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.

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 first real-world case of an Alzheimer's disease patient who achieved PET-defined amyloid clearance sufficient to meet the discontinuation criteria and successfully discontinue donanemab therapy, and to illustrate the feasibility of PET-guided individualized treatment duration in clinical practice.

Methods: A 78-year-old female patient with AD was systematically evaluated before and after donanemab therapy. Cognitive function, amyloid-β (Aβ) and Tau PET imaging, and MRI findings were longitudinally monitored, along with the assessment of treatment-related adverse events.

Results: After six infusions of donanemab, the patient's Aβ load decreased to 7.02 Centiloids (CL), meeting the predefined discontinuation criterion. Tau deposition showed a mild visual reduction compared with baseline. The MoCA score increased from 17 to 21, mainly in the orientation domain, while activities of daily living remained stable. Asymptomatic amyloid-related imaging abnormalities (ARIA) was detected and remained stable during follow-up

Conclusion: This case demonstrates that donanemab can achieve substantial Aβ clearance with favorable safety in real-world settings. PET-based quantitative guidance for individualized therapy duration appears feasible, though long-term follow-up is required to assess the durability of Aβ clearance and its downstream impact on Tau dynamics and clinical outcomes, providing insights for precision application of anti-Aβ therapies.

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.

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.

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.

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.

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.

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.

Autoimmune encephalitis (AE) is a group of inflammatory disorders caused by immune-mediated attacks on the central nervous system, with common clinical manifestations including psychiatric and behavioral abnormalities, cognitive and motor impairments and epileptic seizures. Conventional first-line therapies mainly rely on corticosteroids, intravenous immunoglobulin, and plasma exchange. However, a subset of patients exhibits suboptimal responses or high relapse rates, underscoring the urgent need for the development of novel therapeutic strategies. In recent years, targeted therapeutic approaches have advanced rapidly in the field of AE, primarily focusing on key immune components such as B cells, T cells, the complement cascade, and key inflammatory cytokines. Anti-CD20 monoclonal antibodies have demonstrated promising efficacy in refractory AE. Moreover, emerging agents such as ocrelizumab, epratuzumab, telitacicept, and daratumumab have provided refined strategies for the precise depletion of B cells and plasma cells. In parallel, cytokine-targeting biologics, Janus kinase inhibitors, and the proteasome inhibitor bortezomib have shown potential value for modulating aberrant immune responses. In addition, chimeric antigen receptor (CAR)-T cell immunotherapy is gradually emerging as an important frontier in exploratory research. Looking ahead, by integrating neurorestorative strategies with artificial intelligence-assisted diagnostic and therapeutic decision-making, targeted therapies are expected to drive AE management from traditional empirical immunosuppression toward a new era of precision intervention, thereby enabling more efficient and personalized disease management.

Parkinson's disease (PD) is a common neurodegenerative disorder whose pathogenesis is complex and remains incompletely understood. Oligomers formed by the abnormal aggregation of α‍-synuclein (α‍-syn) are considered one of the central culprits of PD pathology. These oligomers accumulate not only within neurons but also propagate pathological changes by mediating neuron-glia crosstalk. Accumulating evidence indicates that α‍-syn oligomers exacerbate neuronal injury and accelerate neurodegeneration by triggering glial activation and inflammatory responses. Nevertheless, the precise molecular mechanisms through which α-syn oligomers transduce signals between neurons and glia are still largely unresolved. Here we systematically review the biogenesis and toxic mechanisms of α-syn oligomers, the activation states of glial cells and their associated inflammatory pathways, and the latest advances in intercellular signaling between the two compartments, with the goal of illuminating the pivotal roles of these processes in PD pathobiology. By integrating these molecular insights, we aim to provide new theoretical frameworks and research directions for the early diagnosis and treatment of Parkinson's disease, thereby fostering the development of innovative therapeutic strategies.

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 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.

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.

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.

