1
|
Liu J, Tian Y, Wei S, Wang W, Wang D, Zhou H, Zhang XY. Association of empathy with clinical symptoms and cognitive function in Chinese chronic schizophrenia patients with and without deficit syndrome. Prog Neuropsychopharmacol Biol Psychiatry 2022; 119:110592. [PMID: 35716800 DOI: 10.1016/j.pnpbp.2022.110592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/09/2022] [Accepted: 06/12/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients with deficit syndrome (DS) are known to experience cognitive impairment. However, there is no consistent conclusion on the impairment of neurocognitive features in DS patients, and no studies have examined their empathy. The purpose of this study was to compare neurocognition and empathy in patients with DS and non-DS schizophrenia. METHODS Totally, 665 patients with chronic schizophrenia were enrolled. DS patients were identified by the Proxy Scale for Deficit Syndrome (PDS). Neurocognition and social cognition were assessed by Repeatable Battery for the measurement of Neuropsychological Status (RBANS) and the Interpersonal Reactivity Index (IRI), respectively. In addition, psychopathological symptom severity was assessed by the Positive and Negative Syndrome Scale (PANSS). RESULTS Participants included 150 patients with DS and 140 patients with non-DS. DS patients performed significantly worse on the all RBANS domain (except for visuospatial) and total scores as well as IRI scores. Regression analysis showed that PANSS general psychopathology and education were associated with RBANS total score in the DS group (adjusted R2 = 0.29), while education and PANSS negative symptoms were correlated with RBANS total score in non-DS patients (adjusted R2 = 0.33). In the non-DS group, suicide attempts and PANSS negative symptom score were independently associated with IRI total score (adjusted R2 = 0.06), whereas in the DS group, no variable was associated with IRI total score. CONCLUSIONS Our findings suggest that patients with DS may have poor neurocognitive and empathy performance. In chronic schizophrenia patients, negative symptoms may play a different role in cognition between DS and non-DS groups.
Collapse
Affiliation(s)
- Junyao Liu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yang Tian
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Shuochi Wei
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Wenjia Wang
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Dongmei Wang
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Huixia Zhou
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiang-Yang Zhang
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China..
| |
Collapse
|
2
|
Schroeder PA, Seewald A, Svaldi J. Spotlight on the Left Frontal Cortex: No Evidence for Response Inhibition from Cathodal High-Definition tDCS over Left IFG or Left DLPFC. J Cogn Neurosci 2022; 34:1090-1102. [PMID: 35303094 DOI: 10.1162/jocn_a_01849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Inhibitory control functions draw on a fronto-basal network with central cortical hubs at the right inferior frontal gyrus (IFG) and the pre-SMA. However, few neuropsychological studies investigated the role of brain regions in the left frontal cortex and some previous evidence from bilateral studies remained inconclusive. This study presents a systematic investigation with high-definition transcranial direct current stimulation (HD tDCS) in a focal 4 × 1 configuration, which was used to target the left IFG or the left dorsolateral prefrontal cortex (DLPFC) with 1-mA active or sham cathodal HD tDCS. Healthy participants were randomized into three groups. We analyzed performance in an adaptive stop-signal task to quantify inhibitory control before (baseline), during cathodal HD tDCS (on-line), and after cathodal HD tDCS (off-line) to either left IFG, left DLPFC, or sham. Results from 67 participants and Bayesian analyses indicated moderate evidence against an effect of cathodal tDCS (left DLPFC and left IFG compared with sham) regardless of timing, that is, on-line or off-line cathodal HD tDCS. The study results are examined in view of previous neuropsychological and neurostimulation studies with bilateral and unilateral cathodal tDCS in healthy and patient samples. Theoretically, our results are compatible with a right-lateralization of response inhibition functions and suggest a negligible role of the left frontal hemisphere in healthy participants, but more stimulation parameters can be still explored in the left hemisphere. In line with previous studies, right inferior frontal gyrus seems a more promising target to investigate or alleviate response inhibition with tDCS.
