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  • 1
    In: Molecular Psychiatry, Springer Science and Business Media LLC
    Kurzfassung: β-amyloid (Aβ) and tau aggregation as well as neuronal injury and atrophy (ATN) are the major hallmarks of Alzheimer’s disease (AD), and biomarkers for these hallmarks have been linked to neuroinflammation. However, the detailed regional associations of these biomarkers with microglial activation in individual patients remain to be elucidated. We investigated a cohort of 55 patients with AD and primary tauopathies and 10 healthy controls that underwent TSPO-, Aβ-, tau-, and perfusion-surrogate-PET, as well as structural MRI. Z -score deviations for 246 brain regions were calculated and biomarker contributions of Aβ (A), tau (T), perfusion (N1), and gray matter atrophy (N2) to microglial activation (TSPO, I) were calculated for each individual subject. Individual ATN-related microglial activation was correlated with clinical performance and CSF soluble TREM2 (sTREM2) concentrations. In typical and atypical AD, regional tau was stronger and more frequently associated with microglial activation when compared to regional Aβ (AD: β T  = 0.412 ± 0.196 vs. β A  = 0.142 ± 0.123, p   〈  0.001; AD-CBS: β T  = 0.385 ± 0.176 vs. β A  = 0.131 ± 0.186, p  = 0.031). The strong association between regional tau and microglia reproduced well in primary tauopathies (β T  = 0.418 ± 0.154). Stronger individual associations between tau and microglial activation were associated with poorer clinical performance. In patients with 4RT, sTREM2 levels showed a positive association with tau-related microglial activation. Tau pathology has strong regional associations with microglial activation in primary and secondary tauopathies. Tau and Aβ related microglial response indices may serve as a two-dimensional in vivo assessment of neuroinflammation in neurodegenerative diseases.
    Materialart: Online-Ressource
    ISSN: 1359-4184 , 1476-5578
    Sprache: Englisch
    Verlag: Springer Science and Business Media LLC
    Publikationsdatum: 2023
    ZDB Id: 1502531-7
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
    In: Alzheimer's & Dementia, Wiley, Vol. 17, No. S1 ( 2021-12)
    Kurzfassung: 18‐kDa translocator protein position‐emission‐tomography (TSPO‐PET) imaging emerged for in vivo assessment of neuroinflammation in preclinical and clinical research of Alzheimer’s disease (AD). Higher TSPO‐PET binding as a surrogate of microglial activation in females has been reported for cognitively normal humans (HC), but sex effects have not yet been systematically evaluated in patients with AD. Thus, we aimed to investigate the impact of sex and the body mass index (BMI) on the relationship between β‐amyloid‐accumulation and microglial activation in AD. Method Fifty‐six patients with AD (34 female; BMI 24.9±4.0; age 71.1±7.7 years; 100% Aβ‐positive; MMSE 20.9±5.5) and 13 Aβ‐negative HC (7 female; BMI 24.2±3.3; age 70.6±7.5 years; MMSE 29.0±1.0) underwent TSPO‐PET ( 18 F‐GE‐180) and β‐amyloid‐PET imaging (Aβ‐PET; 18 F‐flutemetamol). The brain was parcellated into 218 cortical regions and standardized‐uptake‐value‐ratios (SUVr, cerebellar reference) were calculated for TSPO‐ and Aβ‐PET. Per AD patient, the averaged regional increase of TSPO‐ and Aβ‐PET SUVr (z‐score) was calculated versus HC. We used the function between regional Aβ‐PET and TSPO‐PET SUVr to determine the Aβ‐plaque dependent microglial response (slope) and the Aβ‐plaque independent microglial response (intercept) at the single patient level (Figure 1). All PET read‐outs were compared between sexes and we tested for a moderation effect of sex on the association between BMI and microglial activation, controlled for age. Result In AD the mean cortical TSPO‐PET z‐score of females (+0.69±0.72) was higher when compared to males (+0.30±0.73; p=0.048; Figure 2), whereas Aβ‐PET z‐scores were similar (female: +4.56±1.76; male: +4.44±2.08). The Aβ‐plaque independent microglial response was stronger in females with AD (intercept: +0.35±0.63) when compared to males (‐0.23±0.71; p=0.0024) whereas the Aβ‐plaque dependent microglial response was indifferent between sexes (Figure 2). BMI and the Aβ‐plaque independent microglial response were significantly associated in females (β=0.35, p=0.043) but not in males (β=‐0.02, p=0.940; BMI*sex interaction: F (3,52) =4.77, p=0.0052; Figure 3). Conclusion Females with AD comprise a higher Aβ‐plaque independent microglia response, whereas the microglial response to fibrillar Aβ is indifferent between sexes. BMI is positively associated with the Aβ‐plaque independent microglia response in females with AD but not in males, indicating that sex and BMI need to be considered when studying neuroinflammation in AD.
