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Article ; Online: A 10-Year Study of the Trend of Accidental Falls in the Elderly in a Japanese Hospital.

Takekawa, Toru / Obuchi, Kei / Watanabe, Shu / Yamada, Naoki / Abo, Masahiro

Zeitschrift fur Orthopadie und Unfallchirurgie

2024

Abstract: Elderly people are prone to falls. We established the Falls Prevention Working Group (FPWG) at our hospital in 2015 to reduce the number of falls during hospitalization. This study compared the trend of in-hospital falls in the elderly in two time ... ...

Title translation	Eine 10-Jahres-Studie über die Entwicklung von Sturzunfällen bei älteren Menschen in einem japanischen Krankenhaus - Empfehlungen multidisziplinärer Teams zur Reduzierung von Stürzen bei älteren Menschen.
Abstract	Elderly people are prone to falls. We established the Falls Prevention Working Group (FPWG) at our hospital in 2015 to reduce the number of falls during hospitalization. This study compared the trend of in-hospital falls in the elderly in two time periods (2008/9 and 2018/9) and determined the effects of FPWG-implemented measures. Using medical records, we counted the monthly number of falls suffered by patients during hospitalization in April 2008-March 2009 and April 2018-March 2019. We also categorized the falls according to the severity of fall-related complications.A total of 3609 hospital falls were recorded during the 2008-2019 period (2008/9: n = 433, 2018/9: n = 324). Falls were more common in patients aged 70-79 in 2008/9 but were noted in those aged ≥ 80 in 2018/9. The mean number of falls/month (27.3 ± 6.4, range: 12-45) was stable throughout the year. The incidence of falls in 2018/9 (1.90/1000 per persons per day) was significantly lower than in 2008/9 (2.30/1000, p = 0.006). Level ≥ 3b accidents, reflecting serious accidents with complications, were encountered in 12 of 433 accidents in 2008/9 compared with significantly fewer accidents (2 of the same severity among 324 accidents) in 2018/9 (p = 0.030).Our results showed a decrease in in-hospital falls in 2018/9 and that the sufferers were older relative to 10 years earlier. A multidisciplinary team should recommend measures to prevent falls and an environment "resilient" to falls, and encourage patients to be aware of possible falls.
Language	English
Publishing date	2024-04-11
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2280747-0
ISSN	1864-6743 ; 1438-941X ; 1864-6697 ; 0044-3220
ISSN (online)	1864-6743 ; 1438-941X
ISSN	1864-6697 ; 0044-3220
DOI	10.1055/a-2276-0011
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Article: A 10-Year Study of the Trend of Accidental Falls in the Elderly in a Japanese Hospital

Takekawa, Toru / Obuchi, Kei / Watanabe, Shu / Yamada, Naoki / Abo, Masahiro

Zeitschrift für Orthopädie und Unfallchirurgie

2024

Abstract	Elderly people are prone to falls. We established the Falls Prevention Working Group (FPWG) at our hospital in 2015 to reduce the number of falls during hospitalization. This study compared the trend of in-hospital falls in the elderly in two time periods (2008/9 and 2018/9) and determined the effects of FPWG-implemented measures. Using medical records, we counted the monthly number of falls suffered by patients during hospitalization in April 2008-March 2009 and April 2018-March 2019. We also categorized the falls according to the severity of fall-related complications. A total of 3609 hospital falls were recorded during the 2008–2019 period (2008/9: n = 433, 2018/9: n = 324). Falls were more common in patients aged 70–79 in 2008/9 but were noted in those aged ≥ 80 in 2018/9. The mean number of falls/month (27.3 ± 6.4, range: 12–45) was stable throughout the year. The incidence of falls in 2018/9 (1.90/1000 per persons per day) was significantly lower than in 2008/9 (2.30/1000, p = 0.006). Level ≥ 3b accidents, reflecting serious accidents with complications, were encountered in 12 of 433 accidents in 2008/9 compared with significantly fewer accidents (2 of the same severity among 324 accidents) in 2018/9 (p = 0.030). Our results showed a decrease in in-hospital falls in 2018/9 and that the sufferers were older relative to 10 years earlier. A multidisciplinary team should recommend measures to prevent falls and an environment “resilient” to falls, and encourage patients to be aware of possible falls.
Keywords	accidental falls ; interdisciplinary team ; longevity ; risk management ; prevention and control ; Sturzunfälle ; interdisziplinäres Team ; Langlebigkeit ; Risikomanagement ; Prävention und Kontrolle
Language	English
Publishing date	2024-04-11
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2280747-0
ISSN	1864-6743 ; 1438-941X ; 1864-6697 ; 0044-3220
ISSN (online)	1864-6743 ; 1438-941X
ISSN	1864-6697 ; 0044-3220
DOI	10.1055/a-2276-0011
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Article ; Online: Multimodal treatment, including extracorporeal shock wave therapy, for refractory chronic tension-type headache: a case report.

