Impairments of Speed and Amplitude of Movement in Parkinson's Disease: A Pilot Study
Identifieur interne : 000E41 ( PascalFrancis/Checkpoint ); précédent : 000E40; suivant : 000E42Impairments of Speed and Amplitude of Movement in Parkinson's Disease: A Pilot Study
Auteurs : Alberto J. Espay [Canada, États-Unis] ; Dorcas E. Beaton [Canada] ; Francesca Morgante [Canada, Italie] ; Carolyn A. Gunraj [Canada] ; Anthony E. Lang [Canada] ; Robert Chen [Canada]Source :
- Movement disorders [ 0885-3185 ] ; 2009.
Descripteurs français
- Pascal (Inist)
English descriptors
Abstract
Bradykinesia, characterized by slowness and decreased amplitude of movement, is often considered the most important deficit in Parkinson's disease (PD). The current clinical rating of bradykinesia in PD, based on the motor subscale of the Unified Parkinson's disease Rating Scale (UPDRS-III), does not individually weigh the impairments in speed and amplitude of rapid alternating movements. We sought to categorize movement in PD to determine whether speed and amplitude have different relationships to current measures of motor impairment and disability. Categories of speed and amplitude (normal, slow/low, and very-slow/very-low) were ascertained using an electromagnetic tracking device. Amplitude was disproportionally more affected than speed in the "off" state. UPDRS-III and the Schwab & England disability scale were worst in patients with very impaired amplitude and best in patients with normal amplitude. A similarly graded relationship was not found for categories of speed impairment. The examiner clinical global impression of change mirrored "off" state amplitude but not speed categories. Levodopa, however, normalized speed to a greater extent than amplitude. Our observations suggest that amplitude and speed impairments may be associated with different functional aspects in PD and deserve separate clinical assessment.
Affiliations:
Links toward previous steps (curation, corpus...)
Links to Exploration step
Pascal:09-0257358Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Impairments of Speed and Amplitude of Movement in Parkinson's Disease: A Pilot Study</title><author><name sortKey="Espay, Alberto J" sort="Espay, Alberto J" uniqKey="Espay A" first="Alberto J." last="Espay">Alberto J. Espay</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>The Neuroscience Institute, Department of Neurology, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Beaton, Dorcas E" sort="Beaton, Dorcas E" uniqKey="Beaton D" first="Dorcas E." last="Beaton">Dorcas E. Beaton</name><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Mobility Program Clinical Research Unit, Department of Medicine, University of Toronto</s1><s2>Ontario</s2><s3>CAN</s3><sZ>2 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Morgante, Francesca" sort="Morgante, Francesca" uniqKey="Morgante F" first="Francesca" last="Morgante">Francesca Morgante</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Dipartimento di Neuroscienze, Scienze Psichiatriche ed Anestesiologiche, Universitd di Messina</s1><s2>Messina</s2><s3>ITA</s3><sZ>3 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Messina</wicri:noRegion></affiliation></author><author><name sortKey="Gunraj, Carolyn A" sort="Gunraj, Carolyn A" uniqKey="Gunraj C" first="Carolyn A." last="Gunraj">Carolyn A. Gunraj</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Chen, Robert" sort="Chen, Robert" uniqKey="Chen R" first="Robert" last="Chen">Robert Chen</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">09-0257358</idno><date when="2009">2009</date><idno type="stanalyst">PASCAL 09-0257358 INIST</idno><idno type="RBID">Pascal:09-0257358</idno><idno type="wicri:Area/PascalFrancis/Corpus">000E65</idno><idno type="wicri:Area/PascalFrancis/Curation">001E54</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000E41</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Impairments of Speed and Amplitude of Movement in Parkinson's Disease: A Pilot Study</title><author><name sortKey="Espay, Alberto J" sort="Espay, Alberto J" uniqKey="Espay A" first="Alberto J." last="Espay">Alberto J. Espay</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>The Neuroscience Institute, Department of Neurology, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Beaton, Dorcas E" sort="Beaton, Dorcas E" uniqKey="Beaton D" first="Dorcas E." last="Beaton">Dorcas E. Beaton</name><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Mobility Program Clinical Research Unit, Department of Medicine, University of Toronto</s1><s2>Ontario</s2><s3>CAN</s3><sZ>2 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Morgante, Francesca" sort="Morgante, Francesca" uniqKey="Morgante F" first="Francesca" last="Morgante">Francesca Morgante</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Dipartimento di Neuroscienze, Scienze Psichiatriche ed Anestesiologiche, Universitd di Messina</s1><s2>Messina</s2><s3>ITA</s3><sZ>3 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Messina</wicri:noRegion></affiliation></author><author><name sortKey="Gunraj, Carolyn A" sort="Gunraj, Carolyn A" uniqKey="Gunraj C" first="Carolyn A." last="Gunraj">Carolyn A. Gunraj</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Chen, Robert" sort="Chen, Robert" uniqKey="Chen R" first="Robert" last="Chen">Robert Chen</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Amplitude</term><term>Evaluation scale</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Speed</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Vitesse déplacement</term><term>Amplitude</term><term>Echelle d'évaluation</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Bradykinesia, characterized by slowness and decreased amplitude of movement, is often considered the most important deficit in Parkinson's disease (PD). The current clinical rating of bradykinesia in PD, based on the motor subscale of the Unified Parkinson's disease Rating Scale (UPDRS-III), does not individually weigh the impairments in speed and amplitude of rapid alternating movements. We sought to categorize movement in PD to determine whether speed and amplitude have different relationships to current measures of motor impairment and disability. Categories of speed and amplitude (normal, slow/low, and very-slow/very-low) were ascertained using an electromagnetic tracking device. Amplitude was disproportionally more affected than speed in the "off" state. UPDRS-III and the Schwab & England disability scale were worst in patients with very impaired amplitude and best in patients with normal amplitude. A similarly graded relationship was not found for categories of speed impairment. The examiner clinical global impression of change mirrored "off" state amplitude but not speed categories. Levodopa, however, normalized speed to a greater extent than amplitude. Our observations suggest that amplitude and speed impairments may be associated with different functional aspects in PD and deserve separate clinical assessment.