{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T06:57:29Z","timestamp":1775804249054,"version":"3.50.1"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Knee osteoarthritis (KOA) is one of the most common musculoskeletal disorders in older adults, often leading to chronic pain, functional decline, and reduced quality of life. Conventional rehabilitation strategies frequently achieve only partial relief, which has stimulated interest in non-invasive electrical stimulation (NIES) as an adjunctive therapy. Therefore, the aim of this study was to synthesize the available evidence on the effects of NIES on pain and function in middle-aged and older adults with knee osteoarthritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis, conducted in accordance with PRISMA guidelines, evaluated randomized and controlled trials investigating the effects of transcranial direct current stimulation (tDCS), neuromuscular electrical stimulation (NMES and WB-EMS), transcutaneous electrical nerve stimulation (TENS), and innovative modalities such as cranial electrical stimulation (CES) and transcutaneous vagus nerve stimulation (tVNS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 15 randomized controlled trials, including 1,137 participants, met the inclusion criteria. The overall pooled analysis demonstrated significant improvements in pain and function with NIES, though heterogeneity was high. Subgroup analyses showed that tDCS produced consistent, moderate analgesic effects, while NMES and WB-EMS improved quadriceps strength, mobility, and patient-reported outcomes, especially in individuals with muscle weakness. TENS yielded the most variable results, with limited efficacy beyond short-term analgesia. CES and tVNS were supported by only two small trials, suggesting potential benefits but precluding pooled analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NIES appears to be a safe and promising adjunct in multimodal rehabilitation for KOA, though further large-scale, high-quality trials are required to confirm its clinical effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>identifier: CRD420251174723.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1792432","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T06:02:05Z","timestamp":1775800925000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Noninvasive electrical stimulation on pain and function in knee osteoarthritis in middle-aged and older adults: systematic review and meta-analysis of randomized clinical trials"],"prefix":"10.3389","volume":"13","author":[{"given":"Marta","family":"Cano-Orihuela","sequence":"first","affiliation":[{"name":"Department of Health Sciences, Faculty of Health Sciences, University of Atl\u00e1ntico Medio","place":["Las Palmas de Gran Canaria, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agust\u00edn","family":"Aibar-Almaz\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Faculty of Health Sciences, University of Ja\u00e9n","place":["Ja\u00e9n, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulino","family":"Vico-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Faculty of Health Sciences, University of Atl\u00e1ntico Medio","place":["Las Palmas de Gran Canaria, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fidel","family":"Hita-Contreras","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Faculty of Health Sciences, University of Atl\u00e1ntico Medio","place":["Las Palmas de Gran Canaria, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yolanda","family":"Castellote-Caballero","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Faculty of Health Sciences, University of Ja\u00e9n","place":["Ja\u00e9n, Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"B1","unstructured":"Osteoarthritis Fact Sheet\n          \n          2023"},{"key":"B2","doi-asserted-by":"publisher","first-page":"481","DOI":"10.3892\/etm.2023.12180","article-title":"Knee osteoarthritis: Current status and research progress in treatment (Review)","volume":"26","author":"Geng","year":"2023","journal-title":"Exp Ther Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"100587","DOI":"10.1016\/j.eclinm.2020.100587","article-title":"Global regional prevalence incidence and risk factors of knee osteoarthritis in population-based studies","volume":"29","author":"Cui","year":"2020","journal-title":"EClinicalMedicine."