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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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 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 .

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.

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.

Objective To report the clinical characteristics and rehabilitation course of a patient who developed rhabdomyolysis with peripheral nerve injury following combined quetiapine and alcohol intoxication, and to review the literature to enhance understanding of quetiapine intoxication and emphasize the importance of early rehabilitation intervention in patients with concomitant peripheral nerve injury to improve prognosis. Methods The clinical characteristics, electromyography findings, and rehabilitation course of a patient who developed rhabdomyolysis with peripheral nerve injury following combined quetiapine and alcohol intoxication were described in detail, and the relevant literature was reviewed. Results A 14-year-old female was admitted with a 20-day history of bilateral lower limb weakness. Following quetiapine combined with alcohol intoxication, decreased muscle strength in both lower limbs developed, resulting in inability to stand or walk, and peripheral nerve damage in both lower limbs was indicated by electromyography. After two weeks of rehabilitation training, improvements were observed in the lower limb muscle strength, balance function, and activities of daily living. At two months after onset, the patient was able to stand with support between parallel bars for 30 min, and at one year, she was able to walk independently indoors with the aid of a walker. Conclusion Although the mechanism underlying peripheral neuropathy caused by quetiapine intoxication remains unclear, functional recovery can be improved by early and intensive rehabilitation.

Objective: To investigate the correlation between phosphorylated Tau at threonine 181 (p-Tau 181) in peripheral blood and brain injury in premature infants.

Methods: The p-Tau 181 level in the peripheral blood of premature infants was retrospectively analyzed. Twenty-eight premature infants were selected, including 13 in the brain injury group and 15 in the control group. The level of p-Tau 181 in peripheral blood was detected by Simoa assay.

Results: The plasma level of p-Tau 181 in the brain injury group was significantly higher than that in the control group (P < 0.05). The result of logistic regression analysis revealed that the elevated level of p-Tau 181 in plasma was an independent risk factor of brain injury.

Conclusion: There may be overexpression of p-Tau 181 in plasma in premature infants with brain injury.

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.

Objective: To evaluate the efficacy and compliance of long-acting injectable antipsychotics (LAIA) in schizophrenia patients under the community-based health management model, and to analyze the compliance influencing factors, so as to provide a scientific basis for optimizing the application of LAIA in community.

Methods: Schizophrenia patients who were evaluated by psychiatrists as suitable for LAIA treatment in Shanghai Changning District Mental Health Center from July 1, 2021 to June 30, 2022 were selected as the subjects. At the start of treatment and after 1 year of treatment, all enrolled schizophrenia patients underwent personal clinical characteristic assessments using Family Burden Scale (FBS), World Health Organization Quality of Life-Brief Scale (WHOQOL-BREF), Social Disability Screening Schedule (SDSS), Brief Psychiatric Rating Scale (BPRS) and Clinician-Rated Dimensions of Psychosis Symptom Severity (CRDPSS). The differences in the scores of the scales before and after LAIA treatment were analyzed by paired-samples rank-sum test, the differences in the scores of the scales among schizophrenia patients with different compliance were analyzed by the independent-samples rank-sum test. The χ² test was used to analyze the differences in baseline clinical characteristics among schizophrenia patients with different compliance, and multivariable logistic regression was used to analyze the factors influencing the compliance of schizophrenia patients receiving LAIA treatment.

Results: This study included a total of 116 patients with schizophrenia, of whom 79 (68.1%) had good compliance and 37 (31.9%) had poor compliance. There were statistically significant differences in occupational status, source of medical expenses, family supervision, social participation, and previous hospitalization frequency between the good compliance group and the poor compliance group (all P<0.05). After one year of LAIA treatment, the scores of FBS, WHOQOL-BREF, BPRS, and CRDPSS for schizophrenia patients showed significant differences compared to those before treatment (all P<0.05). Source of medical expenses, previous hospitalization frequency, and social participation were independent factors affecting the compliance of schizophrenia patients receiving LAIA treatment (all P<0.05).