    Materialart: Online-Ressource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2021
    ZDB Id: 2201940-6
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
    In: Alzheimer's & Dementia, Wiley, Vol. 17, No. S1 ( 2021-12)
    Kurzfassung: Dynamic 60‐minute positron‐emission‐tomography (PET) imaging with the novel tau radiotracer [ 18 F]PI‐2620 facilitated accurate discrimination between patients with progressive supranuclear palsy (PSP) and healthy controls (HCs). We now aimed to investigate if shorter acquisition and static time windows of [ 18 F]PI‐2620 tau‐PET can be used for imaging of patients with PSP. Method We evaluated 37 patients at five different centers with probable or possible PSP Richardson syndrome (PSP‐RS) together with ten HCs. [ 18 F]PI‐2620 PET was performed by a dynamic 60 minute scan. Distribution volume ratios (DVRs, multilinear reference tissue model 2, cerebellar reference) were calculated using full and truncated scan durations (0‐60, 0‐50, 0‐40, 0‐30, and 0‐20 minutes p.i.). Standardized uptake value ratios (SUVrs, cerebellar reference) were obtained from static imaging windows with 20 minutes duration (20‐40, 30‐50, and 40‐60 minutes p.i.). All DVR and SUVr data were compared with regard to their potential to discriminate patients with PSP‐RS from HCs in predefined subcortical and cortical target regions (effect size, receiver operating area under the curve (AUC), multi‐region classifier). Finally, we tested if shorter [ 18 F]PI‐2620 PET imaging can also be applied to patients with Alzheimer’s disease (n=11). Result The effect size of 0‐50 and 0‐40 DVR was equivalent to 0‐60 DVR (averaged Cohen’s d: 1.22 and 1.16 vs. 1.26), whereas the performance dropped for 0‐30 or 0‐20 DVR. The 20‐40 SUVr indicated the best performance of all short static acquisition windows (averaged Cohen’s d: 0.99). The globus pallidus internus discriminated patients with PSP and healthy controls at a similarly high level for 0‐60 DVR (AUC: 0.96), 0‐40 DVR (AUC: 0.96), and 20‐40 SUVr (AUC: 0.94). The multi‐region classifier sensitivity of these time windows was consistently 86%. 0‐40 DVR showed similar performance in Alzheimer’s disease when compared to 0‐60 DVR. Conclusion Short dynamic acquisition and static imaging windows can be used for [ 18 F]PI‐2620 PET imaging of PSP. 0‐40 minute dynamic scanning offers the best balance between accuracy and economic scanning and is may also be suitable for [ 18 F]PI‐2620 PET imaging of Alzheimer’s disease.
