With the intensification of population aging in China, neurodegenerative diseases have significantly impacted the health of the elderly population. Parkinson's disease (PD) is the second most common neurodegenerative disorder. In recent years, the incidence and prevalence of PD in China have shown an upward trend, imposing a substantial burden on patients, their families and sciety. To optimize the PD prevention and treatment system, Renji Hospital, Shanghai Jiao Tong University School of Medicine has led an initiative involving experts from various authoritative institutions (School of Public Health, Shanghai Jiao Tong University School of Medicine; School of Public Health, Fudan University; Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; West China Hospital, Sichuan University; Department of Neurology, First Affiliated Hospital of Anhui Medical University) to jointly compile the China Parkinson's Disease Report, 2025. This report presents epidemiological data on PD in China, provides an in-depth analysis of the latest economic burden of PD, and comprehensively assesses the current state of PD diagnosis and treatment services as well as the allocation of public health resources in China. The report aims to offer scientific technical guidance and robust data support for PD diagnosis and treatment, while providing professional insights to support government and relevant departments in formulating targeted health policies and interventions. It also seeks to establish a platform for academic exchange and collaboration in this field both domestically and internationally. Through the dissemination and application of this report, it is expected to not only provide a valuable reference for professionals, but also raise public awareness of PD.

Neurological disorders such as stroke and Parkinson's disease often lead to postural control and balance dysfunction. Traditional neuromodulation techniques primarily target the cerebral cortex, while research on modulation techniques and mechanisms involving the cerebellum and other neural circuits for postural control remains insufficient. Neuromodulation based on the theory of central pathways and posture control (CPPC) integrates sensory inputs including visual, vestibular and proprioceptive with multi-level neural pathways (e.g. medial and lateral motor systems), in combined with neuroplasticity mechanisms, to provide precise interventions for motor dysfunction. CPPC approach employs multimodal approaches, including transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and repetitive peripheral magnetic stimulation (rPMS). It adheres to 4 principles, which are internal and external synergy, proximal-distal integration, multi-dimensional reconstruction and compliance with physiological principles. By targeting the cerebellum, core muscle groups and cortico-spinal pathways, CPPC-based neuromodulation techniques have demonstrated significant improvements in patients' balance and motor function. Clinical studies have shown that CPPC approach enhances neural remodeling and functional recovery through centralperipheral synergistic intervention and temporal coordination strategies. Future research should explore individualized target localization, dose-response relationships and mechanism of multimodal integration to improve the establishment of precision rehabilitation systems. CPPC approach provides new ideas for neurological rehabilitation and has significant implications on both clinical treatment and research.

Parkinson's disease (PD) is a common neurodegenerative disease that severely impacts patients' quality of life. The diagnostic and therapeutic techniques for PD are improving due to the continuous advancement in medicine. This review summaries recent clinical research achievements in both traditional Chinese medicine (TCM) and western medicine, as well as our team's clinical experiences, proposing that an integrated TCM and western medicine treatment approach is the optimal strategy for enhancing PD therapeutic outcomes and improving patients' quality of life. The integrated TCM and western medicine in the treatment of PD, including the Chinese herbal medicine, acupuncture and traditional physical therapy, has unique advantages in the management of the whole course of PD, especially TCM plays an important role in early intervention, reducing the amount of western medicine and adverse reactions, improving non-movement symptoms, delaying the progress of the disease, and improving the quality of patients' life.

Alzheimer's disease (AD) is a common neurodegenerative disease. With the aging of the global population, the number of patients with AD is constantly increasing, bringing heavy burdens to the patients, families and society. The early and accurate diagnosis of AD has always been a hot and difficult issue. In recent years, with the advancement of scientific research, there have been significant achievements in the study of imaging and biofluid biomarkers of AD, such as the new breakthroughs in PET imaging technology in detecting amyloid and Tau protein deposition in the brain, and the discovery and application of blood biomarkers among biofluid biomarkers. In 2024, The National Institute on Aging and Alzheimer's Association (NIA-AA) updated the diagnostic and staging guidelines for AD, namely the Revised Criteria for Diagnosis and Staging of Alzheimer's Disease (2024). This paper aims to interpret the guidelines and review the progress in the diagnosis and staging of AD, providing more accurate diagnostic basis for clinicians and helping researchers to further explore the pathogenesis of AD.

Schizophrenia is a chronic and severe mental disorder that often occurs in adolescence or early adulthood, with a lifetime prevalence of 1%. More than half of patients experience mental disabilities, which have varying degrees of impact on themselves, their families, and society. Cognitive impairment is one of the core symptoms of schizophrenia and an important cause of mental disability, which has adverse effects on the daily functioning and overall clinical outcomes of schizophrenia patients. In recent years, cognitive impairment has become a research hot spot in the field of schizophrenia. More and more evidences suggest that cognitive impairment already exists in patients' childhood and continues to affect their condition and social functioning. Most treatment interventions for cognitive impairment in schizophrenia, including the use of medication and non-medication therapies, have varying effects and lack precise and effective intervention methods. In this article, we provide a descriptive review of the treatment measures for cognitive impairment in schizophrenia and offer some suggestions on how future work can improve cognitive dysfunction in schizophrenia.

Epilepsy is a recurrent chronic brain disease with a variety of different pathological mechanisms and clinical manifestations. Epilepsy is one of the most common brain diseases which has the characteristics of repeatability, complexity, suddenness and long course. The incidence rate of epilepsy is relatively high in infant stage and elderly stage. The traditional Chinese medicine characteristic therapy has significant advantages in the treatment of epilepsy by adjusting the function of viscera and the operation of qi and blood in meridians, based on the holistic concept, the principle of syndrome differentiation and treatment, the theory of viscera and the theory of meridians. This article summarizes and analyzes the research progress of traditional Chinese medicine characteristic therapies for epilepsy, such as acupuncture, bloodletting, massage, auricular point pressing, and acupoint catgut embedding. We show the effect of traditional Chinese medicine characteristic therapy on patients.We aim to provide patients with better treatment and rehabilitation protection.

