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Wang P, Li C, Del Sol-Calderón P, Mallol L, Hernández-Álvarez E, Donoso-Navarro E, Gil-Ligero M, Rosado-Garcia S, Sánchez-Lòpez AJ, Martín-Moratinos M, Bella-Fernández M, Blasco-Fontecilla H. Biosignature of self-injury behaviors in adolescence: Role of β-endorphin in an acute inpatient unit. Front Psychiatry 2022; 13:933275. [PMID: 36046158 PMCID: PMC9421366 DOI: 10.3389/fpsyt.2022.933275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 07/25/2022] [Indexed: 11/23/2022] Open
Abstract
Self-injurious behavior (SIB) (either non-suicidal self-injury, NSSI; or suicide attempts, SA) is a common reason for adolescent psychiatric emergency hospitalizations. Altered basal serum β-endorphin (BE) levels have been reported in adults with a history of SIB, but information is lacking in adolescents. We analyzed the psychoclinical profile and serum BE level of 39 adolescents admitted to the acute unit at a hospital in Spain due to SIB. The Mean (SD) serum BE level was high (190.53 ± 74.83). Regarding time sequence, the onset age of NSSI and SA were related (p < 0.001). The older the onset age of NSSI, the shorter the transition between NSSI and the onset of SA behavior (p = 0.05), but this difference does not lead the variation of BE (p = 0.81). Patients diagnosed with depression had lower serum BE levels than adolescents with other diagnoses (p = 0.03). Although adolescents who seem to be addicted to SIB had higher levels of BE, this finding was not statistically significant. The relationship between serum BE levels and SIB in adolescents requires further investigation.
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Affiliation(s)
- Ping Wang
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain.,Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHISA), Madrid, Spain
| | - Chao Li
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain.,Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHISA), Madrid, Spain
| | - Pablo Del Sol-Calderón
- Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHISA), Madrid, Spain
| | - Leticia Mallol
- Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHISA), Madrid, Spain
| | - Elena Hernández-Álvarez
- Department of Clinical Biochemistry, Puerta de Hierro University Hospital, IDIPHISA, Madrid, Spain
| | | | - María Gil-Ligero
- Biobank, Puerta de Hierro-Segovia de Arana Health Research Institute, Madrid, Spain
| | - Silvia Rosado-Garcia
- Biobank, Puerta de Hierro-Segovia de Arana Health Research Institute, Madrid, Spain
| | - Antonio José Sánchez-Lòpez
- Biobank, Puerta de Hierro-Segovia de Arana Health Research Institute, Madrid, Spain.,Neuroimmunology Unit, Puerta de Hierro-Segovia de Arana Health Research Institute, Madrid, Spain
| | - Marina Martín-Moratinos
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain.,Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHISA), Madrid, Spain
| | - Marcos Bella-Fernández
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain.,Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHISA), Madrid, Spain.,Department of Psychology, Pontifical University of Comillas, Madrid, Spain
| | - Hilario Blasco-Fontecilla
- Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain.,Department of Psychiatry, Puerta de Hierro University Hospital, Health Research Institute Puerta de Hierro-Segovia de Arana (IDIPHISA), Madrid, Spain.,Center of Biomedical Network Research on Mental Health (CIBERSAM), Madrid, Spain.,Korian, Paris, France
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2
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Pilozzi A, Carro C, Huang X. Roles of β-Endorphin in Stress, Behavior, Neuroinflammation, and Brain Energy Metabolism. Int J Mol Sci 2020; 22:E338. [PMID: 33396962 PMCID: PMC7796446 DOI: 10.3390/ijms22010338] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/23/2020] [Accepted: 12/26/2020] [Indexed: 12/25/2022] Open
Abstract
β-Endorphins are peptides that exert a wide variety of effects throughout the body. Produced through the cleavage pro-opiomelanocortin (POMC), β-endorphins are the primarily agonist of mu opioid receptors, which can be found throughout the body, brain, and cells of the immune system that regulate a diverse set of systems. As an agonist of the body's opioid receptors, β-endorphins are most noted for their potent analgesic effects, but they also have their involvement in reward-centric and homeostasis-restoring behaviors, among other effects. These effects have implicated the peptide in psychiatric and neurodegenerative disorders, making it a research target of interest. This review briefly summarizes the basics of endorphin function, goes over the behaviors and regulatory pathways it governs, and examines the variability of β-endorphin levels observed between normal and disease/disorder affected individuals.
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Affiliation(s)
| | | | - Xudong Huang
- Neurochemistry Laboratory, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA; (A.P.); (C.C.)
