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Baxendale S. The impact of suppressing puberty on neuropsychological function: A review. Acta Paediatr 2024. [PMID: 38334046 DOI: 10.1111/apa.17150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/12/2024] [Accepted: 01/30/2024] [Indexed: 02/10/2024]
Abstract
AIM Concerns have been raised regarding the impact of medications that interrupt puberty, given the magnitude and complexity of changes that occur in brain function and structure during this sensitive window of neurodevelopment. This review examines the literature on the impact of pubertal suppression on cognitive and behavioural function in animals and humans. METHODS All studies reporting cognitive impacts of treatment with GnRH agonists/antagonists for pubertal suppression in animals or humans were sought via a systematic search strategy across the PubMed, Embase, Web of Science and PsycINFO databases. RESULTS Sixteen studies were identified. In mammals, the neuropsychological impacts of puberty blockers are complex and often sex specific (n = 11 studies). There is no evidence that cognitive effects are fully reversible following discontinuation of treatment. No human studies have systematically explored the impact of these treatments on neuropsychological function with an adequate baseline and follow-up. There is some evidence of a detrimental impact of pubertal suppression on IQ in children. CONCLUSION Critical questions remain unanswered regarding the nature, extent and permanence of any arrested development of cognitive function associated with puberty blockers. The impact of puberal suppression on measures of neuropsychological function is an urgent research priority.
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Godfrey JR, Howell BR, Mummert A, Shi Y, Styner M, Wilson ME, Sanchez M. Effects of social rank and pubertal delay on brain structure in female rhesus macaques. Psychoneuroendocrinology 2023; 149:105987. [PMID: 36529113 PMCID: PMC9931669 DOI: 10.1016/j.psyneuen.2022.105987] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 12/05/2022]
Abstract
Adverse social experience during childhood and adolescence leads to developmental alterations in emotional and stress regulation and underlying neurocircuits. We examined the consequences of social subordination (low social rank) in juvenile female rhesus monkeys, as an ethologically valid model of chronic social stressor exposure, on brain structural and behavioral development through the pubertal transition. Adolescence is a developmental period of extensive brain remodeling and increased emotional and stress reactivity. Puberty-induced increases in gonadal hormones, particularly estradiol (E2), are likely involved due to its organizational effects on the brain and behavior. Thus, we also examined how experimentally delaying pubertal onset with Lupron (gonadotropin releasing hormone -GnRH- agonist used clinically to delay early puberty) interacted with social rank (dominant vs. subordinate) to affect brain and behavioral outcomes. Using a longitudinal experimental design, structural MRI (sMRI) scans were collected on socially housed juvenile female rhesus monkeys living in indoor-outdoor enclosures prior to the onset of puberty (18-25 months), defined as menarche or the initial occurrence of perineal swelling and coloration, and again at 29-36 months, when all control animals had reached puberty but none of the Lupron-treated had. We examined the effects of both social rank and pubertal delay on overall structural brain volume (i.e. intracranial, grey matter (GM) and white matter (WM) volumes), as well as on cortico-limbic regions involved in emotion and stress regulation: amygdala (AMYG), hippocampus (HC), and prefrontal cortex (PFC). Measures of stress physiology, social behavior, and emotional reactivity were collected to examine functional correlates of the brain structural effects. Apart from expected developmental effects, subordinates had bigger AMYG volumes than dominant animals, most notably in the right hemisphere, but pubertal delay with Lupron-treatment abolished those differences, suggesting a role of gonadal hormones potentiating the brain structural impact of social stress. Subordinates also had elevated baseline cortisol, indicating activation of stress systems. In general, Lupron-treated subjects had smaller AMYG and HC volume than controls, but larger total PFC (driven by bigger GM volumes), and different, region-specific, developmental patterns dependent on age and social rank. These findings highlight a region-specific effect of E2 on structural development during female adolescence, independent of those due to chronological age. Pubertal delay and AMYG volume, in turn, predicted differences in emotional reactivity and social behavior. These findings suggest that exposure to developmental increases in E2 modifies the consequences of adverse social experience on the volume of cortico-limbic regions involved in emotional and stress regulation during maturation. But, even more importantly, they indicate different brain structural effects of chronological age and pubertal developmental stage in females, which are very difficult to disentangle in human studies. These findings have additional relevance for young girls who experience prolonged pubertal delays or for those whose puberty is clinically arrested by pharmacological administration of Lupron.