Epilepsy is a chronic brain disease characterized by central nervous system dysfunction, and its frequent seizures have a serious impact on the quality of life for patients. At present, the primary treatment is based on Western anti-epileptic medications; however, long-term use of these drugs can lead to a series of adverse reactions. Chaihu Jia Longgu Muli Decoction, mentioned in Article 107 of the On Cold Damage (Shang Han Lun), has been commonly used by both ancient and modern physicians to treat mental and emotional diseases such as "chest fullness and agitation". In recent years, many studies have shown that this formula has a significant efficacy in treating epilepsy. Chaihu Jia Longgu Muli Decoction can exert its anti-epileptic effects by regulating neurotransmitters, enhancing the function of central nervous systems cells, and modulating inflammatory markers. This formula serves multiple functions, including harmonizing the Shaoyang, Tongyang Xiezhuo, and tranquilizing mind. Its effects are multi-targeted and systemic in nature. In the clinical treatment of patients with epilepsy, Chaihu Jia Longgu Muli Decoction has played an important role. This article offers a comprehensive overview of the recent developments regarding this formula's application in epilepsy treatment, focusing on the prescription compatibility, its underlying mechanisms of action, and relevant clinical observations.

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.

Epilepsy is a common chronic brain disorder, with approximately 30% of patients being resistant to conventional anti-epileptic drugs, necessitating precision medicine strategies for individualized treatment. This article systematically reviews the key advances and future directions in the precision treatment of epilepsy, , with its core framework built on three main pillars. First, targeted therapies based on genetic etiology serves as the cornerstone of precision medicine. By using genetic diagnostics to identify pathogenic mutations (such as in SCN1A and KCNQ2), treatment strategies can be tailored with channel modulators, receptor antagonists, or ketogenic diets that address the underlying causes. Second, pharmacogenomics aids in the personalized selection of conventional anti-epileptic drugs by analyzing key genes such as CYP2C9 and HLA-B*15:02, effectively predicting therapeutic efficacy and preventing severe adverse reactions. Third, for drug-resistant epilepsy, precision surgical techniques and neuromodulation methods accurately localize the epileptogenic focus, providing effective intervention options for patients. In the future, integrating multi-omics data, developing of novel targeted therapies, and overcoming clinical translation bottlenecks will be crucial in making precision treatments accessible to a broader patient population.

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.

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.

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.

Epilepsy is a chronic neurological disorder often complicated by drug resistance and comorbidities, with limited benefits from conventional therapies. This review explores the role of neuro-immune interactions in epilepsy, detailing a core mechanism where seizures disrupt the blood-brain barrier, enabling immune cell infiltration and activating glial cells to release pro-inflammatory factors, thus perpetuating a vicious cycle. Key signaling pathways are also discussed. The article surveys diagnostic advances, including neuro-immune biomarkers and technologies like multimodal imaging and single-cell sequencing. For treatment, immunomodulatory strategies—such as targeting inflammation, modulating glial cells or gut microbiota, and cell therapies—as well as the development of novel anti-seizure medications​ are summarized. Current challenges involve controversies over immune cell functions and inflammatory causality, as well as limitations in animal models and clinical translation. Future directions like multi-omics integration, artificial intelligence, and novel delivery systems are highlighted, offering a new paradigm for precise, etiology-targeted therapy in drug-resistant epilepsy.

Myasthenia gravis (MG) is an autoimmune neuromuscular junction disorder mediated by pathogenic autoantibodies. Although modern medicine offers effective short-term symptom control, its long-term treatment is limited by adverse drug reactions, complications, and disease recurrence. Integrated traditional Chinese and western medicine (ICWM) has demonstrated potential advantages in the immunomodulatory treatment of MG. Various traditional Chinese medicine (TCM) monomers and compound prescriptions exert therapeutic effects through multiple mechanisms, including suppression of autoantibody production, regulation of cellular immune imbalance, inhibition of complement activation, and modulation of cytokine networks and signaling pathways. These actions help restore neuromuscular junction function and alleviating MG symptoms. Furthermore, combining TCM with conventional therapies may help reduce adverse reactions, enhance remission rates, and improve the patients' quality of life. This also provides new insights into personalized treatment strategies. However, current experimental and clinical research on ICWM for MG still requires further refinement and standardization to meet higher scientific rigor.

