Psychoneurobiology Research and Personalized Treatment of Schizophrenia

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Mechanisms of Diseases".

Deadline for manuscript submissions: closed (30 June 2021) | Viewed by 35496

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Guest Editor
National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
Interests: EEG; memory; cognitive neuroscience; psychiatry; brain; pharmacology; executive function; psychopathology; cognitive neuropsychology; neuroimaging

Special Issue Information

Dear colleagues,

In an effort to develop effective treatments for unmet needs in schizophrenia, translational approaches—i.e., bridging preclinical and clinical studies—have been pursued, without noticeable success. To overcome the paucity of breakthrough therapeutics, novel paradigms from molecular biology, brain sciences, computational psychiatry and their combinations deserve consideration. In addition to psychotic symptoms, key areas of cognitive function—e.g., neurocognition, social cognition and metacognition—have attracted growing interest in an effort to improve social outcomes, or functionality, for patients. These endeavors should bear personalized or precision medicine in mind. 

Besides the development of innovative compounds, there has been a trend towards non-pharmacological therapeutics, e.g., cognitive rehabilitation and neuromodulation (e.g., non-invasive brain stimulation) targeting schizophrenia. Further investigations into neurofeedback and environmental factors are also warranted. It is noteworthy that the effects of these treatment modalities have been related to biological markers provided by neurophysiological, neurochemical and structural/functional brain imaging methods. 

This Special Issue will provide a forum for researchers interested in the phenomenology, underlying mechanisms and treatment of schizophrenia. Contributions will include, but not be limited to, papers dealing with genetic, molecular, imaging, physiological, psychological and behavioral issues. Overall, the information in this Special Issue will facilitate the development of personal therapeutics of greater clinical value.

Dr. Tomiki Sumiyoshi
Guest Editor

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Keywords

  • molecular biology
  • biomarkers
  • precision medicine
  • cognitive science
  • neuropsychology
  • cognitive enhancers
  • neuromodulation
  • neurofeedback
  • environmental factors
  • functionality

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Published Papers (11 papers)

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Editorial

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3 pages, 175 KiB  
Editorial
Psychoneurobiology Research and Personalized Treatment of Schizophrenia
by Tomiki Sumiyoshi
J. Pers. Med. 2021, 11(12), 1319; https://doi.org/10.3390/jpm11121319 - 7 Dec 2021
Viewed by 1945
Abstract
Psychoneurobiological approaches have been used to develop effective treatments for unmet needs in schizophrenia, e [...] Full article