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Affiliation(s)
- Jodi R Godfrey
- Yerkes National Primate Research Center, Emory University, 954 Gatewood Road, Atlanta, GA 30329, USA
| | - Brittany R Howell
- Yerkes National Primate Research Center, Emory University, 954 Gatewood Road, Atlanta, GA 30329, USA; Department of Psychiatry & Behavioral Sciences, School of Medicine, Emory University, 12 Executive Park Drive NE #200, Atlanta, GA 30322, USA; Fralin Biomedical Research Institute at Virginia Tech Carilion, 2 Riverside Circle, Roanoke, VA 24016, USA; Department of Human Development and Family Science, Virginia Tech, 366 Wallace Hall, 295 West Campus Drive, Blacksburg, VA 24061, USA
| | - Amanda Mummert
- Department of Anthropology, Emory University, 1557 Dickey Drive, Atlanta, GA 30322, USA
| | - Yundi Shi
- Department of Psychiatry, University of North Carolina, 352 Medical School Wing C, Chapel Hill, NC 27599, USA
| | - Martin Styner
- Department of Psychiatry, University of North Carolina, 352 Medical School Wing C, Chapel Hill, NC 27599, USA
| | - Mark E Wilson
- Yerkes National Primate Research Center, Emory University, 954 Gatewood Road, Atlanta, GA 30329, USA; Department of Psychiatry & Behavioral Sciences, School of Medicine, Emory University, 12 Executive Park Drive NE #200, Atlanta, GA 30322, USA
| | - Mar Sanchez
- Yerkes National Primate Research Center, Emory University, 954 Gatewood Road, Atlanta, GA 30329, USA; Department of Psychiatry & Behavioral Sciences, School of Medicine, Emory University, 12 Executive Park Drive NE #200, Atlanta, GA 30322, USA.
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Li H, Li Y, Luo C, Liang X, Liu Z, Liu Y, Ling Y. New Approach for Targeted Treatment of Mild COVID-19 by Honeysuckle through Network Pharmacology Analysis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9604456. [PMID: 35237344 PMCID: PMC8885207 DOI: 10.1155/2022/9604456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/13/2021] [Accepted: 12/30/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the potential pharmacological value of extracts from honeysuckle on patients with mild coronavirus disease 2019 (COVID-19) infection. METHODS The active components and targets of honeysuckle were screened by Traditional Chinese Medicine Database and Analysis Platform (TCMSP). SwissADME and pkCSM databases predict pharmacokinetics of ingredients. The Gene Expression Omnibus (GEO) database collected transcriptome data for mild COVID-19. Data quality control, differentially expressed gene (DEG) identification, enrichment analysis, and correlation analysis were implemented by R toolkit. CIBERSORT evaluated the infiltration of 22 immune cells. RESULTS The seven active ingredients of honeysuckle had good oral absorption and medicinal properties. Both the active ingredient targets of honeysuckle and differentially expressed genes of mild COVID-19 were significantly enriched in immune signaling pathways. There were five overlapping immunosignature genes, among which RELA and MAP3K7 expressions were statistically significant (P < 0.05). Finally, immune cell infiltration and correlation analysis showed that RELA, MAP3K7, and natural killer (NK) cell are with highly positive correlation and highly negatively correlated with hematopoietic stem cells. CONCLUSION Our analysis suggested that honeysuckle extract had a safe and effective protective effect against mild COVID-19 by regulating a complex molecular network. The main mechanism was related to the proportion of infiltration between NK cells and hematopoietic stem cells.
