute behavioral syndrome of anterior thalamic infarction: A prospective study of 12 cases. Annals of Neurology, 48(2), 220\u2013227. https:\/\/doi.org\/10.1002\/1531-8249(200008)48:2<220::Aid-ana12>3.0.Co;2-m.","journal-title":"Annals of Neurology"},{"key":"148_CR9","doi-asserted-by":"publisher","unstructured":"Li, S., Kumar, Y., Gupta, N., Abdelbaki, A., Sahwney, H., Kumar, A., \u2026 Mangla, R. (2018). Clinical and neuroimaging findings in thalamic territory infarctions: A review. Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging., 28(4), 343\u2013349. https:\/\/doi.org\/10.1111\/jon.12503.","DOI":"10.1111\/jon.12503"},{"issue":"1 Evolution and","key":"148_CR10","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1111\/j.1749-6632.1977.tb41923.x","volume":"299","author":"GA Ojemann","year":"1977","unstructured":"Ojemann, G. A. (1977). Asymmetric function of the thalamus in man. Annals of the New York Academy of Sciences., 299(1 Evolution and), 380\u2013396. https:\/\/doi.org\/10.1111\/j.1749-6632.1977.tb41923.x.","journal-title":"Annals of the New York Academy of Sciences."},{"issue":"3","key":"148_CR11","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/j.cortex.2010.09.002","volume":"47","author":"W Ld","year":"2011","unstructured":"Ld, W., Brouns, R., Kavadias, D., Engelborghs, S., PPd, D., & Mari\u00ebn, P. (2011). Cognitive, affective and behavioural disturbances following vascular thalamic lesions: a review. Cortex; a journal devoted to the study of the nervous system and behavior, 47(3), 273\u2013319. https:\/\/doi.org\/10.1016\/j.cortex.2010.09.002.","journal-title":"Cortex; a journal devoted to the study of the nervous system and behavior"},{"issue":"3","key":"148_CR12","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1161\/01.str.17.3.434","volume":"17","author":"J Bogousslavsky","year":"1986","unstructured":"Bogousslavsky, J., Regli, F., & Assal, G. (1986). The syndrome of unilateral tuberothalamic artery territory infarction. Stroke., 17(3), 434\u2013441. https:\/\/doi.org\/10.1161\/01.str.17.3.434.","journal-title":"Stroke."},{"issue":"1","key":"148_CR13","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1007\/s00415-019-09560-1","volume":"267","author":"M Fritsch","year":"2020","unstructured":"Fritsch, M., Krause, T., Klostermann, F., Villringer, K., Ihrke, M., & Nolte, C. H. (2020). \"Thalamic aphasia\" after stroke is associated with left anterior lesion location. Journal of Neurology, 267(1), 106\u2013112. https:\/\/doi.org\/10.1007\/s00415-019-09560-1.","journal-title":"Journal of Neurology"},{"issue":"3","key":"148_CR14","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1002\/ana.1139","volume":"50","author":"S Ortigue","year":"2001","unstructured":"Ortigue, S., Viaud-Delmon, I., Annoni, J. M., Landis, T., Michel, C., Blanke, O., et al. (2001). Pure representational neglect after right thalamic lesion. Annals of Neurology, 50(3), 401\u2013404. https:\/\/doi.org\/10.1002\/ana.1139.","journal-title":"Annals of Neurology"},{"issue":"1","key":"148_CR15","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1136\/jnnp.66.1.36","volume":"66","author":"YD van der Werf","year":"1999","unstructured":"van der Werf, Y. D., Weerts, J. G., Jolles, J., Witter, M. P., Lindeboom, J., & Scheltens, P. (1999). Neuropsychological correlates of a right unilateral lacunar thalamic infarction. Journal of Neurology, Neurosurgery & Psychiatry., 66(1), 36\u201342. https:\/\/doi.org\/10.1136\/jnnp.66.1.36.","journal-title":"Journal of Neurology, Neurosurgery & Psychiatry."},{"issue":"12","key":"148_CR16","doi-asserted-by":"publisher","first-page":"1817","DOI":"10.1212\/01.wnl.0000219679.95223.4c","volume":"66","author":"E Carrera","year":"2006","unstructured":"Carrera, E., & Bogousslavsky, J. (2006). The thalamus and behavior: Effects of anatomically distinct strokes. Neurology., 66(12), 1817\u20131823. https:\/\/doi.org\/10.1212\/01.wnl.0000219679.95223.4c.","journal-title":"Neurology."},{"issue":"14","key":"148_CR17","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1212\/wnl.0000000000008209","volume":"93","author":"A Gu\u00e9don","year":"2019","unstructured":"Gu\u00e9don, A., Thiebaut, J.