In 2022, the International Cerebral Amyloid Angiopathy Association published the Boston criteria version 2.0 for cerebral amyloid angiopathy: a multicentre, retrospective, MRIneuropathology diagnostic accuracy study. This updated version has made significant revisions, including lowering the minimum age for diagnosing cerebral amyloid angiopathy, adding symptoms such as convexal subarachnoid hemorrhage, transient focal neurological episodes, and cognitive impairment/dementia, and incorporating multiple hemorrhagic and non-hemorrhagic imaging biomarkers. Compared with previous diagnostic versions, this latest version of the criteria demonstrates significantly improved diagnostic sensitivity, particularly in patients with symptomatic intracerebral hemorrhage. Therefore, this paper aims to summarize the Boston criteria version 2.0 for cerebral amyloid angiopathy with evidence from China Brain Bank and the clinical practice experience of our team as references for domestic peers.

Objective: To investigate the clinical effectiveness and safety of lecanemab in patients with early-onset Alzheimer's disease (EOAD), thereby providing a reference for the clinical application of disease-modifying treatment (DMT).

Methods: The diagnosis and treatment process of a 54-year-old male patient with EOAD were reported, and the disease modifying effect of lecanemab was analyzed based on clinical manifestations, imaging features, treatment response and relevant literature.

Results: After receiving traditional anti-dementia drug treatment, the patient initiated treatment with lecanemab (10 mg/kg body weight, once every 2 weeks) and was followed up for 9 months. Before treatment, the Mini-mental State Examination (MMSE) scale score was 20, Montreal Cognitive Assessment (MoCA) scale score was 12, amyloid β-protein (Aβ)- PET showed a standardized uptake value ratio (SUVR) of 1.325 (positive), and the Centiloid value was 51.073. After 9 months of treatment, β -PET indicated a reduction in SUVR to 1.015 (below the negative threshold of 1.10) and a decrease of 55.688 units in Centiloid value; Tau-PET showed no further progression of pathological deposits. Clinical assessments revealed improvement of 1 point in MMSE score (to 21 points), and stable scores in MoCA and Boston Naming Test (BNT). No adverse effects, such as cerebral microhemorrhages or edema, were observed during treatment.

Conclusion: This case report shows that lecanemab can effectively clear the deposition of Aβ in the brain, delay the pathological progression of Tau protein, improve the function in the patient with EOAD, and has good safety. This case provides clinical evidence for early DMT intervention in EOAD.

Post-stroke aphasia is a language function impairment caused by damage to the dominant hemisphere of the brain and is one of the common complications following a stroke. Transcranial direct current stimulation (tDCS) is an emerging non-invasive brain stimulation technique in recent years. By combining tDCS with functional imaging techniques such as functional magnetic resonance imaging (fMRI), it is possible to further clarify the recovery mechanisms of post-stroke aphasia, aiming to provide more precise and individualized treatment for subsequent patients with post-stroke aphasia. This approach has significant application prospects and clinical values in the rehabilitation of aphasia. This article integrates the latest research on tDCS for the treatment of post-stroke aphasia, intending to provide more basis for the rehabilitation of aphasia.

Amyloid-related imaging abnormalities (ARIA) are abnormal appearances on the image. In a narrow sense, the default refers specifically to abnormalities on MRI, not CT or PET. MRI findings are characteristic, including ARIA-E (edema/effusion) and ARIA-H (hemorrhage). These abnormalities occur only in patients with Alzheimer's disease (AD) and in specific disease scenarios, and are associated with β-amyloid (Aβ), which has diagnostic specificity. This article introduces the history and definition of ARIA, imaging manifestations and detection methods, severity grading of ARIA-E and ARIA-H, and clinical issues related to ARIA, in order to provide references for clinical identification and treatment of ARIA.

Objective: To systematically evaluate the value of different aspiration risk assessment tools for assessing aspiration risk in stroke patients with dysphagia.

Methods: The literatures to evaluate the risk of aspiration in stroke patients with swallowing disorders using different tools were searched from databases including CNKI, Wanfang Database, VIP, PubMed, Cochrane Library, and Web of Science from databases establishment until April 2024. The combined sensitivity, combined specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and area under the curve (AUC) of different tools for diagnosing aspiration were calculated comparing with the gold standard.

Results: A total of 17 eligible studies were included, mainly including four risk assessment tools for aspiration, namely Kubota water swallowing test (WST), standardized swallowing assessment (SSA), Toronto bedside swallowing screening test (TOR-BSST), and Gussing swallowing screen (GUSS). The Meta-analysis results showed that the combined sensitivity of WST was 0.57 (95% CI: 0.51-0.62, P＝0.006), combined specificity was 0.80 (95% CI: 0.74-0.85, P＝0.014), DOR was 5.94 (95% CI: 3.42-10.31, P＝0.153), and AUC was 0.75. The combined sensitivity of SSA was 0.87 (95% CI: 0.82-0.90, P＝0.124), combined specificity was 0.65 (95% CI: 0.59-0.71, P＝0.031), DOR was 11.88 (95% CI: 5.63-25.07, P=0.214), and AUC was 0.73. The combined sensitivity of TOR-BSST was 0.65 (95% CI: 0.56-0.74, P＝ 0.004), combined specificity was 0.70 (95% CI: 0.62-0.77, P＝0.000), DOR was 3.40 (95% CI: 2.06-5.62, P＝0.000), and AUC was 0.69. The combined sensitivity of GUSS was 0.96 (95% CI: 0.91-0.99, P＝0.425), combined specificity was 0.62 (95% CI: 0.52-0.71, P＝0.729), DOR was 34.71 (95% CI: 12.39-97.24, P＝0.893), and AUC was 0.92.