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3
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Ferdousi M, Finn DP. Stress-induced modulation of pain: Role of the endogenous opioid system. PROGRESS IN BRAIN RESEARCH 2018; 239:121-177. [DOI: 10.1016/bs.pbr.2018.07.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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4
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van Dongen RM, Zielman R, Noga M, Dekkers OM, Hankemeier T, van den Maagdenberg AM, Terwindt GM, Ferrari MD. Migraine biomarkers in cerebrospinal fluid: A systematic review and meta-analysis. Cephalalgia 2016; 37:49-63. [PMID: 26888294 DOI: 10.1177/0333102415625614] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To perform a meta-analysis of migraine biomarkers in cerebrospinal fluid (CSF) and of corresponding blood concentrations. Methods We conducted a systematic search for studies that measured biochemical compounds in CSF of chronic or episodic migraineurs and non-headache controls. Subsequent searches retrieved studies with blood measurements of selected CSF biomarkers. If a compound was assessed in three or more studies, results were pooled in a meta-analysis with standardised mean differences (SMD) as effect measures. Results Sixty-two compounds were measured in 40 CSF studies. Most important results include: increased glutamate (five studies, SMD 2.22, 95% CI: 1.30, 3.13), calcitonin gene-related peptide (CGRP) (three studies, SMD: 3.80, 95% CI: 3.19, 4.41) and nerve growth factor (NGF) (three studies, SMD: 6.47, 95% CI: 5.55, 7.39) in chronic migraine patients and decreased β-endorphin (β-EP) in both chronic (four studies, SMD: -1.37, 95% CI: -1.80, -0.94) and interictal episodic migraine patients (three studies, SMD: -1.12, 95% CI: -1.65, -0.58). In blood, glutamate (interictal) and CGRP (chronic, interictal and ictal) were increased and β-EP (chronic, interictal and ictal) was decreased. Conclusions Glutamate, β-EP, CGRP and NGF concentrations are altered in CSF and, except for NGF, also in blood of migraineurs. Future research should focus on the pathophysiological roles of these compounds in migraine.
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Affiliation(s)
- Robin M van Dongen
- 1 Department of Neurology, Leiden University Medical Centre, the Netherlands
| | - Ronald Zielman
- 1 Department of Neurology, Leiden University Medical Centre, the Netherlands
| | - Marek Noga
- 2 Division of Analytical Biosciences, Leiden Academic Centre for Drug Research, the Netherlands
| | - Olaf M Dekkers
- 3 Department of Clinical Epidemiology, Leiden University Medical Centre, the Netherlands.,4 Department of Clinical Epidemiology, Aarhus University Hospital, Denmark
| | - Thomas Hankemeier
- 2 Division of Analytical Biosciences, Leiden Academic Centre for Drug Research, the Netherlands
| | - Arn Mjm van den Maagdenberg
- 1 Department of Neurology, Leiden University Medical Centre, the Netherlands.,5 Department of Human Genetics, Leiden University Medical Centre, the Netherlands
| | - Gisela M Terwindt
- 1 Department of Neurology, Leiden University Medical Centre, the Netherlands
| | - Michel D Ferrari
- 1 Department of Neurology, Leiden University Medical Centre, the Netherlands
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5
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Hegadoren KM, O'Donnell T, Lanius R, Coupland NJ, Lacaze-Masmonteil N. The role of beta-endorphin in the pathophysiology of major depression. Neuropeptides 2009; 43:341-53. [PMID: 19647870 DOI: 10.1016/j.npep.2009.06.004] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2009] [Revised: 06/04/2009] [Accepted: 06/25/2009] [Indexed: 12/19/2022]
Abstract
A role for beta-endorphin (beta-END) in the pathophysiology of major depressive disorder (MDD) is suggested by both animal research and studies examining clinical populations. The major etiological theories of depression include brain regions and neural systems that interact with opioid systems and beta-END. Recent preclinical data have demonstrated multiple roles for beta-END in the regulation of complex homeostatic and behavioural processes that are affected during a depressive episode. Additionally, beta-END inputs to regulatory pathways involving feeding behaviours, motivation, and specific types of motor activity have important implications in defining the biological foundations for specific depressive symptoms. Early research linking beta-END to MDD did so in the context of the hypothalamic-pituitary-adrenal (HPA) axis activity, where it was suggested that HPA axis dysregulation may account for depressive symptoms in some individuals. The primary aims of this paper are to use both preclinical and clinical research (a) to critically review data that explores potential roles for beta-END in the pathophysiology of MDD and (b) to highlight gaps in the literature that limit further development of etiological theories of depression and testable hypotheses. In addition to examining methodological and theoretical challenges of past clinical studies, we summarize studies that have investigated basal beta-END levels in MDD and that have used challenge tests to examine beta-END responses to a variety of experimental paradigms. A brief description of the synthesis, location in the CNS and behavioural pharmacology of this neuropeptide is also provided to frame this discussion. Given the lack of clinical improvement observed with currently available antidepressants in a significant proportion of depressed individuals, it is imperative that novel mechanisms be investigated for antidepressant potential. We conclude that the renewed interest in elucidating the role of beta-END in the pathophysiology of MDD must be paralleled by consensus building within the research community around the heterogeneity inherent in mood disorders, standardization of experimental protocols, improved discrimination of POMC products in analytical techniques and consistent attention paid to important confounds like age and gender.