Hereditary epilepsy refers to a type of epilepsy in which seizures are directly triggered by genetic defects and constitute the core clinical manifestation of the disease. In recent years, with the rapid advancement of gene detection technologies, the genetic mechanisms associated with epilepsy have been progressively elucidated, thereby driving progress in the precision diagnosis and treatment of the condition. Genetic testing has become a crucial tool for the clinical diagnosis and management of hereditary epilepsy. Based on in-depth analysis of specific gene mutations and pathogenic mechanisms, more targeted individualized treatment plans can be developed for patients. This article aims to focus on the etiological classification of hereditary epilepsy and the latest research advances in its precision diagnosis and treatment. Overall, the prospects for precision medicine in hereditary epilepsy are promising. Moving forward, continued multidisciplinary collaboration and sustained efforts are needed to further integrate genetics into clinical practice for epilepsy.

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.

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.

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.

Vascular dementia (VaD), as the second most prevalent type of dementia after Alzheimer's disease, seriously affects the quality of life of patients. Although VaD is theoretically reversible, there is currently no definitive treatment available. Traditional Chinese Medicine (TCM) has been widely employed in VaD management due to its distinct advantages of proven efficacy, minimal adverse effects, cost-effectiveness, and multi-target intervention. The integration of TCM with modern medical approaches can better serve clinical practices. This article systematically reviews the main research advances in VaD over the past decade from both clinical treatment and basic research perspectives. It covers the current mainstream clinical interventions for VaD, along with exploratory findings regarding the mechanisms and potential targets of TCM in VaD treatment. Furthermore, considering the current trends in scientific and technological advancements, we provide insights and prospects on future research avenues and therapeutic development for VaD.

Post-stroke depression (PSD) is one of the most common neuropsychiatric complications following stroke, with a high incidence rate. Depressive states inhibit the secretion of brain-derived neurotrophic factors and hinder neural repair. Early identification and intervention of PSD are crucial for patients' functional recovery, quality of life, and prognosis. Antidepressants can significantly improve depressive symptoms, and early use of antidepressants can also improve patients' motor and cognitive functions. Combining pharmacotherapy with exercise therapy and occupational therapy can enhance the effectiveness of drug treatment. Early intervention for PSD can correct patients' negative cognition towards post-stroke dysfunction, reduce the risk of depressive relapse, and avoid long-term psychosocial impairment.

This article reports a case diagnosed as hepatolenticular degeneration, with cranial MRI images suggesting the "face of the panda cub" in the pontine tegmentum. By reviewing the discovery process and pathophysiological mechanisms of numerous special neuroimaging signs of hepatolenticular degeneration, we trend to explore the special imaging diagnosis and differential diagnosis of hepatolenticular degeneration.

Multiple system atrophy (MSA) is a rare neurodegenerative disorder with very low incidence and prevalence worldwide. Clinically, it presents as a heterogeneous combination of autonomic failure, Parkinsonism and cerebellar ataxia. This review synthesizes current evidence on the epidemiology, subtype distribution, natural history and prognostic modifiers of MSA, with particular emphasis on the prodromal phase (e.g., rapid eye movement sleep behavior disorder and pure autonomic failure), hallmark clinical milestones after diagnosis (e.g., recurrent falls, wheelchair dependence, dysphagia, and inspiratory stridor), and key determinants of disease progression (including age at onset, severity of autonomic involvement, motor subtype and levodopa responsiveness). The clinical features and prognostic contrasts between young-onset and late-onset MSA are examined, and the future priorities focusing on biomarker development, early diagnosis and prodromal detection, and optimization of multidisciplinary care strategies are highlighted, aiming to inform clinical practice and interventional research.

Objective： To evaluate the effects of botulinum toxin type A (BTX-A) injection combined with serial plaster casting on fine motor function and upper limb spasticity in children with spastic cerebral palsy (CP).

Methods： A total of 119 children with CP were stratified according to clinical subtype and Manual Ability Classification System (MACS) level, and then randomly divided into an experimental group (n=61) and a control group (n=58) using a random number table. The control group received a single BTX-A injection combined with conventional upper limb rehabilitation training and guidance. The experimental group received additional serial plaster casting. Therapeutic effects were assessed using the Fine Motor Function Measure (FMFM) and the Modified Tardieu Scale (MTS), which assessed spasticity using parameter X, before BTX-A injection, at 1 month, and at 3 months after injection.

