Obsessive-compulsive disorder

强迫症
  • 文章类型: Journal Article
    强迫症(OCD)是一种使人衰弱的精神疾病,由于我们对其病理生理学的了解有限,因此难以治疗。大脑网络中的功能连接,通过神经影像学研究评估,在理解强迫症中起着举足轻重的作用。虽然脑电图(EEG)和功能磁共振成像(fMRI)已广泛用于强迫症研究,很少有人完全综合了他们的发现。为了弥合这个差距,我们回顾了166项研究(10项脑电图,156fMRI)发布至2023年12月。在脑电图研究中,强迫症在delta和alpha波段表现出较低的连通性,与其他频段的发现不一致。静息状态功能磁共振成像研究报告了默认模式网络(DMN)和感觉运动皮质-纹状体-丘脑-皮质(CSTC)电路中相互冲突的连接模式。许多研究观察到DMN和显著性网络(SN)之间的静息状态连通性降低,在OCD中包含“三重网络模型”。DMN-SN中与任务相关的超连通性以及SN和额叶网络之间的低连通性表明与OCD相关的认知不灵活性,可能是由于三重网络功能障碍。总之,我们的评论强调了强迫症的不同连通性差异,揭示复杂的大脑网络相互作用,有助于症状表现。然而,结果相互矛盾的存在强调了有针对性的研究以全面了解强迫症的病理生理学的必要性.
    Obsessive-compulsive disorder (OCD) is a debilitating psychiatric condition that is difficult to treat due to our limited understanding of its pathophysiology. Functional connectivity in brain networks, as evaluated through neuroimaging studies, plays a pivotal role in understanding OCD. While both electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) have been extensively employed in OCD research, few have fully synthesized their findings. To bridge this gap, we reviewed 166 studies (10 EEG, 156 fMRI) published up to December 2023. In EEG studies, OCD exhibited lower connectivity in delta and alpha bands, with inconsistent findings in other frequency bands. Resting-state fMRI studies reported conflicting connectivity patterns within the default mode network (DMN) and sensorimotor cortico-striato-thalamo-cortical (CSTC) circuitry. Many studies observed decreased resting-state connectivity between the DMN and salience network (SN), implicating the \'triple network model\' in OCD. Task-related hyperconnectivity within the DMN-SN and hypoconnectivity between the SN and frontoparietal network suggest OCD-related cognitive inflexibility, potentially due to triple network dysfunction. In conclusion, our review highlights diverse connectivity differences in OCD, revealing complex brain network interplay that contributes to symptom manifestation. However, the presence of conflicting findings underscores the necessity for targeted research to achieve a comprehensive understanding of the pathophysiology of OCD.
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  • 文章类型: Journal Article
    背景:自我吸收是指过度,持久性,以及对自我信息的严格关注。本研究旨在将自我吸收量表(SAS)引入中国,并评估其潜在变量结构,网络结构,心理测量属性,和非临床中国样本中的临床效用。
    方法:209名参与者完成了SAS翻译以及简短的一般健康问卷(GHQ-12)。反省-反思问卷(RRQ)的反省子量表,正念注意意识量表(MAAS),私人自我意识量表(PrSCS),强迫性量表修订(OCI-R)和分离经历量表(DES-II)。此外,30名受访者完成了中文版SAS,并在2周后进行了重新测试。
    结果:中文版SAS(CH-SAS)具有理想的双相关因素结构,并删除了反向评分项目,在不同性别之间是不变的。CH-SAS网络结构中的核心项目与过度的自我沉浸有关,自我吸收的不可控性和焦虑方面。CH-SAS的Cronbach\α系数为0.903,而McDonald\的omega系数为0.916,重测可靠性为0.908。CH-SAS及其两个分量表与RRQ的反思性分量表(范围为0.474至0.616;p<.001)和GHQ-12(范围为0.479至0.538;p<.001)具有中度正相关,与MAAS呈中度负相关(范围为-0.413至-0.360;p<.001)。PrSCS与CH-SAS和PrSAS几乎没有相关性(p>0.05),其与PubSAS的相关性在0.05水平上显著,相关系数非常低(r=0.157)。分层回归分析表明,CH-SAS可以显著预测强迫症的严重程度,焦虑,沉思,解离,注意注意意识。
    结论:CH-SAS具有出色的可靠性,包括内部一致性和重测可靠性。此外,它表现出良好的结构有效性,以及收敛和发散有效性的有力证据。此外,使用CH-SAS测量的自我吸收对OCD的预测贡献显着超过其他相关心理因素,表明其临床实用性。
    BACKGROUND: Self-absorption refers an excessive, persistent, and rigid preoccupation with information regarding the self. This study aims to introduce the Self-Absorption Scale (SAS) into China with an assessment of its latent variable structure, network structure, psychometric properties, and clinical utility in a nonclinical Chinese sample.