Conclusion: Under the community health management model, LAIA can effectively improve the psychiatric symptoms of schizophrenia patients, enhance their quality of life, and reduce their family burden, and while enhance their compliance, but some patients still face issues with poor compliance. In future community health management practices, measures such as strengthening the responsibility of caregivers, encouraging patients to actively participate in social activities, and reducing the rate of disease recurrence and re-hospitalization can be taken to optimize the LAIA treatment in community. This will further improve the compliance and overall efficacy of LAIA treatment for schizophrenia patients in community, thereby facilitating their better integration into society.

This paper explores the integration of the academic thought of Guangxi school of traditional Chinese medicine into the teaching of internal medicine of traditional Chinese medicine, using traditional Chinese medicine brain disorders as an example. The philosophy of Guangxi school of traditional Chinese medicine was formed under the unique climate and cultural background of Guangxi Zhuang Autonomous Region, encompassing theoretical systems such as "Sanjiao cidi", "promoting yang and dispersing nodules","five organs generating dampness", and "toxin deficiency causing disease". The article outlines specific measures for integrating it into teaching, including restructuring teaching content, innovating teaching methods, reforming teaching evaluation, combining clinical practice, and sharing teaching resources. Teaching practice has shown that these measures have effectively improved students' theoretical performance, case analysis scores, and clinical abilities. Most students recognized their contribution to the cultivation of clinical thinking. However, challenges still exist, such as insufficient theoretical knowledge among teachers, necessitating further optimization of the teaching system.

Narcolepsy (NC) is a rare chronic neurological disorder. Current western medical treatments (such as central stimulants, antidepressants, and sodium gamma-hydroxybutyrate) primarily aim to reduce excessive daytime sleepiness, control cataplexy, and improve nighttime sleep, thereby alleviating clinical symptoms. However, long-term use of western medications may lead to issues such as drug dependence, drug resistance, and adverse effects. In contrast, traditional Chinese medicine (TCM), guided by the principles of "treatment based on syndrome differentiation" and "holistic regulation", offers unique advantages in improving NC symptoms, reducing the risk of disease recurrence, and enhancing quality of life. It can compensate for the limitations of western medicine, reduce dosage requirements of western drugs, and mitigate their side effects, thereby improving treatment safety. Additionally, TCM may delay cognitive impairment and protect brain function. Therefore, this study systematically reviews recent advances in both western medicine and TCM for the treatment of NC, and further explores the benefits of integrated western and TCM approaches under a holistic medical model, with the aim of optimizing clinical strategies and providing new insights for the management of NC.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease, and its pathogenesis is complex and has not been fully elucidated. In recent years, the dysregulation of the gut-brain axis (GBA) is considered to play an important role in the pathogenesis and progression of ALS. Intestinal microbiota and their metabolites, intestinal barrier function, immune system activation, and neuroinflammation communicate bidirectionally with the central nervous system through GBA, thereby influencing the pathological process of ALS. Meanwhile, various active components of Chinese herbal medicine have shown significant potential in regulating GBA function, improving gut microenvironment, and alleviate neuroinflammation. For instance, berberine can activate autophagy to clear TAR DNA-binding protein 43 (TDP-43) aggregates; ginsenoside and its non-saponin component Gintonin can inhibit the TLR4-LPA1 signaling pathway to regulate neuroinflammatory responses; ligustrazine derivative tetramethylpyrazine nitrone (TMPN) can enhance the mitochondrial antioxidant function mediated by PGC1-α (peroxisome proliferator-activated receptor gamma coactivator 1-α); the 7,8-dihydroxyflavone (7,8-DHF) prodrug R13 can activate the TrkB-AMPK pathway to improve neuronal energy metabolism. This paper systematically reviews the mechanism of GBA in the pathogenesis and development of ALS, and focuses on discussing the potential mechanisms and research progress on Chinese herbal medicine interventions for ALS through the modulation of GBA function, aiming to provide new strategies and insights for ALS treatment.