    Materialart: Online-Ressource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2021
    ZDB Id: 2201940-6
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
    In: Alzheimer's & Dementia, Wiley, Vol. 17, No. S4 ( 2021-12)
    Kurzfassung: Cortico‐basal degeneration (CBD) and progressive supranuclear palsy (PSP) are 4R‐tauopathies characterized by progressive tau pathology spread that typically starts in the subcortex. Pre‐clinical studies suggest that tau spreads across connected neurons in an activity‐dependent manner, indicating that the brains’ connectome may mediate tau spreading. Supporting this, we found in Alzheimer’s disease that PET‐assessed cortical tau spreads across functionally connected regions. Here, we assessed whether connectivity mediates cortical/subcortical tau spreading also in 4R‐tauopathies, by combining resting‐state fMRI connectivity with i) 2 nd generation in vivo tau‐PET (PI2620) in CBS and PSP and ii) post‐mortem tau assessments in PSP. Method We assessed PI2620 tau‐PET in 24 CBS‐patients, 28 PSP‐patients and 15 healthy controls. Voxel‐wise tau‐PET differences were determined between patients vs. controls and mean tau‐PET SUVRs were assessed for 232 cortical/subcortical‐ROIs (Fig. 1A). Semi‐quantitative post‐mortem AT8‐stained neuronal tau was assessed in two additional, non‐overlapping PSP samples (Munich: n=96; & UPENN: n=97). Neuropathological ROIs were reconstructed in MRI‐standard‐space (Figs. 1B & C). Functional connectivity was assessed between tau‐PET‐ROIs and neuropathological‐ROIs using out‐of‐sample resting‐state fMRI from 69 elderly amyloid‐ and tau‐negative controls. Using linear regression, we assessed the association between ROI‐to‐ROI connectivity and covariance in tau‐PET or post‐mortem tau levels in spatially corresponding ROI pairs. For tau‐PET, we further tested at the subject level, whether functional connectivity of tau epicenters (i.e. ROIs with highest tau‐PET in a given subject) predicted tau deposition in connected regions, using linear mixed models controlling for age, gender and random intercept. Result PSP and CBS patients showed elevated tau‐PET compared to controls (Fig. 2). Higher functional connectivity was associated with higher covariance in tau‐PET in PSP and CBS (b=0.402‐0.715, Fig. 3A‐D, all p 〈 0.001). For post‐mortem data, higher ROI‐to‐ROI functional connectivity was also associated higher covariance in tau in both PSP samples (b=0.468 & 0.765, p 〈 0.001, Fig. 3E & F). Using tau‐PET we found further that connectivity patterns of subject‐level subcortical tau epicenters was associated with subject‐level tau‐PET uptake in connected regions (Fig. 4B‐E, all p 〈 0.001). Conclusion Highly functionally connected brain regions share similar tau levels in 4R‐tauopathies as indicated by tau‐PET and post‐mortem assessments, suggesting that brain connectivity is associated with inter‐regional tau spreading in 4R‐tauopathies.
    Materialart: Online-Ressource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2021
    ZDB Id: 2201940-6
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 5
    In: European Journal of Nuclear Medicine and Molecular Imaging, Springer Science and Business Media LLC, Vol. 48, No. 12 ( 2021-11), p. 3872-3885
    Kurzfassung: Dynamic 60-min positron emission tomography (PET) imaging with the novel tau radiotracer [ 18 F]PI-2620 facilitated accurate discrimination between patients with progressive supranuclear palsy (PSP) and healthy controls (HCs). This study investigated if truncated acquisition and static time windows can be used for [ 18 F]PI-2620 tau-PET imaging of PSP. Methods Thirty-seven patients with PSP Richardson syndrome (PSP-RS) were evaluated together with ten HCs. [ 18 F]PI-2620 PET was performed by a dynamic 60-min scan. Distribution volume ratios (DVRs) were calculated using full and truncated scan durations (0–60, 0–50, 0–40, 0–30, and 0–20 min p.i.). Standardized uptake value ratios (SUVrs) were obtained 20–40, 30–50, and 40–60 min p.i.. All DVR and SUVr data were compared with regard to their potential to discriminate patients with PSP-RS from HCs in predefined subcortical and cortical target regions (effect size, area under the curve (AUC), multi-region classifier). Results 0–50 and 0–40 DVR showed equivalent effect sizes as 0–60 DVR (averaged Cohen’s d: 1.22 and 1.16 vs. 1.26), whereas the performance dropped for 0–30 or 0–20 DVR. The 20–40 SUVr indicated the best performance of all static acquisition windows (averaged Cohen’s d: 0.99). The globus pallidus internus discriminated patients with PSP-RS and HCs at a similarly high level for 0–60 DVR (AUC: 0.96), 0–40 DVR (AUC: 0.96), and 20–40 SUVr (AUC: 0.94). The multi-region classifier sensitivity of these time windows was consistently 86%. Conclusion Truncated and static imaging windows can be used for [ 18 F]PI-2620 PET imaging of PSP. 0–40 min dynamic scanning offers the best balance between accuracy and economic scanning.