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Affiliation(s)
- Huijuan Li
- Department of Pharmacy, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Yan Li
- Department of Pharmacy, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Chunxiang Luo
- Department of Pharmacy, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Xueyan Liang
- Department of Pharmacy, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Zixuan Liu
- Institute of Green Algae, Longhua Branch, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, 518120 Guangdong, China
| | - Yu Liu
- Department of Cardiology, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Yunzhi Ling
- Department of Pathology, Longhua Branch, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, Guangdong, Shenzhen 518120, China
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Hough D, Robinson JE, Bellingham M, Fleming LM, McLaughlin M, Jama K, Haraldsen IRH, Solbakk AK, Evans NP. Peripubertal GnRH and testosterone co-treatment leads to increased familiarity preferences in male sheep. Psychoneuroendocrinology 2019; 108:70-77. [PMID: 31229635 PMCID: PMC6712355 DOI: 10.1016/j.psyneuen.2019.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 05/29/2019] [Accepted: 06/12/2019] [Indexed: 01/08/2023]
Abstract
Chronic gonadotropin-releasing hormone agonist (GnRHa) treatment is effective for the medical suppression of the hypothalamic-pituitary-gonadal axis in situations like central precocious puberty and gender dysphoria. However, its administration during the peripubertal period could influence normal brain development and function because GnRH receptors are expressed in brain regions that regulate emotions, cognition, motivation and memory. This study used an ovine model to determine whether chronic peripubertal GnRHa-treatment affected the developmental shift from preference of familiarity to novelty. Experimental groups included Controls and GnRHa-treated rams. To differentiate between effects of altered GnRH signaling and those associated with the loss of sex steroids, a group was also included that received testosterone replacement as well as GnRHa (GnRHa + T). Preference for a novel versus familiar object was assessed during 5-min social isolation at 8, 28 and 46 weeks of age. Approach behavior was measured as interactions with and time spent near the objects, whereas avoidance behavior was measured by time spent in the entrance zone and attempts to escape the arena via the entry point. Emotional reactivity was measured by the number of vocalizations, escape attempts and urinations. As Control and GnRHa-treated rams aged, their approach behaviors showed a shift from preference for familiarity (8 weeks) to novelty (46 weeks). In contrast, relative to the Controls the GnRHa + T rams exhibited more approach behaviors towards both objects, at 28 and 46 weeks of age and preferred familiarity at 46 weeks of age. Vocalisation rate was increased in GnRHa treated rams in late puberty (28 weeks) compared to both Control and GnRHa + T rams but this effect was not seen in young adulthood (46 weeks). These results suggest that the specific suppression of testosterone during a developmental window in late puberty may reduce emotional reactivity and hamper learning a flexible adjustment to environmental change. The results also suggest that disruption of either endogenous testosterone signalling or a synergistic action between GnRH and testosterone signalling, may delay maturation of cognitive processes (e.g. information processing) that affects the motivation of rams to approach and avoid objects.
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Affiliation(s)
- D Hough
- College of Medical, Veterinary and Life Sciences, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G61 1QH, UK
| | - JE Robinson
- College of Medical, Veterinary and Life Sciences, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G61 1QH, UK
| | - M Bellingham
- College of Medical, Veterinary and Life Sciences, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G61 1QH, UK
| | - LM Fleming
- College of Medical, Veterinary and Life Sciences, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G61 1QH, UK
| | - M McLaughlin
- College of Medical, Veterinary and Life Sciences, School of Veterinary Medicine, University of Glasgow, Glasgow G61 1QH, UK
| | - K Jama
- College of Medical, Veterinary and Life Sciences, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G61 1QH, UK
| | - IRH Haraldsen
- Department of Neuropsychiatry and Psychosomatic Medicine, Division of Surgery and Clinical Neuroscience, Oslo University Hospital – Rikshospitalet, 0027 Oslo, Norway
| | - AK Solbakk
- Department of Neurosurgery, Division of Surgery and Clinical Neuroscience, Oslo University Hospital – Rikshospitalet, 0027 Oslo, Norway,Department of Psychology, University of Oslo, Pb 1094 Blindern, 0317 Oslo, Norway,Department of Neuropsychology, Helgeland Hospital, 8607 Mosjøen, Norway
| | - NP Evans
- College of Medical, Veterinary and Life Sciences, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G61 1QH, UK,Corresponding author.