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e508","DOI":"10.1016\/s2665-9913(23)00163-7","article-title":"Global regional and national burden of osteoarthritis 1990\u20132020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021","volume":"5","author":"GBD","year":"2023","journal-title":"Lancet Rheumatol."},{"key":"B5","unstructured":"Musculoskeletal Health\n          \n          2022"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1154","DOI":"10.1016\/j.joca.2013.05.016","article-title":"The relationship between quadriceps muscle weakness and worseningof knee pain in the most cohort: a 5-year longitudinal study","volume":"21","author":"Glass","year":"2013","journal-title":"Osteoarthritis Cartilage."},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04179-8","article-title":"The effects on pain, physical function, and quality of life of quadriceps strengthening exercises combined with Baduanjin qigong in older adults with knee osteoarthritis: a quasi-experimental study","author":"Wang","year":"2021","journal-title":"BMC Musculoskelet Disord."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1344","DOI":"10.1002\/acr.22317","article-title":"association of thigh muscle strength with knee symptoms and radiographic disease stage of osteoarthritis: data from the osteoarthritis initiative","volume":"66","author":"Ruhdorfer","year":"2014","journal-title":"Arthritis Care Res."},{"key":"B9","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1152\/physrev.00061.2017","volume":"99","author":"Larsson","year":"2019","journal-title":"Physiol Rev."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1636976","DOI":"10.3389\/fmed.2025.1636976","article-title":"Burden of osteoarthritis in older adults (aged 55 years) in the United States and China: a comparative analysis of temporal trends risk factor contributions and projected burden to 2030 using global burden of disease study 2021 data","volume":"12","author":"Han","year":"2025","journal-title":"Front Med."},{"key":"B11","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1007\/s40262-024-01466-0","article-title":"Influence of ageing on the pharmacodynamics and pharmacokinetics of chronically administered medicines in geriatric patients: a review","volume":"64","author":"Ngcobo","year":"2025","journal-title":"Clin Pharmacokinet."},{"key":"B12","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1016\/j.joca.2014.10.008","article-title":"Knee extensor muscle weakness is a risk factor for development of knee osteoarthritis","volume":"23","author":"Oiestad","year":"2015","journal-title":"Arthritis Care Res."},{"key":"B13","doi-asserted-by":"publisher","first-page":"293","DOI":"10.2340\/16501977-2062","article-title":"Effects of neuromuscular electrical stimulation and low-level laser therapy on neuromuscular parameters and health status in elderly women with knee osteoarthritis: a randomized trial","volume":"48","author":"de Oliveira Melo","year":"2013","journal-title":"J Rehabil Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"100429","DOI":"10.1016\/j.ocarto.2023.100429","article-title":"The past and future of perioperative interventions to reduce arthrogenic quadriceps muscle inhibition after total knee arthroplasty: a narrative review","volume":"6","author":"Churchill","year":"2023","journal-title":"Osteoarthr Cartil Open."},{"key":"B15","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1007\/s00776-004-0876-2","article-title":"Age-related quadriceps-dominant muscle atrophy and incident radiographic knee osteoarthritis","volume":"10","author":"Ikeda","year":"2005","journal-title":"J Orthop Sci."},{"key":"B16","doi-asserted-by":"publisher","first-page":"769","DOI":"10.1016\/j.joca.2010.02.002","article-title":"Quadriceps weakness predicts risk for knee joint space narrowing in women in the MOST cohort","volume":"18","author":"Segal","year":"2010","journal-title":"Osteoarthr. Cartil."},{"key":"B17","doi-asserted-by":"publisher","first-page":"714","DOI":"10.14336\/AD.2024.0124-1","volume":"16","author":"Wang","year":"2024","journal-title":"Aging Dis."},{"key":"B18","doi-asserted-by":"publisher","first-page":"137","DOI":"10.2147\/JPR.S493162","article-title":"Latest advancements in transcutaneous electrical nerve stimulation (tens) and electronic muscle stimulation (EMS): revisiting an established therapy with new possibilities","volume":"18","author":"Patel","year":"2025","journal-title":"J Pain Res."