The prevalence of late-life depression (LLD) among people over 60 years old worldwide is as high as 28.4%, and the incidence rate of LLD in China is 31.21%. Its clinical manifestations are mainly physical symptoms and cognitive impairment, which are easily misdiagnosed as physical diseases. Neuroimaging studies have revealed that the pathological mechanism of LLD is closely related to abnormal brain structure and function, including reduced gray matter volume in brain regions such as the prefrontal lobe and hippocampus, excessive activation of the default mode network (DMN), and weakened connections of the executive control network. These findings provide targets for neuroregulation therapy. The response rate of traditional antidepressant drugs is only 50%, and some have cardiovascular and cognitive risks. However, non-invasive neuroregulation techniques have shown significant potential. Electroconvulsive therapy (ECT) has a remission rate of over 50% for severe patients, but it has obvious cognitive side effects. Magnetic seizure therapy achieves focal epileptic seizures through precise magnetic field stimulation, with efficacy comparable to that of ECT and less cognitive impact. Bilateral repetitive transcranial magnetic stimulation (TMS) and deep TMS(dTMS) are recommended as first-line regimens. Transcranial direct current stimulation is suitable for patients with mild to moderate conditions due to its high safety. In the future, it is necessary to optimize individualized parameters by integrating multi-modal assessment, explore combined therapies and telemedicine applications, in order to improve the diagnosis and treatment effect of LLD.

This study retrieved literature on fire needle therapy for bulbar palsy from the China National Knowledge Infrastructure (CNKI), VIP Chinese Science and Technology Journals Database, Wanfang Data Knowledge Service Platform, SinoMed, PubMed, Cochrane Library, Web of Science, and EBSCO Medline, spanning from the inception of the databases to March 1, 2025. The selected literature was categorized and analyzed based on acupuncture point selection, treatment methods, and therapeutic mechanisms. A total of 19 Chinese articles and 3 English articles were included. The five most frequently used acupoints were Zusanli, Lianquan, Fengchi, Quchi and Hegu. Extraordinary points were predominantly selected based on local symptoms. This study summarized common acupoints to provide guidance for fire needle therapy in bulbar palsy, highlighting its clinical value and offering new treatment perspectives for the condition. However, significant gaps remain in research on individualized treatment under syndrome differentiation and mechanism studies, warranting further investigation.

Bladder dysfunction is a common complication following spinal cord injury (SCI), significantly impacting patients' quality of life. Appropriate bladder management is crucial for improving outcomes and enhancing quality of life. This article provides a brief overview of non-surgical management strategies for bladder dysfunction following SCI, including ultrasound assessment, urodynamic studies, pharmacotherapy, posterior tibial nerve stimulation, and triggered voiding, aiming to offer guidance for bladder management in SCI patients.

Objective Neuromodulation techniques represent an emerging approach in rehabilitation medicine. This study aimed to explore the multi-dimensional constraints hindering their implementation in community hospitals, as well as their potential advantages, limitations, and strategic recommendations for broader adoption. Methods Using a purposeful sampling method, six community hospitals with demonstration-level rehabilitation centers in Xuhui District, Shanghai, were selected between June 2024 and December 2024. A mixed-methods design was employed, including questionnaires administered to rehabilitation department heads and medical staff (n = 64), along with in-depth individual interviews (9 managers and 6 rehabilitation therapy teams). This approach systematically evaluated the current status of neuromodulation technology adoption and its influencing factors in community healthcare settings. Results Key findings revealed a critical shortage of certified rehabilitation physicians (23.8% of total rehabilitation department physicians). Questionnaire-based scoring (\overline{x}±s) highlighted three major barriers for the implementation of neuromodulation techniques in community healthcare centers: high financial burden of equipment (7.50±2.34; top 1), technical complexity of operations (6.75±2.47; top 2), and insufficient healthcare policy support (6.64±2.80; top 3). Conclusion The application of neuromodulation techniques in community-based rehabilitation faces significant challenges. To address these, efforts should be made to strengthen the workforce and professional training in the department of rehabilitation medicine in community hospitals. It is recommended to establish a systematic continuing education program in rehabilitation medicine to enhance healthcare personnel's professional competence and sense of recognition. Additionally, enhanced policy support, centralized procurement of equipment, and tiered resource allocation are essential to reduce economic barriers. These strategies may facilitate the integration of neuromodulation technologies into community healthcare, ultimately improving rehabilitation service quality and patient outcomes.