{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:41:50Z","timestamp":1793317310678,"version":"4.5.0"},"reference-count":54,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>We report a case of hereditary sensory and autonomic neuropathy presenting with childhood-onset symmetric distally predominant limb hypoesthesia to tactile, thermal, and painful stimuli. Exome sequencing identified a homozygous pathogenic variant in the with-no-lysine (K) kinase 1 (WNK1), lysine deficient protein kinase 1 gene. The clinical, electrophysiological, and genetic findings confirmed a diagnosis of hereditary sensory and autonomic neuropathy type 2A (HSAN 2A). This case highlights the importance of genetic confirmation in the evaluation of early-onset neuropathies, especially when the most common causes have been ruled out. Significantly, our observations underscore the potential role of skin biopsy in identifying autonomic abnormalities in HSAN 2, possibly contributing to a better understanding of these rare neuropathies. We also reviewed the reported cases of this disease in the literature to highlight its phenotypic variability.<\/jats:p>","DOI":"10.3390\/brainsci15111163","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T17:38:22Z","timestamp":1761759502000},"page":"1163","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hereditary Sensory and Autonomic Neuropathy Type 2: A Case Report and a Review of the Literature"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4534-205X","authenticated-orcid":false,"given":"Cosmanna","family":"Ragucci","sequence":"first","affiliation":[{"name":"Dipartimento di Scienze Biomediche e Neuromotorie, Universit\u00e0 di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7385-2744","authenticated-orcid":false,"given":"Alessandro","family":"Furia","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, 40139 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"Palombo","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, 40139 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2208-376X","authenticated-orcid":false,"given":"Maria Pia","family":"Giannoccaro","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche e Neuromotorie, Universit\u00e0 di Bologna, 40138 Bologna, Italy"},{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, 40139 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3607-2394","authenticated-orcid":false,"given":"Veria","family":"Vacchiano","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, 40139 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Incensi","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, 40139 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitantonio","family":"Di Stasi","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, 40139 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9718-2044","authenticated-orcid":false,"given":"Giovanni","family":"Rizzo","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, 40139 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1815-1013","authenticated-orcid":false,"given":"Rocco","family":"Liguori","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche e Neuromotorie, Universit\u00e0 di Bologna, 40138 Bologna, Italy"},{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, 40139 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo Angelo","family":"Donadio","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche e Neuromotorie, Universit\u00e0 di Bologna, 40138 Bologna, Italy"},{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, 40139 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1038\/nrneurol.2011.227","article-title":"Mechanisms of disease in hereditary sensory and autonomic neuropathies","volume":"8","author":"Rotthier","year":"2012","journal-title":"Nat. Rev. Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Auer-Grumbach, M. (2013). Hereditary sensory and autonomic neuropathies. Handbook of Clinical Neurology, Elsevier.","DOI":"10.1093\/med\/9780199698073.003.0009"},{"key":"ref_3","unstructured":"Dyck, P.J., Griffin, P.K., Low, P.A., and Poduslo, J.F. (1993). Neuronal atrophy and degeneration predominantly affecting peripheral sensory and autonomic neurons. Peripheral Neuropathy, WB Saunders."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1007\/s11910-019-0974-3","article-title":"Hereditary Sensory and Autonomic Neuropathies: Adding More to the Classification","volume":"19","author":"Schwartzlow","year":"2019","journal-title":"Curr. Neurol. Neurosci. