{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T16:00:50Z","timestamp":1764086450419,"version":"3.45.0"},"reference-count":50,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National High Level Hospital Clinical Research Funding","award":["2025-PUMCH-D-003"],"award-info":[{"award-number":["2025-PUMCH-D-003"]}]},{"name":"STI2030-Major Projects","award":["2022ZD0211600"],"award-info":[{"award-number":["2022ZD0211600"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Objective: To explore the value of multimodal molecular imaging in diagnosing and differentiating dementia with Lewy bodies (DLB). Methods: A retrospective analysis was conducted on clinical data and multimodal molecular imaging of 40 probable DLB patients treated at Peking Union Medical College Hospital (August 2017\u2013December 2024). All 40 had 18F-FDG PET\/CT; 15 had 131I-MIBG imaging; 11 had 18F-FP-CIT PET\/CT. A total of 12 patients with poor cognition or atypical 18F-FDG PET\/CT underwent 18F-AV45 PET\/CT (2 also had 18F-PM-PBB3 imaging). A sex- and age-matched control group (cognitively normal, same-period health checkup 18F-FDG PET\/CT) was included. 18F-FDG PET\/CT images were visually and semi-quantitatively analyzed (ROI, SPM). 18F-AV45 PET\/CT was assessed both visually and semi-quantitatively; 131I-MIBG imaging and 18F-FP-CIT PET\/CT were visually evaluated. Results: The 40 DLB patients (29 males, 11 females; mean age 72 years) had distinct initial symptoms: 8 (20%) presented with cognitive decline as the first symptom, 23 (57.5%) with parkinsonian symptoms as the first symptom, and 9 (22.5%) with both symptoms occurring simultaneously. Mean intervals: 16.25 months from initial cognitive decline to parkinsonian symptoms, and 24.43 months from initial parkinsonian symptoms to cognitive decline. All had parkinsonian symptoms and cognitive impairment; 38 (95%) had visual hallucinations; and 26 (65%) had REM sleep behavior disorder. 18F-FDG PET\/CT: 30(75%) showed typical occipital hypometabolism and posterior cingulate island sign; 10 (25%) had atypical findings. 131I-MIBG (15\/15, 100%): cardiac sympathetic denervation. 18F-FP-CIT (10\/11, 90.9%): basal ganglia dopaminergic damage. 18F-AV45 (9\/12, 81.8%): positive. Semi-quantitative 18F-FDG analysis revealed parietal, occipital, and lateral temporal hypometabolism in DLB (left more severe than right). Conclusions: Dementia with Lewy bodies (DLB) presents with pre-onset parkinsonism and cognitive impairment, plus high rates of visual hallucinations and sleep disorders. Key imaging features\u2014occipital hypometabolism\/island sign on 18F-FDG PET\/CT, cardiac sympathetic denervation on 131I-MIBG, and basal ganglia dopaminergic damage on 18F-FP-CIT\u2014aid DLB diagnosis. 18F-AV45 PET\/CT detects A\u03b2 pathology in severely cognitively impaired patients, suggesting these DLB patients may have underlying AD pathology beyond DLB.<\/jats:p>","DOI":"10.3390\/brainsci15121264","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T15:29:47Z","timestamp":1764084587000},"page":"1264","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Study on Multimodal Imaging Applications in Dementia with Lewy Bodies: From Imaging Features to Clinical Practice Implications"],"prefix":"10.3390","volume":"15","author":[{"given":"Qijun","family":"Li","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China"},{"name":"Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing 100730, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhaoxia","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China"},{"name":"Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing 100730, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1855-9325","authenticated-orcid":false,"given":"Junshan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Menglin","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China"},{"name":"Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing 100730, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenhao","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China"},{"name":"Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing 100730, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruixue","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, Dongcheng District, Beijing 100730, China"},{"name":"Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing 100730, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1016\/S0140-6736(20)32205-4","article-title":"Alzheimer\u2019s disease","volume":"397","author":"Scheltens","year":"2021","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/ageing\/afi190","article-title":"A systematic review of prevalence and incidence studies of dementia with Lewy bodies","volume":"34","author":"Zaccai","year":"2005","journal-title":"Age Ageing"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Bousiges, O., and Blanc, F. (2022). Biomarkers of Dementia with Lewy Bodies: Differential Diagnostic with Alzheimer\u2019s Disease. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23126371"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s13195-018-0350-6","article-title":"Clinical prevalence of Lewy body dementia","volume":"10","author":"Kane","year":"2018","journal-title":"Alzheimers Res. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1176\/jnp.12.4.425","article-title":"A review of the cognitive and behavioral symptoms in dementia with Lewy bodies","volume":"12","author":"Simard","year":"2000","journal-title":"J. Neuropsychiatry Clin. Neurosci."},{"key":"ref_6","first-page":"53","article-title":"A systematic review of cognitive decline in dementia with Lewy bodies versus Alzheimer\u2019s disease","volume":"6","author":"Breitve","year":"2014","journal-title":"Alzheimers Res. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"543","DOI":"10.2147\/NDT.S189050","article-title":"Aripiprazole for the treatment of psychotic symptoms in patients with dementia with Lewy bodies: A case series","volume":"15","author":"Shimizu","year":"2019","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e227216","DOI":"10.1136\/bcr-2018-227216","article-title":"Neuroleptic malignant syndrome as part of an akinetic crisis associated with sepsis in a patient with Lewy body disease","volume":"12","author":"Manabe","year":"2019","journal-title":"BMJ Case Rep."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1007\/s40266-018-00636-7","article-title":"Pharmacological Management of Dementia with Lewy Bodies","volume":"36","author":"Hershey","year":"2019","journal-title":"Drugs Aging"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Beach, T.G., Serrano, G.E., Zhang, N., Driver-Dunckley, E.D., Sue, L.I., Shill, H.A., Mehta, S.H., Belden, C., Tremblay, C., and Choudhury, P. (2024). Clinicopathological Heterogeneity of Lewy Body Diseases: The Profound Influence of Comorbid Alzheimer\u2019s Disease. medRxiv.","DOI":"10.1101\/2024.08.30.24312864"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e209460","DOI":"10.1212\/WNL.0000000000209460","article-title":"Differential Vulnerability of Hippocampal Subfields to Amyloid and Tau Deposition in the Lewy Body Diseases","volume":"102","author":"Ye","year":"2024","journal-title":"Neurology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1038\/s41531-024-00745-8","article-title":"Plasma biomarkers of neurodegeneration in patients and high risk subjects with Lewy body disease","volume":"10","author":"Hiraga","year":"2024","journal-title":"NPJ Park. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1186\/s13195-014-0065-2","article-title":"Comorbidity profile in dementia with Lewy bodies versus Alzheimer\u2019s disease: A linkage study between the Swedish Dementia Registry and the Swedish National Patient Registry","volume":"6","author":"Fereshtehnejad","year":"2014","journal-title":"Alzheimers Res. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1097\/RLU.0000000000005081","article-title":"Identifying Mixed Dementia With Lewy Bodies and Alzheimer Disease Using Multitracer PET Imaging: A Case Study","volume":"49","author":"Li","year":"2024","journal-title":"Clin. Nucl. Med."},{"key":"ref_15","first-page":"1","article-title":"Frederic Lewy: How the two World Wars changed his life, work, and name","volume":"82","author":"Pozzobon","year":"2024","journal-title":"Arq. Neuropsiquiatr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1007\/s12640-010-9207-x","article-title":"Neuroprotective upregulation of endogenous alpha-synuclein precedes ubiquitination in cultured dopaminergic neurons","volume":"19","author":"Musgrove","year":"2011","journal-title":"Neurotox. Res."},{"key":"ref_17","first-page":"879","article-title":"Aggregation of alpha-synuclein in Lewy bodies of sporadic Parkinson\u2019s disease and dementia with Lewy bodies","volume":"152","author":"Baba","year":"1998","journal-title":"Am. J. Pathol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1002\/acn3.52295","article-title":"Relationship of cognitive decline with glucocerebrosidase activity and amyloid-beta 42 in DLB and PD","volume":"12","author":"Gonzalez","year":"2025","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"101441","DOI":"10.1016\/j.disamonth.2022.101441","article-title":"Recent advances in Lewy body dementia: A comprehensive review","volume":"69","author":"Prasad","year":"2023","journal-title":"Dis. Mon."