Collapse
Affiliation(s)
| | - Anna Seewald
- University of Tübingen, Germany.,University of Marburg, Germany
| | | |
Collapse
|
3
|
Saporta N, Peled-Avron L, Scheele D, Lieberz J, Hurlemann R, Shamay-Tsoory SG. Touched by Loneliness - How Loneliness Impacts the Response to Observed Human Touch: a tDCS Study. Soc Cogn Affect Neurosci 2021; 17:142-150. [PMID: 34907421 PMCID: PMC8824677 DOI: 10.1093/scan/nsab122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 10/19/2021] [Accepted: 12/14/2021] [Indexed: 11/18/2022] Open
Abstract
Lonely people often crave connectedness. However, they may also experience their environment as threatening, entering a self-preserving state that perpetuates loneliness. Research shows conflicting evidence about their response to positive social cues, and little is known about their experience of observed human touch. The right inferior frontal gyrus (rIFG) is part of an observation–execution network implicated in observed touch perception. Correlative studies also point to rIFG’s involvement in loneliness. We examined the causal effect of rIFG anodal transcranial direct current stimulation on high- and low-loneliness individuals observing human touch. In a cross-over design study, 40 participants watched pictures of humans or objects touching or not touching during anodal and sham stimulations. Participants indicated whether pictures contained humans or objects, and their reaction time was measured. Results show that the reaction time of low-loneliness individuals to observed human touch was significantly slower during anodal stimulation compared to high-loneliness individuals, possibly due to them being more emotionally distracted by it. Lonely individuals also reported less liking of touch. Our findings support the notion that lonely individuals are not drawn to positive social cues. This may help explain the perpetuation of loneliness, despite social opportunities that could be available to lonely people.
Collapse
Affiliation(s)
- Nira Saporta
- School of Psychological Sciences, University of Haifa, Haifa 3498838, Israel
| | - Leehe Peled-Avron
- School of Psychological Sciences, University of Haifa, Haifa 3498838, Israel
| | - Dirk Scheele
- Division of Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital Bonn, 53105 Bonn, Germany.,Department of Psychiatry, School of Medicine & Health Sciences, University of Oldenburg, 26129 Oldenburg, Germany
| | - Jana Lieberz
- Division of Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital Bonn, 53105 Bonn, Germany
| | - René Hurlemann
- Department of Psychiatry, School of Medicine & Health Sciences, University of Oldenburg, 26129 Oldenburg, Germany.,Research Center Neurosensory Science, University of Oldenburg, 26129 Oldenburg, Germany
| | | |
Collapse
|
4
|
Impaired Cognitive Empathy in Outpatients with Chronic Musculoskeletal Pain: A Cross-Sectional Study. Neural Plast 2021; 2021:4430594. [PMID: 34616448 PMCID: PMC8487839 DOI: 10.1155/2021/4430594] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/30/2021] [Indexed: 12/15/2022] Open
Abstract
Background In recent years, a growing number of researchers showed significant interest in psychological and social interventions to manage chronic musculoskeletal (MSK) pain. Cognitive and emotional empathy is an attractive and valuable sociopsychological factor that may provide protection and resilience against chronic MSK pain. However, its effect on outpatients remains underexplored. Objective To compare the empathy ability between chronic MSK pain outpatients and healthy controls and explore the relationship between cognitive/emotional empathy and chronic pain. Methods Patients with chronic MSK pain (n = 22) and healthy controls (n = 26) completed the pain assessment and empathy ability task, utilizing a multidimensional empathy assessment tool with satisfactory reliability and validity (i.e., the Chinese version of the Multifaceted Empathy Test (MET-C)). Results The data indicated that the chronic MSK pain outpatients had impaired cognitive empathy (i.e., lower squared cognitive empathy accuracy: Student's t = −2.119, P = 0.040, and longer task completion time: Student's t = 3.382, P = 0.002) compared to healthy controls, and cognitive empathy was negatively correlated with pain intensity (r = −0.614, P = 0.002). Further, the impaired cognitive empathy was present in identifying positive, but not negative emotions. Conclusion These results indicate that chronic MSK pain is associated with impaired empathy ability. Our studies contribute to offering a potential direction for developing psychosocial interventions to treat chronic MSK pain.