},{"key":"B19","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1016\/j.cger.2010.03.002","volume":"26","author":"Loeser","year":"2010","journal-title":"Clin Geriatr Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1186\/s12891-024-08154-x","article-title":"Impact of electrical muscle stimulation-induced muscle contractions on endogenous pain modulatory system: a quantitative sensory testing evaluation","volume":"25","author":"Ohga","year":"2024","journal-title":"BMC Musculoskelet. Disord."},{"key":"B21","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1016\/j.jbspin.2010.08.001","article-title":"Management recommendations for knee osteoarthritis: how usable are they?","volume":"77","author":"Poitras","year":"","journal-title":"Joint Bone Spine."},{"key":"B22","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1177\/0269215511431902","article-title":"Neuromuscular electrical stimulation in the treatment of knee osteoarthritis: a systematic review and meta-analysis","volume":"26","author":"Giggins","year":"2012","journal-title":"Clin Rehabil."},{"key":"B23","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1186\/s12951-023-02211-8","article-title":"Microvesicles-hydrogel breaks the cycle of cellular senescence by improving mitochondrial function to treat osteoarthritis","volume":"21","author":"Liu","year":"2023","journal-title":"J Nanobiotechnology."},{"key":"B24","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.joca.2014.11.014","article-title":"Electrical stimulation for pain relief in knee osteoarthritis: Bayesian network meta-analysis","volume":"23","author":"Li","year":"2015","journal-title":"Osteoarthr. Cartil."},{"key":"B25","doi-asserted-by":"publisher","first-page":"e0178621","DOI":"10.1371\/journal.pone.0178621","article-title":"Effective treatment options for musculoskeletal pain in primary care: a systematic overview of current evidence","volume":"12","author":"Babatunde","year":"2017","journal-title":"PLoS ONE."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.3390\/life12111690","article-title":"Safety of electrotherapy treatment in patients with knee osteoarthritis and comorbidities","volume":"17","author":"Silva","year":"2022","journal-title":"Clin Interv Aging."},{"key":"B27","doi-asserted-by":"publisher","first-page":"e2062","DOI":"10.1002\/pri.2062","article-title":"Effectiveness of neuromuscular electrical stimulation training combined with exercise on patient-reported outcomes measures in people with knee osteoarthritis: a systematic review and meta-analysis","volume":"29","author":"Carvalho","year":"2024","journal-title":"Physiother."},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1177\/02692155211065636","article-title":"Effects of transcutaneous electrical nerve stimulation (TENS) in people with knee osteoarthritis: a systematic review and meta-analysis","author":"Wu","year":"2022","journal-title":"Clin Rehabil."},{"key":"B29","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/j.joca.2014.11.014","volume":"23","author":"Zeng","year":"2015","journal-title":"Osteoarthritis Cartilage."},{"key":"B30","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ."},{"key":"B31","unstructured":"editors\n          \n          \n            \n              Higgins\n              JPT\n            \n            \n              Thomas\n              J\n            \n            \n              Chandler\n              J\n            \n            \n              Cumpston\n              M\n            \n            \n              Li\n              T\n            \n            \n              Page\n              MJ\n            \n          \n          Cochrane Handbook for Systematic Reviews of Interventions version 6.5 (updated August 2024)"},{"key":"B32","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomized trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ."},{"key":"B33","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.jphys.2019.08.005","article-title":"Clinimetrics: physiotherapy evidence database (PEDro) scale","volume":"66","author":"Cashin","year":"2020","journal-title":"J Physiother."},{"key":"B34","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1016\/j.neucli.2021.06.002","volume":"51","author":"Rahimi","year":"2021","journal-title":"Neurophysiol Clin."},{"key":"B35","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1016\/j.brs.2021.02.018","article-title":"Motor cortex transcranial direct current stimulation effects on knee osteoarthritis pain in elderly subjects with dysfunctional descending pain inhibitory system: a randomized controlled trial","volume":"14","author":"Tavares","year":"2021","journal-title":"Brain Stimulation."