Research

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13 pages, 273 KiB  
Article
Study Protocol: The Evaluation Study for Social Cognition Measures in Japan (ESCoM)
by Ryotaro Kubota, Ryo Okubo, Hisashi Akiyama, Hiroki Okano, Satoru Ikezawa, Akane Miyazaki, Atsuhito Toyomaki, Yohei Sasaki, Yuji Yamada, Takashi Uchino, Takahiro Nemoto, Tomiki Sumiyoshi, Naoki Yoshimura and Naoki Hashimoto
J. Pers. Med. 2021, 11(7), 667; https://doi.org/10.3390/jpm11070667 - 16 Jul 2021
Cited by 6 | Viewed by 2619
Abstract
In schizophrenia, social cognitive impairment is considered one of the greatest obstacles to social participation. Although numerous measures have been developed to assess social cognition, only a limited number of them have become available in Japan. We are therefore planning this evaluation study [...] Read more.
In schizophrenia, social cognitive impairment is considered one of the greatest obstacles to social participation. Although numerous measures have been developed to assess social cognition, only a limited number of them have become available in Japan. We are therefore planning this evaluation study for social cognition measures in Japan (ESCoM) to confirm their psychometric characteristics and to promote research focused on social cognition. Participants in the cross-sectional observational study will be 140 patients with schizophrenia recruited from three Japanese facilities and 70 healthy individuals. In our primary analysis, we will calculate several psychometric indicators with a focus on whether they can independently predict social functioning. In secondary analyses, we will assess the reliability and validity of the Japanese translations of each measure and conduct an exploratory investigation of patient background, psychiatric symptoms, defeatist performance belief, and gut microbiota as determinants of social cognition. The protocol for this study is registered in UMIN-CTR, unique ID UMIN000043777. Full article
18 pages, 1844 KiB  
Article
Schizophrenia-Like Behavioral Impairments in Mice with Suppressed Expression of Piccolo in the Medial Prefrontal Cortex
by Atsumi Nitta, Naotaka Izuo, Kohei Hamatani, Ryo Inagaki, Yuka Kusui, Kequan Fu, Takashi Asano, Youta Torii, Chikako Habuchi, Hirotaka Sekiguchi, Shuji Iritani, Shin-ichi Muramatsu, Norio Ozaki and Yoshiaki Miyamoto
J. Pers. Med. 2021, 11(7), 607; https://doi.org/10.3390/jpm11070607 - 26 Jun 2021
Cited by 9 | Viewed by 3501
Abstract
Piccolo, a presynaptic cytomatrix protein, plays a role in synaptic vesicle trafficking in the presynaptic active zone. Certain single-nucleotide polymorphisms of the Piccolo-encoding gene PCLO are reported to be associated with mental disorders. However, a few studies have evaluated the relationship between Piccolo [...] Read more.
Piccolo, a presynaptic cytomatrix protein, plays a role in synaptic vesicle trafficking in the presynaptic active zone. Certain single-nucleotide polymorphisms of the Piccolo-encoding gene PCLO are reported to be associated with mental disorders. However, a few studies have evaluated the relationship between Piccolo dysfunction and psychotic symptoms. Therefore, we investigated the neurophysiological and behavioral phenotypes in mice with Piccolo suppression in the medial prefrontal cortex (mPFC). Downregulation of Piccolo in the mPFC reduced regional synaptic proteins, accompanied with electrophysiological impairments. The Piccolo-suppressed mice showed an enhanced locomotor activity, impaired auditory prepulse inhibition, and cognitive dysfunction. These abnormal behaviors were partially ameliorated by the antipsychotic drug risperidone. Piccolo-suppressed mice received mild social defeat stress showed additional behavioral despair. Furthermore, the responses of these mice to extracellular glutamate and dopamine levels induced by the optical activation of mPFC projection in the dorsal striatum (dSTR) were inhibited. Similarly, the Piccolo-suppressed mice showed decreased depolarization-evoked glutamate and -aminobutyric acid elevations and increased depolarization-evoked dopamine elevation in the dSTR. These suggest that Piccolo regulates neurotransmission at the synaptic terminal of the projection site. Reduced neuronal connectivity in the mPFC-dSTR pathway via suppression of Piccolo in the mPFC may induce behavioral impairments observed in schizophrenia. Full article
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13 pages, 1360 KiB  
Article
Prolonged P300 Latency in Antipsychotic-Free Subjects with At-Risk Mental States Who Later Developed Schizophrenia
by Yuko Higuchi, Tomiki Sumiyoshi, Takahiro Tateno, Suguru Nakajima, Daiki Sasabayashi, Shimako Nishiyama, Yuko Mizukami, Tsutomu Takahashi and Michio Suzuki
J. Pers. Med. 2021, 11(5), 327; https://doi.org/10.3390/jpm11050327 - 21 Apr 2021
Cited by 8 | Viewed by 2823
Abstract
We measured P300, an event-related potential, in subjects with at-risk mental states (ARMS) and aimed to determine whether P300 parameter can predict progression to overt schizophrenia. Thirty-three subjects with ARMS, 39 with schizophrenia, and 28 healthy controls participated in the study. All subjects [...] Read more.
We measured P300, an event-related potential, in subjects with at-risk mental states (ARMS) and aimed to determine whether P300 parameter can predict progression to overt schizophrenia. Thirty-three subjects with ARMS, 39 with schizophrenia, and 28 healthy controls participated in the study. All subjects were antipsychotic-free. Subjects with ARMS were followed-up for more than two years. Cognitive function was measured by the Brief assessment of Cognition in Schizophrenia (BACS) and Schizophrenia Cognition Rating Scale (SCoRS), while the modified Global Assessment of Functioning (mGAF) was used to assess global function. Patients with schizophrenia showed smaller P300 amplitudes and prolonged latency at Pz compared to those of healthy controls and subjects with ARMS. During the follow-up period, eight out of 33 subjects with ARMS developed overt psychosis (ARMS-P) while 25 did not (ARMS-NP). P300 latency of ARMS-P was significantly longer than that of ARMS-NP. At baseline, ARMS-P elicited worse cognitive functions, as measured by the BACS and SCoRS compared to ARMS-NP. We also detected a significant relationship between P300 amplitudes and mGAF scores in ARMS subjects. Our results suggest the usefulness of prolonged P300 latency and cognitive impairment as a predictive marker of later development of schizophrenia in vulnerable individuals. Full article