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1212\/WNL.0000000000004058","article-title":"Diagnosis and management of dementia with Lewy bodies: Fourth consensus report of the DLB Consortium","volume":"89","author":"Mckeith","year":"2017","journal-title":"Neurology"},{"key":"ref_21","unstructured":"Neuronal Degeneration Professional Committee of Chinese Society of Microcirculation (2021). Guidelines for diagnosis and treatment of dementia with Lewy bodies in China. Chin. J. Geriatr., 40, 1473\u20131484."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1093\/brain\/aww005","article-title":"MRI visual rating scales in the diagnosis of dementia: Evaluation in 184 post-mortem confirmed cases","volume":"139","author":"Harper","year":"2016","journal-title":"Brain"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.2967\/jnumed.109.065870","article-title":"The 18F-FDG PET cingulate island sign and comparison to 123I-beta-CIT SPECT for diagnosis of dementia with Lewy bodies","volume":"50","author":"Lim","year":"2009","journal-title":"J. Nucl. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.3233\/JAD-220392","article-title":"A Mini-Mental State Examination Formula May Help to Distinguish Alzheimer\u2019s Disease from Dementia with Lewy Bodies","volume":"89","author":"Ala","year":"2022","journal-title":"J. Alzheimers Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/mdc3.13569","article-title":"Montreal Cognitive Assessment Predicts the Short-Term Risk of Lewy Body Disease in Isolated REM Sleep Behavior Disorder with Reduced MIBG Scintigraphy","volume":"10","author":"Miyamoto","year":"2023","journal-title":"Mov. Disord. Clin. Pr."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Liampas, I., Kyriakoulopoulou, P., Siokas, V., Tsiamaki, E., Stamati, P., Kefalopoulou, Z., Chroni, E., and Dardiotis, E. (2024). Apolipoprotein E Gene in alpha-Synucleinopathies: A Narrative Review. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25031795"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Cheon, M., Kim, S.M., Ha, S.W., Kang, M.J., Yang, H.E., and Yoo, J. (2022). Diagnostic Performance for Differential Diagnosis of Atypical Parkinsonian Syndromes from Parkinson\u2019s Disease Using Quantitative Indices of (18)F-FP-CIT PET\/CT. Diagnostics, 12.","DOI":"10.3390\/diagnostics12061402"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Yang, Z., Kinney, J.W., Cordes, D., and Alzheimer\u2019s Disease Neuroimaging Initiative (2024). Uptake of 18F-AV45 in the Putamen Provides Additional Insights into Alzheimer\u2019s Disease beyond the Cortex. Biomolecules, 14.","DOI":"10.3390\/biom14020157"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1038\/s41380-018-0342-8","article-title":"Tau PET imaging in neurodegenerative tauopathies-still a challenge","volume":"24","author":"Leuzy","year":"2019","journal-title":"Mol. Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jalz.2014.07.003","article-title":"The Centiloid Project: Standardizing quantitative amyloid plaque estimation by PET","volume":"11","author":"Klunk","year":"2015","journal-title":"Alzheimers Dement."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1136\/jnnp.2006.110122","article-title":"Dementia with Lewy bodies: A comparison of clinical diagnosis, FP-CIT single photon emission computed tomography imaging and autopsy","volume":"78","author":"Walker","year":"2007","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1111\/ggi.13853","article-title":"Association between clinical symptoms and post-mortem neuropathology in dementia with Lewy bodies","volume":"20","author":"Kaneko","year":"2020","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Jellinger, K.A., and Korczyn, A.D. (2018). Are dementia with Lewy bodies and Parkinson\u2019s disease dementia the same disease?. BMC Med., 16.","DOI":"10.1186\/s12916-018-1016-8"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e937397","DOI":"10.12659\/AJCR.937397","article-title":"Neuroleptic Sensitivity in Dementia with Lewy Body and Use of Pimavanserin in an Inpatient Setting: A Case Report","volume":"23","author":"Abadir","year":"2022","journal-title":"Am. J. Case Rep."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1176\/jnp.10.2.227","article-title":"Neuroleptic sensitivity to clozapine in dementia with Lewy bodies","volume":"10","author":"Burke","year":"1998","journal-title":"J. Neuropsychiatry Clin. Neurosci."