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1.
Hum Brain Mapp ; 44(17): 5729-5748, 2023 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-37787573

RESUMO

Despite the known benefits of data-driven approaches, the lack of approaches for identifying functional neuroimaging patterns that capture both individual variations and inter-subject correspondence limits the clinical utility of rsfMRI and its application to single-subject analyses. Here, using rsfMRI data from over 100k individuals across private and public datasets, we identify replicable multi-spatial-scale canonical intrinsic connectivity network (ICN) templates via the use of multi-model-order independent component analysis (ICA). We also study the feasibility of estimating subject-specific ICNs via spatially constrained ICA. The results show that the subject-level ICN estimations vary as a function of the ICN itself, the data length, and the spatial resolution. In general, large-scale ICNs require less data to achieve specific levels of (within- and between-subject) spatial similarity with their templates. Importantly, increasing data length can reduce an ICN's subject-level specificity, suggesting longer scans may not always be desirable. We also find a positive linear relationship between data length and spatial smoothness (possibly due to averaging over intrinsic dynamics), suggesting studies examining optimized data length should consider spatial smoothness. Finally, consistency in spatial similarity between ICNs estimated using the full data and subsets across different data lengths suggests lower within-subject spatial similarity in shorter data is not wholly defined by lower reliability in ICN estimates, but may be an indication of meaningful brain dynamics which average out as data length increases.


Assuntos
Mapeamento Encefálico , Imageamento por Ressonância Magnética , Humanos , Mapeamento Encefálico/métodos , Imageamento por Ressonância Magnética/métodos , Reprodutibilidade dos Testes , Rede Nervosa/diagnóstico por imagem , Encéfalo/diagnóstico por imagem
2.
bioRxiv ; 2023 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-37503085

RESUMO

Background: Recent advances in resting-state fMRI allow us to study spatial dynamics, the phenomenon of brain networks spatially evolving over time. However, most dynamic studies still use subject-specific, spatially-static nodes. As recent studies have demonstrated, incorporating time-resolved spatial properties is crucial for precise functional connectivity estimation and gaining unique insights into brain function. Nevertheless, estimating time-resolved networks poses challenges due to the low signal-to-noise ratio, limited information in short time segments, and uncertain identification of corresponding networks within and between subjects. Methods: We adapt a reference-informed network estimation technique to capture time-resolved spatial networks and their dynamic spatial integration and segregation. We focus on time-resolved spatial functional network connectivity (spFNC), an estimate of network spatial coupling, to study sex-specific alterations in schizophrenia and their links to multi-factorial genomic data. Results: Our findings are consistent with the dysconnectivity and neurodevelopment hypotheses and align with the cerebello-thalamo-cortical, triple-network, and frontoparietal dysconnectivity models, helping to unify them. The potential unification offers a new understanding of the underlying mechanisms. Notably, the posterior default mode/salience spFNC exhibits sex-specific schizophrenia alteration during the state with the highest global network integration and correlates with genetic risk for schizophrenia. This dysfunction is also reflected in high-dimensional (voxel-level) space in regions with weak functional connectivity to corresponding networks. Conclusions: Our method can effectively capture spatially dynamic networks, detect nuanced SZ effects, and reveal the intricate relationship of dynamic information to genomic data. The results also underscore the potential of dynamic spatial dependence and weak connectivity in the clinical landscape.

3.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 3594-3598, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-36086046

RESUMO

This paper proposes an independent component analysis (ICA)-based framework for exploring associations between neural signals measured with magnetoencephalography (MEG) and non-neuroimaging data of healthy subjects. Our proposed framework contains methods for subject group identification, latent source estimation of MEG, and discriminatory source visualization. Hierarchical clustering on principal components (HCPC) is used to cluster subject groups based on cognitive scores, and ICA is performed on MEG evoked responses such that not only higher-order statistics but also sample dependence within sources is taken into account. The clustered subject labels and estimated sources are jointly analyzed to determine discriminatory sources. Finally, discriminatory sources are used to calculate global difference maps (GDMs) for the summary. Results using a new data set reveal that estimated sources are significantly correlated with cognitive measures and subject demographics. Discriminatory sources have significant correlations with variables that have not been previously used for group identification, and GDMs can effectively identify group differences.