    Materialart: Online-Ressource
    ISSN: 1619-7070 , 1619-7089
    Sprache: Englisch
    Verlag: Springer Science and Business Media LLC
    Publikationsdatum: 2021
    ZDB Id: 2098375-X
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 6
    In: Movement Disorders, Wiley, Vol. 36, No. 4 ( 2021-04), p. 883-894
    Kurzfassung: Neuroinflammation has received growing interest as a therapeutic target in neurodegenerative disorders, including 4‐repeat tauopathies. Objectives The aim of this cross‐sectional study was to investigate 18 kDa translocator protein positron emission tomography (PET) as a biomarker for microglial activation in the 4‐repeat tauopathies corticobasal degeneration and progressive supranuclear palsy. Methods Specific binding of the 18 kDa translocator protein tracer 18 F‐GE‐180 was determined by serial PET during pharmacological depletion of microglia in a 4‐repeat tau mouse model. The 18 kDa translocator protein PET was performed in 30 patients with corticobasal syndrome (68 ± 9 years, 16 women) and 14 patients with progressive supranuclear palsy (69 ± 9 years, 8 women), and 13 control subjects (70 ± 7 years, 7 women). Group comparisons and associations with parameters of disease progression were assessed by region‐based and voxel‐wise analyses. Results Tracer binding was significantly reduced after pharmacological depletion of microglia in 4‐repeat tau mice. Elevated 18 kDa translocator protein labeling was observed in the subcortical brain areas of patients with corticobasal syndrome and progressive supranuclear palsy when compared with controls and was most pronounced in the globus pallidus internus, whereas only patients with corticobasal syndrome showed additionally elevated tracer binding in motor and supplemental motor areas. The 18 kDa translocator protein labeling was not correlated with parameters of disease progression in corticobasal syndrome and progressive supranuclear palsy but allowed sensitive detection in patients with 4‐repeat tauopathies by a multiregion classifier. Conclusions Our data indicate that 18 F‐GE‐180 PET detects microglial activation in the brain of patients with 4‐repeat tauopathy, fitting to predilection sites of the phenotype. The 18 kDa translocator protein PET has a potential for monitoring neuroinflammation in 4‐repeat tauopathies. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
    Materialart: Online-Ressource
    ISSN: 0885-3185 , 1531-8257
    URL: Issue
    RVK:
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2021
    ZDB Id: 2041249-6
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 7
    In: Annals of Neurology, Wiley, Vol. 92, No. 5 ( 2022-11), p. 768-781
    Kurzfassung: Alzheimer disease (AD) is characterized by amyloid β (Aβ) plaques and neurofibrillary tau tangles, but increasing evidence suggests that neuroinflammation also plays a key role, driven by the activation of microglia. Aβ and tau pathology appear to spread along pathways of highly connected brain regions, but it remains elusive whether microglial activation follows a similar distribution pattern. Here, we assess whether connectivity is associated with microglia activation patterns. Methods We included 