Conclusion: For the risk assessment of aspiration in stroke patients with swallowing disorders, WST, SSA, TOR-BSST and GUSS all have good diagnostic values, and GUSS has a higher comprehensive diagnostic efficiency.

Neuromyelitis optica spectrum disorder (NMOSD) is a recurrent inflammatory demyelinating disease of the central nervous system, mainly affecting the optic nerve and spinal cord, with clinical manifestations such as decreased visual acuity, dyskinesia, pain, vesico-rectal dysfunction, cognitive dysfunction, and so on. It is characterized by high recurrence rate, high disability rate and long disease duration, which seriously affects patients' quality of life. Although recent advances in diagnostic and therapeutic techniques have improved the prognosis of NMOSD patients, most patients are still left with different degrees of dysfunction, and systematic rehabilitation interventions are urgently needed. Based on the existing research evidence, this review details the common dysfunctions of NMOSD and their pathological mechanisms, including visual dysfunction, spinal cord damage-related dysfunctions (dyskinesia, pain, and vesico-rectal dysfunction), and cognitive dysfunction. Meanwhile, it focuses on the latest advances in rehabilitation therapy of NMOSD, covering multidisciplinary and integrated intervention strategies of physical therapy, occupational therapy, psychological intervention and the application of emerging technologies [e.g., brain-computer interface (BCI), brain-spinal interface (BSI), etc.], with the aim of providing a theoretical basis and practical guidance for the clinical rehabilitation practice of NMOSD patients.

Objective: To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) combined with exercise training on balance function, coordination function, walking function, and activities of daily living in patients with cerebellar ataxia.

Methods: Four patients with cerebellar ataxia were enrolled, and they received a 15-day intervention of rTMS (high-frequency 5Hz stimulation targeting the cerebellar vermis, once daily for 20 minutes per session) combined with exercise training (twice daily for 30 minutes per session). Rehabilitation assessments were conducted before and after the intervention, including muscle strength (manual muscle testing, MMT), balance function (Berg balance scale, BBS), coordination function (finger-to-nose test, alternating movement test, heel-knee-shin test), walking function (Holden functional ambulation classification, FAC), and activities of daily living (modified Barthel index, MBI).

Results: After the intervention of rTMS combined with exercise training, all four patients showed improvements in MMT grade, BBS scores and MBI scores, three patients showed improvements in FAC grades. Results of finger-to-nose test, alternating movement test, and heel-knee-shin test demonstrated significant improvements in coordination function for all patients.

Conclusion: rTMS combined with exercise training can enhance balance function, coordination function, walking function, and activities of daily living in patients with cerebellar ataxia.

Non-invasive neuromodulation techniques have attracted extensive attention due to their safety, effectiveness, and repeatability. Among them, transcranial focused ultrasound stimulation (tFUS), as an emerging regulatory method, has shown clinical potential in the treatment of mental illnesses by virtue of its advantages such as non-invasiveness, high spatial resolution, and ability to target deep brain regions. This article summarizes the biophysical mechanisms of tFUS, as well as the regulatory targets, effects, and research progress of tFUS in various mental illnesses including depression, obsessive-compulsive disorder, substance abuse, anxiety disorder, and schizophrenia. It also discusses the main problems existing at the current stage, such as the lack of clinical studies, small-sample exploratory trials, incomplete clarification of mechanisms, and the lack of standardized parameters. In addition, it looks forward to its future development directions: Conducting large-sample, multi-center randomized controlled trials, integrating neuroimaging and other technologies, promoting its transformation into a precise and standardized treatment method so as to provide a theoretical basis and practical reference for the clinical transformation of tFUS in the treatment of mental disorders.

Elderly patients with cognitive impairment face a series of safety incidents, which not only affect their quality of life, but also pose potential risks to their families and society. Current research primarily focuses on safety issues in medical settings, such as falls, choking,wandering, medication safety, and violent behaviors, while there is relatively less attention given to risks associated with household fires, abuse, property safety, and driving safety. The assessment of safety incidents mainly relies on subjective evaluation tools, while objective assessment tools still need further development. There is insufficient evidence for nursing interventions targeting different degrees or settings of cognitive impairment. This paper reviews the research progress on the incidence rate, influencing factors, subjective and objective evaluation tools, and evidence-based nursing measures of the safety incidents, in order to provide guidance for medical providers to carry out safety management of elderly patients with cognitive impairment and continuously improve the management of safety care.

Stroke is characterized by high incidence, high mortality, and high disability rates. A series of functional impairments caused by stroke are the primary reasons for patient disability, making stroke rehabilitation a research hotspot in cerebrovascular disease recovery. The pathogenesis is characterized by underlying deficiency and manifesting excess, The occurrence of stroke is closely related to microcirculatory disorders and abnormal energy metabolism, while traditional Chinese medicine theory attributes its pathogenesis to “deficiency in origin and excess in manifestation”. For patients with ischemic stroke (IS) of the “qi deficiency and blood stasis”, rehabilitation strategies primarily focus on restoring neurological function, regulating neural reflexes, and promoting brain functional remodeling. Both traditional Chinese medicine and western medicine have shown favorable clinical efficacy in treating IS patients. Western medicine focusing on reperfusion after ischemia. However, its clinical outcomes are limited by the “no reflow” phenomenon after revascularization and controversies surrounding the efficacy of neuroprotective agents. Traditional Chinese medicine demonstrates unique advantages through tonifying qi and activating blood circulation, regulating gut microbiota-brain axis, and other holistic interventions. This article primarily discusses the clinical approaches for the synergistic intervention of traditional Chinese medicine and western medicine in “qi deficiency and blood stasis” type IS, systematically reviews the mechanisms and clinical evidences of both treatments, and explores synergistic enhancement pathways of them. By integrating clinical trials, basic research, and guideline consensus from the past five years, this review aims to provide new ideas and methods for the integrated traditional Chinese and western medicine therapy of “qi deficiency and blood stasis” type IS. It also seeks to offer a scientific basis for optimizing individualized treatment plans and advancing the internationalization of the integration traditional Chinese and western medicine.