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Wojniusz S, Callens N, Sütterlin S, Andersson S, De Schepper J, Gies I, Vanbesien J, De Waele K, Van Aken S, Craen M, Vögele C, Cools M, Haraldsen IR. Cognitive, Emotional, and Psychosocial Functioning of Girls Treated with Pharmacological Puberty Blockage for Idiopathic Central Precocious Puberty. Front Psychol 2016; 7:1053. [PMID: 27462292 PMCID: PMC4940404 DOI: 10.3389/fpsyg.2016.01053] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 06/27/2016] [Indexed: 01/28/2023] Open
Abstract
Central precocious puberty (CPP) develops due to premature activation of the hypothalamic-pituitary-gonadal (HPG) axis, resulting in early pubertal changes and rapid bone maturation. CPP is associated with lower adult height and increased risk for development of psychological problems. Standard treatment of CPP is based on postponement of pubertal development by blockade of the HPG axis with gonadotropin releasing hormone analogs (GnRHa) leading to abolition of gonadal sex hormones synthesis. Whereas the hormonal and auxological effects of GnRHa are well-researched, there is a lack of knowledge whether GnRHa treatment influences psychological functioning of treated children, despite the fact that prevention of psychological problems is used as one of the main reasons for treatment initiation. In the present study we seek to address this issue by exploring differences in cognitive function, behavior, emotional reactivity, and psychosocial problems between GnRHa treated CPP girls and age-matched controls. Fifteen girls with idiopathic CPP; median age 10.4 years, treated with slow-release GnRHa (triptorelin acetate-Decapeptyl SR® 11.25) and 15 age-matched controls, were assessed with a comprehensive test battery consisting of paper and pencil tests, computerized tasks, behavioral paradigms, heart rate variability, and questionnaires filled in by the children's parents. Both groups showed very similar scores with regard to cognitive performance, behavioral and psychosocial problems. Compared to controls, treated girls displayed significantly higher emotional reactivity (p = 0.016; Cohen's d = 1.04) on one of the two emotional reactivity task conditions. Unexpectedly, the CPP group showed significantly lower resting heart rates than the controls (p = 0.004; Cohen's d = 1.03); lower heart rate was associated with longer treatment duration (r = -0.582, p = 0.037). The results suggest that GnRHa treated CPP girls do not differ in their cognitive or psychosocial functioning from age matched controls. However, they might process emotional stimuli differently. The unexpected finding of lower heart rate that was associated with longer duration of the treatment should be further explored by methods appropriate for assessment of cardiac health.
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Affiliation(s)
- Slawomir Wojniusz
- Division of Surgery and Clinical Neuroscience, Department of Medical Neurobiology, Oslo University HospitalOslo, Norway; Department of Physiotherapy, Oslo and Akershus University College of Applied SciencesOslo, Norway
| | - Nina Callens
- Division of Pediatric Endocrinology, Department of Pediatrics, Ghent University Hospital and Ghent University Ghent, Belgium
| | - Stefan Sütterlin
- Division of Surgery and Clinical Neuroscience, Department of Medical Neurobiology, Oslo University HospitalOslo, Norway; Section for Psychology, Lillehammer University CollegeLillehammer, Norway
| | - Stein Andersson
- Division of Surgery and Clinical Neuroscience, Department of Medical Neurobiology, Oslo University HospitalOslo, Norway; Department of Psychology, University of OsloOslo, Norway
| | - Jean De Schepper
- Division of Pediatric Endocrinology, Department of Pediatrics, Ghent University Hospital and Ghent UniversityGhent, Belgium; Division of Pediatric Endocrinology, Department of Pediatrics, Brussels University HospitalBrussels, Belgium
| | - Inge Gies
- Division of Pediatric Endocrinology, Department of Pediatrics, Brussels University Hospital Brussels, Belgium
| | - Jesse Vanbesien
- Division of Pediatric Endocrinology, Department of Pediatrics, Brussels University Hospital Brussels, Belgium
| | - Kathleen De Waele
- Division of Pediatric Endocrinology, Department of Pediatrics, Ghent University Hospital and Ghent University Ghent, Belgium
| | - Sara Van Aken
- Division of Pediatric Endocrinology, Department of Pediatrics, Ghent University Hospital and Ghent University Ghent, Belgium
| | - Margarita Craen
- Division of Pediatric Endocrinology, Department of Pediatrics, Ghent University Hospital and Ghent University Ghent, Belgium
| | - Claus Vögele
- Research Unit INSIDE, Institute for Health and Behavior, University of Luxembourg Luxembourg, Luxembourg
| | - Martine Cools
- Division of Pediatric Endocrinology, Department of Pediatrics, Ghent University Hospital and Ghent University Ghent, Belgium
| | - Ira R Haraldsen
- Division of Surgery and Clinical Neuroscience, Department of Medical Neurobiology, Oslo University Hospital Oslo, Norway
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Sex differences and stress across the lifespan. Nat Neurosci 2015; 18:1413-20. [PMID: 26404716 DOI: 10.1038/nn.4112] [Citation(s) in RCA: 466] [Impact Index Per Article: 51.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 08/17/2015] [Indexed: 12/11/2022]
Abstract
Sex differences in stress responses can be found at all stages of life and are related to both the organizational and activational effects of gonadal hormones and to genes on the sex chromosomes. As stress dysregulation is the most common feature across neuropsychiatric diseases, sex differences in how these pathways develop and mature may predict sex-specific periods of vulnerability to disruption and increased disease risk or resilience across the lifespan. The aging brain is also at risk to the effects of stress, where the rapid decline of gonadal hormones in women combined with cellular aging processes promote sex biases in stress dysregulation. In this Review, we discuss potential underlying mechanisms driving sex differences in stress responses and their relevance to disease. Although stress is involved in a much broader range of diseases than neuropsychiatric ones, we highlight here this area and its examples across the lifespan.