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>24</s2></fA05><fA06><s2>7</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Impairments of Speed and Amplitude of Movement in Parkinson's Disease: A Pilot Study</s1></fA08><fA11 i1="01" i2="1"><s1>ESPAY (Alberto J.)</s1></fA11><fA11 i1="02" i2="1"><s1>BEATON (Dorcas E.)</s1></fA11><fA11 i1="03" i2="1"><s1>MORGANTE (Francesca)</s1></fA11><fA11 i1="04" i2="1"><s1>GUNRAJ (Carolyn A.)</s1></fA11><fA11 i1="05" i2="1"><s1>LANG (Anthony E.)</s1></fA11><fA11 i1="06" i2="1"><s1>CHEN (Robert)</s1></fA11><fA14 i1="01"><s1>Toronto Western Research Institute and Division of Neurology, Department of Medicine, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></fA14><fA14 i1="02"><s1>The Neuroscience Institute, Department of Neurology, Movement Disorders Center, University of Cincinnati</s1><s2>Cincinnati, Ohio</s2><s3>USA</s3><sZ>1 aut.</sZ></fA14><fA14 i1="03"><s1>Mobility Program Clinical Research Unit, Department of Medicine, University of Toronto</s1><s2>Ontario</s2><s3>CAN</s3><sZ>2 aut.</sZ></fA14><fA14 i1="04"><s1>Dipartimento di Neuroscienze, Scienze Psichiatriche ed Anestesiologiche, Universitd di Messina</s1><s2>Messina</s2><s3>ITA</s3><sZ>3 aut.</sZ></fA14><fA20><s1>1001-1008</s1></fA20><fA21><s1>2009</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000188271060070</s5></fA43><fA44><s0>0000</s0><s1>© 2009 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>36 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>09-0257358</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Movement disorders</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Bradykinesia, characterized by slowness and decreased amplitude of movement, is often considered the most important deficit in Parkinson's disease (PD). The current clinical rating of bradykinesia in PD, based on the motor subscale of the Unified Parkinson's disease Rating Scale (UPDRS-III), does not individually weigh the impairments in speed and amplitude of rapid alternating movements. We sought to categorize movement in PD to determine whether speed and amplitude have different relationships to current measures of motor impairment and disability. Categories of speed and amplitude (normal, slow/low, and very-slow/very-low) were ascertained using an electromagnetic tracking device. Amplitude was disproportionally more affected than speed in the "off" state. UPDRS-III and the Schwab & England disability scale were worst in patients with very impaired amplitude and best in patients with normal amplitude. A similarly graded relationship was not found for categories of speed impairment. The examiner clinical global impression of change mirrored "off" state amplitude but not speed categories. Levodopa, however, normalized speed to a greater extent than amplitude. Our observations suggest that amplitude and speed impairments may be associated with different functional aspects in PD and deserve separate clinical assessment.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC02 i1="02" i2="X"><s0>002B17G</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Maladie de Parkinson</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Parkinson disease</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Pathologie du système nerveux</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Vitesse déplacement</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Speed</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Velocidad desplazamiento</s0><s5>09</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Amplitude</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Amplitude</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Amplitud</s0><s5>10</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Echelle d'évaluation</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Evaluation scale</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Escala evaluación</s0><s5>11</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Pathologie de l'encéphale</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Syndrome extrapyramidal</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Pathologie du système nerveux central</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>40</s5></fC07><fN21><s1>187</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>Canada</li><li>Italie</li><li>États-Unis</li></country><region><li>Ohio</li><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><region name="Ontario"><name sortKey="Espay, Alberto J" sort="Espay, Alberto J" uniqKey="Espay A" first="Alberto J." last="Espay">Alberto J. Espay</name></region><name sortKey="Beaton, Dorcas E" sort="Beaton, Dorcas E" uniqKey="Beaton D" first="Dorcas E." last="Beaton">Dorcas E. Beaton</name><name sortKey="Chen, Robert" sort="Chen, Robert" uniqKey="Chen R" first="Robert" last="Chen">Robert Chen</name><name sortKey="Gunraj, Carolyn A" sort="Gunraj, Carolyn A" uniqKey="Gunraj C" first="Carolyn A." last="Gunraj">Carolyn A. Gunraj</name><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><name sortKey="Morgante, Francesca" sort="Morgante, Francesca" uniqKey="Morgante F" first="Francesca" last="Morgante">Francesca Morgante</name></country><country name="États-Unis"><region name="Ohio"><name sortKey="Espay, Alberto J" sort="Espay, Alberto J" uniqKey="Espay A" first="Alberto J." last="Espay">Alberto J. Espay</name></region></country><country name="Italie"><noRegion><name sortKey="Morgante, Francesca" sort="Morgante, Francesca" uniqKey="Morgante F" first="Francesca" last="Morgante">Francesca Morgante</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Santé/explor/MovDisordV3/Data/PascalFrancis/Checkpoint
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000E41 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/PascalFrancis/Checkpoint/biblio.hfd -nk 000E41 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Santé
|area= MovDisordV3
|flux= PascalFrancis
|étape= Checkpoint
|type= RBID
|clé= Pascal:09-0257358
|texte= Impairments of Speed and Amplitude of Movement in Parkinson's Disease: A Pilot Study
}}
| This area was generated with Dilib version V0.6.23. |  |