Object: To improve the understanding of osmotic demyelination syndrome (ODS) after coronavirus disease 2019 (COVID-19) infection.

Method: The clinical manifestations and imaging features of 4 patients with ODS after COVID-19 infection were retrospectively described, and the related literatures were reviewed and analyzed.

Results: All 4 patients suffered from severe hyponatremia and overcorrection after COVID19 infection, with clinical manifestations including fever, vomiting, disturbance of consciousness, convulsions and movement disorders. No abnormalities were found in head MRI examination the early stage of the disease, and extrapontine lesions with or without pontine involvement appeared after 2-3 weeks. The patients were treated with gammaglobulin, steroids and plasmapheresis. Two patients achieved favorable outcomes, while the other two had poor prognoses.

Conclusion: Patients with COVID-19 infection are at high risk of ODS, which may be related to overly rapid sodium supplementation within 24 hours in the context of pre-existing hyponatremia. Other contributing factors include hypertension and hypovolemia induced by diuretic use. Close monitoring of serum sodium levels is essential during sodium supplementation. If the patient exhibits symptoms such as altered consciousness or head MRI suggests lesions involving the cortex, more aggressive immunotherapy and appropriate nursing measures should be taken.

There is a lot of confusion and misunderstanding in the terms for functional neurological disorders, functional neurosurgery and functional neurology (similar to chiropractic neurology) in daily academic and clinical situations. Functional neurological disorders represent a specific type of disease, where "functional" refers to the nature of the disease; functional neurosurgery is an emerging branch of neurosurgery, where "functional" refers to the restoration of function as a result of neurosurgical intervention; functional neurology is a branch of alternative medicine that integrates the theories of chiropractic neurology, rehabilitation, neurology, acupuncture and other disciplines.

The diagnosis of mental disorders relies predominantly on a symptom-based descriptive diagnostic system currently, lacking reliable biomarkers and golden standards. The diagnostic method restricts the accuracy of disease diagnosis to a large extent. Traditional psychiatric diagnosis is based on medical history and mental examination. The difficulties in diagnosis include subjective judgment on disorders, lacking of multi-dimensional perspectives, and deficits in the diagnostic holism. During the psychiatric diagnosis, we should integrate syndrome clusters features, functional impairment, and illness background; We can utilize the auxiliary examinations to enhance diagnostic accuracy. Based on the efforts above, it can promote comprehensive advancements in psychiatric diagnosis, treatment, and clinical research.

Objective: To explore the effect of mirror therapy on patients with dysphagia in the poststroke pharyngeal phase under embodied cognition theory.

Methods: 40 patients with pharyngeal dysphagia after stroke were randomly divided into 2 groups according to random number table method, with 20 cases in each group. There were no statistically significant differences in gender, age, stroke type, and disease duration ratio. Each group received routine swallowing treatment, and each group received different intervention training on the basis of routine. The control group received static mirror therapy, and the observation group received dynamic mirror therapy. The swallowing function of the patients was evaluated by the Fujijima swallowing efficacy evaluation scale, the Kubota water swallowing test (WST), and the video fluoroscopic swallowing study (VFSS) before and after treatment, and the total effective rate was compared by WST grading.

Results: After treatment, the scores of Fujijima swallowing efficacy evaluation scale and VFSS in 2 groups were significantly improved compared with those before treatment (P values <0.001), and the observation group was significantly improved compared with the control group (P values of 0.020 and <0.001, respectively). After treatment, the WST grade score of the two groups decreased, and the decrease of the observation group was more obvious than that of the control group, the difference was statistically significant (P＝0.044). After treatment, the comprehensive effective rate of the 2 groups was significantly different (P＝0.045).

Conclusion: Both dynamic mirror therapy and static mirror therapy can improve the swallowing function of patients with pharyngeal dysphagia after stroke, and the therapeutic effect of dynamic mirror therapy based on embodied cognition theory is superior to static mirror therapy.

Objective: To clarify the effect of comprehensive rehabilitation treatment on the improvement of the activities of daily living (ADL) of stroke patients during a single hospitalization period, and to explore the influencing factors of the improvement of ADL at the time of discharge.

Methods: This study was a retrospective study. A total of 320 stroke patients with hemiplegia admitted to the Rehabilitation Medicine Center of The First Affiliated Hospital of Nanjing Medical University, from January 2022 to December 2024 were selected as the research objects. Descriptive statistical analysis was used to analyze the improvement of ADL of stroke patients at the time of discharge. The patients were grouped according to the minimal clinically important difference (MCID), which was defined as an increase of more than 10 points in the Barthel index (BI). Univariate and multivariate analyses were used to screen the influencing factors of ADL improvement.

Results: The comprehensive rehabilitation treatment during a single hospitalization period increased the average BI score of the patients by 12.86 points. Univariate analysis showed that the course of disease, BI score at admission, standing balance, walking ability, cognitive impairment, and emotional disorder were significantly correlated with ADL improvement (P<0.05). Multivariate Logistic regression analysis indicated that the course of disease (OR＝ 0.996, P＝0.041), concurrent hypertension (OR＝0.558, P＝0.050), and walking function (OR＝0.716, P＝0.000) were independent predictive factors for ADL improvement.