Results： At 1 month after treatment, FMFM scores and MTS parameter X scores significantly improved in both groups (P < 0.05), with the experimental group showing superior outcomes compared to the control group (P < 0.05). At 3 months, all scores in the experimental group remained improved despite a slight decrease, while in the control group, all indicators except for elbow extension showed no statistically significant difference compared to those at 1 month post-treatment.

Conclusion： BTX-A combined with conventional upper limb rehabilitation training can significantly improve upper limb muscle spasticity and large-joint motor function in children with CP. The addition of serial plaster casting helps to further enhance hand function and prolong the therapeutic effect.

Vascular cognitive impairment (VCI) is the second most common type of cognitive disorder in the elderly population, ranking only after Alzheimer's disease, with its clinical spectrum encompassing the entire progression from mild cognitive impairment to vascular dementia. Inflammaging, a prevalent low-grade chronic inflammatory state during aging, is closely associated with various age-related diseases, and has been confirmed to play a pivotal role in the occurrence and progression of VCI. The neurovascular unit (NVU), a core structure for maintaining normal brain function, consists of neurons, glial cells, vascular endothelial cells, pericytes, and the basement membrane. Through a complex intercellular signaling network, the NVU collaboratively regulates cerebral blood flow, maintains blood-brain barrier integrity, and provides the metabolic support for neuronal activity. This review focuses on the NVU to systematically elucidate the mechanisms by which inflammaging contributes to the development of VCI, aiming to reveal the intrinsic relationship between inflammaging and VCI from an inflammatory perspective and provide a theoretical basis for a deeper understanding of the pathophysiological processes of VCI.

Objective: To investigate the neurological clinical manifestations, diagnosis, and key treatment strategies of acute intermittent porphyria (AIP), with the aim of improving early recognition and standardized management of the disease.

Methods: The clinical data of a patient who presented with abdominal pain and seizures at disease onset was reported, and a literature review regarding the clinical features, pathogenesis, diagnosis, differential diagnosis, and treatment of AIP was conducted.

Results: The patient successively developed acute abdominal pain, epileptic seizures, and predominantly proximal motor axonal neuropathy. Urinary porphobilinogen (PBG) levels were significantly elevated, and genetic testing revealed a heterozygous mutation in the hydroxymethylbilane synthase (HMBS) gene.

Conclusion: The neurological manifestations of AIP exhibited a characteristic temporal pattern of evolution, and urinary PBG screening is crucial for early diagnosis. Early initiation of hemin therapy is essential to halt disease progression and improve clinical outcomes.

Movement disorders are one of common neurological complications following solid organ transplantation. They encompass various clinical manifestations, including tremor, myoclonus, and chorea, which significantly impact patients' quality of life. Neurological complications following solid organ transplantation are generally observed at a relatively high overall incidence, with variations across different types of organ transplants. Among these, neurological complications are relatively more common after liver transplantation, which is associated with multiple factors such as hepatic encephalopathy. Although the underlying mechanisms remain incompletely understood, these complications are thought to arise from neurotoxicity from immunosuppressive drugs, metabolic disturbances, and surgical factors. Post-transplant movement disorders often coexist with multiple symptoms, necessitating an active search for underlying causes, ruling out possibilities such as ischemic-hypoxic encephalopathy, infection, or stroke. If movement disorders occur in isolation, the neurotoxicity of medications, such as immunosuppressive agents, should be considered first. Treatment involves etiological management (optimizing the immunosuppressive regimen) and symptomatic therapy (such as antiepileptic drugs, clonazepam, or botulinum toxin injections). With timely intervention, most cases achieve favorable outcomes with a good prognosis. This review focuses on the epidemiology, clinical manifestations, associated symptoms, diagnosis and differential diagnosis, treatment, and prognosis of involuntary movements following liver, kidney, and heart transplantation, aiming to serve as a clinical reference.