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.

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

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.

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

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

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

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

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

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

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

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.

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

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.

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

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

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.

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

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

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

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

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

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.

Misfolding and clumping of proteins in the brain has been linked to various neurodegenerative diseases, these include Alzheimer' s disease (AD), Parkinson' s disease (PD) and amyotrophic lateral sclerosis (ALS). In pathological, these neurodegenerative diseases are related to protein misfolding and aggregation. AD is pathologically characterized by abnormal aggregation of ß -amyloid protein and tau protein neurofibrillary tangles in the brain, and PD is pathologically related to abnormal aggregation of a-synuclein in dopaminergic neurons in the brain. The misfolding of specific protein, such as transactive response element DNA binding protein-43 (TDP-43) and inclusion body formation, is one of the markers of ALS. Sleep disorder is not only a concomitant symptom of patients with these diseases, but also a precursor symptom of the onset of these diseases. This review elaborates on the abnormal protein aggregation characteristics and sleep disorder features of AD, PD, and ALS, and summarizes the potential of sleep disorder in early diagnosis and treatment of these diseases. Sleep disorder may become early diagnostic clues and treatment entry point for neurodegenerative diseases.

Objective: To analyse a case report of "central- peripheral- central" rehabilitation modefor cognitive impairment in a patient with delayed encephalopathy after carbon monoxide poisoning (DEACMP), and to provide ideas for clinical cognitive impairment rehabilitation.

Methods:The clinical data, rehabilitation diagnosis, treatment process, and the changes ofcognitive function, language function and daily living ability of an adult patient withDEACMP were reported, and the efficacy was analyzed in conjunction with the relevantliterature.

Results: A 42 -year -old male patient was admitted to the hospital with“55 days ofcognitive impairment after carbon monoxide poisoning", and physical examinationrevealed that he was unable to speak, unresponsive, and uncooperative. MRl of the headshowed symmetrical patchy abnormal signals in the basal ganglia area and radiativecrown area, which was clinically diagnosed as DEACMP. The patient was given "hyperbaricoxygen therapy+transcranial magnetic stimulation+transcranial direct current+Schuelllanguage training+ognitive training"for central regulation, and "Lee Silverman VoiceTreatment (LSVT) training+daily living ability training" for peripheral intervention, withhis cognitive function had significantly improved. The score of modified Barthel index was15 points at admission and 60 points at discharge. The result showed that the patientcould achieve basic self- care in daily living.

Conclusion: DEACMP often leads to severe cognitive impairment, poor prognosis and highdisability rate. The application of"central-peripheral-central"rehabilitation mode tocognitive impairment of DEACMP can effectively promote the recovery of cognitivefunction in patients.

Alzheimer's disease (AD)is a neurodegenerative disorder characterized by memoryimpairment, cognitive decline and neuronal loss. Its pathogenesis involves a variety offactors, among which amyloid-β (Aβ) is critical in neurons and the body. Aβ is thedecomposition product of human amyloid precursor protein(APP) through various amyloidprocessing routes and non-amyloid processing routes, and is cleared through various wayssuch as cerebrospinal fuid and inter-tissue fluid lymphatic drainage, cell clearance, bloodand brain barrier transport and enzymatic hydrolysis. The generation and clearance of Aβ is a dyamic and balanced process, and the imbalance of its balance will accumulate Aβ in the brain, leading to neuronal cell death, impaired synaptic function and neuronalnetwork changes, inducing and exacerbate AD symptoms. This review expounded themechanisms of Aβ generation, clearance and metabolism in AD, summarized theinteraction mechanisms of Aβ with neurons, astrocytes, urea cycle, etc, and provided newideas for further discovery of new therapeutic and diagnostic targets for AD.

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.

Epilepsy, as a difficult-to-treat disease in the clinic, is characterized by seizuresrecurrence, and stereotype. Without pharmacologic intervention,the physical and mentalhealth of patients will be seriously affected. After searching through the literature ofTraditional Chinese Medicine (TCM) treatment of epilepsy at home and abroad, it wasfound that anti-epileptic drugs were used to rapidly control the symptoms during theseizure period, and in the remission period of epilepsy, it was supplemented with TCMevidence-based treatment. Based on the identification of phlegm, blood stasis, anddeficiency, the treatment principles included soothing the liver, resolving phlegmdispelling blood stasis, and tonifying deficiency. The treatment methods mainly includedacupuncture, acupoint embedding,moxibustion, and TCM decoctions. Multiple studiessuggested that TCM can effectively reduce the frequency of epileptic seizures, alleviateseizure symptoms, and alleviate adverse reactions, with good clinical treatment effects.The aim of this study was to summarize the latest advances in the treatment of epilepsy with TCM, and to provided guidance for future clinical practice.