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12 pages, 426 KiB  
Article
Evaluation of Social Cognition Measures for Japanese Patients with Schizophrenia Using an Expert Panel and Modified Delphi Method
by Hiroki Okano, Ryotaro Kubota, Ryo Okubo, Naoki Hashimoto, Satoru Ikezawa, Atsuhito Toyomaki, Akane Miyazaki, Yohei Sasaki, Yuji Yamada, Takahiro Nemoto and Masafumi Mizuno
J. Pers. Med. 2021, 11(4), 275; https://doi.org/10.3390/jpm11040275 - 6 Apr 2021
Cited by 9 | Viewed by 2587
Abstract
Social cognition is strongly linked to social functioning outcomes, making it a promising treatment target. Because social cognition measures tend to be sensitive to linguistic and cultural differences, existing measures should be evaluated based on their relevance for Japanese populations. We aimed to [...] Read more.
Social cognition is strongly linked to social functioning outcomes, making it a promising treatment target. Because social cognition measures tend to be sensitive to linguistic and cultural differences, existing measures should be evaluated based on their relevance for Japanese populations. We aimed to establish an expert consensus on the use of social cognition measures in Japanese populations to provide grounds for clinical use and future treatment development. We assembled a panel of experts in the fields of schizophrenia, social psychology, social neuroscience, and developmental disorders. The panel engaged in a modified Delphi process to (1) affirm expert consensus on the definition of social cognition and its constituent domains, (2) determine criteria to evaluate measures, and (3) identify measures appropriate for Japanese patients with a view toward future quantitative research. Through two online voting rounds and two online video conferences, the panel agreed upon a definition and four-domain framework for social cognition consistent with recent literature. Evaluation criteria for measures included feasibility and tolerability, reliability, clinical effectiveness, validity, and international comparability. The panel finally identified nine promising measures, including one task originally developed in Japan. In conclusion, we established an expert consensus on key discussion points in social cognition and arrived at an expert-selected set of measures. We hope that this work facilitates the use of these measures in Japanese clinical scenarios. We plan to further examine these measures in a psychometric evaluation study. Full article
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9 pages, 278 KiB  
Communication
Genetic Polymorphisms of 5-HT Receptors and Antipsychotic-Induced Metabolic Dysfunction in Patients with Schizophrenia
by Diana Z. Paderina, Anastasiia S. Boiko, Ivan V. Pozhidaev, Anna V. Bocharova, Irina A. Mednova, Olga Yu. Fedorenko, Elena G. Kornetova, Anton J.M. Loonen, Arkadiy V. Semke, Nikolay A. Bokhan and Svetlana A. Ivanova
J. Pers. Med. 2021, 11(3), 181; https://doi.org/10.3390/jpm11030181 - 5 Mar 2021
Cited by 14 | Viewed by 2872
Abstract
Background: Antipsychotic-induced metabolic syndrome (MetS) is a multifactorial disease with a genetic predisposition. Serotonin and its receptors are involved in antipsychotic-drug-induced metabolic disorders. The present study investigated the association of nine polymorphisms in the four 5-hydroxytryptamine receptor (HTR) genes HTR1A, [...] Read more.
Background: Antipsychotic-induced metabolic syndrome (MetS) is a multifactorial disease with a genetic predisposition. Serotonin and its receptors are involved in antipsychotic-drug-induced metabolic disorders. The present study investigated the association of nine polymorphisms in the four 5-hydroxytryptamine receptor (HTR) genes HTR1A, HTR2A, HTR3A, and HTR2C and the gene encoding for the serotonin transporter SLC6A4 with MetS in patients with schizophrenia. Methods: A set of nine single-nucleotide polymorphisms of genes of the serotonergic system was investigated in a population of 475 patients from several Siberian regions (Russia) with a clinical diagnosis of schizophrenia. Genotyping was performed and the results were analyzed using chi-square tests. Results: Polymorphic variant rs521018 (HTR2C) was associated with higher body mass index in patients receiving long-term antipsychotic therapy, but not with drug-induced metabolic syndrome. Rs1150226 (HTR3A) was also associated but did not meet Hardy–Weinberg equilibrium. Conclusions: Our results indicate that allelic variants of HTR2C genes may have consequences on metabolic parameters. MetS may have too complex a mechanistic background to be studied without dissecting the syndrome into its individual (causal) components. Full article
16 pages, 1575 KiB  
Article
Cannabis Use Induces Distinctive Proteomic Alterations in Olfactory Neuroepithelial Cells of Schizophrenia Patients
by Marta Barrera-Conde, Karina Ausin, Mercedes Lachén-Montes, Joaquín Fernández-Irigoyen, Liliana Galindo, Aida Cuenca-Royo, Cristina Fernández-Avilés, Víctor Pérez, Rafael de la Torre, Enrique Santamaría and Patricia Robledo
J. Pers. Med. 2021, 11(3), 160; https://doi.org/10.3390/jpm11030160 - 25 Feb 2021
Cited by 11 | Viewed by 2974
Abstract
A close epidemiological link has been reported between cannabis use and schizophrenia (SCZ). However, biochemical markers in living humans related to the impact of cannabis in this disease are still missing. Olfactory neuroepithelium (ON) cells express neural features and offer a unique advantage [...] Read more.
