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Editorial
Understanding sleep and sleep disturbances in autism spectrum disorder, and management of insomnia: an update
Hye-Geum Kim
Yeungnam Univ J Med. 2021;38(4):265-266.   Published online September 13, 2021
DOI: https://doi.org/10.12701/yujm.2021.01459
  • 2,663 View
  • 81 Download
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Review articles
Psychiatric understanding and treatment of patients with amputations
So-Hye Jo, Suk-Hun Kang, Wan-Seok Seo, Bon-Hoon Koo, Hye-Geum Kim, Seok-Ho Yun
Yeungnam Univ J Med. 2021;38(3):194-201.   Published online May 11, 2021
DOI: https://doi.org/10.12701/yujm.2021.00990
  • 10,339 View
  • 308 Download
  • 11 Crossref
AbstractAbstract PDF
Amputation changes the lives of patients and their families. Consequently, the patient must adapt to altered body function and image. During this adaptation process, psychological problems, such as depression, anxiety, and posttraumatic stress disorder, can occur. The psychological difficulties of patients with amputation are often accepted as normal responses that are often poorly recognized by patients, family members, and their primary physicians. Psychological problems can interfere with rehabilitation and cause additional psychosocial problems. Therefore, their early detection and treatment are important. A multidisciplinary team approach, including mental health professionals, is ideal for comprehensive and biopsychosocial management. Mental health professionals could help patients set realistic goals and use adaptive coping styles. Psychiatric approaches should consider the physical, cognitive, psychological, social, and spiritual functions and social support systems before and after amputation. The abilities and limitations of physical, cognitive, psychological, and social functions should also be considered. To improve the patient’s adaptation, psychological interventions such as short-term psychotherapy, cognitive behavioral therapy, mindfulness meditation, biofeedback, and group psychotherapy can be helpful.

Citations

Citations to this article as recorded by  
  • Depression and Anxiety Symptoms Among Lebanese Lower Limb Traumatic Amputees: Association with Education, Employment, Adjustment to Amputation and Prosthesis Satisfaction
    Nour El Hoda Saleh, Fatima Hamiye, Marwa Summaka, Hiba Zein, Rami El Mazbouh, Ibrahim Naim
    Psychiatry.2024; 87(1): 51.     CrossRef
  • Building a Multidisciplinary Clinic Dedicated to Upper-Extremity Limb Loss
    Anirudh Kulkarni, Margaret Luthringer, Alta Fried, Matt Mikosz, Jamie Mauro, Gina Radice Vella, Tara Lally, Ajul Shah
    The Journal of Hand Surgery.2024; 49(3): 267.     CrossRef
  • Effect of Increasing Assistance From a Powered Prosthesis on Weight-Bearing Symmetry, Effort, and Speed During Stand-Up in Individuals With Above-Knee Amputation
    Grace R. Hunt, Sarah Hood, Lukas Gabert, Tommaso Lenzi
    IEEE Transactions on Neural Systems and Rehabilitation Engineering.2023; 31: 11.     CrossRef
  • The Effect of Motivational Interview-Based Counseling in Individuals With Amputation: A Randomized Controlled Trial in Turkey
    Gülhan Küçük Öztürk, Nuray Şimşek
    Rehabilitation Nursing.2023; 48(5): 160.     CrossRef
  • Psychosocial patient perspectives following major lower-limb amputation due to vascular aetiology: a protocol for a systematic meta-aggregation study
    Sisse Heiden Laursen, Helle Lund Rasmussen, Dinnie Seidelin, Peter Hørslev Pedersen, Tanja Mortensen Chræmmer
    BMJ Open.2023; 13(9): e076794.     CrossRef
  • Quality of life following non-dysvascular lower limb amputation is contextualized through occupations: a qualitative study