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/S0303-8467(03)00003-9","article-title":"Terminal changes in hereditary sensory and autonomic neuropathy: A long-term follow-up of a sporadic case","volume":"105","author":"Lee","year":"2003","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1093\/brain\/awh712","article-title":"Clinical, pathological and genetic characterization of hereditary sensory and autonomic neuropathy type 1 (HSAN I)","volume":"129","author":"Houlden","year":"2006","journal-title":"Brain"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1097\/00019052-200410000-00007","article-title":"Hereditary sensory neuropathies","volume":"17","author":"Houlden","year":"2004","journal-title":"Curr. Opin. Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1097\/01.wco.0000245370.82317.f6","article-title":"Recent advances in hereditary sensory and autonomic neuropathies","volume":"19","author":"Verhoeven","year":"2006","journal-title":"Curr. Opin. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1111\/cge.13037","article-title":"WNK1\/HSN2 founder mutation in patients with hereditary sensory and autonomic neuropathy: A Japanese cohort study","volume":"92","author":"Yuan","year":"2017","journal-title":"Clin. Genet."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Jin, J.-Y., Wu, P.-F., He, J.-Q., Fam, L.-L., Yuan, Z.-Z., Pang, X.-Y., Tang, J.-Y., and Zhang, L.-Y. (2020). Novel Compound Heterozygous DST Variants Causing Hereditary Sensory and Autonomic Neuropathies VI in Twins of a Chinese Family. Front. Genet., 11.","DOI":"10.3389\/fgene.2020.00492"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1093\/pch\/pxac098","article-title":"Living without pain. Case series of patients with hereditary sensory and autonomic neuropathies in a Canadian tertiary care centre","volume":"28","author":"Reddi","year":"2023","journal-title":"Paediatr. Child. Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1016\/j.ajhg.2012.09.015","article-title":"Mutation in TECPR2 Reveals a Role for Autophagy in Hereditary Spastic Paraparesis","volume":"91","author":"Ruzzo","year":"2012","journal-title":"Am. J. Hum. Genet."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Moeinafshar, A., Tehrani Fateh, S., Hashemi-Gorji, F., Karimzadeh, P., Gholibeglou, E., Rostami, M., Sadeghi, H., Miryounesi, M., and Ghasemi, M.-R. (2024). Novel TECPR2 variant in two cases of hereditary sensory and autonomic neuropathy type 9: Insights from genetic characterization and comprehensive literature review. BMC Neurol., 24.","DOI":"10.1186\/s12883-024-03963-y"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1002\/mus.10499","article-title":"Familial dysautonomia","volume":"29","author":"Axelrod","year":"2004","journal-title":"Muscle Nerve"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"I2","DOI":"10.1007\/s102860200014","article-title":"Hereditary sensory and autonomic neuropathies: Familial dysautonomia and other HSANs","volume":"12","author":"Axelrod","year":"2002","journal-title":"Clin. Aut. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/1750-1172-2-39","article-title":"Hereditary sensory and autonomic neuropathies: Types II, III, and IV","volume":"2","author":"Axelrod","year":"2007","journal-title":"Orphanet J. Rare Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1002\/ana.103","article-title":"A novel TRK A (NTRK1) mutation associated with hereditary sensory and autonomic neuropathy type V","volume":"49","author":"Houlden","year":"2001","journal-title":"Ann. Neurol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1002\/ana.23524","article-title":"Hereditary sensory autonomic neuropathy caused by a mutation in dystonin","volume":"71","author":"Edvardson","year":"2012","journal-title":"Ann. Neurol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"I33","DOI":"10.1007\/s102860200017","article-title":"Assessment and evaluation of hereditary sensory and autonomic neuropathies with autonomic and neurophysiological examinations","volume":"12","author":"Hilz","year":"2002","journal-title":"Clin. Aut. Res."},{"key":"ref_20","unstructured":"Adam, M.P., Feldman, J., Mirzaa, G.M., Pagon, R.A., Wallace, S.E., and Amemiya, A. (2025, October 15). Hereditary Sensory and Autonomic Neuropathy Type II, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK49247\/."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1086\/420795","article-title":"Identification of a Novel Gene (HSN2) Causing Hereditary Sensory and Autonomic Neuropathy Type II through the Study of Canadian Genetic Isolates","volume":"74","author":"MacDonald","year":"2004","journal-title":"Am. J. Hum. Genet."