A close epidemiological link has been reported between cannabis use and schizophrenia (SCZ). However, biochemical markers in living humans related to the impact of cannabis in this disease are still missing. Olfactory neuroepithelium (ON) cells express neural features and offer a unique advantage to study biomarkers of psychiatric diseases. The aim of our study was to find exclusively deregulated proteins in ON cells of SCZ patients with and without a history of cannabis use. Thus, we compared the proteomic profiles of SCZ non-cannabis users (SCZ/nc) and SCZ cannabis users (SCZ/c) with control subjects non-cannabis users (C/nc) and control cannabis users (C/c). The results revealed that the main cascades affected in SCZ/nc were cell cycle, DNA replication, signal transduction and protein localization. Conversely, cannabis use in SCZ patients induced specific alterations in metabolism of RNA and metabolism of proteins. The levels of targeted proteins in each population were then correlated with cognitive performance and clinical scores. In SCZ/c, the expression levels of 2 proteins involved in the metabolism of RNA (MTREX and ZNF326) correlated with several cognitive markers and clinical signs. Moreover, use duration of cannabis negatively correlated with ZNF326 expression. These findings indicate that RNA-related proteins might be relevant to understand the influence of cannabis use on SCZ. Full article
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11 pages, 917 KiB  
Article
Increased Heschl’s Gyrus Duplication in Schizophrenia Spectrum Disorders: A Cross-Sectional MRI Study
by Tsutomu Takahashi, Daiki Sasabayashi, Yoichiro Takayanagi, Atsushi Furuichi, Mikio Kido, Tien Viet Pham, Haruko Kobayashi, Kyo Noguchi and Michio Suzuki
J. Pers. Med. 2021, 11(1), 40; https://doi.org/10.3390/jpm11010040 - 12 Jan 2021
Cited by 7 | Viewed by 2720
Abstract
Duplicated Heschl’s gyrus (HG) is prevalent in patients with schizophrenia and may reflect early neurodevelopmental anomalies. However, it currently remains unclear whether patients with schizotypal disorder, a prototypic disorder within the schizophrenia spectrum, exhibit a similar HG gyrification pattern. In this magnetic resonance [...] Read more.
Duplicated Heschl’s gyrus (HG) is prevalent in patients with schizophrenia and may reflect early neurodevelopmental anomalies. However, it currently remains unclear whether patients with schizotypal disorder, a prototypic disorder within the schizophrenia spectrum, exhibit a similar HG gyrification pattern. In this magnetic resonance imaging study, HG gyrification patterns were examined in 47 patients with schizotypal disorder, 111 with schizophrenia, and 88 age- and sex-matched healthy subjects. HG gyrification patterns were classified as single, common stem duplication (CSD), or complete posterior duplication (CPD). The prevalence of the duplicated HG patterns (CSD or CPD) bilaterally was higher in the schizophrenia and schizotypal groups than in healthy controls, whereas no significant difference was observed between the schizophrenia and schizotypal groups. Schizophrenia patients with the right CPD pattern had less severe positive symptoms, whereas the right single HG pattern was associated with higher doses of antipsychotic medication in schizotypal patients. The present study demonstrated shared HG gyrification patterns in schizophrenia spectrum disorders, which may reflect a common biological vulnerability factor. HG patterns may also be associated with susceptibility to psychopathology. Full article
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13 pages, 839 KiB  
Article
Cognitive Insight in First-Episode Psychosis: Changes during Metacognitive Training
by Irene Birulés, Raquel López-Carrilero, Daniel Cuadras, Esther Pousa, Maria Luisa Barrigón, Ana Barajas, Ester Lorente-Rovira, Fermín González-Higueras, Eva Grasa, Isabel Ruiz-Delgado, Jordi Cid, Ana de Apraiz, Roger Montserrat, Trinidad Pélaez, Steffen Moritz, the Spanish Metacognition Study Group and Susana Ochoa
J. Pers. Med. 2020, 10(4), 253; https://doi.org/10.3390/jpm10040253 - 27 Nov 2020
Cited by 15 | Viewed by 3883
Abstract
Background: Metacognitive training (MCT) has demonstrated its efficacy in psychosis. However, the effect of each MCT session has not been studied. The aim of the study was to assess changes in cognitive insight after MCT: (a) between baseline, post-treatment, and follow-up; (b) after [...] Read more.
Background: Metacognitive training (MCT) has demonstrated its efficacy in psychosis. However, the effect of each MCT session has not been studied. The aim of the study was to assess changes in cognitive insight after MCT: (a) between baseline, post-treatment, and follow-up; (b) after each session of the MCT controlled for intellectual quotient (IQ) and educational level. Method: A total of 65 patients with first-episode psychosis were included in the MCT group from nine centers of Spain. Patients were assessed at baseline, post-treatment, and 6 months follow-up, as well as after each session of MCT with the Beck Cognitive Insight Scale (BCIS). The BCIS contains two subscales: self-reflectiveness and self-certainty, and the Composite Index. Statistical analysis was performed using linear mixed models with repeated measures at different time points. Results: Self-certainty decreased significantly (p = 0.03) over time and the effect of IQ was negative and significant (p = 0.02). From session 4 to session 8, all sessions improved cognitive insight by significantly reducing self-certainty and the Composite Index. Conclusions: MCT intervention appears to have beneficial effects on cognitive insight by reducing self-certainty, especially after four sessions. Moreover, a minimum IQ is required to ensure benefits from MCT group intervention. Full article
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Review