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Delli Pizzi, S., Franciotti, R., Tartaro, A., Caulo, M., Thomas, A., Onofrj, M., and Bonanni, L. (2014). Structural alteration of the dorsal visual network in DLB patients with visual hallucinations: A cortical thickness MRI study. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0086624"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1038\/s41467-022-28087-0","article-title":"Mapping brain structural differences and neuroreceptor correlates in Parkinson\u2019s disease visual hallucinations","volume":"13","author":"Vignando","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1016\/S0140-6736(15)00462-6","article-title":"Lewy body dementias","volume":"386","author":"Walker","year":"2015","journal-title":"Lancet"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Wennstr\u00f6m, M., Surova, Y., Hall, S., Nilsson, C., Minthon, L., Bostr\u00f6m, F., Hansson, O., and Nielsen, H.M. (2013). Low CSF levels of both alpha-synuclein and the alpha-synuclein cleaving enzyme neurosin in patients with synucleinopathy. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0053250"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.tins.2022.11.007","article-title":"alpha-Synuclein in synaptic function and dysfunction","volume":"46","author":"Sharma","year":"2023","journal-title":"Trends Neurosci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e2850","DOI":"10.1002\/brb3.2850","article-title":"Amyloid-beta PET in Alzheimer\u2019s disease: A systematic review and Bayesian meta-analysis","volume":"13","author":"Ruan","year":"2023","journal-title":"Brain Behav."},{"key":"ref_42","first-page":"1741","article-title":"Neuroimaging findings of common types of neurodegenerative dementia","volume":"44","author":"Li","year":"2024","journal-title":"Basic. Clin. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3005","DOI":"10.1093\/brain\/aws234","article-title":"Cognitive impairment, decline and fluctuations in older community-dwelling subjects with Lewy bodies","volume":"135","author":"Schneider","year":"2012","journal-title":"Brain"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1038\/s41531-023-00534-9","article-title":"Substantia nigral dopamine transporter uptake in dementia with Lewy bodies","volume":"9","author":"Lee","year":"2023","journal-title":"NPJ Park. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1002\/mdc3.12369","article-title":"Comment on: Dopamine Transporter (DaT) Scan Utilization in a Movement Disorder Center","volume":"4","author":"Bhattacharjee","year":"2017","journal-title":"Mov. Disord. Clin. Pr."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"O\u2019Shea, D.M., Arkhipenko, A., Galasko, D., Goldman, J.G., Sheikh, Z.H., Petrides, G., Toledo, J.B., and Galvin, J.E. (2024). Practical use of DAT SPECT imaging in diagnosing dementia with Lewy bodies: A US perspective of current guidelines and future directions. Front. Neurol., 15.","DOI":"10.3389\/fneur.2024.1395413"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1007\/s00259-022-05941-3","article-title":"(123)I-MIBG imaging in heart failure: Impact of comorbidities on cardiac sympathetic innervation","volume":"50","author":"Gargiulo","year":"2023","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref_48","first-page":"1099","article-title":"Reduced cardiac uptake and enhanced washout of 123I-MIBG in pure autonomic failure occurs conjointly with Parkinson\u2019s disease and dementia with Lewy bodies","volume":"47","author":"Kashihara","year":"2006","journal-title":"J. Nucl. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1007\/s12350-020-02501-w","article-title":"The prognostic value of (123)I-mIBG SPECT cardiac imaging in heart failure patients: A systematic review","volume":"29","author":"Pontico","year":"2022","journal-title":"J. Nucl. Cardiol."},{"key":"ref_50","first-page":"1326","article-title":"Pharmacological interference with 123I-metaiodobenzylguanidine: A limitation to developing cardiac innervation imaging in clinical practice?","volume":"17","author":"Stefanelli","year":"2013","journal-title":"Eur. Rev. Med. Pharmacol. Sci."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/15\/12\/1264\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T15:56:38Z","timestamp":1764086198000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/15\/12\/1264"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,25]]},"references-count":50,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["brainsci15121264"],"URL":"https:\/\/doi.org\/10.3390\/brainsci15121264","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,25]]}}}