    METHODS: 209 participants completed the translated SAS as well as the Short General Health Questionnaire (GHQ-12), rumination subscale of the Rumination-Reflection Questionnaire (RRQ), the Mindful Attention Awareness Scale (MAAS), the Private Self-Consciousness Scale (PrSCS), the Obsessive-Compulsive Inventory-Revised (OCI-R) and the Dissociative Experiences Scale (DES-II). In addition, 30 respondents completed the Chinese version of the SAS and retested it 2 weeks later.
    RESULTS: The Chinese version of the SAS (CH-SAS) had a desirable two-correlated-factor structure with the reverse scored item removed, which was invariant across different genders. The core items in the network structure of the CH-SAS were related to excessive self-immersion, uncontrollability and anxiety aspects of self-absorption. The Cronbach\'s alpha coefficient for the CH-SAS was 0.903 while the McDonald\'s omega coefficient was 0.916 and the test-retest reliability was 0.908. The CH-SAS and its two subscales had moderate positive correlations with the rumination subscale of the RRQ (ranging from 0.474 to 0.616; p < .001) and the GHQ-12 (ranging from 0.479 to 0.538; p < .001), and moderate negative correlations with the MAAS (ranging from - 0.413 to - 0.360; p < .001). The PrSCS has almost no correlation with the CH-SAS and PrSAS (p > .05), and its correlation with the PubSAS was significant at the 0.05 level, with a remarkably low correlation coefficient (r = .157). The hierarchical regression analysis suggested that the CH-SAS can significantly predict the severity of OCD beyond factors such as depression, anxiety, rumination, dissociation, and mindful attention awareness.
    CONCLUSIONS: The CH-SAS demonstrates excellent reliability, including internal consistency and test-retest reliability. Additionally, it exhibits favorable structural validity, as well as strong evidence of convergent and divergent validity. Furthermore, the self-absorption measured using the CH-SAS contributed significantly to the prediction of OCD beyond other relevant psychological factors, suggesting its clinical utility.
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  • 文章类型: Journal Article
    开发了用于隔离纹状体的大规模生物物理网络模型,以优化潜在的纹状体内深部脑刺激,强迫症。该模型基于具有小世界连通性的修正的霍奇金-赫克斯利方程,而关于神经元位置的空间信息取自详细的人类地图集。该模型产生神经元时空活动模式,将健康与病理状况分开。三种生物标志物用于优化刺激方案有关刺激频率,振幅和定位:整个网络的平均活动,整个网络的频谱(节律性)以及上述两者的组合。通过最小化上述生物标志物与正常状态的偏差,我们计算出最佳的脑深部刺激参数,关于位置,振幅和频率。我们的结果表明,在DBS优化过程中,在频率同步和整体网络活动之间存在明显的权衡,在体内研究中也观察到了这一点。
    A large-scale biophysical network model for the isolated striatal body is developed to optimise potential intrastriatal deep brain stimulation applied to, e.g. obsessive-compulsive disorder. The model is based on modified Hodgkin-Huxley equations with small-world connectivity, while the spatial information about the positions of the neurons is taken from a detailed human atlas. The model produces neuronal spatiotemporal activity patterns segregating healthy from pathological conditions. Three biomarkers were used for the optimisation of stimulation protocols regarding stimulation frequency, amplitude and localisation: the mean activity of the entire network, the frequency spectrum of the entire network (rhythmicity) and a combination of the above two. By minimising the deviation of the aforementioned biomarkers from the normal state, we compute the optimal deep brain stimulation parameters, regarding position, amplitude and frequency. Our results suggest that in the DBS optimisation process, there is a clear trade-off between frequency synchronisation and overall network activity, which has also been observed during in vivo studies.