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Nuruddin S, Syverstad GHE, Lillehaug S, Leergaard TB, Nilsson LNG, Ropstad E, Krogenæs A, Haraldsen IRH, Torp R. Elevated mRNA-levels of gonadotropin-releasing hormone and its receptor in plaque-bearing Alzheimer's disease transgenic mice. PLoS One 2014; 9:e103607. [PMID: 25089901 PMCID: PMC4121068 DOI: 10.1371/journal.pone.0103607] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 07/04/2014] [Indexed: 12/27/2022] Open
Abstract
Research on Alzheimer's disease (AD) has indicated an association between hormones of the hypothalamic-pituitary-gonadal (HPG) axis and cognitive senescence, indicating that post meno-/andropausal changes in HPG axis hormones are implicated in the neuropathology of AD. Studies of transgenic mice with AD pathologies have led to improved understanding of the pathophysiological processes underlying AD. The aims of this study were to explore whether mRNA-levels of gonadotropin-releasing hormone (Gnrh) and its receptor (Gnrhr) were changed in plaque-bearing Alzheimer's disease transgenic mice and to investigate whether these levels and amyloid plaque deposition were downregulated by treatment with a gonadotropin-releasing hormone analog (Gnrh-a; Leuprorelin acetate). The study was performed on mice carrying the Arctic and Swedish amyloid-β precursor protein (AβPP) mutations (tgArcSwe). At 12 months of age, female tgArcSwe mice showed a twofold higher level of Gnrh mRNA and more than 1.5 higher level of Gnrhr mRNA than age matched controls. Male tgArcSwe mice showed the same pattern of changes, albeit more pronounced. In both sexes, Gnrh-a treatment caused significant down-regulation of Gnrh and Gnrhr mRNA expression. Immunohistochemistry combined with quantitative image analysis revealed no significant changes in the plaque load after Gnrh-a treatment in hippocampus and thalamus. However, plaque load in the cerebral cortex of treated females tended to be lower than in female vehicle-treated mice. The present study points to the involvement of hormonal changes in AD mice models and demonstrates that these changes can be effectively counteracted by pharmacological treatment. Although known to increase in normal aging, our study shows that Gnrh/Gnrhr mRNA expression increases much more dramatically in tgArcSwe mice. Treatment with Leuprorelin acetate successfully abolished the transgene specific effects on Gnrh/Gnrhr mRNA expression. The present experimental approach should serve as a platform for further studies on the usefulness of Gnrh-a treatment in suppressing plaque development in AD.
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Affiliation(s)
- Syed Nuruddin
- Norwegian School of Veterinary Science, Oslo, Norway
| | | | - Sveinung Lillehaug
- Department of Anatomy, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Trygve B. Leergaard
- Department of Anatomy, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Lars N. G. Nilsson
- Department of Pharmacology, University of Oslo and Oslo University Hospital, Oslo, Norway
- Department of Public Health & Caring Sciences / Geriatrics, Uppsala University, Uppsala, Sweden
| | - Erik Ropstad
- Norwegian School of Veterinary Science, Oslo, Norway
| | | | - Ira Ronit Hebold Haraldsen
- Department of Neuropsychiatry and Psychosomatic Medicine, Division of Surgery and Clinical Neuroscience, Oslo University Hospital - Rikshospitalet, Oslo, Norway
| | - Reidun Torp
- Department of Anatomy, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- * E-mail:
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