    Stephanie R. Cimino, Sander L. Hitzig, Vera Fung, Katie N. Dainty, Crystal MacKay, Joanna E. M. Sale, Amanda L. Mayo, Sara J. T. Guilcher
    Disability and Rehabilitation.2023; : 1.     CrossRef
  • Finger prosthesis: A novel way to restore the form, function, and esthetics
    Nagaveni S. Somayaji, Pallawi Sinha, Jitendra Sharan, Jagadish Prasad Rajaguru, Anand Marya
    Clinical Case Reports.2023;[Epub]     CrossRef
  • Predicting amputation using machine learning: A systematic review
    Patrick Fangping Yao, Yi David Diao, Eric P. McMullen, Marlin Manka, Jessica Murphy, Celina Lin, Noman Naseer
    PLOS ONE.2023; 18(11): e0293684.     CrossRef
  • Understanding Gangrene in the Context of Peripheral Vascular Disease: Prevalence, Etiology, and Considerations for Amputation-Level Determination
    Abhilasha Bhargava, Chandrashekhar Mahakalkar, Shivani Kshirsagar
    Cureus.2023;[Epub]     CrossRef
  • PEER SUPPORT FOR INDIVIDUALS WITH MAJOR LIMB LOSS: A SCOPING REVIEW
    Mia Costa-Parke, Anna Maria Di Lella, Ashley Walker, Lee Verweel, Crystal MacKay
    CANADIAN PROSTHETICS & ORTHOTICS JOURNAL.2023;[Epub]     CrossRef
  • The Mediating Role of Mental Toughness in the Relationship between Mindfulness and Body Image Concern in Amputees
    Afrooz Pourfahimi, Ali Khaneh Keshi, Alireza Homayouni
    The Neuroscience Journal of Shefaye Khatam.2023; 11(4): 42.     CrossRef
Effects and mechanisms of a mindfulness-based intervention on insomnia
Hye-Geum Kim
Yeungnam Univ J Med. 2021;38(4):282-288.   Published online January 14, 2021
DOI: https://doi.org/10.12701/yujm.2020.00850
  • 39,522 View
  • 165 Download
  • 5 Crossref
AbstractAbstract PDF
Medication alone is not sufficient to treat insomnia. In addition, the side effects of sleep medications themselves cannot be ignored during treatment. Insomnia begins with poor sleep quality and discomfort, but as it continues, patients fall into a vicious circle of insomnia with negative thoughts and dysfunctional and distorted perceptions related to sleep. Mindfulness-based intervention for insomnia corrects these sequential cognitive and behavioral processes. The mindfulness technique basically recognizes all the thoughts, feelings, and experiences that occur to us as they are, nonjudgmentally, and then trains them to return to the senses of our body. In this way, while noticing all the processes of the sequential vicious cycle and training them to return to our bodies (e.g., breathing), mindfulness determines whether we are really sleepy or just fatigued. This mindfulness-based intervention can be a useful nonpharmaceutical intervention for insomnia, and its stability and efficacy has been proven by many studies.

Citations

Citations to this article as recorded by  
  • Comparative efficacy and acceptability of interventions for insomnia in breast cancer patients: A protocol for systematic review and network meta-analysis
    Zhifan Li, Qian Wang, Junxia Xu, Qihua Song, Xiaoling Ling, Ya Gao, Junqiang Lei, Andrea Giannini
    PLOS ONE.2023; 18(3): e0282614.     CrossRef
  • Cognitive and Somatic Mediators of the Effects of Trait Mindfulness on Mental Health Adjustment Following Bereavement
    Mariel Emrich, Crystal L. Park, Adam B. David, Lucy Finkelstein-Fox
    Mindfulness.2023; 14(12): 2932.     CrossRef
  • Effectiveness of a 4-Day Mindfulness-Based Intervention in a 2-Month Follow-Up for Chinese Incarcerated People
    Jieting Zhang, Zening Zheng, Lina Wang, Christina M. Luberto, Man (Sophie) Zhang, Yuhua Wen, Qi Su, Can Jiao
    Behavior Therapy.2022; 53(5): 981.     CrossRef
  • Understanding sleep and sleep disturbances in autism spectrum disorder, and management of insomnia: an update
    Hye-Geum Kim
    Yeungnam University Journal of Medicine.2021; 38(4): 265.     CrossRef