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Affiliation(s)
- K M Hegadoren
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada T6G 2G3.
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Abstract
OBJECTIVE The object of this review is to examine the published literature for cerebrospinal fluid laboratory measures of primary headache disorders to identify biomarkers and provide recommendations for future biomarker discovery. BACKGROUND Biomarkers may distinguish deviation from a normal state, provide insight into mechanisms of pathophysiology, quantify the degree of change, discriminate what may be clinically overlapping disorders, and allow monitoring and/or selection of specific treatment. High-throughput, discovery technologies fuel the ability to reveal more biomarkers than past hypothesis-driven studies. DESIGN OR METHODS: Publications were identified in PubMed, ISI web of knowledge (both Web of Science and BIOSYS), and SciFinder, using the key words for cerebrospinal fluid (CSF) and migraine, headache, or biomarkers. Additional references were sought from the papers identified in these searches. Data were assessed relating to all primary headache types for clinical and scientific methods and results. RESULTS Fifty-five out of 82 biomarkers were found from 55 publications, though none have been validated for clinical utility. Data for site (ventricular, cervical, lumbar) and timing of CSF collection, headache state, and diagnostic description were patchy, and controls were often poorly defined. Most routinely performed CSF measurements were within normal limits. Most levels of pain-related molecules were reduced, and concentrations of most neurotransmitters, neuropeptides, proteins, and small molecules were increased. Though few studies assessed the specificity of biomarkers for primary headaches, it is clear that there are differences in CSF biomarkers between migraine, cluster headache, tension-type headache, and trigeminal neuralgia. CONCLUSIONS The high proportion (67%) of biomarkers identified from laboratory measures tested thus far predicts that many more biomarkers will be identified for primary headaches when more candidates are evaluated. In order to discover and evaluate more biomarkers, especially those that may have clinical application for headache management, 3 recommendations are encouraged: prospective design of care-independent studies; evaluation of more clinical variables; and evaluation of substantially more candidates by using discovery-based research methods. Outlines of approaches to pursue these aims are proposed.
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Affiliation(s)
- Michael G Harrington
- Molecular Neurology Program, Huntington Medical Research Institutes, 99 North El Molino Avenue, Pasadena, CA 91101, USA
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Loder E, Harrington MG, Cutrer M, Sandor P, De Vries B. Selected Confirmed, Probable, and Exploratory Migraine Biomarkers. Headache 2006; 46:1108-27. [PMID: 16866715 DOI: 10.1111/j.1526-4610.2006.00525.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Elizabeth Loder
- Harvard Medical School and the John R. Graham Headache Centre, Department of Neurology, Brigham and Women's/Faulkner Hospital, Boston, MA, USA
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Bäcker M, Gareus IK, Knoblauch NTM, Michalsen A, Dobos GJ. [Acupuncture in the treatment of pain--hypothesis to adaptive effects]. Complement Med Res 2005; 11:335-45. [PMID: 15604624 DOI: 10.1159/000082815] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A basic principle in conventional pain therapy is that the treatment should be tailored to the pathological mechanism of the disease. This is based on the knowledge of the effector mechanisms of the applied treatment modalities. Although for acupuncture the mode of action still remains elusive in many parts, evidence about its mechanisms in pain treatment is growing. A better understanding of the hypalgesic effects of acupuncture might lead to a more differentiated and mechanism guided application. The aim of this article is to evaluate the scientific data about the neurobiological mechanisms of acupuncture in the treatment of pain. Data are critically evaluated regarding their relevance for clinical practice. Possible mechanisms are differentiated in local and systemic effects and the question of point specificity is discussed. Additionally a comprehensive hypothesis is set up for the long-term effects of acupuncture in the treatment of chronic pain. In this context acupuncture is considered as a mode of repetitive, nociceptive stimulation, which induces adaptive processes on different physiological levels leading to an improved ability of the nociceptive system to cope with painful stimuli.
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Affiliation(s)
- M Bäcker
- Klinik für Innere Medizin V. Naturheilkunde und Integrative Medizin, Essen.