Takekawa, Toru / Chino, Toshifumi / Yamada, Naoki / Watanabe, Shu / Abo, Masahiro / Sengoku, Renpei

Journal of medical case reports

2023 Volume 17, Issue 1, Page(s) 478

Abstract: Background: Few reports have described multidisciplinary treatment, including extracorporeal shock wave therapy, for patients with refractory chronic tension-type headache. In this study, we conducted multidisciplinary treatment for a patient with ... ...

Abstract	Background: Few reports have described multidisciplinary treatment, including extracorporeal shock wave therapy, for patients with refractory chronic tension-type headache. In this study, we conducted multidisciplinary treatment for a patient with chronic tension-type headache who suffered from chronic headache refractory to treatment. Case presentation: The patient was a 45-year-old Japanese male suffering from 20 years of headache. As his headache had worsened recently, he visited a local clinic. With the diagnosis of suspected tension-type headache, its treatment was unsuccessful and he was referred to our hospital. The neurology department confirmed the tension-type headache and prescribed another medication, but he showed no improvement. Then, the patient was referred to the rehabilitation medicine department for consultation. At the initial visit, we identified multiple myofascial trigger points in his bilateral posterior neck and upper back regions. At the initial visit, he was prescribed 10 mL of 1% lidocaine injected into the muscles in these areas. In addition, he received 2000 extracorporeal shock wave therapy into bilateral trapezius muscles, and was instructed to take oral Kakkonto extract granules, benfotiamine, pyridoxine hydrochloride, and cyanocobalamin. Cervical muscle and shoulder girdle stretches and exercises were also recommended. At follow-up treatment visits, we used extracorporeal shock wave therapy to bilateral trapezius muscles, which led to immediate pain relief. After 11 weeks, he was not taking any medication and his headache was subjectively improved and his medical treatment ended. Conclusion: A patient with chronic tension-type headache refractory to regular treatment was successfully treated with a multimodal approach including extracorporeal shock wave therapy in addition to standard treatment. For patients with tension-type headache accompanied by myofascial trigger points, it may be recommended to promptly consider aggressive multimodal treatment that includes extracorporeal shock wave therapy.
MeSH term(s)	Humans ; Male ; Middle Aged ; Combined Modality Therapy ; Extracorporeal Shockwave Therapy ; Headache ; Myofascial Pain Syndromes/complications ; Myofascial Pain Syndromes/diagnosis ; Myofascial Pain Syndromes/therapy ; Tension-Type Headache/therapy ; Tension-Type Headache/diagnosis ; Tension-Type Headache/etiology
Language	English
Publishing date	2023-10-31
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2269805-X
ISSN	1752-1947 ; 1752-1947
ISSN (online)	1752-1947
ISSN	1752-1947
DOI	10.1186/s13256-023-04092-9
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Article ; Online: Treatment outcome of local injection of botulinum toxin for claw toe: Differences between cerebral hemorrhage and infarction.

Takekawa, Toru / Hara, Takatoshi / Yamada, Naoki / Sato, Tomoharu / Hasegawa, Yuki / Takagi, Satoshi / Kobayashi, Kazushige / Kitajima, Tomohide / Abo, Masahiro

Clinical neurology and neurosurgery

2023 Volume 226, Page(s) 107620

Abstract: Background: Some patients with post-stroke claw toe respond well to botulinum toxin (BoNT) treatment while others do not. This study was designed to assess the impact of stroke type (cerebral hemorrhage and cerebral infarction) on the outcome of BoNT ... ...