Assuntos
Cognição , Magnetoencefalografia , Humanos , Magnetoencefalografia/métodos
4.
IEEE Trans Neural Netw ; 19(4): 596-609, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18390307

RESUMO

In this paper, we use complex analytic functions to achieve independent component analysis (ICA) by maximization of non-Gaussianity and introduce the complex maximization of non-Gaussianity (CMN) algorithm. We derive both a gradient-descent and a quasi-Newton algorithm that use the full second-order statistics providing superior performance with circular and noncircular sources as compared to existing methods. We show the connection among ICA methods through maximization of non-Gaussianity, mutual information, and maximum likelihood (ML) for the complex case, and emphasize the importance of density matching for all three cases. Local stability conditions are derived for the CMN cost function that explicitly show the effects of noncircularity on convergence and demonstrated through simulation examples.


Assuntos
Algoritmos , Redes Neurais de Computação , Análise de Componente Principal , Simulação por Computador , Dinâmica não Linear
5.
Hum Brain Mapp ; 27(1): 47-62, 2006 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16108017

RESUMO

The acquisition of both structural MRI (sMRI) and functional MRI (fMRI) data for a given study is a very common practice. However, these data are typically examined in separate analyses, rather than in a combined model. We propose a novel methodology to perform independent component analysis across image modalities, specifically, gray matter images and fMRI activation images as well as a joint histogram visualization technique. Joint independent component analysis (jICA) is used to decompose a matrix with a given row consisting of an fMRI activation image resulting from auditory oddball target stimuli and an sMRI gray matter segmentation image, collected from the same individual. We analyzed data collected on a group of schizophrenia patients and healthy controls using the jICA approach. Spatially independent joint-components are estimated and resulting components were further analyzed only if they showed a significant difference between patients and controls. The main finding was that group differences in bilateral parietal and frontal as well as posterior temporal regions in gray matter were associated with bilateral temporal regions activated by the auditory oddball target stimuli. A finding of less patient gray matter and less hemodynamic activity for target detection in these bilateral anterior temporal lobe regions was consistent with previous work. An unexpected corollary to this finding was that, in the regions showing the largest group differences, gray matter concentrations were larger in patients vs. controls, suggesting that more gray matter may be related to less functional connectivity in the auditory oddball fMRI task.


Assuntos
Mapeamento Encefálico , Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Imageamento por Ressonância Magnética , Esquizofrenia/fisiopatologia , Estimulação Acústica , Algoritmos , Percepção Auditiva/fisiologia , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Radiografia
6.
Neuroimage ; 30(2): 544-53, 2006 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-16246587

RESUMO

Event-related potential (ERP) studies of the brain's response to infrequent, target (oddball) stimuli elicit a sequence of physiological events, the most prominent and well studied being a complex, the P300 (or P3) peaking approximately 300 ms post-stimulus for simple stimuli and slightly later for more complex stimuli. Localization of the neural generators of the human oddball response remains challenging due to the lack of a single imaging technique with good spatial and temporal resolution. Here, we use independent component analyses to fuse ERP and fMRI modalities in order to examine the dynamics of the auditory oddball response with high spatiotemporal resolution across the entire brain. Initial activations in auditory and motor planning regions are followed by auditory association cortex and motor execution regions. The P3 response is associated with brainstem, temporal lobe, and medial frontal activity and finally a late temporal lobe "evaluative" response. We show that fusing imaging modalities with different advantages can provide new information about the brain.