},{"key":"B36","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1016\/j.neucli.2020.08.005","article-title":"Randomized clinical trial comparing transcranial direct current stimulation (tDCS) and transcutaneous electrical nerve stimulation (TENS) in knee osteoarthritis","volume":"50","author":"Sajadi","year":"2020","journal-title":"Neurophysiol Clin."},{"key":"B37","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/j.jocn.2020.05.003","article-title":"Feasibility and efficacy of remotely supervised cranial electrical stimulation for pain in older adults with knee osteoarthritis: a randomized controlled pilot study","volume":"77","author":"Ahn","year":"2020","journal-title":"J Clin Neurosci."},{"key":"B38","doi-asserted-by":"publisher","first-page":"684","DOI":"10.1186\/s12891-025-08924-1","article-title":"Transcranial direct current stimulation enhances the efficacy of wearable transcutaneous electrical nerve stimulation for mild knee osteoarthritis in the middle-aged person: a randomized controlled trial","volume":"26","author":"Xia","year":"2025","journal-title":"BMC Musculoskelet Disord."},{"key":"B39","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1186\/s12891-024-07266-8","article-title":"A controlled randomized trial with a 12-week follow-up investigating the effects of medium-frequency neuromuscular electrical stimulation on pain VMO thickness and functionality in patients with knee osteoarthritis","volume":"25","author":"Moezy","year":"2024","journal-title":"BMC Musculoskelet Disord"},{"key":"B40","doi-asserted-by":"publisher","first-page":"20804","DOI":"10.1038\/s41598-024-71552-7","article-title":"Effectiveness of whole-body electromyostimulation on knee pain and physical function in knee osteoarthritis: a randomized controlled trial","volume":"14","author":"Kast","year":"2024","journal-title":"Sci Rep."},{"key":"B41","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s12891-025-08288-6","article-title":"Transcutaneous vagus nerve stimulation as a pain modulator in knee osteoarthritis: a randomized controlled clinical trial","volume":"26","author":"Elsehrawy","year":"2025","journal-title":"BMC Musculoskelet Disord."},{"key":"B42","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1177\/1099800419869845","article-title":"The effect of transcranial direct current stimulation on inflammation in older adults with knee osteoarthritis: a Bayesian residual change analysis","volume":"22","author":"Suchting","year":"2020","journal-title":"Biol Res Nurs."},{"key":"B43","doi-asserted-by":"publisher","first-page":"7294","DOI":"10.1038\/s41598-020-64176-0","article-title":"Transcutaneous electrical nerve stimulation improves stair climbing capacity in people with knee osteoarthritis","volume":"10","author":"Iijima","year":"2020","journal-title":"Sci Rep."},{"key":"B44","doi-asserted-by":"publisher","first-page":"e22","DOI":"10.5435\/JAAOSGlobal-D-22-00115","article-title":"A novel mobile app-based neuromuscular electrical stimulation therapy for the management of knee osteoarthritis: results from an extension study of a randomized double-blind sham-controlled multicenter trial","volume":"6","author":"Dasa","year":"2022","journal-title":"J Am Acad Orthop Surg Glob Res Rev."},{"key":"B45","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1055\/s-0040-1713420","article-title":"Neuromuscular electrical stimulation use after total knee arthroplasty improves early return to function: a randomized trial","volume":"35","author":"Klika","year":"2022","journal-title":"J Knee Surg."},{"key":"B46","doi-asserted-by":"publisher","first-page":"e930363","DOI":"10.12659\/MSM.930363","article-title":"Prospective single-center comparison of transcranial direct current stimulation plus electroacupuncture and standard analgesia in patients after total knee arthroplasty: effect on rehabilitation and functional recovery","volume":"27","author":"Li","year":"2021","journal-title":"Med Sci Monit."},{"key":"B47","doi-asserted-by":"publisher","first-page":"2676","DOI":"10.1093\/pm\/pnaa268","article-title":"Changes in experimental pain sensitivity from using home-based remotely supervised transcranial direct current stimulation in older adults with knee osteoarthritis","volume":"21","author":"Suchting","year":"2020","journal-title":"Pain Medicine."