32 Aβ‐positive early AD subjects (18 women, 14 men) and 18 Aβ‐negative age‐matched healthy controls (10 women, 8 men) from the prospective ActiGliA (Activity of Cerebral Networks, Amyloid and Microglia in Aging and Alzheimer's Disease) study. All participants underwent microglial activation positron emission tomography (PET) with the third‐generation mitochondrial 18 kDa translocator protein (TSPO) ligand [ 18 F]GE‐180 and magnetic resonance imaging (MRI) to measure resting‐state functional and structural connectivity. Results We found that inter‐regional covariance in TSPO‐PET and standardized uptake value ratio was preferentially distributed along functionally highly connected brain regions, with MRI structural connectivity showing a weaker association with microglial activation. AD patients showed increased TSPO‐PET tracer uptake bilaterally in the anterior medial temporal lobe compared to controls, and higher TSPO‐PET uptake was associated with cognitive impairment and dementia severity in a disease stage‐dependent manner. Interpretation Microglial activation distributes preferentially along highly connected brain regions, similar to tau pathology. These findings support the important role of microglia in neurodegeneration, and we speculate that pathology spreads throughout the brain along vulnerable connectivity pathways. ANN NEUROL 2022;92:768–781
    Materialart: Online-Ressource
    ISSN: 0364-5134 , 1531-8249
    URL: Issue
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2022
    ZDB Id: 2037912-2
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 8
    In: Nature Communications, Springer Science and Business Media LLC, Vol. 13, No. 1 ( 2022-03-15)
    Kurzfassung: Tau pathology is the main driver of neuronal dysfunction in 4-repeat tauopathies, including cortico-basal degeneration and progressive supranuclear palsy. Tau is assumed to spread prion-like across connected neurons, but the mechanisms of tau propagation are largely elusive in 4-repeat tauopathies, characterized not only by neuronal but also by astroglial and oligodendroglial tau accumulation. Here, we assess whether connectivity is associated with 4R-tau deposition patterns by combining resting-state fMRI connectomics with both 2 nd generation 18 F-PI-2620 tau-PET in 46 patients with clinically diagnosed 4-repeat tauopathies and post-mortem cell-type-specific regional tau assessments from two independent progressive supranuclear palsy patient samples ( n  = 97 and n  = 96). We find that inter-regional connectivity is associated with higher inter-regional correlation of both tau-PET and post-mortem tau levels in 4-repeat tauopathies. In regional cell-type specific post-mortem tau assessments, this association is stronger for neuronal than for astroglial or oligodendroglial tau, suggesting that connectivity is primarily associated with neuronal tau accumulation. Using tau-PET we find further that patient-level tau patterns are associated with the connectivity of subcortical tau epicenters. Together, the current study provides combined in vivo tau-PET and histopathological evidence that brain connectivity is associated with tau deposition patterns in 4-repeat tauopathies.