Objective: To observe the efficacy of speech and language therapy in one case ofhereditary spastic paraplegia (HSP).

Methods: A patient with HSP who participated in this study from November 2023 toDecember 2023 was treated with repetitive transcranial magnetic therapy (rTMS) combined with speech and language therapy. The pantient's improvement of dysarthriawas assessed by Frenchay dysarthria assessment scale,maximal phonation time (MPT)、speech intelligibility and Oral- diadochokinesis (DDk).

Results: The total score of Frenchay dysarthria assessment scale was 95 before treatmentand 113 after treatment. MPT was 4 seconds before treatment and 10 seconds aftertreatment. Speech intelligibility score was 86 points before treatment and 100 points aftertreatment,The sequential motion rates (SMR) in DDK before treatment were 4, and aftertreatment, the SMR was 9.

Conclusion: Patients with HSP who received rTMS and speech and language therapypromoted improvements in oral motor function, as well as a significant increase in theclarity of their consonants, suggesting that this protocol may improve dysarthria.

Objective:Enhance understanding of neuroautoimmune disorders associated with glutamic acid decarboxylase(GAD) antibodies to prevent misdiagnoses.

Methods:The clinical data of a patient primarily exhibiting stiff person syndrome was reported, reviewing symptomatology, pathogenesis,diagnostic processes, and treatment modalities based on existing literature.

Results:Symptoms in patients with GAD antibody-associated neurological syndrome vary and imaging results are often non-specific. The presence of GAD antibodies is crucial for accurate diagnosis. In this reported case, the patient showed improvement following plasma exchange therapy and maintained symptom stability with ongoing immunotherapy.

Conclusion:Stiff person syndrome frequently manifests in anti-GADantibody associated neurological syndromes. The intrathecal synthesis of GAD antibodies strongly supports diagnosis. Immunomodulatory therapy has proven effective in treating this condition.

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

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

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

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

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

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

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

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

Objective: To screen the risk factors of white matter lesion (WML) and explore therelationship between WML with stroke and dementia.

Methods: In this study, a total of 260 patients with WML and 60 without WML underwentMRl were collected. The patients with WML were divided into 3 grades according toFazekas scale. Gender, age,education level, hypertension,diabetes, hyperlipemia,hyperhomocysteinemia, overweight, smoking and drinking history, and stroke history ofall enrolled patients were collected. Multiple ordered logistic regression analysis was usedto identify the risk factors of WML. Compare whether the degree of WMl in strokepatients is more severe than in non-stroke patients. MMSE scale was used to score theenrolled patients, analyzed the relationship between WML and cognition.

Results: Age, history of hypertension, hyperhomocysteinemia and smoking were correlatedwith the severity of WML, The Fazekas classification of stroke patients was statisticallydifferent from that of non-stroke patients(2=-10.305,P=0.000). With the increase ofFazekas grading, the MMSE score ofpatients decreased(r_s-0.511,P=0.000).

Conclusion: Age, hypertension, hyperhomocysteinemia and smoking are independent riskfactors for WML. WM may be a predictive signal of stroke. The more severe the degree ofWML, the higher the risk of dementia in patients.

Objective: To report the clinical data of a patient who developed Miller-Fisher syndrome (MFS), the variant type of Guillain-Barré syndrome (GBS) after the administration of adalimumab, which aims to provide novel evidence of the association between TNF-α inhibitor and GBS.

Methods: We reported a case of MFS in a Crohn's disease patient following adalimumab administration. The clinical manifestations, auxiliary examinations, radiological scans, and diagnostic and treatment procedures were stated. Furthermore, the possible pathogenesis was assessed by reviewing the relevant references.

Results: A male patient aged 32 years old was diagnosed as Crohn 's disease three years ago. He was treated with infliximab for three years before switching to adalimumab for over four months. Ten days after his last dose of adalimumab, he complained of " double visions for 6 days" and was admitted to the hospital. On examination, there was limited movement in both eyes, and no abnormality was seen on brain MRI scanning with or without enhancement. The autoantibodies (anti-GT1a IgG antibody and anti-GQ1b IgG antibody) were positive in his blood test. He was diagnosed as MFS, which is a variant type of GBS. After discontinuing adalimumab, he was treated with intravenous immunoglobin, vitamin B₁₂, and vitamin B₁. His symptoms improved and he was discharged.

Conclusion:GBS can be caused by adalimumab, but the mechanism should be further investigated. Clinically, more attention should be paid to the possible increased risk of developing peripheral neuropathies when monoclonal antibody therapy is applied.

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.

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.

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.