  • Effects of mindful breathing combined with sleep-inducing exercises in patients with insomnia
    Hui Su, Li Xiao, Yue Ren, Hui Xie, Xiang-Hong Sun
    World Journal of Clinical Cases.2021; 9(29): 8740.     CrossRef
Cognitive dysfunctions in individuals with diabetes mellitus
Hye-Geum Kim
Yeungnam Univ J Med. 2019;36(3):183-191.   Published online July 24, 2019
DOI: https://doi.org/10.12701/yujm.2019.00255
  • 14,101 View
  • 420 Download
  • 37 Crossref
AbstractAbstract PDF
Some patients with type 1 and type 2 diabetes mellitus (DM) present with cognitive dysfunctions. The pathophysiology underlying this complication is not well understood. Type 1 DM has been associated with a decrease in the speed of information processing, psychomotor efficiency, attention, mental flexibility, and visual perception. Longitudinal epidemiological studies of type 1 DM have indicated that chronic hyperglycemia and microvascular disease, rather than repeated severe hypoglycemia, are associated with the pathogenesis of DM-related cognitive dysfunction. However, severe hypoglycemic episodes may contribute to cognitive dysfunction in high-risk patients with DM. Type 2 DM has been associated with memory deficits, decreased psychomotor speed, and reduced frontal lobe/executive function. In type 2 DM, chronic hyperglycemia, long duration of DM, presence of vascular risk factors (e.g., hypertension and obesity), and microvascular and macrovascular complications are associated with the increased risk of developing cognitive dysfunction. The pathophysiology of cognitive dysfunction in individuals with DM include the following: (1) role of hyperglycemia, (2) role of vascular disease, (3) role of hypoglycemia, and (4) role of insulin resistance and amyloid. Recently, some investigators have proposed that type 3 DM is correlated to sporadic Alzheimer’s disease. The molecular and biochemical consequences of insulin and insulin-like growth factor resistance in the brain compromise neuronal survival, energy production, gene expression, plasticity, and white matter integrity. If patients claim that their performance is worsening or if they ask about the effects of DM on functioning, screening and assessment are recommended.

Citations

Citations to this article as recorded by  
  • Diabetic Encephalopathy: Role of Oxidative and Nitrosative Factors in Type 2 Diabetes
    Debashree Mazumdar, Santosh Singh
    Indian Journal of Clinical Biochemistry.2024; 39(1): 3.     CrossRef
  • Nephroprotective properties of Achillea millefolium green-formulated Au NPs in streptozotocin-induced diabetic nephropathy in mice: Introducing a novel therapeutic drug for the treatment of nephropathy
    Nana Li, Xiu Wang, Shanshan Kong
    Inorganic Chemistry Communications.2024; 161: 112103.     CrossRef
  • Changes in selected hematological parameters in patients with type 1 and type 2 diabetes: a systematic review and meta-analysis
    Getachew Mesfin Bambo, Daniel Asmelash, Ermiyas Alemayehu, Alemu Gedefie, Tadesse Duguma, Samuel Sahile Kebede
    Frontiers in Medicine.2024;[Epub]     CrossRef
  • A new nomogram model for the individualized prediction of mild cognitive impairment in elderly patients with type 2 diabetes mellitus
    Yuanyuan Jiang, Xueyan Liu, Huiying Gao, Jingzheng Yan, Yingjuan Cao
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • Metformin Prevents NDEA-Induced Memory Impairments Associated with Attenuating Beta-Amyloid, Tumor Necrosis Factor-Alpha, and Interleukin-6 Levels in the Hippocampus of Rats
    Teresa Ponce-Lopez, José Antonio González Álvarez Tostado, Fernando Dias, Keren Happuck Montiel Maltez
    Biomolecules.2023; 13(9): 1289.     CrossRef
  • Quercetin: an effective polyphenol in alleviating diabetes and diabetic complications
