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Duffy BA, Choy M, Chuapoco MR, Madsen M, Lee JH. MRI compatible optrodes for simultaneous LFP and optogenetic fMRI investigation of seizure-like afterdischarges. Neuroimage 2015. [PMID: 26208873 DOI: 10.1016/j.neuroimage.2015.07.038] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In preclinical studies, implanted electrodes can cause severe degradation of MRI images and hence are seldom used for chronic studies employing functional magnetic resonance imaging. In this study, we developed carbon fiber optrodes (optical fiber and electrode hybrid devices), which can be utilised in chronic longitudinal studies aiming to take advantage of emerging optogenetic technologies, and compared them with the more widely used tungsten optrodes. We find that optrodes constructed using small diameter (~130 μm) carbon fiber electrodes cause significantly reduced artifact on functional MRI images compared to those made with 50 μm diameter tungsten wire and at the same time the carbon electrodes have lower impedance, which leads to higher quality LFP recordings. In order to validate this approach, we use these devices to study optogenetically-induced seizure-like afterdischarges in rats sedated with dexmedetomidine and compare these to sub (seizure) threshold stimulations in the same animals. The results indicate that seizure-like afterdischarges involve several extrahippocampal brain regions that are not recruited by subthreshold optogenetic stimulation of the hippocampus at 20 Hz. Subthreshold stimulation led to activation of the entire ipsilateral hippocampus and septum, whereas afterdischarges additionally produced activations in the contralateral hippocampal formation, neocortex, cerebellum, nucleus accumbens, and thalamus. Although we demonstrate just one application, given the ease of fabrication, we anticipate that carbon fiber optrodes could be utilised in a variety of studies that could benefit from longitudinal optogenetic functional magnetic resonance imaging.
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Affiliation(s)
- Ben A Duffy
- Department of Neurology and Neurological Sciences, Stanford University, CA 94305 Stanford, CA, USA
| | - ManKin Choy
- Department of Neurology and Neurological Sciences, Stanford University, CA 94305 Stanford, CA, USA
| | - Miguel R Chuapoco
- Department of Neurology and Neurological Sciences, Stanford University, CA 94305 Stanford, CA, USA
| | - Michael Madsen
- Department of Neurology and Neurological Sciences, Stanford University, CA 94305 Stanford, CA, USA
| | - Jin Hyung Lee
- Department of Neurology and Neurological Sciences, Stanford University, CA 94305 Stanford, CA, USA; Department of Bioengineering, Stanford University, CA 94305 Stanford, CA, USA; Department of Neurosurgery, Stanford University, CA 94305 Stanford, CA, USA; Department of Electrical Engineering, Stanford University, CA 94305 Stanford, CA, USA.
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Nagaraj V, Lee S, Krook-Magnuson E, Soltesz I, Benquet P, Irazoqui P, Netoff T. Future of seizure prediction and intervention: closing the loop. J Clin Neurophysiol 2015; 32:194-206. [PMID: 26035672 PMCID: PMC4455045 DOI: 10.1097/wnp.0000000000000139] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The ultimate goal of epilepsy therapies is to provide seizure control for all patients while eliminating side effects. Improved specificity of intervention through on-demand approaches may overcome many of the limitations of current intervention strategies. This article reviews the progress in seizure prediction and detection, potential new therapies to provide improved specificity, and devices to achieve these ends. Specifically, we discuss (1) potential signal modalities and algorithms for seizure detection and prediction, (2) closed-loop intervention approaches, and (3) hardware for implementing these algorithms and interventions. Seizure prediction and therapies maximize efficacy, whereas minimizing side effects through improved specificity may represent the future of epilepsy treatments.