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  • 文章类型: Letter
    没有抽象的礼物。
    No abstract present.
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  • 文章类型: Journal Article
    虽然先前的研究表明,强迫性与目标导向学习系统和习惯性学习系统之间的不平衡有关,对于这种影响是由于单一系统的损害还是由于确定哪个系统控制任何特定时刻的行为的仲裁机制的损害而知之甚少;当前的研究旨在解决这种分歧。十九种酒精使用障碍,30名强迫症(OCD)和20名重度抑郁症患者以及相应的性别和年龄匹配的对照者进行了两种选择,三阶段马尔可夫决策范式。基于模型和无模式的强化学习模型用于独立拟合其行为数据。在基于模型的策略最佳的任务条件下,酒精使用障碍和强迫症患者的基于模型的策略选择少于健康对照。只有OCD患者在无模型使用最佳的任务条件下表现出更高的行为控制系统切换。重度抑郁症患者与匹配的对照组没有差异。这些发现表明,双重系统之间仲裁控制的功能障碍可能是涉及强迫性的各种疾病的基础。
    While previous research has shown that compulsivity is related to an imbalance between goal-directed and habitual learning systems, very little is known about whether this effect is due to the impairment of a single system or the impairment of the arbitration mechanism that determines which system controls behaviour at any given moment; the current study aims to address this disagreement. Nineteen alcohol use disorder, 30 obsessive-compulsive disorder (OCD) and 20 major depressive disorder patients and corresponding sex- and age-matched controls performed two-choice, three-stage Markov decision-making paradigm. Model-based and mode-free reinforcement learning models were used to independently fitted their behavioural data. Alcohol use disorder and OCD patients showed less model-based strategy choice than healthy controls in task conditions where the model-based strategy was optimal. Only OCD patients showed higher behavioural control system switching in task conditions where model-free use was optimal. Major depressive disorder patients did not differ from the matched control in both. These findings suggest that dysfunction in arbitration control between dual systems may be the basis for diverse disorders involving compulsivity.
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  • 文章类型: Journal Article
    强迫症(OCD)是一种使人衰弱的精神障碍,治疗困难明显。其发病机制尚未完全阐明。对病因和机制的进一步认识有待进一步探索。我们使用等量异位标签进行基于相对和绝对定量(iTRAQ)的蛋白质组学分析,以比较强迫症患者和健康对照之间的血清蛋白质组谱。从而找出OCD在下游生物过程中的可能机制。纳入81例无药强迫症患者和78例健康对照。总共鉴定了475种蛋白质。完全正确,选择80种p<0.05的蛋白质进行基因集富集分析(GSEA),并且只有组间倍数变化≥1.2且q值<0.2的那些才被接受为差异表达蛋白(DEP)。我们观察到免疫炎症相关途径的显着富集,随着有趣的表达趋势,免疫炎症相关蛋白在GSEA中上调。之后,2个上调蛋白和13个下调蛋白被接受为DEP。根据现有文献,大多数DEP没有在强迫症中报告。这些DEP富含121个基因本体论(GO)术语,包括肝细胞生长因子受体活性,血管生成素-PRI复合物,等等。在京都基因和基因组百科全书(KEGG)数据库中,DEP的途径包括粘附点。包括STXBP5L在内的DEP变更,GRN,和ANG在强迫症动物模型中进行了验证。我们的研究表明,强迫症患者在炎症背景下表现出神经元或非神经元细胞功能的多因素损害。采用更大样本量的进一步研究,纵向设计,分层分析,将需要多组学方法。实验室的实验对于阐明该机制至关重要。
    Obsessive-compulsive disorder (OCD) is a debilitating mental disorder with obvious difficulties in treatment. Its pathogenesis has not been fully elucidated. Further understanding of etiology and mechanism needs to be explored further. We employed the isobaric tag for relative and absolute quantitation (iTRAQ)-based proteomic analysis to compare serum proteome profile between OCD patients and healthy controls, in order to find out the possible mechanism of OCD in the downstream biological process. Eighty-one drug-free OCD patients and 78 healthy controls