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Bruehl S, McCubbin JA, Harden RN. Theoretical review: altered pain regulatory systems in chronic pain. Neurosci Biobehav Rev 1999; 23:877-90. [PMID: 10541062 DOI: 10.1016/s0149-7634(99)00039-1] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This review synthesizes the existing literature regarding the relationship between resting blood pressure and pain sensitivity, and the literature indicating possible endogenous opioid dysfunction in chronic pain. Adaptive interactions between the cardiovascular and pain regulatory systems occur in healthy individuals, with greater blood pressure associated with decreased acute pain sensitivity. Endogenous opioids appear necessary for full expression of this relationship. There is ample evidence indicating diminished endogenous opioid CSF/plasma levels in chronic pain patients, yet little is known about the functional effects of these opioid changes. A theoretical model is proposed based upon the literature reviewed suggesting progressive dysfunction in endogenous opioid systems with increasing chronic pain duration. This dysfunction is hypothesized to result in dysregulation of normally adaptive relationships between the cardiovascular and pain regulatory systems, resulting in increased chronic pain intensity and increased acute pain sensitivity among chronic pain patients. Preliminary data are consistent with the hypothesis of progressive opioid changes resulting in dysfunctional alterations in the adaptive blood pressure-pain relationship. Clinical implications of this theory are discussed.
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Affiliation(s)
- S Bruehl
- Northwestern University Medical School and Center for Pain Studies, Rehabilitation Institute of Chicago, IL 60611, USA
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10
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Vaerøy H, Nyberg F, Terenius L. No evidence for endorphin deficiency in fibromyalgia following investigation of cerebrospinal fluid (CSF) dynorphin A and Met-enkephalin-Arg6-Phe7. Pain 1991; 46:139-143. [PMID: 1684241 DOI: 10.1016/0304-3959(91)90068-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The CSF levels of Met-enkephalin-Arg6-Phe7 and dynorphin A were measured in patients with fibromyalgia. The mean CSF Met-enkephalin-Arg6-Phe7 level was 35.1 +/- 2.4 fmol/ml (mean +/- S.E.M.). The mean CSF level of dynorphin A was 14.3 +/- 0.9 fmol/ml. Regression analysis showed a statistically significant correlation between Met-enkephalin-Arg6-Phe7 and dynorphin A (r = 0.5369, P = 0.001). When correlated to the previously measured CSF levels of beta-endorphin, a statistically significant correlation was found with Met-enkephalin-Arg6-Phe7 (r = 0.5055, P = 0.03) but not with dynorphin A (P greater than 0.05). The Met-enkephalin-Arg6-Phe7 and dynorphin A levels are elevated compared to the levels available for comparison groups. Therefore, a lack of endorphin secretion does not seem to be the basis for the hyperalgesia observed in these patients.
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Affiliation(s)
- Henning Vaerøy
- Department of Biological and Medical Psychology, University of Bergen, BergenNorway Department of Pharmaceutical Pharmacology, University of Uppsala, UppsalaSweden Department of Experimental Drug Dependence Research, Karolinska Institute, StockholmSweden
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Martignoni E, Facchinetti F, Rossi F, Sances G, Genazzani AR, Nappi G. Neuroendocrine evidence of deranged noradrenergic activity in chronic migraine. Psychoneuroendocrinology 1989; 14:357-63. [PMID: 2554358 DOI: 10.1016/0306-4530(89)90005-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Migraine is a psychobiological disorder in which a recurrent failure of opioid and adrenergic systems might occur, as plasma and CSF studies suggest. In order to elucidate the relationship between noradrenergic and opioidergic functions, the plasma beta-endorphin (beta-EP) response to clonidine and the cortisol response to dexamethasone were evaluated together in 25 patients suffering from migraine without aura, and with chronic tension headache (MTH). Baseline beta-EP plasma levels and beta-EP response to clonidine were significantly lower in MTH subjects than in controls, suggesting a postsynaptic hypothalamo-pituitary impairment. Forty-four percent of the MTH subjects showed either a lack of suppression of plasma cortisol following dexamethasone administration, or basal cortisol concentrations higher than controls and suppressors, suggesting a disinhibition of the hypothalamopituitary-adrenal (HPA) axis. An inverse correlation was found between pain severity and beta-EP secretion induced by clonidine (delta max), and no relationship was found between beta-EP and mood. These data suggest a failure of central noradrenergic activity, or perhaps an impaired secretion of beta-EP not related to HPA axis hyperactivity or to affective state.
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Affiliation(s)
- E Martignoni
- Department of Neurology, IRCCS C. Mondino, University of Pavia, Italy
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Martignoni E, Sances G, Nappi G. Significance of hormonal changes in migraine and cluster headache. Gynecol Endocrinol 1987; 1:295-319. [PMID: 3332538 DOI: 10.3109/09513598709023616] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- E Martignoni
- Department of Neurology, C. Mondino Foundation, University of Pavia, Italy
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