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Affiliation(s)
- Vivek Nagaraj
- Graduate Program in Neuroscience, University of Minnesota
| | - Steven Lee
- Weldon School of Biomedical Engineering, Purdue University
| | | | - Ivan Soltesz
- Department of Anatomy & Neurobiology, University of California, Irvine
| | | | - Pedro Irazoqui
- Weldon School of Biomedical Engineering, Purdue University
| | - Theoden Netoff
- Graduate Program in Neuroscience, University of Minnesota
- Department of Biomedical Engineering, University of Minnesota
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Krook-Magnuson E, Soltesz I. Beyond the hammer and the scalpel: selective circuit control for the epilepsies. Nat Neurosci 2015; 18:331-8. [PMID: 25710834 PMCID: PMC4340083 DOI: 10.1038/nn.3943] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 01/03/2015] [Indexed: 12/12/2022]
Abstract
Current treatment options for epilepsy are inadequate, as too many patients suffer from uncontrolled seizures and from negative side effects of treatment. In addition to these clinical challenges, our scientific understanding of epilepsy is incomplete. Optogenetic and designer receptor technologies provide unprecedented and much needed specificity, allowing for spatial, temporal and cell type-selective modulation of neuronal circuits. Using such tools, it is now possible to begin to address some of the fundamental unanswered questions in epilepsy, to dissect epileptic neuronal circuits and to develop new intervention strategies. Such specificity of intervention also has the potential for direct therapeutic benefits, allowing healthy tissue and network functions to continue unaffected. In this Perspective, we discuss promising uses of these technologies for the study of seizures and epilepsy, as well as potential use of these strategies for clinical therapies.
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Affiliation(s)
- Esther Krook-Magnuson
- Department of Anatomy & Neurobiology, University of California, Irvine, 192 Irvine Hall, Irvine, California 92697
| | - Ivan Soltesz
- Department of Anatomy & Neurobiology, University of California, Irvine, 192 Irvine Hall, Irvine, California 92697
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Zhao M, McGarry LM, Ma H, Harris S, Berwick J, Yuste R, Schwartz TH. Optical triggered seizures using a caged 4-Aminopyridine. Front Neurosci 2015; 9:25. [PMID: 25698919 PMCID: PMC4316705 DOI: 10.3389/fnins.2015.00025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 01/14/2015] [Indexed: 11/16/2022] Open
Abstract
Animal models of epilepsy are critical not only for understanding the fundamental mechanism of epilepsy but also for testing the efficacy of new antiepileptic drugs and novel therapeutic interventions. Photorelease of caged molecules is widely used in biological research to control pharmacologic events with high spatio-temporal resolution. We developed a technique for in vivo optical triggering of neocortical seizures using a novel caged compound based on ruthenium photochemistry (RuBi-4AP). Epileptiform events in mouse cortex were induced with blue light in both whole brain and focal illumination. Multi-electrode array recording and optical techniques were used to characterize the propagation of these epileptic events, including interictal spikes, polyspikes, and ictal discharges. These results demonstrate a novel optically-triggered seizure model, with high spatio-temporal control, that could have widespread application in the investigation of ictal onset, propagation and to develop novel light-based therapeutic interventions.
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Affiliation(s)
- Mingrui Zhao
- Department of Neurological Surgery, Brain and Mind Center, New York Presbyterian Hospital, Weill Medical College of Cornell UniversityNew York, NY, USA
| | - Laura M. McGarry
- Department of Biological Sciences, Columbia UniversityNew York, NY, USA
| | - Hongtao Ma
- Department of Neurological Surgery, Brain and Mind Center, New York Presbyterian Hospital, Weill Medical College of Cornell UniversityNew York, NY, USA
| | - Samuel Harris
- Department of Neurological Surgery, Brain and Mind Center, New York Presbyterian Hospital, Weill Medical College of Cornell UniversityNew York, NY, USA
- Department of Psychology, University of SheffieldSheffield, UK
| | - Jason Berwick
- Department of Psychology, University of SheffieldSheffield, UK
| | - Rafael Yuste
- Department of Biological Sciences, Columbia UniversityNew York, NY, USA
| | - Theodore H. Schwartz
- Department of Neurological Surgery, Brain and Mind Center, New York Presbyterian Hospital, Weill Medical College of Cornell UniversityNew York, NY, USA
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Musto AE, Walker CP, Petasis NA, Bazan NG. Hippocampal neuro-networks and dendritic spine perturbations in epileptogenesis are attenuated by neuroprotectin d1. PLoS One 2015; 10:e0116543. [PMID: 25617763 PMCID: PMC4305283 DOI: 10.1371/journal.pone.0116543] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 12/10/2014] [Indexed: 12/11/2022] Open
Abstract
Purpose Limbic epileptogenesis triggers molecular and cellular events that foster the establishment of aberrant neuronal networks that, in turn, contribute to temporal lobe epilepsy (TLE). Here we have examined hippocampal neuronal network activities in the pilocarpine post-status epilepticus model of limbic epileptogenesis and asked whether or not the docosahexaenoic acid (DHA)-derived lipid mediator, neuroprotectin D1 (NPD1), modulates epileptogenesis. Methods Status epilepticus (SE) was induced by intraperitoneal administration of pilocarpine in adult male C57BL/6 mice. To evaluate simultaneous hippocampal neuronal networks, local field potentials were recorded from multi-microelectrode arrays (silicon probe) chronically implanted in the dorsal hippocampus. NPD1 (570 μg/kg) or vehicle was administered intraperitoneally daily for five consecutive days 24 hours after termination of SE. Seizures and epileptiform activity were analyzed in freely-moving control and treated mice during epileptogenesis and epileptic periods. Then hippocampal dendritic spines were evaluated using Golgi-staining. Results We found brief spontaneous microepileptiform activity with high amplitudes in the CA1 pyramidal and stratum radiatum in epileptogenesis. These aberrant activities were attenuated following systemic NPD1 administration, with concomitant hippocampal dendritic spine protection. Moreover, NPD1 treatment led to a reduction in spontaneous recurrent seizures. Conclusions Our results indicate that NPD1 displays neuroprotective bioactivity on the hippocampal neuronal network ensemble that mediates aberrant circuit activity during epileptogenesis. Insight into the molecular signaling mediated by neuroprotective bioactivity of NPD1 on neuronal network dysfunction may contribute to the development of anti-epileptogenic therapeutic strategies.