Conclusion: Comprehensive rehabilitation therapy during a single hospitalization cycle resulted in clinically significant improvement in ADL in 45.9% of stroke patients. The course of disease, concurrent hypertension, and walking function at admission might be the main factors affecting the improvement of ADL. Early intervention of rehabilitation, prevention and management of underlying diseases, and the formulation of appropriate rehabilitation goals would help improve the patients' ability of ADL and further enhance their quality of life.

This article reviews the discovery process and pathophysiological mechanisms of a distinctive neuroimaging feature known as the hot cross bun (HCB) sign, through reporting a patient with HCB sign in the pontine on MRI image and who was ultimately diagnosed as multiple system atrophy-cerebellar subtype (MSA-C). Then the association of HCB sign with various neurological diseases and its significance in differential diagnosis and treatment have been discussed.

In recent years, with the rapid development of interdisciplinary medicine and engineering, neuroregulation techniques have achieved unprecedented advancements. Among these innovations, non-invasive neuroregulation techniques, a form of non-invasive brain stimulation, characterized by high safety, good tolerance, favorable cost-effectiveness and simple operation, have been widely used in clinical practice. Although traditional electroconvulsive therapy (ECT) demonstrates well-established efficacy, its application is significantly limited by a tendency to induce whole-brain discharges and frequent association with notable cognitive side effects. In contrast, other non-invasive neuromodulation techniques, such as transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS), commonly face challenges including limited stimulation depth, difficulties in individualized implementation and suboptimal therapeutic outcomes. However, a novel non-invasive neuromodulation technique—temporal interference stimulation (TIS), holds promise for overcoming these limitations. Based on the biophysical mechanism of generating low-frequency envelope waves through cross-high-frequency electric fields, TIS achievies precise regulation of deep brain regions through non-vector integration, demonstrating potential to emerge as a mainstream clinical treatment for mental diseases.

Current technological advances in clinical and research fields have enabled people to have a deeper and comprehensive understanding of Alzheimer's disease (AD). β -Amyloid (Aβ) is the core biomarker of AD. Aβ-PET can objectively detect the abnormal Aβ deposition and distribution in the brain, and can be widely used in the early accurate diagnosis and therapeutic evaluation of AD. This article elaborates on the detection methods and advantages and disadvantages of AD biomarkers, with a focus on the application and value of Aβ-PET in the diagnosis and treatment of AD.

Objective: To explore the characteristics of P300 event-related potential in children with autism spectrum disorders (ASD) of different severity levels and to analyze the correlation between its latency or amplitude and the severity of ASD.

Methods: The study included 100 children with ASD who visited the Shenzhen Luohu District Maternal and Child Health Hospital from October 2022 to October 2023. Children with ASD were divided into 2 groups (mild to moderate group and severe group) according to the scoring results of the Childhood Autism Rating Scale (CARS). We compared the characteristics of P300 event-related potential latency and amplitude at midline sites (Fz, Cz and Pz) between the two groups. We explored the relationship between latency or amplitude and the severity of ASD in children.

Results: The study included a total of 100 children with ASD, including 59 in the mild to moderate group and 41 in the severe group. There was no statistically significant difference in age, gender, family history, and medication treatment history between the two groups. (P>0.05). Factors such as the latency of P300 at the Fz, Cz, and Pz midline loci (P values of <0.001, 0.008, and 0.004, respectively) and the amplitude of P300 at the Cz and Pz midline loci (P values of <0.001 and 0.004, respectively) were statistically significant between the two groups according to the univariate logistic analysis. The latency value of Fz locus P300 might be a risk factor for the severity of ASD [OR＝1.018 (95% CI: 1.008-1.028), P<0.001], while the amplitude value of Cz locus P300 might be a protective factor for the severity of ASD [OR＝0.505 (95% CI: 0.352-0.726), P<0.001] based on the multiple logistic regression analysis. The P300 latency values of various midline loci in ASD children were positively correlated with CARS scores (all P<0.01), and the P300 amplitude values of Cz and Pz midline loci in ASD children were negatively correlated with CARS scores (all P<0.001) according to the correlation analysis of CARS scores of enrolled ASD children.

Conclusion: There are significant differences in the expression of P300 event-related potential in children with ASD of different severity levels. Children with ASD of higher severity have lower P300 latency at each midline locus, and lower P300 amplitude at Cz and Pz midline loci; The latency value of Fz locus P300 may be a risk factor for the severity of ASD, while the amplitude value of Cz locus P300 may be a protective factor for the severity of ASD. The latency and amplitude detection of P300 event-related potential can provide an objective neurophysiological basis for evaluating the severity of ASD in children.

Schizophrenia is a severe mental illness, with patients exhibiting an average lifespan reduction of 10-15 years compared to the general population. The main causes of death in schizophrenia patients include cardiovascular disease, suicide, and accidental injury. As a non-invasive examination method, fundus photography can effectively assess microvascular lesions, thereby predicting the risk of cardiovascular disease. Given that cardiovascular disease is a common comorbidity in schizophrenia patients and is closely related to their high mortality rate, the application of fundus photography in schizophrenia patients not only facilitates early identification of potential cardiovascular problems, but also provides important reference for predicting the patient's life expectancy. Consequently, non-invasive fundus photography holds promise for enhancing monitoring approaches and treatment strategies for schizophrenia patients, ultimately contributing to extended lifespan.

The "using disease-modifying treatments in multiple sclerosis: Association of British Neurologists (ABN) 2024 guidance" (hereinafter referred to as the 2024 ABN guideline) introduces significant updates to treatment strategies for multiple sclerosis (MS). The guideline emphasizes that MS should be considered a single disease characterized by both relapsing and progressive components, with mechanism of dynamic coexistence of inflammation and neurodegeneration. For the first time, the guideline adopts a comprehensive management approach termed "treatment-monitoring-transition", categorizing disease-modifying treatment (DMT) drugs into four groups including medium/high-efficacy treatments for relapsing-remitting MS and specific medications for progressive MS. The guideline also compares the advantages and disadvantages of advanced treatment versus early high-efficacy treatment, recommending that patients with high disease activity prioritize early high-efficacy interventions. Additionally, special attention is given to medication considerations for pregnant women. This article provides an interpretation of the full-cycle management approach for DMT and decision-making for specific patient populations in clinical practice, in alignment with the 2024 ABN guideline.