were enrolled. A total of 475 proteins were identified. Totally, 80 proteins with p < 0.05 were selected for gene set enrichment analysis (GSEA), and only those with a fold change ≥1.2 and q value <0.2 between groups were accepted as differentially expressed proteins (DEPs). We observed a significant enrichment of immuno-inflammation-related pathways, along with intriguing expression trends that immuno-inflammation-related proteins were upregulated in GSEA. After that, 2 up-regulated proteins and 13 down-regulated ones were accepted as DEP. According to the available literature, most of the DEPs have not been reported in OCD. These DEPs were enriched in 121 gene ontology (GO) terms, including hepatocyte growth factor receptor activity, angiogenin-PRI complex, and so on. DEPs were enriched in pathways including adherens junction in the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Alterations in DEPs including STXBP5L, GRN, and ANG were validated in OCD animal models. Our study suggested that OCD patients manifested multifactorial impairment in neuronal or non-neuronal cellular function under the inflammatory background. Further research employing larger sample sizes, longitudinal design, stratified analysis, and multiomics methodology will be needed. Experiments in laboratories were essential in illuminating the mechanism.
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  • 文章类型: Journal Article
    这项研究的目的是确定连带蛋白和闭塞蛋白的水平,肠上皮中的紧密连接(TJ)蛋白,强迫症(OCD)患者和健康对照者之间会有所不同。我们还打算研究是否有或没有重度抑郁症(MDD)合并症的强迫症患者以及与健康对照相比,这些差异是否会有所不同。
    60名诊断为OCD的患者和30名健康对照者被纳入研究。病例采用耶鲁-布朗强迫症量表(Y-BOCS)和汉密尔顿抑郁量表(HDRS)。根据HDRS评分和是否存在MDD合并症,将患者分为两个亚组。使用ELISA方法测量连带蛋白和闭塞蛋白水平。这项研究是在2021年4月至2021年10月之间进行的。
    OCD患者组的Zonulin和occludin水平明显高于对照组(p<0.001)。与没有MDD(OCD-MDD)的患者相比,患有MDD合并症(OCDMDD)的OCD患者中两者的水平也显着较高(p<0.001)。随着OCD患者组疾病严重程度的增加,zonulin和occludin水平也显着升高(分别为p<0.001,p=0.001)。根据OCD+MDD组的HDRS评分,两者的水平均与抑郁症的严重程度一致(p<0.001)。确定OCD的持续时间与连带蛋白和闭塞蛋白水平之间呈正相关。对整个OCD组的评估显示,Y-BOCS和HDRS评分与zonulin和occludin之间呈中度正相关。
    在这项研究中,OCD患者的Zonulin和occludin水平明显高于健康对照组。该升高与疾病持续时间和严重程度呈正相关,OCD伴MDD合并症的增加更为明显。这些发现指出了强迫症患者肠屏障和血脑屏障的可能紊乱。
    UNASSIGNED: The aim of this study is to determine whether the levels of zonulin and occludin, tight junctions (TJ) proteins in the intestinal epithelium, will differ between obsessive compulsive disorder (OCD) patients and healthy controls. We also intended to investigate whether these would vary in OCD patients with and without major depressive disorder (MDD) comorbidity and in comparison with healthy controls.
    UNASSIGNED: Sixty patients diagnosed with OCD and 30 healthy controls were included in the study. The cases were administered the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Hamilton Depression Rating Scale (HDRS). The patients were divided into two subgroups based on their HDRS scores and presence of MDD comorbidity. Zonulin and occludin levels were measured using the ELISA method. The research was carried out between April 2021 and October 2021.