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Affiliation(s)
- Alberto E. Musto
- Neuroscience Center of Excellence, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States of America
- * E-mail: (NGB); (AEM)
| | - Chelsey P. Walker
- Neuroscience Center of Excellence, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States of America
| | - Nicos A. Petasis
- Department of Chemistry, Loker Hydrocarbon Research Institute, University of Southern California, Los Angeles, California, United States of America
| | - Nicolas G. Bazan
- Neuroscience Center of Excellence, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States of America
- * E-mail: (NGB); (AEM)
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Wagner FB, Truccolo W, Wang J, Nurmikko AV. Spatiotemporal dynamics of optogenetically induced and spontaneous seizure transitions in primary generalized epilepsy. J Neurophysiol 2014; 113:2321-41. [PMID: 25552645 DOI: 10.1152/jn.01040.2014] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 12/23/2014] [Indexed: 11/22/2022] Open
Abstract
Transitions into primary generalized epileptic seizures occur abruptly and synchronously across the brain. Their potential triggers remain unknown. We used optogenetics to causally test the hypothesis that rhythmic population bursting of excitatory neurons in a local neocortical region can rapidly trigger absence seizures. Most previous studies have been purely correlational, and it remains unclear whether epileptiform events induced by rhythmic stimulation (e.g., sensory/electrical) mimic actual spontaneous seizures, especially regarding their spatiotemporal dynamics. In this study, we used a novel combination of intracortical optogenetic stimulation and microelectrode array recordings in freely moving WAG/Rij rats, a model of absence epilepsy with a cortical focus in the somatosensory cortex (SI). We report three main findings: 1) Brief rhythmic bursting, evoked by optical stimulation of neocortical excitatory neurons at frequencies around 10 Hz, induced seizures consisting of self-sustained spike-wave discharges (SWDs) for about 10% of stimulation trials. The probability of inducing seizures was frequency-dependent, reaching a maximum at 10 Hz. 2) Local field potential power before stimulation and response amplitudes during stimulation both predicted seizure induction, demonstrating a modulatory effect of brain states and neural excitation levels. 3) Evoked responses during stimulation propagated as cortical waves, likely reaching the cortical focus, which in turn generated self-sustained SWDs after stimulation was terminated. Importantly, SWDs during induced and spontaneous seizures propagated with the same spatiotemporal dynamics. Our findings demonstrate that local rhythmic bursting of excitatory neurons in neocortex at particular frequencies, under susceptible ongoing brain states, is sufficient to trigger primary generalized seizures with stereotypical spatiotemporal dynamics.