Assuntos
Encéfalo/fisiologia , Circulação Cerebrovascular/fisiologia , Potenciais Evocados P300/fisiologia , Adulto , Algoritmos , Eletroencefalografia , Potenciais Evocados Auditivos/fisiologia , Feminino , Hemodinâmica/fisiologia , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade
7.
Conf Proc IEEE Eng Med Biol Soc ; 2006: 3672-5, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17946195

RESUMO

The acquisition of multiple brain imaging types for a given study is a very common practice. However these data are typically examined in separate analyses, rather than in a combined model. We propose a novel methodology to perform joint independent component analysis across image modalities, including structural MRI data, functional MRI activation data and EEG data, and to visualize the results via a joint histogram visualization technique. Evaluation of which combination of fused data is most useful is determined by using the Kullback-Leibler divergence. We demonstrate our method on a data set composed of functional MRI data from two tasks, structural MRI data, and EEG data collected on patients with schizophrenia and healthy controls. We show that combining data types can improve our ability to distinguish differences between groups.


Assuntos
Encéfalo/fisiologia , Eletroencefalografia/métodos , Imageamento por Ressonância Magnética/métodos , Encéfalo/anatomia & histologia , Líquido Cefalorraquidiano , Potenciais Evocados , Hemodinâmica , Humanos , Substância Cinzenta Periaquedutal/fisiologia
8.
Neuroimage ; 25(2): 527-38, 2005 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-15784432

RESUMO

Independent component analysis (ICA) is a data-driven approach utilizing high-order statistical moments to find maximally independent sources that has found fruitful application in functional magnetic resonance imaging (fMRI). Being a blind source separation technique, ICA does not require any explicit constraints upon the fMRI time courses. However, for some fMRI data analysis applications, such as for the analysis of an event-related paradigm, it would be useful to flexibly incorporate paradigm information into the ICA analysis. In this paper, we present an approach for constrained or semi-blind ICA (sbICA) analysis of event-related fMRI data by imposing regularization on certain estimated time courses using the paradigm information. We demonstrate the performance of our approach using both simulations and fMRI data from a three-stimulus auditory oddball paradigm. Simulation results suggest that (1) a regression approach slightly outperforms ICA when prior information is accurate and ICA outperforms the general linear model (GLM)-based approach when prior information is not completely accurate, (2) prior information improves the robustness of ICA in the presence of noise, and (3) ICA analysis using prior information with temporal constraints can outperform a regression approach when the prior information is not completely accurate. Using fMRI data, we compare a regression-based conjunction analysis of target and novel stimuli, both of which elicit an orienting response, to an sbICA approach utilizing both the target and novel stimuli to constrain the ICA time courses. Results show similar positive associations for both GLM and sbICA, but sbICA detects additional negative associates consistent with regions implicated in a default mode of brain activity. This suggests that task-related default mode decreases have a more "complex" signal that benefits from a flexible modeling approach. Compared with a traditional GLM approach, the sbICA approach provides a flexible way to analyze fMRI data that reduces the assumptions placed upon the hemodynamic response of the brain. The advantages and limitations of our technique are discussed in detail in the manuscript to provide guidelines to the reader for developing useful applications. The use of prior time course information in a spatial ICA analysis, which combines elements of both a regression approach and a blind ICA approach, may prove to be a useful tool for fMRI analysis.


Assuntos
Encéfalo/fisiologia , Imageamento por Ressonância Magnética , Análise de Componente Principal/métodos , Percepção Auditiva , Humanos , Tempo
9.
Neuroimage ; 20(3): 1661-9, 2003 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-14642476

RESUMO

Independent component analysis (ICA), a data-driven approach utilizing high-order statistical moments to find maximally independent sources, has found fruitful application in functional magnetic resonance imaging (fMRI). A limitation of the standard fMRI ICA model is that a given component's time course is required to have the same delay at every voxel. As spatially varying delays (SVDs) may be found in fMRI data, using an ICA model with a fixed temporal delay for each source will have two implications. Larger SVDs can result in the splitting of regions with different delays into different components. Second, smaller SVDs can result in a biased ICA amplitude estimate due to only a slight delay difference. We propose a straightforward approach for incorporating this prior temporal information and removing the limitation of a fixed source delay by performing ICA on the amplitude spectrum of the original fMRI data (thus removing latency information). A latency map is then estimated for each component using the resulting component images and the raw data. We show that voxels with similar time courses, but different delays, are grouped into the same component. Additionally, when using traditional ICA, the amplitudes of motor areas are diminished due to systematic delay differences between visual and motor areas. The amplitudes are more accurately estimated when using a latency-insensitive ICA approach. The resulting time courses, the component maps, and the latency maps may prove useful as an addition to the collection of methods for fMRI data analysis.