    UNASSIGNED: Zonulin and occludin levels were significantly higher in the OCD patient group than in the control group (p<0.001). The levels of both were also significantly higher in the OCD patients with MDD comorbidity (OCD+MDD) compared to those without MDD (OCD-MDD) (p<0.001). Zonulin and occludin levels also rose significantly as disease severity increased in the OCD patient group (respectively; p<0.001, p=0.001). The levels of both increased in line with the severity of depression based on HDRS scores in the OCD+MDD group (p<0.001). A positive correlation was determined between the duration of OCD and zonulin and occludin levels. Evaluation of the entire OCD group revealed a moderate positive correlation between Y-BOCS and HDRS scores and zonulin and occludin.
    UNASSIGNED: Zonulin and occludin levels in this research were significantly higher in the patients with OCD than in the healthy controls. That elevation was positively correlated with disease duration and severity, and the increase was significantly more pronounced in OCD with MDD comorbidity. These findings point to a possible disorder in the intestinal barrier and blood-brain barrier in OCD patients.
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  • 文章类型: Journal Article
    精神病患者,特别是精神病和强迫症(OCD),经常表现出执行功能和视觉空间记忆的缺陷。传统评估,例如雷伊奥斯特里思复杂图形测试(RCFT),在临床环境中进行需要时间和精力.这项研究旨在开发一种使用RCFT并基于眼动追踪的深度学习模型,以检测精神疾病患者在视觉空间记忆编码过程中受损的执行功能。96例首发精神病患者,49例临床精神病风险高,104患有强迫症,和159名健康对照,在3分钟的RCFT图形记忆任务中记录眼球运动,获得了组织和即时召回分数。这些分数,以及图中指示眼睛聚焦位置的固定点,用于训练长期短期记忆注意力模型,以检测受损的执行功能和视觉空间记忆。该模型区分了正常执行功能和受损执行功能,F1得分为83.5%,并确定了视觉空间记忆缺陷,F1得分为80.7%,不管精神病诊断。这些发现表明,这种基于眼动跟踪的深度学习模型可以在视觉空间记忆编码过程中直接快速地识别受损的执行功能。在各种精神和神经系统疾病中具有潜在的应用。
    Patients with mental illnesses, particularly psychosis and obsessive‒compulsive disorder (OCD), frequently exhibit deficits in executive function and visuospatial memory. Traditional assessments, such as the Rey‒Osterrieth Complex Figure Test (RCFT), performed in clinical settings require time and effort. This study aimed to develop a deep learning model using the RCFT and based on eye tracking to detect impaired executive function during visuospatial memory encoding in patients with mental illnesses. In 96 patients with first-episode psychosis, 49 with clinical high risk for psychosis, 104 with OCD, and 159 healthy controls, eye movements were recorded during a 3-min RCFT figure memorization task, and organization and immediate recall scores were obtained. These scores, along with the fixation points indicating eye-focused locations in the figure, were used to train a Long Short-Term Memory + Attention model for detecting impaired executive function and visuospatial memory. The model distinguished between normal and impaired executive function, with an F1 score of 83.5%, and identified visuospatial memory deficits, with an F1 score of 80.7%, regardless of psychiatric diagnosis. These findings suggest that this eye tracking-based deep learning model can directly and rapidly identify impaired executive function during visuospatial memory encoding, with potential applications in various psychiatric and neurological disorders.