Collapse
|
5
|
Li Y, Li W, Zhang T, Zhang J, Jin Z, Li L. Probing the role of the right inferior frontal gyrus during Pain-Related empathy processing: Evidence from fMRI and TMS. Hum Brain Mapp 2021; 42:1518-1531. [PMID: 33283946 PMCID: PMC7927301 DOI: 10.1002/hbm.25310] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 11/22/2020] [Accepted: 11/26/2020] [Indexed: 01/10/2023] Open
Abstract
Recent studies have suggested that the right inferior frontal gyrus (rIFG) may be involved in pain-related empathy. To verify the role of the rIFG, we performed a functional magnetic resonance imaging (fMRI) experiment to replicate previous research and further designed a noninvasive repetitive transcranial magnetic stimulation (rTMS) experiment to probe the causal role of the rIFG in pain-related empathy processing. We assigned 74 volunteers (37 females) to three groups. Group 1 (n = 26) performed a task in which participants were required to perceive pain in others (task of pain: TP) and we used fMRI to observe the activity of the rIFG during pain-related empathy processing. Then, we applied online rTMS to the rIFG and the vertex site (as reference site) to observe the performance of Group 2 (n = 24; performing TP) and Group 3 (n = 24; performing a control task of identifying body parts; task of body: TB). fMRI experiment demonstrated stronger activation in the rIFG than in the vertex during the perception of pain in others (p < .0001, Bonferroni-corrected). rTMS experiment indicated that when the rIFG was temporarily disrupted, participants perceived pain in others significantly more slowly (p < .0001, Bonferroni-corrected) than when the vertex was disrupted. Our results provide evidence that the rIFG is involved in pain-related empathy processing, which yields insights into how the brain perceives pain in others.
Collapse
Affiliation(s)
- Yun Li
- MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Psychiatry and Psychology, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduChina
- School of ManagementChengdu University of Traditional Chinese MedicineChengduChina
| | - Wenjuan Li
- MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Psychiatry and Psychology, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Tingting Zhang
- MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Psychiatry and Psychology, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Junjun Zhang
- MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Psychiatry and Psychology, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Zhenlan Jin
- MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Psychiatry and Psychology, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduChina
| | - Ling Li
- MOE Key Lab for Neuroinformation, High‐Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, Center for Psychiatry and Psychology, School of Life Science and TechnologyUniversity of Electronic Science and Technology of ChinaChengduChina
| |
Collapse
|
6
|
Bahji A, Forth E, Yang CC, Khalifa N. Transcranial direct current stimulation for empathy: A systematic review and meta-analysis. Soc Neurosci 2021; 16:232-255. [PMID: 33567964 DOI: 10.1080/17470919.2021.1889657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Transcranial Direct Current Stimulation (tDCS) has been used to modulate empathy, but no studies have meta-analyzed the evidence base for its efficacy. This study aimed to determine the efficacy of tDCS at modulating empathy. We conducted a systematic review and meta-analysis of randomized controlled trials involving anodal or cathodal versus sham tDCS to modulate empathy in healthy adults and clinical populations. Random-effects modelling was applied to pooling overall efficacy estimates using standardized mean differences (Hedge's g) and 95% confidence intervals. Outcome measures for tasks designed to measure empathy were reaction time and accuracy. Anodal tDCS appears to improve lab-based computerized measures of cognitive empathy in healthy adult volunteers. While the evidence provided by this review may be of relevance to individuals with impaired empathic capabilities, the generalizability of our findings is geared towards nonclinical populations given the preponderance of healthy volunteers in our review. Hence, it is not clear if moderate improvements in speed and accuracy on lab-based computerized empathy measures would lead to meaningful clinical improvements. Future studies should consider the use of tDCS to modulate empathy in clinical populations.
Collapse
Affiliation(s)
- Anees Bahji
- Department of Psychiatry, University of Calgary, Calgary, Canada
| | - Evan Forth
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada
| | - Cheng-Chang Yang
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Najat Khalifa
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada.,Department of Psychiatry, Queen's University, Kingston, Canada
| |
Collapse
|
7
|
High definition transcranial direct current stimulation (HD-tDCS): A systematic review on the treatment of neuropsychiatric disorders. Asian J Psychiatr 2021; 56:102542. [PMID: 33486461 DOI: 10.1016/j.ajp.2020.102542] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 12/14/2020] [Accepted: 12/28/2020] [Indexed: 12/15/2022]
Abstract
HD-tDCS (High-definition transcranial direct current stimulation) is a novel non-invasive brain stimulation (NIBS) technique based on the principle that when weak intensity electric currents are targeted on specific areas of the scalp, they cause underlying cortical stimulation. HD-tDCS shares its technical methodology with conventional tDCS (montage comprising of one anode and one cathode) except for a few modifications that are believed to have focal and longer-lasting neuromodulation effects. Although HD-tDCS is a recently available NIBS technique, impactful studies, case reports, and few controlled trials have been conducted in this context, facilitating an understanding of its neurobiological effects and the clinical translation of the same in health care set-up. The current article narratively reviews the mechanism of action of HD-tDCS, and it systematically examines the cognitive, clinical, and neurobiological effects of HD-tDCS in healthy volunteers as well as patients with neuropsychiatric conditions. Thus, this review attempts to explore the role of HD-tDCS in present-day practice and the future in the context of various neurological and psychiatric disorders.