Assuntos
Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Adulto , Algoritmos , Mapeamento Encefálico/métodos , Circulação Cerebrovascular/fisiologia , Simulação por Computador , Interpretação Estatística de Dados , Feminino , Humanos , Masculino , Modelos Neurológicos , Estimulação Luminosa , Percepção Visual/fisiologia
10.
Opt Lett ; 28(5): 310-2, 2003 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-12659428

RESUMO

We compare the eye-opening penalty from a first-order polarization mode dispersion (PMD) model with that from an all-order PMD model in optical fiber transmission systems. Evaluating the performance by taking into account only first-order PMD produces a good approximation of the true eye-opening penalty of uncompensated systems when the penalty is low. However, when the penalties are high, this model overestimates the penalty for outage probabilities in the range of interest for systems designers, which is typically approximately 10(-5) to 10(-6).

11.
Magn Reson Med ; 48(1): 180-92, 2002 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12111945

RESUMO

In BOLD fMRI a series of MR images is acquired and examined for task-related amplitude changes. These functional changes are small, so it is important to maximize detection efficiency. Virtually all fMRI processing strategies utilize magnitude information and ignore the phase, resulting in an unnecessary loss of efficiency. As the optimum way to model the phase information is not clear, a flexible modeling technique is useful. To analyze complex data sets, independent component analysis (ICA), a data-driven approach, is proposed. In ICA, the data are modeled as spatially independent components multiplied by their respective time-courses. There are thus three possible approaches: 1) the time-courses can be complex-valued, 2) the images can be complex-valued, or 3) both the time-courses and the images can be complex-valued. These analytic approaches are applied to data from a visual stimulation paradigm, and results from three complex analysis models are presented and compared with magnitude-only results. Using the criterion of the number of contiguous activated voxels at a given threshold, an average of 12-23% more voxels are detected by complex-valued ICA estimation at a threshold of /Z/ > 2.5. Additionally, preliminary results from the complex models reveal a phase modulation similar to the magnitude time-course in some voxels, and oppositely modulated in other voxels.


Assuntos
Imageamento por Ressonância Magnética/métodos , Encéfalo/fisiologia , Humanos , Modelos Teóricos
12.
Neuroimage ; 14(5): 1080-8, 2001 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11697939

RESUMO

The Motor-Free Visual Perception Test, revised (MVPT-R), provides a measure of visual perceptual processing. It involves different cognitive elements including visual discrimination, spatial relationships, and mental rotation. We adapted the MVPT-R to an event-related functional MRI (fMRI) environment to investigate the brain regions involved in the interrelation of these cognitive elements. Two complementary analysis methods were employed to characterize the fMRI data: (a) a general linear model SPM approach based upon a model of the time course and a hemodynamic response estimate and (b) independent component analysis (ICA), which does not constrain the specific shape of the time course per se, although we did require it to be at least transiently task-related. Additionally, we implemented ICA in a novel way to create a group average that was compared with the SPM group results. Both methods yielded similar, but not identical, results and detected a network of robustly activated visual, inferior parietal, and frontal eye-field areas as well as thalamus and cerebellum. SPM appeared to be the more sensitive method and has a well-developed theoretical approach to thresholding. The ICA method segregated functional elements into separate maps and identified additional regions with extended activation in response to presented events. The results demonstrate the utility of complementary analyses for fMRI data and suggest that the cerebellum may play a significant role in visual perceptual processing. Additionally, results illustrate functional connectivity between frontal eye fields and prefrontal and parietal regions.