Abstract	Background: Some patients with post-stroke claw toe respond well to botulinum toxin (BoNT) treatment while others do not. This study was designed to assess the impact of stroke type (cerebral hemorrhage and cerebral infarction) on the outcome of BoNT treatment for claw toe. Methods: We retrospectively examined the medical records of patients who received local BoNT (onabotulinumtoxin A) injections into the flexor hallucis longus (FHL) and flexor digitorum longus (FDL) muscles. All patients suffered stroke-related leg paralysis and spasticity. Results: The study participants were 58 patients (mean age, 61.4 ± 10.3 years, ± SD) with time since stroke of 6.7 ± 4.4 years. The stroke type was cerebral hemorrhage (n = 38) and cerebral infarction (n = 20). After a total of 124 BoNT administrations with medical records entries on the subjective symptoms, the odds for symptomatic improvement was approximately 5.8 times higher in patients of the infarction group compared with the hemorrhage group (OR = 5.787, 95% CI = 2.369-14.134, p = 0. 000). Fifty-one patients (32 with cerebral hemorrhage, 19 with cerebral infarction) received the first local BoNT injection and had available medical records, analysis of which showed a significantly higher rate of symptomatic improvement in patients of the infarction group than those of the hemorrhage group (p = 0.006). After adjustment by factors known to influence treatment outcome (degree of spasticity and paralysis, BoNT dosage, and extent of FDL muscle control of toe movements), the treatment effect was predominantly higher in patients with cerebral infarction. Conclusion: The BoNT treatment response was better for claw toes in cerebral infarction patients than in hemorrhage patients, possibly suggesting that claw toe is associated with more severe spasticity in this group of patients.
MeSH term(s)	Humans ; Middle Aged ; Aged ; Hammer Toe Syndrome/complications ; Retrospective Studies ; Botulinum Toxins, Type A ; Stroke/complications ; Muscle Spasticity ; Paralysis ; Cerebral Hemorrhage/complications ; Treatment Outcome ; Cerebral Infarction/complications ; Infarction/complications ; Neuromuscular Agents
Chemical Substances	Botulinum Toxins, Type A (EC 3.4.24.69) ; Neuromuscular Agents
Language	English
Publishing date	2023-02-09
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	193107-6
ISSN	1872-6968 ; 0303-8467
ISSN (online)	1872-6968
ISSN	0303-8467
DOI	10.1016/j.clineuro.2023.107620
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Article: Claw Toe: Anatomic Guide for Injection of Botulinum Toxin into Foot Muscles.

Takekawa, Toru / Takagi, Satoshi / Kitajima, Tomohide / Sato, Tomoharu / Kinoshita, Kazuo / Abo, Masahiro

The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques

2021 Volume 49, Issue 1, Page(s) 102–108

Abstract: Background: Poor response to injection of botulinum toxin (BoNT) into the flexor digitorum longus (FDL) muscle has been reported especially in patients with claw foot deformity. We previously advocated BoNT injection into the flexor hallucis longus (FHL) ...

Abstract	Background: Poor response to injection of botulinum toxin (BoNT) into the flexor digitorum longus (FDL) muscle has been reported especially in patients with claw foot deformity. We previously advocated BoNT injection into the flexor hallucis longus (FHL) muscle in such patients. Here, we determined the functional and anatomical relationships between FHL and FDL. Methods: Toe flexion pattern was observed during electrical stimulation of FHL and FDL muscles in 31 post-stroke patients with claw-foot deformity treated with BoNT. The FHL and FDL tendon arrangement was also studied in five limbs of three cadavers. Results: Electrical stimulation of the FHL muscle elicited big toe flexion in all 28 cases examined and second toe in 25, but the response was limited to the big toe in 3. FDL muscle stimulation in 29 patients elicited weak big toe flexion in 1 and flexion of four toes (2nd to 5th) in 16 patients. Cadaver studies showed division of the FHL tendon with branches fusing with the FDL tendon in all five limbs examined; none of the tendons was inserted only in the first toe. No branches of the FDL tendon merged with the FHL tendon. Conclusion: Our results showed coupling of FHL and FDL tendons in most subjects. Movements of the second and third toes are controlled by both the FDL and FHL muscles. The findings highlight the need for BoNT injection in both the FDL and FHL muscles for the treatment of claw-toe deformity.
MeSH term(s)	Botulinum Toxins/therapeutic use ; Foot ; Hammer Toe Syndrome/drug therapy ; Humans ; Muscle, Skeletal ; Tendons/physiology
Chemical Substances	Botulinum Toxins (EC 3.4.24.69)
Language	English
Publishing date	2021-03-26
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	197622-9
ISSN	0317-1671
ISSN	0317-1671
DOI	10.1017/cjn.2021.52
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Article ; Online: Rehabilitation therapy for a severe case of coronavirus disease 2019: a case report.