Objective: To report the clinical features, diagnostic process, and treatment strategy of a patient with posterior cortical atrophy (PCA), and to enhance the awareness of peers on this subject through a literature review.

Methods: We analyzed the clinical data of a PCA patient and summaried the literature on the clinical characteristics, diagnostic methods, differential diagnosis, and treatment strategies of the disease.

Results: A 67-year-old male patient presented with a chief complaint of memory decline for over 3 years. The clinical manifestations included progressive visuospatial deficits, visual perceptual impairments, and Gerstmanns syndrome. The neuropsychological assessment of the patient revealed there's a global fluctuating cognitive decline accompanied by relatively preserved early memory. Brain MRI of the patient showed the atrophy in the parietal, occipital, and temporal lobes, among which the parietal lobe being most prominently affected. The analysis of cerebrospinal fluid(CSF) demonstrated the Aβ1-42/Aβ1-40 ratio decreased and the phosphorylated Tau protein (181) increased in the patient's CSF. Overall, the patient was diagnosed with Alzheimer's disease-related posterior cortical atrophy. Treatment strategies of this patient included applying acetylcholinesterase inhibitors and Nmethyl-D-aspartate receptor antagonists.

Conclusion: PCA is a neurodegenerative disorder primarily characterized by visual and spatial cognitive impairments. Its unique clinical presentation makes it prone to misdiagnosis or underdiagnosis. Improving awareness of PCA and combining clinical manifestations, neuropsychological assessments, imaging studies, and biomarker detection can facilitate early diagnosis and intervention.

Objective: To investigate the predictive value of neutrophil to lymphocyte ratio (NLR) combined with hematoma imaging features for delayed perihematoma edema (dPHE) after spontaneous basal ganglia hemorrhage.

Methods: Retrospective inclusion of patients with spontaneous basal ganglia hemorrhage admitted to the neurology department of Jinhua Hospital affiliated to Zhejiang University School of Medicine (Jinhua Municipal Central Hospital) from January 2017 to December 2023. We compared clinical data between the dPHE group and no-dPHE group based on the univariate analysis and multivariate binary logistic regression analysis. We identified the independent influencing factors of dPHE, and evaluated the predictive value of the model for dPHE using receiver operating characteristic (ROC).

Results: A total of 372 patients were included in this study, including 115 in the dPHE group and 257 in the no-dPHE group. Univariate analysis showed that the baseline National Institutes of Health Stroke Scale (NIHSS) score, baseline hematoma volume, high-sensitivity Creactive protein, lymphocyte count, NLR, blend sign, lateral hematoma, and high-dose mannitol proportion in the dPHE group were significantly higher than those in the non-dPHE group (P<0.05). Moreover, the NIHSS score and hospitalization expenses in the dPHE group were higher than those in the no-dPHE group (P<0.05), and their hospitalization time was also longer in the dPHE group (P<0.05). Furthermore, the multivariate logistic regression analysis revealed that NLR [odds ratio (OR) ＝1.138 (95% CI: 1.056-1.227); P＝0.001], baseline hematoma volume [OR＝1.187 (95% CI: 1.132-1.246); P<0.001] and lateral hematoma [OR＝3.067 (95% CI: 1.611-5.838); P＝0.001] were independent predictive factors of dPHE. ROC analysis showed that the area under the curve of the model was 0.810 (95% CI: 0.765-0.856).

Conclusion: The higher the baseline NLR, the larger the hematoma volume, and patients with lateral basal ganglia hemorrhage are more susceptible to dPHE.

Objective: To design and produce a type of medical restraint gloves with rehabilitation function for use in patients with post-stroke hemiplegia and catheterization, and evaluate its limb restraint protection effect and assisted rehabilitation ability.

Methods: 70 stroke patients with hemiplegia and catheterization who were admitted to the department of neurology in the Second Affiliated Hospital of Fujian Medical University from April 1, 2023 to January 12, 2024 and met the inclusion and exclusion criteria were selected as the study subjects. They were randomly divided into an observation group and a control group, with 35 patients in each group. The observation group used medical restraint gloves with rehabilitation function for protective restraint, while the control group used traditional restraint belts. Both groups of patients underwent 14 days of early limb exercise and observation. The neurology physical restraint checklist and Brunnstrom recovery stage were used to evaluate the skin integrity, fingertip blood flow, paralyzed upper limb movement ability, and unplanned extubation of the patient's restraint site.

Results: There was no statistically significant difference in stroke type, age, gender, educat on level, marital status, medical insurance payment method, number of strokes, catheterization status, and paralyzed limb condition between the 2 groups of patients. During the 14 day intervention and observation period, the proportion of skin integrity at the constraint site in the observation group was higher than that in the control group (P＝0.032), the proportion of patients with good fingertip blood flow at the constraint site in the observation group was higher than that in the control group (P＝0.003), and the improvement of upper limb motor ability on the paralyzed side in the observation group was higher than that in the control group (P<0.001), with statistically significant differences. There was no statistically significant difference in the unplanned extubation rate between the observation group and the control group (P＝0.112).

Conclusion: Medical restraint gloves with rehabilitation function can better protect and restrain patients with limb hemiplegia and catheterization after stroke, and have a certain improvement effect on the motor function of the paralyzed upper limb, promoting early limb rehabilitation of stroke patients.