Assuntos
Encéfalo/fisiologia , Aprendizagem por Discriminação/fisiologia , Modelos Lineares , Imageamento por Ressonância Magnética , Rede Nervosa/fisiologia , Orientação/fisiologia , Reconhecimento Visual de Modelos/fisiologia , Atenção/fisiologia , Mapeamento Encefálico , Cerebelo/fisiologia , Córtex Cerebral/fisiologia , Circulação Cerebrovascular/fisiologia , Potenciais Evocados Visuais/fisiologia , Humanos , Análise de Componente Principal , Resolução de Problemas/fisiologia , Valores de Referência , Tálamo/fisiologia
13.
Hum Brain Mapp ; 14(3): 140-51, 2001 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11559959

RESUMO

Independent component analysis (ICA) is a promising analysis method that is being increasingly applied to fMRI data. A principal advantage of this approach is its applicability to cognitive paradigms for which detailed models of brain activity are not available. Independent component analysis has been successfully utilized to analyze single-subject fMRI data sets, and an extension of this work would be to provide for group inferences. However, unlike univariate methods (e.g., regression analysis, Kolmogorov-Smirnov statistics), ICA does not naturally generalize to a method suitable for drawing inferences about groups of subjects. We introduce a novel approach for drawing group inferences using ICA of fMRI data, and present its application to a simple visual paradigm that alternately stimulates the left or right visual field. Our group ICA analysis revealed task-related components in left and right visual cortex, a transiently task-related component in bilateral occipital/parietal cortex, and a non-task-related component in bilateral visual association cortex. We address issues involved in the use of ICA as an fMRI analysis method such as: (1) How many components should be calculated? (2) How are these components to be combined across subjects? (3) How should the final results be thresholded and/or presented? We show that the methodology we present provides answers to these questions and lay out a process for making group inferences from fMRI data using independent component analysis.


Assuntos
Mapeamento Encefálico/métodos , Imageamento por Ressonância Magnética/métodos , Processamento de Sinais Assistido por Computador , Córtex Visual/anatomia & histologia , Córtex Visual/fisiologia , Algoritmos , Humanos , Processamento de Imagem Assistida por Computador/métodos , Modelos Neurológicos
14.
IEEE Trans Inf Technol Biomed ; 5(2): 150-8, 2001 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-11420993

RESUMO

Quantitative analysis of magnetic resonance (MR) images is a powerful tool for image-guided diagnosis, monitoring, and intervention. The major tasks involve tissue quantification and image segmentation where both the pixel and context images are considered. To extract clinically useful information from images that might be lacking in prior knowledge, we introduce an unsupervised tissue characterization algorithm that is both statistically principled and patient specific. The method uses adaptive standard finite normal mixture and inhomogeneous Markov random field models, whose parameters are estimated using expectation-maximization and relaxation labeling algorithms under information theoretic criteria. We demonstrate the successful applications of the approach with synthetic data sets and then with real MR brain images.


Assuntos
Imageamento por Ressonância Magnética , Modelos Estatísticos , Algoritmos , Encéfalo/anatomia & histologia , Humanos
15.
Hum Brain Mapp ; 13(1): 43-53, 2001 May.
Artigo em Inglês | MEDLINE | ID: mdl-11284046

RESUMO

Independent component analysis (ICA) is a technique that attempts to separate data into maximally independent groups. Achieving maximal independence in space or time yields two varieties of ICA meaningful for functional MRI (fMRI) applications: spatial ICA (SICA) and temporal ICA (TICA). SICA has so far dominated the application of ICA to fMRI. The objective of these experiments was to study ICA with two predictable components present and evaluate the importance of the underlying independence assumption in the application of ICA. Four novel visual activation paradigms were designed, each consisting of two spatiotemporal components that were either spatially dependent, temporally dependent, both spatially and temporally dependent, or spatially and temporally uncorrelated, respectively. Simulated data were generated and fMRI data from six subjects were acquired using these paradigms. Data from each paradigm were analyzed with regression analysis in order to determine if the signal was occurring as expected. Spatial and temporal ICA were then applied to these data, with the general result that ICA found components only where expected, e.g., S(T)ICA "failed" (i.e., yielded independent components unrelated to the "self-evident" components) for paradigms that were spatially (temporally) dependent, and "worked" otherwise. Regression analysis proved a useful "check" for these data, however strong hypotheses will not always be available, and a strength of ICA is that it can characterize data without making specific modeling assumptions. We report a careful examination of some of the assumptions behind ICA methodologies, provide examples of when applying ICA would provide difficult-to-interpret results, and offer suggestions for applying ICA to fMRI data especially when more than one task-related component is present in the data.


