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.

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.

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.

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.

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.

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

Objective: To 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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

Schizophrenia is a 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.

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.

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.

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.

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 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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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

Objective: To 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.