},{"key":"B48","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1016\/j.joca.2021.10.015","article-title":"Effect of transcutaneous electrical nerve stimulation (TENS) on knee pain and physical function in patients with symptomatic knee osteoarthritis: the ETRELKA randomized clinical trial","volume":"30","author":"Reichenbach","year":"2022","journal-title":"OARS."},{"key":"B49","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1002\/acr.25249","article-title":"Transcranial direct current stimulation for knee osteoarthritis: a systematic review and meta-analysis","volume":"76","author":"Yang","year":"2024","journal-title":"Arthritis Care Res."},{"key":"B50","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1186\/s12891-024-07805-3","volume":"25","author":"Wu","year":"2024","journal-title":"BMC Musculoskelet Disord."},{"key":"B51","doi-asserted-by":"publisher","first-page":"e1121","DOI":"10.2147\/JPR.S333454","article-title":"Transcranial direct current stimulation alleviates chronic pain: systematic review and meta-analysis of randomized controlled trials","volume":"10","author":"Dai","year":"2025","journal-title":"Pain Rep."},{"key":"B52","doi-asserted-by":"publisher","first-page":"7100","DOI":"10.3390\/app14167100","article-title":"Transcranial direct current stimulation in the treatment of chronic knee pain: a scoping review","volume":"14","author":"Tedeschi","year":"2024","journal-title":"Appl. Sci."},{"key":"B53","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/j.artd.2022.03.007","article-title":"Gesheff MG, Mahajan A, et al. A novel mobile app-based neuromuscular electrical stimulation therapy for improvement of knee pain stiffness and function in knee osteoarthritis: a randomized trial","volume":"15","author":"Sax","year":"2022","journal-title":"Arthroplast Today."},{"key":"B54","doi-asserted-by":"publisher","first-page":"101662","DOI":"10.1016\/j.rehab.2022.101662","article-title":"Neuromuscular joint function in knee osteoarthritis: a systematic review and meta-analysis","volume":"66","author":"Tayfur","year":"2023","journal-title":"Ann Phys Rehabil Med."},{"key":"B55","doi-asserted-by":"publisher","first-page":"1","DOI":"10.33425\/2639-846X.1045","article-title":"Effects of transcutaneous electrical nerve stimulation on pain control in patients with knee osteoarthritis a systematic review","volume":"4","author":"Lee","year":"2020","journal-title":"Anesth Pain Res."},{"key":"B56","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1007\/s12035-018-1130-9","article-title":"Role of the prefrontal cortex in pain processing","volume":"56","author":"Ong","year":"","journal-title":"Mol Neurobiol."},{"key":"B57","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/j.apmr.2018.08.189","article-title":"Immediate effects of transcutaneous electrical nerve stimulation on pain and physical performance in individuals with preradiographic knee osteoarthritis: a randomized controlled trial","volume":"100","author":"Shimoura","year":"2019","journal-title":"Arch Phys Med Rehabil."},{"key":"B58","doi-asserted-by":"publisher","first-page":"100545","DOI":"10.1016\/j.ocarto.2024.100545","article-title":"Safety and preliminary efficacy of transcutaneous auricular vagus nerve stimulation on chronic knee pain: a pilot trial","volume":"7","author":"Aoyagi","year":"2024","journal-title":"Osteoarthr Cartil Open."},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glr158","article-title":"Life study investigators. muscle strength and bmi as predictors of major mobility disability in the lifestyle interventions and independence for elders pilot (LIFE-P)","author":"Marsh","year":"2011","journal-title":"J Gerontol A Biol Sci Med Sci."},{"key":"B60","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1097\/AJP.0000000000000233","article-title":"Transcutaneous electrical nerve stimulation in patients with knee osteoarthritis: evidence from randomized-controlled trials","volume":"32","author":"Chen","year":"2016","journal-title":"Clin J Pain."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1792432\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T06:02:10Z","timestamp":1775800930000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1792432\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,10]]},"references-count":60,"alternative-id":["10.3389\/fmed.2026.1792432"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1792432","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,10]]},"article-number":"1792432"}}