    Lei Yan, Mostafa Vaghari-Tabari, Faezeh Malakoti, Soheila Moein, Durdi Qujeq, Bahman Yousefi, Zatollah Asemi
    Critical Reviews in Food Science and Nutrition.2023; 63(28): 9163.     CrossRef
  • Hyperglycemic microenvironment compromises the homeostasis of communication between the bone-brain axis by the epigenetic repression of the osteocalcin receptor, Gpr158 in the hippocampus
    Ericka Patricia da Silva, Geórgia da Silva Feltran, Sérgio Alexandre Alcântara dos Santos, Rodrigo Cardoso de Oliveira, Rahyza I.F. Assis, Luis Antônio Justulin Junior, Denise Carleto Andia, Willian F. Zambuzzi, Alexandra Latini, Rodrigo A. Foganholi da S
    Brain Research.2023; 1803: 148234.     CrossRef
  • Research Progress on Lipocalin-2 in Diabetic Encephalopathy
    Wenjie Zhang, Shihong Chen, Xianghua Zhuang
    Neuroscience.2023; 515: 74.     CrossRef
  • The Management of Diabetes Mellitus Using Medicinal Plants and Vitamins
    Clement G. Yedjou, Jameka Grigsby, Ariane Mbemi, Daryllynn Nelson, Bryan Mildort, Lekan Latinwo, Paul B. Tchounwou
    International Journal of Molecular Sciences.2023; 24(10): 9085.     CrossRef
  • Gender differences in cognitive function and its associated factors among older adults with type 2 diabetes
    Hua-Fen Chen, Ju Ying Jiang, Mei-Hsiu Chen, Rong Lin, Seng Wei Ooi Jerence, Chin-Huan Chang, Cheng-Chen Chou
    Geriatric Nursing.2023; 52: 165.     CrossRef
  • Exploring the Potential of Antidiabetic Agents as Therapeutic Approaches for Alzheimer's and Parkinson's Diseases: A Comprehensive Review
    Mahima Koshatwar, Sourya Acharya, Roshan Prasad, Tejaswee Lohakare, Mayur Wanjari, Avinash B Taksande
    Cureus.2023;[Epub]     CrossRef
  • Isolation and characterization of bacteria from diabetic foot ulcer: amputation, antibiotic resistance and mortality rate
    Muamar M. A. Shaheen, Sewar Al Dahab, Maryiam Abu Fada, Rawand Idieis
    International Journal of Diabetes in Developing Countries.2022; 42(3): 529.     CrossRef
  • Genetic mutations of APOEε4 carriers in cardiovascular patients lead to the development of insulin resistance and risk of Alzheimer's disease
    Komal Jabeen, Kanwal Rehman, Muhammad Sajid Hamid Akash
    Journal of Biochemical and Molecular Toxicology.2022;[Epub]     CrossRef
  • Aqueous Ajwa dates seeds extract improves memory impairment in type-2 diabetes mellitus rats by reducing blood glucose levels and enhancing brain cholinergic transmission
    Vasudevan Mani, Minhajul Arfeen, Sultan Sajid, Yasser Almogbel
    Saudi Journal of Biological Sciences.2022; 29(4): 2738.     CrossRef
  • Diabetes Mellitus-Related Neurobehavioral Deficits in Mice Are Associated With Oligodendrocyte Precursor Cell Dysfunction
    Li-Ping Wang, Jieli Geng, Chang Liu, Yuyang Wang, Zhijun Zhang, Guo-Yuan Yang
    Frontiers in Aging Neuroscience.2022;[Epub]     CrossRef
  • Single-Cell Sequencing Analysis of the db/db Mouse Hippocampus Reveals Cell-Type-Specific Insights Into the Pathobiology of Diabetes-Associated Cognitive Dysfunction
    Shizhan Ma, Wenkai Bi, Xueying Liu, Shangbin Li, Yaxin Qiu, Chengcheng Huang, Renjun Lv, Qingqing Yin
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Impact of time in range during hospitalization on clinical outcomes in diabetic patients with toe amputation: a propensity score matching analysis
    Su Li, Ze-Xin Huang, Dong-hao Lou, Ye-Yong Jiang, Sheng Zhao
    BMC Surgery.2022;[Epub]     CrossRef
  • Aberrant brain functional networks in type 2 diabetes mellitus: A graph theoretical and support-vector machine approach
    Lin Lin, Jindi Zhang, Yutong Liu, Xinyu Hao, Jing Shen, Yang Yu, Huashuai Xu, Fengyu Cong, Huanjie Li, Jianlin Wu
    Frontiers in Human Neuroscience.2022;[Epub]     CrossRef
  • Does diabetes affect the risk of involvement in a motor vehicle crash?