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15 pages, 1076 KiB  
Review
New Insights Regarding Diagnosis and Medication for Schizophrenia Based on Neuronal Synapse–Microglia Interaction
by Naotaka Izuo and Atsumi Nitta
J. Pers. Med. 2021, 11(5), 371; https://doi.org/10.3390/jpm11050371 - 3 May 2021
Cited by 9 | Viewed by 5033
Abstract
Schizophrenia is a common psychiatric disorder that usually develops during adolescence and young adulthood. Since genetic and environmental factors are involved in the disease, the molecular status of the pathology of schizophrenia differs across patients. Recent genetic studies have focused on the association [...] Read more.
Schizophrenia is a common psychiatric disorder that usually develops during adolescence and young adulthood. Since genetic and environmental factors are involved in the disease, the molecular status of the pathology of schizophrenia differs across patients. Recent genetic studies have focused on the association between schizophrenia and the immune system, especially microglia–synapse interactions. Microglia physiologically eliminate unnecessary synapses during the developmental period. The overactivation of synaptic pruning by microglia is involved in the pathology of brain disease. This paper focuses on the synaptic pruning function and its molecular machinery and introduces the hypothesis that excessive synaptic pruning plays a role in the development of schizophrenia. Finally, we suggest a strategy for diagnosis and medication based on modulation of the interaction between microglia and synapses. This review provides updated information on the involvement of the immune system in schizophrenia and proposes novel insights regarding diagnostic and therapeutic strategies for this disease. Full article
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Other