Collapse
|
8
|
Qiao Y, Hu Q, Xuan R, Guo Q, Ge Y, Chen H, Zhu C, Ji G, Yu F, Wang K, Zhang L. High-definition transcranial direct current stimulation facilitates emotional face processing in individuals with high autistic traits: A sham-controlled study. Neurosci Lett 2020; 738:135396. [PMID: 32961273 DOI: 10.1016/j.neulet.2020.135396] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/31/2020] [Accepted: 09/15/2020] [Indexed: 11/29/2022]
Abstract
The deficit in emotional face processing is a critical impairment for individuals with high autistic traits. The temporalparietal junction(TPJ) is considered to be closely related to emotional face processing. The aim of this study was to examine the effect of highdefinition transcranial direct current stimulation (HD-tDCS) over the right temporal-parietal junction (rTPJ) on facial emotion processing of individuals with high autistic traits using eye-tracking technology. Twenty-nine participants with high autistic traits completed an eyetracking task (including happy, fearful and neutral faces) before and after five consecutive days of stimulation (anodal or sham). Results showed that anodal HD-tDCS significantly increased fixation time and fixation count in the mouth area, but this effect was not found after the sham stimulation. Moreover, this increased effect of mouth recognition with anodal rTPJ HD-tDCS was shown in both happy and fearful faces, but no remarkable difference was found in neutral faces. These findings suggest that right TPJ anodal HD-tDCS can facilitate emotional face processing in individuals with high autistic traits.
Collapse
Affiliation(s)
- Yuxi Qiao
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei 230032, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230032, China; Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui Medical University, Hefei 230032, China
| | - Qian Hu
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei 230032, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230032, China; Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui Medical University, Hefei 230032, China
| | - Rongrong Xuan
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei 230032, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230032, China; Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui Medical University, Hefei 230032, China
| | - Qianhui Guo
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei 230032, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230032, China; Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui Medical University, Hefei 230032, China
| | - Yuqi Ge
- Department of First Clinical Medical College, Anhui Medical University, Hefei 230032, China
| | - Han Chen
- Department of First Clinical Medical College, Anhui Medical University, Hefei 230032, China
| | - Chunyan Zhu
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei 230032, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230032, China; Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui Medical University, Hefei 230032, China
| | - Gongjun Ji
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei 230032, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230032, China; Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui Medical University, Hefei 230032, China
| | - Fengqiong Yu
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei 230032, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230032, China; Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui Medical University, Hefei 230032, China
| | - Kai Wang
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei 230032, China; Department of Neurology, First Affiliated Hospital of Anhui Medical University, Hefei 230032, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230032, China; Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui Medical University, Hefei 230032, China.
| | - Lei Zhang
- Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei 230032, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230032, China; Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui Medical University, Hefei 230032, China.
| |
Collapse
|
9
|
Solomons CD, Shanmugasundaram V. Transcranial direct current stimulation: A review of electrode characteristics and materials. Med Eng Phys 2020; 85:63-74. [PMID: 33081965 DOI: 10.1016/j.medengphy.2020.09.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 09/10/2020] [Accepted: 09/25/2020] [Indexed: 12/15/2022]
Abstract
Electrode characteristics are crucial in transcranial direct current stimulation (tDCS) since electrode design and placement determine the cortical area being modulated, current density and spatial resolution of stimulation. Early research on tDCS sought to determine optimal parameters for stimulation by specifying maximum current, duration and sizes of electrodes. Further research focused on determining efficient ways to deliver stimulation to targeted regions on the cortex with minimal discomfort to the user by altering electrode size, placement, shape and material. This review aims to give an insight on the main characteristics of electrodes used in tDCS and on the variability found in electrode parameters and placements from tDCS to high definition tDCS (HD-tDCS) applications and beyond.
Collapse
Affiliation(s)
- Cassandra D Solomons
- School of Electrical Engineering, Vellore Institute of Technology, Vellore 632014, India
| | | |
Collapse
|
10
|
Chen L, Zou X, Tang R, Ke A, He J. Effect of electrode-electrolyte spatial mismatch on transcranial direct current stimulation: a finite element modeling study. J Neural Eng 2019; 16:056012. [DOI: 10.1088/1741-2552/ab29c5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|