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1762","DOI":"10.1212\/01.WNL.0000161849.29944.43","article-title":"Two mutations in the HSN2 gene explain the high prevalence of HSAN2 in French Canadians","volume":"64","author":"Roddier","year":"2005","journal-title":"Neurology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"114552","DOI":"10.1016\/j.expneurol.2023.114552","article-title":"Expression pattern analysis and characterization of the hereditary sensory and autonomic neuropathy 2 A (HSAN2A) gene with no lysine kinase (WNK1) in human dorsal root ganglion","volume":"370","author":"Sapio","year":"2023","journal-title":"Exp. Neurol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1002\/mus.23775","article-title":"Inherited neuropathies: Clinical overview and update","volume":"48","author":"Klein","year":"2013","journal-title":"Muscle Nerve"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Donadio, V., Incensi, A., Vacchiano, V., Infante, R., Magnani, M., and Liguori, R. (2019). The autonomic innervation of hairy skin in humans: An in vivo confocal study. Sci. Rep., 9.","DOI":"10.1038\/s41598-019-53684-3"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1093\/jnen\/nlx021","article-title":"Spine Topographical Distribution of Skin \u03b1-Synuclein Deposits in Idiopathic Parkinson Disease","volume":"76","author":"Donadio","year":"2017","journal-title":"J. Neuropathol. Exp. Neurol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1097\/NEN.0b013e3182729fdc","article-title":"Peripheral Autonomic Neuropathy: Diagnostic Contribution of Skin Biopsy","volume":"71","author":"Donadio","year":"2012","journal-title":"J. Neuropathol. Exp. Neurol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1111\/ene.13608","article-title":"The role of skin biopsy in differentiating small-fiber neuropathy from ganglionopathy","volume":"25","author":"Provitera","year":"2018","journal-title":"Eur. J. Neurol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1007\/s00415-011-6397-y","article-title":"Frequency of mutations in the genes associated with hereditary sensory and autonomic neuropathy in a UK cohort","volume":"259","author":"Davidson","year":"2012","journal-title":"J. Neurol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1002\/ana.20237","article-title":"A mutation in the HSN2 gene causes sensory neuropathy type II in a Lebanese family","volume":"56","author":"Verlaan","year":"2004","journal-title":"Ann. Neurol."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Wang, J.J., Yu, B., and Li, Z. (2019). The coexistence of a novel WNK1 variant and a copy number variation causes hereditary sensory and autonomic neuropathy type IIA. BMC Med. Genet., 20.","DOI":"10.1186\/s12881-019-0828-5"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Yamada, K., Yuan, J., Mano, T., Takashima, H., and Shibata, M. (2016). Arthropathy-related pain in a patient with congenital impairment of pain sensation due to hereditary sensory and autonomic neuropathy type II with a rare mutation in the WNK1\/HSN2 gene: A case report. BMC Neurol., 16.","DOI":"10.1186\/s12883-016-0727-8"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e308","DOI":"10.1111\/1346-8138.14336","article-title":"Repeated hyperhidrosis and chilblain-like swelling with ulceration of the fingers and toes in hereditary sensory and autonomic neuropathy type II","volume":"45","author":"Shima","year":"2018","journal-title":"J. Dermatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1007\/s00415-011-6025-x","article-title":"Hereditary sensory and autonomic neuropathy II due to novel mutation in the HSN2 gene in Mexican families","volume":"258","year":"2011","journal-title":"J. Neurol."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Rahmani, B., Fekrmandi, F., Ahadi, K., Ahadi, T., Alavi, A., Ahmadiani, A., and Asadi, S. (2018). A novel nonsense mutation in WNK1\/HSN2 associated with sensory neuropathy and limb destruction in four siblings of a large Iranian pedigree. BMC Neurol., 18.","DOI":"10.1186\/s12883-018-1201-6"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1038\/s10038-020-0734-x","article-title":"A novel biallelic single base insertion in WNK1 in a Pakistani family with congenital insensitivity to pain","volume":"65","author":"Pastore","year":"2020","journal-title":"J. Hum. Genet."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1212\/01.wnl.0000201191.57519.47","article-title":"Novel mutations in the HSN2 gene causing hereditary sensory and autonomic neuropathy type II","volume":"66","author":"Coen","year":"2006","journal-title":"Neurology"},{"key":"ref_38","first-page":"413","article-title":"A novel homozygous mutation in the WNK1\/HSN2 gene causing hereditary sensory neuropathy type 2","volume":"59","author":"Lipowska","year":"2012","journal-title":"Acta Biochim. Pol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e42","DOI":"10.1212\/NXG.0000000000000042","article-title":"Polyneuropathy in a young Belgian patient: A novel heterozygous mutation in the WNK1\/HSN2 gene","volume":"2","author":"Hasaerts","year":"2016","journal-title":"Neurol. Genet."