Objective: To investigate the effects of aerobic exercise on clinical symptoms and gut microbiota in Parkinson’s disease (PD) patients of different age groups.

Methods: This study included 21 PD patients, divided into age groups of <60 years and ≥60 years, and underwent an 8-week moderate intensity aerobic exercise intervention. Assess patients with relevant scales before and after intervention, and collect their feces for 16S ribosomal RNA amplicon sequencing and statistical analysis.

Results: Only UPDRS-III on-off and total scores showed statistically significant improvement in <60 years old PD patients after aerobic exercise intervention (P＝0.042, P＝ 0.021); UPDRS-II, UPDRS-III on, UPDRS-III off, UPDRS total scores, Berg Balance Scale (BBS) and Tinetti Performance Oriented Mobility Assessment (Tinetti POMA) improved in ≥60 years old PD patients (the P values were 0.029, <0.001, 0.025, <0.001, 0.008 and 0.023 respectively). In addition, after aerobic exercise intervention, the Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), PD Questionnaire 39 (PDQ- 39), Rapid Eye Movement Sleep Behavior Disorder Screening Questionnaire (RBDSQ), Scales for Outcomes in PD Autonomous (SCOPA-AUT), Gastrointestinal Dysfunction Score (Gastrointestinal Dysfunction Score), Gastrointestinal Dysfunction Score (GIDS), Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD) and Non Motor Symptoms Scale (NMSS) scores were improved in ≥60 years old PD patients (P values were 0.002, 0.006, 0.002, 0.016, 0.007, 0.029, 0.002, 0.008, and 0.003, respectively). The NMSS score of PD patients in the <60 age group improved and the difference was statistically significant (P＝0.044) after intervention. Gut microbiota analysis revealed the relative abundance of Fusicatenibacter and Erysipelotrichaceae_UCG-003 were increased in the PD group aged <60 years after aerobic exercise intervention, and the difference was statistically significant compared with the pre-intervention period (Z values were －2.201 and －2.207, and P values were 0.028 and 0.027, respectively).

Conclusion: Moderate-intensity aerobic exercise can improve motor symptoms as well as non-motor symptoms such as cognition, quality of life, sleep, autonomic function, anxiety and depression in PD patients of different age groups. Notably, moderate-intensity aerobic exercise can improve the relative abundance of beneficial gut microbiota, particularly in <60 years old patients .

Calligraphy training, a traditional cultural activity with a 3 000-year history, has recently been demonstrated to positively impact multiple cognitive functions in individuals with cognitive impairment. Research indicates that calligraphy training can enhance cognitive functions. Potential mechanisms through which calligraphy training influence cognitive function include functional reinforcement of the default mode network, co-activation of the visuomotor integration network, involvement of the frontoparietal executive control network, and modulation of neurotransmitter systems and molecular mechanisms underlying neural plasticity. Although existing studies provide preliminary evidence supporting the positive effects of calligraphy training on cognitive function in individuals with cognitive impairment, limitations persist, including small sample sizes, short intervention durations, and a lack of randomized controlled trials. Future research necessitates expanded basic and clinical investigations, particularly evidence-based scientific clinical studies. For example, multi-modal neuroimaging techniques, such as functional MRI and magnetoencephalography, could be employed to parse the spatiotemporal dynamics of visuomotor integration during calligraphic creation. Concurrently, leveraging artificial intelligence to analyze handwriting characteristics derived from calligraphy training could facilitate the development of models correlating these features with electroencephalographic (EEG) signals. Such endeavors are crucial for a deeper exploration of the mechanistic pathways by which calligraphy training impacts cognitive function in this population, ultimately offering novel approaches and methodologies for cognitive impairment intervention.

This case reports a young woman presenting with headache and blurred vision, with imaging revealing multiple ring-enhancing micronodules diffusely distributed throughout the brain, exhibiting a starry sky pattern. The patient had a history of medication abortion 3 weeks prior. Laboratory tests showed significantly elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), strongly positive serum T-cell spot test (T-SPOT), and chest CT demonstrating miliary nodules in both lungs. Integrated with the laboratory findings and imaging features, the patient was ultimately diagnosed with miliary cerebral tuberculosis complicated by pulmonary tuberculosis. Symptoms markedly improved after antitubercular therapy. This article reviews and discusses the differential diagnostic approach to intracranial multiple ring-enhancing lesions (starry sky sign).

Objective: To investigate the efficacy of group art therapy on clinical symptoms and empathy ability in patients with first-episodic remission schizophrenia.

Methods: 60 patients with first-episode remission schizophrenia were included and randomly divided into study group and control group, with 30 patients in each group. The control group was given routine rehabilitation treatment on the basis of drug treatment, while the research group was intervened by group art therapy in addition to the drug and routine rehabilitation treatment for 15 weeks. Before and after the intervention, both groups completed the assessment of Positive And Negative Syndrome Scale (PANSS), Interpersonal Reactivity Index-C (IRI-C), and Personal and Social Performance scale (PSP).

Results: The changes in the scores of the negative symptom factor before and after the intervention in the research group was statistically significant compared with those in the control group (P < 0.001). After the intervention, the changes were superior to those in the control group in terms of the IRI-C total score, perspective taking (PT), imagination (FS), empathic concern (EC), personal distress (PD), and the total score of PSP (P < 0.05).

Conclusion: As a rehabilitation training method, group art therapy can effectively improve the empathy ability of patients with first-episode schizophrenia in remission, reduce clinical symptoms, and improve social function.

Objective: To construct an item response theory (IRT) model for functional assessment of non-acute stroke patients based on the international classification of functioning, disability and health (ICF) for functional assessment, verification of its reliability and validity, and exploration of the overall benefit index and interrelationships of functional items through graphical models (GMs).