Takekawa, Toru / Kashiwabara, Kazumi / Yamada, Naoki / Watanabe, Shu / Hama, Midori / Hashimoto, Gentaro / Abo, Masahiro / Shinfuku, Kyota

Journal of medical case reports

2022 Volume 16, Issue 1, Page(s) 339

Abstract: Background: Patients with severe coronavirus disease 2019 (COVID-19) infection require a long period of time to return to work and society due to significant physical weakness even after recovery. Here we report a patient with a history of nephrectomy ... ...

Abstract	Background: Patients with severe coronavirus disease 2019 (COVID-19) infection require a long period of time to return to work and society due to significant physical weakness even after recovery. Here we report a patient with a history of nephrectomy who developed severe COVID-19 infection associated with muscle weakness but was able to return to society after rehabilitation therapy. Case presentation: A Japanese man in his 40s was admitted to the hospital with PCR-based COVID-19 diagnosis. The respiratory condition worsened rapidly and was treated with extracorporeal membrane-assisted ventilation in the intensive case unit. On admission to the Rehabilitation Department on day T + 30 [T: day patient became febrile (38 °C)], he was unable to stand for a long time and used a walker. Rehabilitation therapy was postponed to prevent COVID-19 spread, but the patient was encouraged to exercise during isolation to improve trunk and lower extremity muscle strength. Physical therapy commenced on day T + 49 to improve gait and trunk and lower limb muscle strength. He was able to walk independently and later returned to work following discharge on day T + 53. A computed tomography scan showed an increase in psoas muscle volume from 276 before to 316 cm Conclusions: We have described the beneficial effects of rehabilitation therapy in a patient with severe COVID-19 infection. In addition to exercise, we believe that nutrition is even more important in increasing skeletal muscle mass. Rehabilitation therapy is recommended to enhance the return of severely ill COVID-19 patients to routine daily activity.
MeSH term(s)	COVID-19 ; COVID-19 Testing ; Humans ; Male ; Muscle Weakness/etiology ; Physical Therapy Modalities/adverse effects ; Respiration, Artificial
Language	English
Publishing date	2022-09-02
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2269805-X
ISSN	1752-1947 ; 1752-1947
ISSN (online)	1752-1947
ISSN	1752-1947
DOI	10.1186/s13256-022-03559-5
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Article: Comparison of the effect and treatment sequence between a 2-week parallel repetitive transcranial magnetic stimulation and rehabilitation and a 2-week rehabilitation-only intervention during a 4-week hospitalization for upper limb paralysis after stroke: An open-label, crossover observational study.

Yamada, Naoki / Kashiwabara, Kazumi / Takekawa, Toru / Hama, Midori / Niimi, Masachika / Hara, Takatoshi / Furumizo, Satoshi / Tsuboi, Marika

Journal of central nervous system disease

2022 Volume 14, Page(s) 11795735211072731

Abstract: Background: NEURO: Objectives: However, this has not been demonstrated using NEURO: Methods: Thirty-seven patients with upper limb paralysis following stroke were recruited and hospitalized for treatments and randomly divided into two groups. ... ...