    Jamie Dow, Lucie Boucher, David Carr, Judith L. Charlton, Linda Hill, Sjaan Koppel, Roy Lilley, Richard Marotolli, Desmond O'Neill, Mark Rapoport, Christine Roy, Neil Swirsky, Vincent Woo, Emmanuelle Gagné, Claude Giroux, Tamara Rader
    Journal of Transport & Health.2022; 27: 101509.     CrossRef
  • No Effects of Acute Psychosocial Stress on Working Memory in Older People With Type 2 Diabetes
    Lorena Vallejo, Mariola Zapater-Fajarí, Teresa Montoliu, Sara Puig-Perez, Juan Nacher, Vanesa Hidalgo, Alicia Salvador
    Frontiers in Psychology.2021;[Epub]     CrossRef
  • Neurovascular coupling alterations in type 2 diabetes: a 5-year longitudinal MRI study
    Yang Zhang, Xiaolu Zhang, Guangyang Ma, Wen Qin, Jiayang Yang, Jiahui Lin, Quan Zhang
    BMJ Open Diabetes Research & Care.2021; 9(1): e001433.     CrossRef
  • Ameliorative effects of endurance training and Matricaria chamomilla flowers hydroethanolic extract on cognitive deficit in type 2 diabetes rats
    Ali Heidarianpour, Fereshteh Mohammadi, Maryam Keshvari, Naser Mirazi
    Biomedicine & Pharmacotherapy.2021; 135: 111230.     CrossRef
  • The link between nutrition and Alzheimer’s disease: from prevention to treatment
    Laís Bhering Martins, Ana Letícia Malheiros Silveira, Antonio Lúcio Teixeira
    Neurodegenerative Disease Management.2021; 11(2): 155.     CrossRef
  • Peripheral Polyneuropathy and Cognitive Impairment in Type II Diabetes Mellitus
    Rasha Elbialy Elsharkawy, Ghada Saed Abdel Azim, Marwa Abdellah Osman, Hend Maghraby Maghraby, Rehab Abdelfattah Mohamed, Eman Mahmoud Abdelsalam, Eman Elshohat Ebrahem, Nora Mohamed Ahmed Seliem
    Neuropsychiatric Disease and Treatment.2021; Volume 17: 627.     CrossRef
  • SLC40A1 Mediates Ferroptosis and Cognitive Dysfunction in Type 1 Diabetes
    Lijun Hao, Jun Mi, Liping Song, Yinnan Guo, Yanli Li, Yiru Yin, Ce Zhang
    Neuroscience.2021; 463: 216.     CrossRef
  • Relationship between peripheral neuropathy and cognitive performance in the elderly population
    Yu-Jen Lin, Tung-Wei Kao, Wei-Liang Chen
    Medicine.2021; 100(20): e26071.     CrossRef
  • The Association Between Diabetes Mellitus and Mild Behavioral Impairment Among Mild Cognitive Impairment: Findings from Singapore
    See Ann Soo, Kok Pin Ng, Fennie Wong, Seyed Ehsan Saffari, Chathuri Yatawara, Zahinoor Ismail, Nagaendran Kandiah
    Journal of Alzheimer's Disease.2021; 82(1): 411.     CrossRef
  • Repurposing of Anti-Diabetic Agents as a New Opportunity to Alleviate Cognitive Impairment in Neurodegenerative and Neuropsychiatric Disorders
    Qian Chen, Ting Cao, NaNa Li, Cuirong Zeng, Shuangyang Zhang, Xiangxin Wu, Bikui Zhang, Hualin Cai
    Frontiers in Pharmacology.2021;[Epub]     CrossRef
  • Mitochondrial remodelling—a vicious cycle in diabetic complications
    Bhoomika Sherkhane, Gundu Chayanika, Anika Sood, Dharmendra Kumar Khatri, Shashi Bala Singh
    Molecular Biology Reports.2021; 48(5): 4721.     CrossRef
  • The Association between the Binding Processes of Working Memory and Vascular Risk Profile in Adults
    Eirini Bika, Despina Moraitou, Elvira Masoura, George Kolios, Georgia Papantoniou, Maria Sofologi, Vasileios Papaliagkas, Georgios Ntritsos
    Brain Sciences.2021; 11(9): 1140.     CrossRef
  • The effect of cordycepin on brain oxidative stress and protein expression in streptozotocin-induced diabetic mice
    Krittika SRISUKSAI, Kongphop PARUNYAKUL, Narumon PHAONAKROP, Sittiruk ROYTAKUL, Wirasak FUNGFUANG
    Journal of Veterinary Medical Science.2021; 83(9): 1425.     CrossRef
  • The Candidate Schizophrenia Risk Gene Tmem108 Regulates Glucose Metabolism Homeostasis