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  • 文章类型: Journal Article
    强迫症(OCD)是一种临床上具有挑战性和难治性的精神疾病,其特征是病理上过度激活的大脑活动。连续theta爆发刺激(cTBS)被认为是一种潜在的非侵入性治疗方法,可诱导对潜在皮层的抑制作用。许多研究表明cTBS对OCD的疗效不令人满意。因此,cTBS似乎对强迫症无效。然而,忽略不同的强迫症严重程度,样本量适中,缺乏纳入住院病人和门诊病人的多中心设计,缺乏个性化的影像引导靶向可能会限制cTBS对强迫症疗效的结论性发现。在初步实验中,根据我们先前的研究,50名OCD住院患者被纳入接受cTBS(连续五天每天10次)或在个性化的右补充前运动区域接受假手术,该区域由与丘脑底核的最高功能连接确定。在扩展实验中,32名OCD门诊患者接受cTBS治疗以推广治疗效果。在治疗前后评估耶鲁-布朗强迫量表(YBOCS)。在初步实验中,cTBS组的有效率为56.52%,分别,明显高于假手术组。进一步分析显示,中度OCD症状患者的YBOCS改善明显优于重度OCD症状患者。在扩展实验中,有效率为50.00%.此外,YBOCS评分仅在有中度OCD症状的患者中显著降低.这是第一个在两个中心进行外部验证设计的研究,以确定OCD症状在cTBS治疗效果中起重要作用。尤其是有中度强迫症症状的患者。
    Obsessive-compulsive disorder (OCD) is a clinically challenging and refractory psychiatric disorder characterized by pathologically hyperactivated brain activity. Continuous theta burst stimulation (cTBS) is considered a potentially non-invasive treatment for inducing inhibitory effects on the underlying cortex. Numerous studies showed an unsatisfactory efficacy of cTBS for OCD. Accordingly, it seems that cTBS is ineffective for OCD. However, the neglect of varying OCD severities, modest sample size, absence of a multicenter design incorporating inpatients and outpatients, and lack of personalized imaging-guided targeting may constrain the conclusive findings of cTBS efficacy for OCD. In the preliminary experiment, 50 inpatients with OCD were enrolled to receive cTBS (10 sessions/day for five continuous days) or sham over the personalized right pre-supplementary motor area determined by the highest functional connectivity with the subthalamic nucleus according to our prior study. In the extension experiment, 32 outpatients with OCD received cTBS to generalize the treatment effects. The Yale-Brown Obsessive-Compulsive Scale (YBOCS) was assessed before and after treatment. In the preliminary experiment, the response rates in the cTBS group were 56.52%, respectively, significantly higher than those in the sham group. Further analysis revealed significant YBOCS improvement in patients with moderate OCD symptoms than those with severe OCD symptoms. In the extension experiment, the response rates were 50.00%. Additionally, a significant decrease in YBOCS scores was only found in patients with moderate OCD symptoms. This is the first study with an external validation design across two centers to identify OCD symptoms as playing an important role in cTBS treatment effects, especially in patients with moderate OCD symptoms.
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  • 文章类型: Journal Article
    强迫症是一种具有明显遗传参与的神经精神疾病。在这种背景下,两种性别的实验室饲养的鹿小鼠表现出过度和持续的大筑巢行为(LNB),这已经被验证了其与临床强迫性的相似性。尽管LNB在生物学和认知水平上与正常筑巢行为(NNB)不同,目前尚不清楚LNB和NNB的表达在多大程度上与家族背景相关。这里,我们随机选择了14只表达NNB和14只LNB的小鼠(在性别之间平均分布),以构成每种表型的7对育种对。允许成对繁殖连续两代的后代,将其培养至成年(12周)并评估嵌套表达。值得注意的是,我们的发现表明,与NNB表达对的后代相比,LNB表达对的后代建立了明显更大的巢,并且每个繁殖对的后代的巢表达,无论亲本表型或窝,是家庭特有的。总的来说,这项研究的结果表明,可以探索LNB的潜力,揭示可能是特定持续行为表型表达基础的遗传性神经认知机制.
    Obsessive-compulsive disorder is a neuropsychiatric condition with notable genetic involvement. Against this background, laboratory-housed deer mice of both sexes varyingly present with excessive and persistent large nesting behavior (LNB), which has been validated for its resemblance of clinical compulsivity. Although LNB differs from normal nesting behavior (NNB) on both a biological and cognitive level, it is unknown to what extent the expression of LNB and NNB is related to familial background. Here, we randomly selected 14 NNB- and 14 LNB-expressing mice (equally distributed between sexes) to constitute 7 breeding pairs of each phenotype. Pairs were allowed to breed two successive generations of offspring, which were raised until adulthood (12 weeks) and assessed for nesting expression. Remarkably, our findings show that offspring from LNB-expressing pairs build significantly larger nests compared to offspring from NNB-expressing pairs and the nesting expression of the offspring of each breeding pair, irrespective of parental phenotype or litter, is family specific. Collectively, the results of this investigation indicate that LNB can be explored for its potential to shed light on heritable neurocognitive mechanisms that may underlie the expression of specific persistent behavioral phenotypes.
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