Abstract	Background: NEURO Objectives: However, this has not been demonstrated using NEURO Methods: Thirty-seven patients with upper limb paralysis following stroke were recruited and hospitalized for treatments and randomly divided into two groups. Group A consisted of 16 patients who underwent NEURO Results: Group A, who underwent NEURO Conclusion: Our findings indicate that rTMS facilitates neuromodulation when combined with OT, which leads to more effective rehabilitation than with OT alone (Trial registration: JMACCT (http://www.jmacct.med.or.jp/); trial ID JMA-IIA00215).
Language	English
Publishing date	2022-01-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2586873-1
ISSN	1179-5735
ISSN	1179-5735
DOI	10.1177/11795735211072731
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Article ; Online: Effects of Flexor Digitorum Longus Muscle Anatomical Structure on the Response to Botulinum Toxin Treatment in Patients with Post-Stroke Claw Foot Deformity.

Takekawa, Toru / Kobayashi, Kazushige / Yamada, Naoki / Takagi, Satoshi / Hara, Takatoshi / Kitajima, Tomohide / Sato, Tomoharu / Sugihara, Hiroshi / Kinoshita, Kazuo / Abo, Masahiro

Toxins

2022 Volume 14, Issue 10

Abstract: 1) Background: The purpose of this retrospective case-control study was to determine the relationship between the control of toe movements by flexor hallucis longus (FHL) and flexor digitorum longus (FDL) muscles and the response to treatment with ... ...

Abstract	(1) Background: The purpose of this retrospective case-control study was to determine the relationship between the control of toe movements by flexor hallucis longus (FHL) and flexor digitorum longus (FDL) muscles and the response to treatment with botulinum toxin (BoNT) in post-stroke patients with claw toe. (2) Methods: Subjects with stroke-related leg paralysis/spasticity and claw toes received multiple injections of BoNT (onabotulinumtoxin A) into the FHL or FDL muscles. We investigated the relationship between the mode of transmission of FHL and FDL muscle tension to each toe (MCT) and treatment outcome using the data of 53 patients who received 124 injections with clinically recorded treatment outcome. We also dissected the potential variables that could determine the treatment outcome. (3) Results: The effectiveness of BoNT treatment was significantly altered by FDL-MCT (OR = 0.400, 95% CI = 0.162-0.987, p = 0.047). Analysis of the response to the first BoNT injection showed an odds ratio of FDL-MCT of approximately 6.0 times (OR = 0.168, 95% CI = 0.033-0.857, p = 0.032). The more tibial the influence of the FDL muscle on each toe, the better the treatment outcome on the claw toe. (4) Conclusions: The anatomic relation between FDL muscle and each toe seems to affect the response to treatment with BoNT in post-stroke patients with claw toes.
MeSH term(s)	Humans ; Hammer Toe Syndrome ; Botulinum Toxins, Type A/therapeutic use ; Case-Control Studies ; Retrospective Studies ; Foot Deformities ; Muscle, Skeletal
Chemical Substances	Botulinum Toxins, Type A (EC 3.4.24.69)
Language	English
Publishing date	2022-09-25
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2518395-3
ISSN	2072-6651 ; 2072-6651
ISSN (online)	2072-6651
ISSN	2072-6651
DOI	10.3390/toxins14100666
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Article: Botulinum toxin treatment for difficult-to-treat finger pressure ulcers caused by severe hand flexion: case report.

Takekawa, Toru / Ikegaya, Mariko / Etoh, Takafumi / Shiio, Yasushi / Sugihara, Hiroshi / Haraikawa, Keiko / Miyamoto, Nozomi / Abo, Masahiro

Journal of wound care

2021 Volume 30, Issue 8, Page(s) 653–659

Abstract: We report the successful treatment of two cases of difficult-to-treat pressure ulcers with botulinum toxin type A (BoNT-A). A 71-year-old male patient with Parkinson's disease presented with severe hand grip deformities of the fingers and a pressure ... ...