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Affiliation(s)
- Fabien B Wagner
- Department of Neuroscience, Brown University, Providence, Rhode Island; School of Engineering, Brown University, Providence, Rhode Island;
| | - Wilson Truccolo
- Department of Neuroscience, Brown University, Providence, Rhode Island; Institute for Brain Science, Brown University, Providence, Rhode Island; and Center for Neurorestoration and Neurotechnology, Department of Veterans Affairs, Providence, Rhode Island
| | - Jing Wang
- School of Engineering, Brown University, Providence, Rhode Island
| | - Arto V Nurmikko
- Department of Neuroscience, Brown University, Providence, Rhode Island; School of Engineering, Brown University, Providence, Rhode Island; Institute for Brain Science, Brown University, Providence, Rhode Island; and
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Cerebellar Directed Optogenetic Intervention Inhibits Spontaneous Hippocampal Seizures in a Mouse Model of Temporal Lobe Epilepsy. eNeuro 2014; 1. [PMID: 25599088 PMCID: PMC4293636 DOI: 10.1523/eneuro.0005-14.2014] [Citation(s) in RCA: 160] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Epilepsy is a condition of spontaneous recurrent seizures. Current treatment options for epilepsy can have major negative side effects and for many patients fail to control seizures. We detected seizures on-line and tested a new selective intervention using a mouse model of temporal lobe epilepsy. Krook-Magnuson et al. report a bidirectional functional connectivity between the hippocampus and the cerebellum in a mouse model of temporal lobe epilepsy, and demonstrate that cerebellar directed on-demand optogenetic intervention can stop seizures recorded from the hippocampus. ![]()
Temporal lobe epilepsy is often medically refractory and new targets for intervention are needed. We used a mouse model of temporal lobe epilepsy, on-line seizure detection, and responsive optogenetic intervention to investigate the potential for cerebellar control of spontaneous temporal lobe seizures. Cerebellar targeted intervention inhibited spontaneous temporal lobe seizures during the chronic phase of the disorder. We further report that the direction of modulation as well as the location of intervention within the cerebellum can affect the outcome of intervention. Specifically, on-demand optogenetic excitation or inhibition of parvalbumin-expressing neurons, including Purkinje cells, in the lateral or midline cerebellum results in a decrease in seizure duration. In contrast, a consistent reduction in spontaneous seizure frequency occurs uniquely with on-demand optogenetic excitation of the midline cerebellum, and was not seen with intervention directly targeting the hippocampal formation. These findings demonstrate that the cerebellum is a powerful modulator of temporal lobe epilepsy, and that intervention targeting the cerebellum as a potential therapy for epilepsy should be revisited.
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Weitz AJ, Fang Z, Lee HJ, Fisher RS, Smith WC, Choy M, Liu J, Lin P, Rosenberg M, Lee JH. Optogenetic fMRI reveals distinct, frequency-dependent networks recruited by dorsal and intermediate hippocampus stimulations. Neuroimage 2014; 107:229-241. [PMID: 25462689 DOI: 10.1016/j.neuroimage.2014.10.039] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 10/06/2014] [Accepted: 10/14/2014] [Indexed: 10/24/2022] Open
Abstract
Although the connectivity of hippocampal circuits has been extensively studied, the way in which these connections give rise to large-scale dynamic network activity remains unknown. Here, we used optogenetic fMRI to visualize the brain network dynamics evoked by different frequencies of stimulation of two distinct neuronal populations within dorsal and intermediate hippocampus. Stimulation of excitatory cells in intermediate hippocampus caused widespread cortical and subcortical recruitment at high frequencies, whereas stimulation in dorsal hippocampus led to activity primarily restricted to hippocampus across all frequencies tested. Sustained hippocampal responses evoked during high-frequency stimulation of either location predicted seizure-like afterdischarges in video-EEG experiments, while the widespread activation evoked by high-frequency stimulation of intermediate hippocampus predicted behavioral seizures. A negative BOLD signal observed in dentate gyrus during dorsal, but not intermediate, hippocampus stimulation is proposed to underlie the mechanism for these differences. Collectively, our results provide insight into the dynamic function of hippocampal networks and their role in seizures.
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Affiliation(s)
- Andrew J Weitz
- Department of Bioengineering, Stanford University, Stanford, CA 94305, USA; Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA 94305, USA
| | - Zhongnan Fang
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA 94305, USA; Department of Electrical Engineering, Stanford University, Stanford, CA 94305, USA
| | - Hyun Joo Lee
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA 94305, USA
| | - Robert S Fisher
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA 94305, USA
| | - Wesley C Smith
- Department of Neuroscience, University of California, Los Angeles, CA 90095, USA
| | - ManKin Choy
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA 94305, USA
| | - Jia Liu
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA 94305, USA; Department of Neuroscience, University of California, Los Angeles, CA 90095, USA; Department of Electrical Engineering, University of California, Los Angeles, CA 90095, USA
| | - Peter Lin
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA 94305, USA
| | - Matthew Rosenberg
- Department of Electrical Engineering, University of California, Los Angeles, CA 90095, USA; Department of Psychology, University of California, Los Angeles, CA 90095, USA
| | - Jin Hyung Lee
- Department of Bioengineering, Stanford University, Stanford, CA 94305, USA; Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA 94305, USA; Department of Electrical Engineering, Stanford University, Stanford, CA 94305, USA; Department of Neurosurgery, Stanford, CA 94305, USA.