Assuntos
Algoritmos , Demografia , Processamento de Sinais Assistido por Computador , Córtex Visual/anatomia & histologia , Córtex Visual/fisiologia , Mapeamento Encefálico , Interpretação Estatística de Dados , Lateralidade Funcional/fisiologia , Humanos , Processamento de Imagem Assistida por Computador , Modelos Lineares , Imageamento por Ressonância Magnética , Testes Neuropsicológicos , Estimulação Luminosa , Desempenho Psicomotor/fisiologia , Percepção Espacial/fisiologia , Fatores de Tempo , Percepção do Tempo/fisiologia
16.
Magn Reson Med ; 44(6): 947-54, 2000 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11108633

RESUMO

The properties of the hemodynamic latencies in functional maps have been relatively unexplored. Accurate methods of estimating hemodynamic latencies are needed to take advantage of this feature of fMRI. A fully automated, weighted least-squares (WLS) method for estimating temporal latencies is reported. Using a weighted linear model, the optimal latency and amplitude of the fMRI response can be determined for those voxels that pass a detection threshold. There is evidence from previous studies that the hemodynamic response may be time-locked to the stimulus within certain limits, less variable earlier in its evolution, and able to resolve information about relative hemodynamic timing. This information can be used to test hypotheses about the sequence and spatial distribution of neural activity. The method can be used to weight the earliest evolution of the hemodynamic response more heavily and decrease bias resulting from the hemodynamic response function. Additionally, the WLS method can control for varying response shapes across the brain and improve latency comparisons between brain regions. The WLS method was developed to study the properties of hemodynamic latencies, which may be increasingly important as event-related fMRI continues to be advanced.


Assuntos
Algoritmos , Imageamento por Ressonância Magnética/métodos , Encéfalo/anatomia & histologia , Encéfalo/fisiologia , Análise de Fourier , Hemodinâmica , Humanos , Análise dos Mínimos Quadrados , Imageamento por Ressonância Magnética/instrumentação , Imageamento por Ressonância Magnética/estatística & dados numéricos , Distribuição Normal , Desempenho Psicomotor , Tempo de Reação , Reprodutibilidade dos Testes , Fatores de Tempo
17.
J Biomed Opt ; 5(4): 425-31, 2000 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11092430

RESUMO

This paper presents an effective two-step scheme for automatic object detection in computed radiography (CR) images. First, various structure elements of the morphological filters, designed by incorporating available morphological features of the objects of interest including their sizes and rough shape descriptions, are used to effectively distinguish the foreign object candidates from the complex background structures. Second, since the boundaries of the objects are the key features in reflecting object characteristics, active contour models are employed to accurately outline the morphological shapes of the suspicious foreign objects to further reduce the rate of false alarms. The actual detection scheme is accomplished by jointly using these two steps. The proposed methods are tested with a database of 50 hand-wrist computed radiographic images containing various types of foreign objects. Our experimental results demonstrate that the combined use of morphological filters and active contour models can provide an effective automatic detection of foreign objects in CR images achieving good sensitivity and specificity, and the accurate descriptions of the object morphological characteristics.


Assuntos
Algoritmos , Corpos Estranhos/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Punho , Cadáver , Processamento Eletrônico de Dados , Vidro , Humanos , Metais , Imagens de Fantasmas , Plásticos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Madeira , Punho/diagnóstico por imagem
18.
J Biomed Opt ; 2(2): 211-7, 1997 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23014875
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