-B., Benichi, S., Mikol, J., Moxham, B., & Plaisant, O. (2019). Dejerine-Roussy syndrome: Historical cases. Neurology., 93(14), 624\u2013629. https:\/\/doi.org\/10.1212\/wnl.0000000000008209.","journal-title":"Neurology."},{"issue":"5\u20136","key":"148_CR18","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1159\/000490070","volume":"79","author":"N Gupta","year":"2018","unstructured":"Gupta, N., & Pandey, S. (2018). Post-thalamic stroke movement disorders: A systematic review. European Neurology, 79(5\u20136), 303\u2013314. https:\/\/doi.org\/10.1159\/000490070.","journal-title":"European Neurology"},{"key":"148_CR19","doi-asserted-by":"publisher","unstructured":"Fritsch, M., Villringer, K., Ganeshan, R., Rangus, I., & Nolte, C. H. (2021). Frequency, clinical presentation and outcome of vigilance impairment in patients with uni- and bilateral ischemic infarction of the paramedian thalamus. Journal of Neurology. https:\/\/doi.org\/10.1007\/s00415-021-10565-y.","DOI":"10.1007\/s00415-021-10565-y"},{"issue":"7","key":"148_CR20","doi-asserted-by":"publisher","first-page":"750","DOI":"10.1038\/nn1075","volume":"6","author":"TEJ Behrens","year":"2003","unstructured":"Behrens, T. E. J., Johansen-Berg, H., Woolrich, M. W., Smith, S. M., Wheeler-Kingshott, C. A. M., Boulby, P. A., \u2026 Matthews, P. M. (2003). Non-invasive mapping of connections between human thalamus and cortex using diffusion imaging. Nature Neuroscience., 6(7), 750\u2013757. https:\/\/doi.org\/10.1038\/nn1075.","journal-title":"Nature Neuroscience."},{"issue":"6","key":"148_CR21","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1111\/jon.12235","volume":"25","author":"J Goerlitz","year":"2015","unstructured":"Goerlitz, J., Wenz, H., Al-Zghloul, M., Kerl, H. U., Groden, C., & F\u00f6rster, A. (2015). Anatomical variations in the posterior circle of Willis and Vascular pathologies in isolated unilateral thalamic infarction. Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging., 25(6), 983\u2013988. https:\/\/doi.org\/10.1111\/jon.12235.","journal-title":"Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging."},{"issue":"12","key":"148_CR22","doi-asserted-by":"publisher","first-page":"2826","DOI":"10.1161\/01.STR.0000147039.49252.2f","volume":"35","author":"E Carrera","year":"2004","unstructured":"Carrera, E., Michel, P., & Bogousslavsky, J. (2004). Anteromedian, central, and posterolateral infarcts of the thalamus: Three variant types. Stroke., 35(12), 2826\u20132831. https:\/\/doi.org\/10.1161\/01.STR.0000147039.49252.2f.","journal-title":"Stroke."},{"issue":"10","key":"148_CR23","doi-asserted-by":"publisher","first-page":"1330","DOI":"10.1016\/s0028-3932(03)00059-9","volume":"41","author":"YD van der Werf","year":"2003","unstructured":"van der Werf, Y. D., Scheltens, P., Lindeboom, J., Witter, M. P., Uylings, H. B. M., & Jolles, J. (2003). Deficits of memory, executive functioning and attention following infarction in the thalamus; a study of 22 cases with localised lesions. Neuropsychologia., 41(10), 1330\u20131344. https:\/\/doi.org\/10.1016\/s0028-3932(03)00059-9.","journal-title":"Neuropsychologia."},{"issue":"6","key":"148_CR24","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1053\/jscd.2000.18741","volume":"9","author":"E Kumral","year":"2000","unstructured":"Kumral, E., Evyapan, D., & Kutluhan, S. (2000). Pure thalamic infarctions: Clinical findings. Journal of Stroke and Cerebrovascular Diseases., 9(6), 287\u2013297. https:\/\/doi.org\/10.1053\/jscd.2000.18741.","journal-title":"Journal of Stroke and Cerebrovascular Diseases."},{"issue":"1","key":"148_CR25","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s42466-020-00068-y","volume":"2","author":"E Barow","year":"2020","unstructured":"Barow, E., Pinnschmidt, H., Boutitie, F., Konigsberg, A., Ebinger, M., Endres, M., et al. (2020). Symptoms and probabilistic anatomical mapping of lacunar infarcts. Neurological Research and Practice, 2(1), 21. https:\/\/doi.org\/10.1186\/s42466-020-00068-y.","journal-title":"Neurological Research and Practice"},{"issue":"1","key":"148_CR26","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/s0022-510x(99)00267-1","volume":"172","author":"D Karussis","year":"2000","unstructured":"Karussis, D., Leker, R. R., & Abramsky, O. (2000). Cognitive dysfunction following thalamic stroke: A study of 16 cases and review of the literature. Journal of the Neurological Sciences, 172(1), 25\u201329. https:\/\/doi.org\/10.1016\/s0022-510x(99)00267-1.","journal-title":"Journal of the Neurological Sciences"},{"issue":"21","key":"148_CR27","doi-asserted-by":"publisher","first-page":"1869","DOI":"10.1212\/01.wnl.0000436078.95856.56","volume":"81","author":"ND Child","year":"2013","unstructured":"Child, N. D., & Benarroch, E. E. (2013). Anterior nucleus of the thalamus: Functional organization and clinical implications. Neurology., 81(21), 1869\u20131876. https:\/\/doi.org\/10.1212\/01.wnl.0000436078.95856.56.","journal-title":"Neurology."