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1038\/s10038-024-01310-0","article-title":"A novel mutation in the WNK1\/HSN2 gene causing hereditary sensory and autonomic neuropathy type 2 in Chinese patient","volume":"70","author":"Ma","year":"2025","journal-title":"J. Hum. Genet."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s12031-024-02282-8","article-title":"A Novel Pathogenic Mutation in WNK1 Gene Causing HSAN Type II in Three Siblings","volume":"74","author":"Naghinejad","year":"2024","journal-title":"J. Mol. Neurosci."},{"key":"ref_42","first-page":"2496","article-title":"Mutations in the nervous system\u2013specific HSN2 exon of WNK1 cause hereditary sensory neuropathy type II","volume":"118","author":"Shekarabi","year":"2008","journal-title":"J. Clin. Investig."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1007\/s10038-006-0033-1","article-title":"Novel mutation in the HSN2 gene in a Korean patient with hereditary sensory and autonomic neuropathy type 2","volume":"51","author":"Cho","year":"2006","journal-title":"J. Hum. Genet."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1212\/01.wnl.0000208415.90685.cd","article-title":"New HSN2 mutation in Japanese patient with hereditary sensory and autonomic neuropathy type 2","volume":"66","author":"Takagi","year":"2006","journal-title":"Neurology"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"W420","DOI":"10.1093\/nar\/gkac373","article-title":"IBS 2.0: An upgraded illustrator for the visualization of biological sequences","volume":"50","author":"Xie","year":"2022","journal-title":"Nucleic Acids Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"3556","DOI":"10.1111\/ene.14959","article-title":"European Academy of Neurology\/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: Report of a joint Task Force\u2014Second revision","volume":"28","author":"Hadden","year":"2021","journal-title":"Eur. J. Neurol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"16795","DOI":"10.1074\/jbc.275.22.16795","article-title":"WNK1, a Novel Mammalian Serine\/Threonine Protein Kinase Lacking the Catalytic Lysine in Subdomain II","volume":"275","author":"Xu","year":"2000","journal-title":"J. Biol. Chem."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1016\/S1388-2457(00)00351-5","article-title":"Absent innervation of skin and sweat glands in congenital insensitivity to pain with anhidrosis","volume":"111","author":"Nolano","year":"2000","journal-title":"Clin. Neurophysiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1212\/WNL.55.1.126","article-title":"Cutaneous innervation in hereditary sensory and autonomic neuropathy type IV","volume":"55","author":"Plumari","year":"2000","journal-title":"Neurology"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/S0887-8994(01)00278-8","article-title":"Congenital insensitivity to pain with anhidrosis","volume":"25","author":"Sztriha","year":"2001","journal-title":"Pediatr. Neurol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1177\/088307389801300511","article-title":"Congenital Insensitivity to Pain with Anhidrosis: Lack of Eccrine Sweat Gland Innervation Confirmed","volume":"13","author":"Ismail","year":"1998","journal-title":"J. Child. Neurol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1007\/s11910-012-0323-2","article-title":"Uses of Skin Biopsy for Sensory and Autonomic Nerve Assessment","volume":"13","author":"Myers","year":"2013","journal-title":"Curr. Neurol. Neurosci. Rep."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Furia, A., Liguori, R., and Donadio, V. (2025). Small-Fiber Neuropathy: An Etiology-Oriented Review. Brain Sci., 15.","DOI":"10.3390\/brainsci15020158"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1111\/ene.12842","article-title":"A multi-center, multinational age- and gender-adjusted normative dataset for immunofluorescent intraepidermal nerve fiber density at the distal leg","volume":"23","author":"Provitera","year":"2016","journal-title":"Eur. J. Neurol."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/15\/11\/1163\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T18:10:27Z","timestamp":1761761427000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/15\/11\/1163"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,29]]},"references-count":54,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["brainsci15111163"],"URL":"https:\/\/doi.org\/10.3390\/brainsci15111163","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,29]]}}}