    Jianbo Yu, Xufeng Liao, Yanzi Zhong, Yongqiang Wu, Xinsheng Lai, Huifeng Jiao, Min Yan, Yu Zhang, Chaolin Ma, Shunqi Wang
    Frontiers in Endocrinology.2021;[Epub]     CrossRef
  • Impact of diabetes on the accuracy and speed of accessing information from episodic and working memory
    Selene Cansino, Frine Torres-Trejo, Cinthya Estrada-Manilla, Eira Castellanos-Domínguez, Ana Zamora-Olivares, Silvia Ruiz Velasco, Jim Grange
    Cogent Psychology.2021;[Epub]     CrossRef
  • Ингибиторы натрий-глюкозного котранспортера способны положительно влиять на состояние головного мозга
    Олег Леонидович Колесников , Алла Алексеевна Колесникова , Юлия Олеговна Тарабрина
    Естественные и Технические Науки.2021; (№11): 149.     CrossRef
  • Melatonin: new insights on its therapeutic properties in diabetic complications
    Mohammad Hossein Pourhanifeh, Azam Hosseinzadeh, Ehsan Dehdashtian, Karim Hemati, Saeed Mehrzadi
    Diabetology & Metabolic Syndrome.2020;[Epub]     CrossRef
  • Diabetic encephalopathy causes the imbalance of neural activities between hippocampal glutamatergic neurons and GABAergic neurons in mice
    Chun Wang, Juan Li, Shidi Zhao, Li Huang
    Brain Research.2020; 1742: 146863.     CrossRef
  • Link between Diabetes and Alzheimer’s Disease Due to the Shared Amyloid Aggregation and Deposition Involving Both Neurodegenerative Changes and Neurovascular Damages
    Gabriela Dumitrita Stanciu, Veronica Bild, Daniela Carmen Ababei, Razvan Nicolae Rusu, Alina Cobzaru, Luminita Paduraru, Delia Bulea
    Journal of Clinical Medicine.2020; 9(6): 1713.     CrossRef
Case report
Apathy syndrome in a patient previously treated with selective serotonin reuptake inhibitors for depression
Hye-Geum Kim, Bon-Hoon Koo, Seung Woo Lee, Eun-Jin Cheon
Yeungnam Univ J Med. 2019;36(3):249-253.   Published online March 15, 2019
DOI: https://doi.org/10.12701/yujm.2019.00150
  • 13,467 View
  • 164 Download
  • 3 Crossref
AbstractAbstract PDF
There is considerable overlap in the clinical presentations of apathy and depression. However, differential diagnosis between apathy and other psychiatric conditions, including depression and dementia, is important. In this report, we present the case of a 67-year-old woman with a history of receiving selective serotonin reuptake inhibitor (SSRI) treatment for depression. Differential diagnosis between treatment-resistant depression and SSRI-induced apathy syndrome was required. The symptoms of her apathy syndrome were relieved after the discontinuation of SSRIs and the addition of olanzapine, methylphenidate, and modafinil. Furthermore, we briefly review related literature in this article.

Citations

Citations to this article as recorded by  
  • Apathy associated with antidepressant drugs: a systematic review
    Vasilios G. Masdrakis, Manolis Markianos, David S. Baldwin
    Acta Neuropsychiatrica.2023; 35(4): 189.     CrossRef
  • Can antidepressant use be associated with emotional blunting in a subset of patients with depression? A scoping review of available literature
    Muhammad Youshay Jawad, Maurish Fatima, Umer Hassan, Zaofashan Zaheer, Muhammad Ayyan, Muhammad Ehsan, Muhmmad Huzaifa Ahmed Khan, Ahsan Qadeer, Abdul Rehman Gull, Muhammad Talha Asif, Mujeeb U. Shad
    Human Psychopharmacology: Clinical and Experimental.2023;[Epub]     CrossRef
  • Investigation of the efficiency of various antidepressant replacement regimens in the development of SSRI-induced apathy syndrome
    V. E. Medvedev, R. A. Kardashyan, V. I. Frolova, A. M. Burno, S. V. Nekrasova, V. I. Salyntsev
    Neurology, Neuropsychiatry, Psychosomatics.2020; 12(2): 48.     CrossRef

JYMS : Journal of Yeungnam Medical Science