    Materialart: Online-Ressource
    ISSN: 2041-1723
    Sprache: Englisch
    Verlag: Springer Science and Business Media LLC
    Publikationsdatum: 2022
    ZDB Id: 2553671-0
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 9
    In: Movement Disorders, Wiley, Vol. 36, No. 9 ( 2021-09), p. 2104-2115
    Kurzfassung: Corticobasal syndrome is associated with cerebral protein aggregates composed of 4‐repeat (~50% of cases) or mixed 3‐repeat/4‐repeat tau isoforms (~25% of cases) or nontauopathies (~25% of cases). Objectives The aim of this single‐center study was to investigate the diagnostic value of the tau PET‐ligand [ 18 F]PI‐2620 in patients with corticobasal syndrome. Methods Forty‐five patients (71.5 ± 7.6 years) with corticobasal syndrome and 14 age‐matched healthy controls underwent [ 18 F]PI‐2620‐PET. Beta‐amyloid status was determined by cerebral β‐amyloid PET and/or CSF analysis. Subcortical and cortical [ 18 F]PI‐2620 binding was quantitatively and visually compared between β‐amyloid‐positive and ‐negative patients and controls. Regional [ 18 F]PI‐2620 binding was correlated with clinical and demographic data. Results Twenty‐four percent (11 of 45) were β‐amyloid‐positive. Significantly elevated [ 18 F]PI‐2620 distribution volume ratios were observed in both β‐amyloid‐positive and β‐amyloid‐negative patients versus controls in the dorsolateral prefrontal cortex and basal ganglia. Cortical [ 18 F]PI‐2620 PET positivity was distinctly higher in β‐amyloid‐positive compared with β‐amyloid‐negative patients with pronounced involvement of the dorsolateral prefrontal cortex. Semiquantitative analysis of [ 18 F]PI‐2620 PET revealed a sensitivity of 91% for β‐amyloid‐positive and of 65% for β‐amyloid‐negative cases, which is in excellent agreement with prior clinicopathological data. Regardless of β‐amyloid status, hemispheric lateralization of [ 18 F]PI‐2620 signal reflected contralateral predominance of clinical disease severity. Conclusions Our data indicate a value of [ 18 F]PI‐2620 for evaluating corticobasal syndrome, providing quantitatively and regionally distinct signals in β‐amyloid‐positive as well as β‐amyloid‐negative corticobasal syndrome. In corticobasal syndrome, [ 18 F]PI‐2620 may potentially serve for a differential diagnosis and for monitoring disease progression. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
    Materialart: Online-Ressource
    ISSN: 0885-3185 , 1531-8257
    URL: Issue
    RVK:
    Sprache: Englisch
    Verlag: Wiley
    Publikationsdatum: 2021
    ZDB Id: 2041249-6
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 10
    In: Frontiers in Aging Neuroscience, Frontiers Media SA, Vol. 13 ( 2022-2-3)
    Kurzfassung: This is a cross-sectional study to evaluate whether β-amyloid-(Aβ)-PET positivity and cortical superficial siderosis (cSS) in patients with cerebral amyloid angiopathy (CAA) are regionally colocalized. Methods Ten patients with probable or possible CAA (73.3 ± 10.9 years, 40% women) underwent MRI examination with a gradient-echo-T2*-weighted-imaging sequence to detect cSS and 18 F-florbetaben PET examination to detect fibrillar Aβ. In all cortical regions of the Hammers Atlas, cSS positivity (MRI: ITK-SNAP segmentation) and Aβ-PET positivity (PET: ≥ mean value + 2 standard deviations of 14 healthy controls) were defined. Regional agreement of cSS- and Aβ-PET positivity was evaluated. Aβ-PET quantification was compared between cSS-positive and corresponding contralateral cSS-negative atlas regions. Furthermore, the Aβ-PET quantification of cSS-positive regions was evaluated in voxels close to cSS and in direct cSS voxels. Results cSS- and Aβ-PET positivity did not indicate similarity of their regional patterns, despite a minor association between the frequency of Aβ-positive patients and the frequency of cSS-positive patients within individual regions ( r s = 0.277, p = 0.032). However, this association was driven by temporal regions lacking cSS- and Aβ-PET positivity. When analyzing all composite brain regions, Aβ-PET values in regions close to cSS were significantly higher than in regions directly affected with cSS ( p & lt; 0.0001). However, Aβ-PET values in regions close to cSS were not different when compared to corresponding contralateral cSS-negative regions ( p = 0.603). Conclusion In this cross-sectional study, cSS and Aβ-PET positivity did not show regional association in patients with CAA and deserve further exploitation in longitudinal designs. In clinical routine, a specific cross-sectional evaluation of Aβ-PET in cSS-positive regions is probably not useful for visual reading of Aβ-PETs in patients with CAA.
    Materialart: Online-Ressource
    ISSN: 1663-4365
    Sprache: Unbekannt
    Verlag: Frontiers Media SA
    Publikationsdatum: 2022
    ZDB Id: 2558898-9
    Standort Signatur Einschränkungen Verfügbarkeit
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