},{"key":"148_CR28","doi-asserted-by":"publisher","unstructured":"Rangus, I., Fritsch, M., Endres, M., Udke, B., & Nolte, C. H. (2021). Frequency and phenotype of thalamic aphasia. Journal of Neurology. https:\/\/doi.org\/10.1007\/s00415-021-10640-4.","DOI":"10.1007\/s00415-021-10640-4"},{"issue":"4","key":"148_CR29","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1155\/2008\/905187","volume":"19","author":"W de Ld","year":"2008","unstructured":"de Ld, W., Verhoeven, J., Engelborghs, S., PPd, D., & Mari\u00ebn, P. (2008). Crossed aphasia and visuo-spatial neglect following a right thalamic stroke: a case study and review of the literature. Behavioural Neurology, 19(4), 177\u2013194. https:\/\/doi.org\/10.1155\/2008\/905187.","journal-title":"Behavioural Neurology"},{"issue":"3","key":"148_CR30","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1016\/j.annemergmed.2014.10.018","volume":"65","author":"RM Mellor","year":"2015","unstructured":"Mellor, R. M., Bailey, S., Sheppard, J., Carr, P., Quinn, T., Boyal, A., et al. (2015). Decisions and delays within stroke patients' route to the hospital: a qualitative study. Annals of Emergency Medicine, 65(3), 279\u201387 e3. https:\/\/doi.org\/10.1016\/j.annemergmed.2014.10.018.","journal-title":"Annals of Emergency Medicine"},{"issue":"1","key":"148_CR31","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1186\/s42466-020-00060-6","volume":"2","author":"C Grefkes","year":"2020","unstructured":"Grefkes, C., & Fink, G. R. (2020). Recovery from stroke: Current concepts and future perspectives. Neurological Research\u00a0and\u00a0Practice, 2(1), 17. https:\/\/doi.org\/10.1186\/s42466-020-00060-6.","journal-title":"Neurological Research\u00a0and\u00a0Practice"},{"issue":"1","key":"148_CR32","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1186\/s42466-019-0044-y","volume":"1","author":"J Eyding","year":"2019","unstructured":"Eyding, J., Bartig, D., Weber, R., Katsanos, A. H., Weimar, C., Hacke, W., & Krogias, C. (2019). Inpatient TIA and stroke care in adult patients in Germany - retrospective analysis of nationwide administrative data sets of 2011 to 2017. Neurological Research\u00a0and\u00a0Practice, 1(1), 39. https:\/\/doi.org\/10.1186\/s42466-019-0044-y.","journal-title":"Neurological Research\u00a0and\u00a0Practice"}],"container-title":["Neurological Research and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42466-021-00148-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s42466-021-00148-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s42466-021-00148-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T02:06:31Z","timestamp":1631498791000},"score":1,"resource":{"primary":{"URL":"https:\/\/neurolrespract.biomedcentral.com\/articles\/10.1186\/s42466-021-00148-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,13]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["148"],"URL":"https:\/\/doi.org\/10.1186\/s42466-021-00148-7","relation":{},"ISSN":["2524-3489"],"issn-type":[{"value":"2524-3489","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,13]]},"assertion":[{"value":"11 June 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 August 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 September 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval for the study was granted by the institutional Review Board of the Ethical Committee at the University Hospital Frankfurt (REC number: 20\/616). Informed written consent was not required for this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The Authors declare that there is no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"49"}}