Abstract	We report the successful treatment of two cases of difficult-to-treat pressure ulcers with botulinum toxin type A (BoNT-A). A 71-year-old male patient with Parkinson's disease presented with severe hand grip deformities of the fingers and a pressure ulcer (PU) on the right hand. He received 240U of BoNT-A into the upper limb muscles, which improved finger mobility during passive extension and resulted in resolution of the palm PU. No recurrence was noted. A 69-year-old female patient with Lewy body dementia presented with a PU on the palm side of the middle finger apex of the right hand, with exposure of the phalanx bone and dark red oedematous granulation of the tip of the finger. Severe muscle tone was noted. She received 240U of BoNT-A injected into the muscles of the upper extremities. This resulted in the disappearance of the contracture between the middle finger cusp and palm, and prompt healing of the PU. A protective finger orthosis was also used to improve hand finger grip and prevent further PUs. Although BoNT-A injection resulted in only slight improvement in the range of motion, it produced relief of pressure with consequent healing of the PU. Injection of BoNT-A into the affected muscles of the patients in this case report was effective in reducing flexor muscle tone, relief of pressure on the palm skin and healing of hand PUs.
MeSH term(s)	Aged ; Botulinum Toxins, Type A/therapeutic use ; Female ; Hand Strength ; Humans ; Male ; Muscle Spasticity ; Pressure Ulcer/drug therapy ; Range of Motion, Articular ; Treatment Outcome
Chemical Substances	Botulinum Toxins, Type A (EC 3.4.24.69)
Language	English
Publishing date	2021-04-12
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1353951-6
ISSN	0969-0700
ISSN	0969-0700
DOI	10.12968/jowc.2021.30.8.653
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Article: Brain perfusion and upper limb motor function: a pilot study on the correlation between evolution of asymmetry in cerebral blood flow and improvement in Fugl-Meyer Assessment score after rTMS in chronic post-stroke patients.

Takekawa, Toru / Kakuda, Wataru / Uchiyama, Mayuki / Ikegaya, Masato / Abo, Masahiro

Journal of neuroradiology = Journal de neuroradiologie

2013 Volume 41, Issue 3, Page(s) 177–183

Abstract: Background and purpose: Few studies have explored the refinement of asymmetry in regional cerebral blood flow in relation to behavioral improvement after treatment. The purpose of this retrospective pilot study was to identify cerebral cortical regions ... ...

Abstract	Background and purpose: Few studies have explored the refinement of asymmetry in regional cerebral blood flow in relation to behavioral improvement after treatment. The purpose of this retrospective pilot study was to identify cerebral cortical regions with improved perfusion that correlated with improvement of upper limb motor function after repetitive transcranial magnetic stimulation (rTMS). Materials and methods: The study subjects were 33 post-stroke patients with upper limb hemiparesis who underwent rTMS combined with intensive occupational therapy (mean ± SD age: 64.9 ± 11.2 years; time since onset of stroke: 57.3 ± 45.9 months). Fugl-Meyer Assessment (FMA) and the Wolf Motor Function Test (WMFT) were applied before and after treatment to evaluate motor function in the affected upper limb. Regional brain perfusion was measured by single-photon emission computed tomography, and the percentages of asymmetry values (asymmetry index [AI]) for 52 bilateral regions of interest were calculated. The change in AI was calculated as the post-intervention minus pre-intervention values. Results: Changes in AI in the superior and middle frontal areas correlated significantly and negatively with changes in FMA score (superior: r = -0.406, P = 0.03, R(2) = 0.251; middle: r = -0.437, P < 0.001, R(2) = 0.306), but not with changes in WMFT log performance time. Conclusion: Changes in AI less than zero reflect improved perfusion, suggesting that upper limb motor function improvement in post-stroke patients reflects evolution of brain perfusion in the superior and middle frontal areas.
MeSH term(s)	Blood Flow Velocity ; Brain/diagnostic imaging ; Brain/physiopathology ; Cerebrovascular Circulation ; Chronic Disease ; Humans ; Middle Aged ; Nerve Net/diagnostic imaging ; Nerve Net/physiopathology ; Paresis/diagnostic imaging ; Paresis/physiopathology ; Paresis/prevention & control ; Pilot Projects ; Radionuclide Imaging ; Recovery of Function ; Retrospective Studies ; Severity of Illness Index ; Stroke/diagnostic imaging ; Stroke/physiopathology ; Stroke/therapy ; Transcranial Magnetic Stimulation ; Treatment Outcome ; Upper Extremity/physiopathology
Language	English
Publishing date	2013-07-22
Publishing country	France
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	131763-5
ISSN	1773-0406 ; 0150-9861
ISSN (online)	1773-0406
ISSN	0150-9861
DOI	10.1016/j.neurad.2013.06.006
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