10 pages, 861 KiB  
Study Protocol
Efficacy and Safety of Multi-Session Transcranial Direct Current Stimulation on Social Cognition in Schizophrenia: A Study Protocol for an Open-Label, Single-Arm Trial
by Yuji Yamada, Takuma Inagawa, Yuma Yokoi, Aya Shirama, Kazuki Sueyoshi, Ayumu Wada, Naotsugu Hirabayashi, Hideki Oi and Tomiki Sumiyoshi
J. Pers. Med. 2021, 11(4), 317; https://doi.org/10.3390/jpm11040317 - 19 Apr 2021
Cited by 6 | Viewed by 3145
Abstract
Backgrounds: Social cognition is defined as the mental operations underlying social behavior. Patients with schizophrenia elicit impairments of social cognition, which is linked to poor real-world functional outcomes. In a previous study, transcranial direct current stimulation (tDCS) improved emotional recognition, a domain of [...] Read more.
Backgrounds: Social cognition is defined as the mental operations underlying social behavior. Patients with schizophrenia elicit impairments of social cognition, which is linked to poor real-world functional outcomes. In a previous study, transcranial direct current stimulation (tDCS) improved emotional recognition, a domain of social cognition, in patients with schizophrenia. However, since social cognition was only minimally improved by tDCS when administered on frontal brain areas, investigations on the effect of tDCS on other cortical sites more directly related to social cognition are needed. Therefore, we present a study protocol to determine whether multi-session tDCS on superior temporal sulcus (STS) would improve social cognition deficits of schizophrenia. Methods: This is an open-label, single-arm trial, whose objective is to investigate the efficacy and safety of multi-session tDCS over the left STS to improve social cognition in patients with schizophrenia. The primary outcome measure will be the Social Cognition Screening Questionnaire. Neurocognition, functional capacity, and psychotic symptoms will also be evaluated by the Brief Assessment of Cognition in Schizophrenia, UCSD Performance-Based Skills Assessment-Brief, and Positive and Negative Syndrome Scale, respectively. Data will be collected at baseline, and 4 weeks after the end of intervention. If social cognition is improved in patients with schizophrenia by tDCS based on this protocol, we may plan randomized controlled trial. Full article
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