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Krook-Magnuson E, Ledri M, Soltesz I, Kokaia M. How might novel technologies such as optogenetics lead to better treatments in epilepsy? ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 813:319-36. [PMID: 25012388 DOI: 10.1007/978-94-017-8914-1_26] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Recent technological advances open exciting avenues for improving the understanding of mechanisms in a broad range of epilepsies. This chapter focuses on the development of optogenetics and on-demand technologies for the study of epilepsy and the control of seizures. Optogenetics is a technique which, through cell-type selective expression of light-sensitive proteins called opsins, allows temporally precise control via light delivery of specific populations of neurons. Therefore, it is now possible not only to record interictal and ictal neuronal activity, but also to test causality and identify potential new therapeutic approaches. We first discuss the benefits and caveats to using optogenetic approaches and recent advances in optogenetics related tools. We then turn to the use of optogenetics, including on-demand optogenetics in the study of epilepsies, which highlights the powerful potential of optogenetics for epilepsy research.
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Affiliation(s)
- Esther Krook-Magnuson
- Department of Anatomy and Neurobiology, University of California, 192 Irvine Hall, Irvine, CA, 92697, USA,
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Kandratavicius L, Balista PA, Lopes-Aguiar C, Ruggiero RN, Umeoka EH, Garcia-Cairasco N, Bueno-Junior LS, Leite JP. Animal models of epilepsy: use and limitations. Neuropsychiatr Dis Treat 2014; 10:1693-705. [PMID: 25228809 PMCID: PMC4164293 DOI: 10.2147/ndt.s50371] [Citation(s) in RCA: 293] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Epilepsy is a chronic neurological condition characterized by recurrent seizures that affects millions of people worldwide. Comprehension of the complex mechanisms underlying epileptogenesis and seizure generation in temporal lobe epilepsy and other forms of epilepsy cannot be fully acquired in clinical studies with humans. As a result, the use of appropriate animal models is essential. Some of these models replicate the natural history of symptomatic focal epilepsy with an initial epileptogenic insult, which is followed by an apparent latent period and by a subsequent period of chronic spontaneous seizures. Seizures are a combination of electrical and behavioral events that are able to induce chemical, molecular, and anatomic alterations. In this review, we summarize the most frequently used models of chronic epilepsy and models of acute seizures induced by chemoconvulsants, traumatic brain injury, and electrical or sound stimuli. Genetic models of absence seizures and models of seizures and status epilepticus in the immature brain were also examined. Major uses and limitations were highlighted, and neuropathological, behavioral, and neurophysiological similarities and differences between the model and the human equivalent were considered. The quest for seizure mechanisms can provide insights into overall brain functions and consciousness, and animal models of epilepsy will continue to promote the progress of both epilepsy and neurophysiology research.
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Affiliation(s)
- Ludmyla Kandratavicius
- Department of Neurosciences and Behavior, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Priscila Alves Balista
- Department of Neurosciences and Behavior, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Cleiton Lopes-Aguiar
- Department of Neurosciences and Behavior, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Rafael Naime Ruggiero
- Department of Neurosciences and Behavior, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Eduardo Henrique Umeoka
- Department of Physiology, Ribeirao Preto School of Medicine, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Norberto Garcia-Cairasco
- Department of Physiology, Ribeirao Preto School of Medicine, University of Sao Paulo, Ribeirao Preto, Brazil
| | | | - Joao Pereira Leite
- Department of Neurosciences and Behavior, University of Sao Paulo, Ribeirao Preto, Brazil
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Kravitz AV, Bonci A. Optogenetics, physiology, and emotions. Front Behav Neurosci 2013; 7:169. [PMID: 24312032 PMCID: PMC3833017 DOI: 10.3389/fnbeh.2013.00169] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 11/03/2013] [Indexed: 12/14/2022] Open
Affiliation(s)
- Alexxai V Kravitz
- Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive, and Kidney Diseases Bethesda, MD, USA
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