Methods: A cross-sectional study was conducted, enrolling non-acute stroke patients admitted by the First Rehabilitation Hospital of Shanghai from July 2023 to December 2023. Assessments included the Mini-Mental State Examination (MMSE), Functional Independence Measure (FIM), Stroke Social Network Scale (SSNS), and ICF Rehabilitation Set (ICF-RS). Based on the Mokken assumption, nonparametric IRT (npIRT) was applied to the ICF-RS items through Mokken Scale Analysis (MSA), by which items suitable for a parametric IRT model (pIRM) were identified, and person-item maps were generated to compare patient's abilities with the difficulty levels of functional items. Based on Bayesian learning, the benefit values of the items and the network parameters of the functional items were estimated using the Ising model, and a maximum spanning tree was generated to visualize the distribution of functional items and the potential intervention pathways.

Results: Adhering to the maximum heterogeneity sampling, a total of 100 non-acute stroke patients (males = 70, females = 30) were included, yielding a Rasch scale containing 22 ICF items with a latent class reliability coefficient (LCRC) of 0.959. The dichotomized Rasch model scores significantly correlated strongly with FIM scores (P < 0.001, r= 0.89). The most difficult items included "b455 Exercise tolerance", "d660 Assisting others" and "d640 Doing housework". The easiest item was "d550 Eating". By integrating IRT and GM, the item "d420 Moving oneself" was identified as a functional item that, although within the patient's ability range, still presents impairments, and its improvement may serve as a "bridge" for alleviating other functional impairments. The Ising model indicated that enhancing the ability of patients in "d510 Washing oneself" would yield the greatest overall functional benefit.

Conclusion: Based on pIRM, a Rasch model with good reliability and validity can be extracted for functional assessment of patients with non-acute phase of stroke, and the application of the IRT model and Ising network analysis can customize personalized rehabilitation goals for patients.

This case reports a middle-aged male patient presented with involuntary limb tremors as the initial symptom. The patient had a history of chronic alcoholism and experienced an upper respiratory tract infection one week prior to symptom onset. Cranial MRI revealed the characteristic of "sandwich sign" in the corpus callosum. Based on the patient's clinical symptoms, physical signs, and ancillary investigations, a diagnosis of primary Marchiaffava-Bignami disease (MBD) was established. By reviewing the pathophysiological mechanism underlying this specific "sandwich sign" imaging finding, this report explores the diagnostic approach for differentiating the "sandwich sign" of the corpus callosum.

Onco-neurology is an emerging multi-disciplinary sub-specialty dedicated to the study of the indirect effects of tumors and their therapeutic processes on the nervous system. Its core lies in elucidating the complex pathophysiological mechanisms by which tumors induce neurological dysfunction through non-metastatic mechanisms. The Neurology and Oncology Departments of Renji Hospital, Shanghai Jiao Tong University School of Medicine, have accumulated extensive experience in the clinical practice of onco-neurology, providing comprehensive and personalized medical care to patients with oncological neurological complications through a multi-disciplinary collaboration model. This article, for the first time, introduces the concept of onco-neurology and elaborates on its classification, diagnosis, and treatment essentials. It aims to establish an organic intersection between oncology and neurology from an academic perspective, providing theoretical guidance and practical instructions for enhancing the efficacy of tumor treatment and reducing nervous system-related adverse effects in clinical practice, ultimately improving tumor patients' quality of life and survival outcomes.

With the acceleration of population aging and environmental changes, neurodegenerative diseases have become a research hot spot in modern medical. However, these diseases are characterized by unknown etiology, insidious onset, suboptimal treatment efficacy, and poor prognosis, which seriously impact the life quality of patients. This article explains the pathological features and clinical characteristics of neurodegenerative diseases, and presents the clinical experience and achievements in the integrated traditional Chinese and western medicine approach for the differentiation and treatment of Parkinson's disease and motor neuron disease. Consequently, a "tripartite integrated" model of traditional Chinese and western syndrome differentiation and treatment is proposed, which combines disease differentiation with syndrome differentiation, macroscopic syndrome differentiation with microscopic syndrome differentiation, and functional syndrome differentiation with morphological syndrome differentiation. It aims to fully leverage the respective strengths and synergistic advantages of traditional Chinese medicine and western medicine, break through the bottleneck of current diagnosis and treatment, and provide new ideas and strategies for the prevention and treatment of neurodegenerative diseases.

Multiple system atrophy (MSA) is a sporadic progressive neurodegenerative disease that is mainly categorized into Parkinsonism (MSA-P) and cerebellar (MSA-C) types. Its core clinical features include rapidly progressive autonomic failure and motor dysfunction. Currently, the etiology of MSA is unknown and involves multiple pathogenic mechanisms, therefore, treatment is limited to symptomatic management, and there is a lack of effective disease-modifying therapy (DMT) to slow down disease progression. Current research focuses on exploring diagnostic and therapeutic strategies combining traditional Chinese and western medicine, such as targeting α‍-synuclein pathology, regulating neuroinflammation, and enhancing neurotrophic support. Basic research and early clinical trials are evaluating the potential of various treatment options. This review aims to summarize the biological mechanisms of MSA and the latest research advancements, in order to facilitate clinical understanding of targeted treatment strategies for MSA.

Rare neurological diseases account for approximately 60% of all rare diseases, representing a category with a relatively large patient population and wide-ranging impact. These disorders are highly heterogeneous, with complex clinical manifestations that may involve neuromuscular, metabolic, immune, or developmental pathways. As a result, they are difficult to diagnose and prone to misdiagnosis. Currently, there is no internationally unified classification standard specifically for rare neurological diseases. In clinical practice, these conditions often face challenges such as delayed diagnosis and limited access to treatment. This article reviews the classification, diagnosis, and treatment of rare neurological diseases, aiming to provide clinical reference.