The fifth edition of the WHO classification of tumors of the central nervous system (CNS5, 2021) is based on the concept of precision medicine. CNS5 incorporates a large number of new molecular diagnostic indicators as well as more detailed clinical and molecular epidemiological follow-up data. Through this, CNS5 has formulated new schemes for reclassifying, sub-classifying, typing, sub-typing, grading, and/or renaming of CNS tumors, and also added a large number of new tumor entities, significantly improving the accuracy, reproducibility, and consistency of diagnosis. This article briefly describes the main modification and significance of CNS5 and the precautions for its application.

Nervous system diseases have emerged as a leading cause of health loss and disability worldwide, and are increasingly recognized as a global public health challenge. In response to this challenge, the development and application of neuroscience technologies for treating nervous system diseases are of paramount importance. As a biomedical engineering technology characterized by multidisciplinary integration and medicine-engineering convergence, neuromodulation technique has become one of the most rapidly advancing fields in modern medicine. This article systematically reviews the principles of neuromodulation, its technological innovations, and progress in clinical applications, while also offering perspectives on future directions to promote the innovative development and clinical translation of neuromodulation technique.

Brain-computer interface (BCI) technology, by establishing direct communication pathways between the brain and external devices, has brought groundbreaking advancements to the diagnosis, treatment and rehabilitation of neurological disorders. A typical BCI system comprises the core steps of "signal acquisition-decoding-control-feedback", an architecture that aligns closely with closed-loop neuromodulation systems, such as responsive neurostimulation (RNS) for epilepsy, which follows a "recording-decoding-intervention" paradigm. Thus, closed-loop neuromodulation can be viewed as an integrated form of BCI designed for specific therapeutic objectives. Currently, BCI has demonstrated significant potential in replacing, restoring and enhancing neural functions across various clinical domains, including the management of drug -resistant epilepsy, motor rehabilitation post- stroke, neuromodulation for Parkinson's disease, functional compensation in spinal cord injury, and objective assessment of consciousness disorder. However, the technology still faces multiple challenges, including biocompatibility, signal stability, algorithmic generalizability, clinical standardization, and ethical-regulatory considerations. This review systematically examines the clinical progress of BCI, with the aim of outlining its technological classifications (non-invasive, partially invasive, and invasive), current applications, and key issues. Furthermore, it explores future directions, such as high-precision bidirectional closed-loop interaction, multimodal neuromodulation integration, intelligent virtual rehabilitation systems, and international collaborative standardization. Ultimately, this review seeks to contribute to the evolution of BCI from an assistive tool toward an intelligent integrated paradigm, laying the groundwork for precision neurology.

Accurate assessment and intervention for prolonged consciousness disorder remain critical challenges in neuroscience. Brain-computer interface (BCI) offers a novel pathway for diagnosis and treatment of consciousness disorder by decoding neural signals, reconstructing conscious communication, and guiding closed-loop neuromodulation. In diagnostic applications, EEG and functional near-infrared spectroscopy (fNIRS) detect brain signals to differentiate consciousness levels, while auditory P300 and steady-state visual evoked potential (SSVEP) paradigms show promise in identifying residual cognitive function. For communication, EEG-based BCI enable functional interaction in select patients, though accuracy and stability vary across modalities. Rehabilitation strategies leveraging BCI, such as neurofeedback and sensorimotor rhythm modulation, demonstrate potential for neural plasticity enhancement, particularly when combined with electrical stimulation. However, challenges persist, including high false-negative rates, signal instability, and limited generalizability of algorithms. Future directions emphasize interdisciplinary collaboration to optimize signal processing, validate multimodal approaches, and explore endovascular BCI for enhanced spatial resolution. Bridging neuroscientific insights with engineering innovations will be pivotal in translating BCI into clinical tools for improving outcomes in prolonged consciousness disorder patients.

Posttraumatic stress disorder (PTSD) is a severe mental disorder triggered by traumatic events. Its core clinical symptoms include intrusive memories, avoidance behaviors, negative alterations in mood and cognitive disorder, and hyperarousal. These symptoms are closely associated with aberrant neural circuitry involving the amygdala, hippocampus and prefrontal cortex. However, current pharmacological and psychological interventions are constrained by limited efficacy, poor compliance, and undesirable side effects. Given the high safety, strong reproducibility, and high patient acceptance, non-invasive electrical and magnetic neuromodulation techniques have emerged as a research focus for improving cognitive impairment in PTSD. This paper reviews the advancements in applying transcranial electrical stimulation (TES) and transcranial magnetic stimulation (TMS) to alleviate cognitive impairment in PTSD, and discusses the potential value of their combined use with psychological therapies. It aims to provide new perspectives for the clinical application of neuromodulation technique in treating cognitive impairment in PTSD.

Spinocerebellar ataxia type 3 (SCA3) is an autosomal dominant neurodegenerative disease, with core clinical symptoms including motor disorders and cognitive impairment. Since there is currently no effective radical treatment, the development of targeted diagnostic strategies and intervention measures to delay disease progression is particularly urgent. In recent years, neuromodulation technique has attracted widespread attention as an emerging therapeutic strategy for neurological diseases; they achieve therapeutic goals by precisely adjusting stimulation parameters to act on specific brain regions. This article aims to systematically discuss the existing efficacy studies of three neuromodulation techniques, including non-invasive techniques such as repetitive transcranial magnetic stimulation (rTMS), transcranial electrical stimulation (TES), and invasive technique such as deep brain stimulation (DBS), in the clinical application of SCA3, and explore the application potential of neuromodulation technique such as transcranial focused ultrasound stimulation (tFUS) and optogenetics in the field of SCA3 treatment. It is expected to provide new ideas and references for the in-depth research and clinical transformation of neuromodulation technique in SCA3.

Over the recent years, electrical stimulation therapy has rapidly evolved as a commonly used neuromodulation therapy for epilepsy. Although open-loop stimulation [such as vagus nerve stimulation (VNS) and anterior nucleus of the thalamus deep brain stimulation (ANT-DBS)] has achieved certain success in treating drug-resistant epilepsy, its fixed-parameters, continuous stimulation paradigm suffers from limitations such as a mismatch between timing and dosage, poor individual adaptability, and more. In contrast, closed-loop stimulation [exemplified by responsive neurostimulator system (RNS)] significantly enhances treatment precision and energy efficiency by monitoring brain activity in real time and delivering responsive stimulation before or during seizures. It also leverages long-term data to optimize stimulation parameters and promote brain network remodeling. This review outlines the development, mechanisms, and recent advances in drug-resistant epilepsy neuromodulation from open-loop stimulation to closed-loop stimulation, and discusses future prospects for more predictive, adaptive, and network- oriented approaches, providing a theoretical foundation for personalized and precise epilepsy treatment.

Drug-resistant epilepsy remains a major challenge in management of epilepsy, with approximately half of patients being unsuitable candidates for resective surgery. In recent years, deep brain stimulation (DBS), as a neuromodulation therapy, has demonstrated promising potential. This review summarizes recent advances in DBS for drug -resistant epilepsy, focusing on major stimulation targets and their associated neurophysiological mechanisms. We also discuss the suitability of various DBS targets for different epilepsy types and provide perspectives on future directions, including individualized adjustment of stimulation parameters and the development of closed-loop stimulation, aiming to inform clinical practice and guide further research in the management of drug-resistant epilepsy.

Stroke is one of the main causes of adult disability. Patients after stroke often suffer from motor dysfunction, which affects their quality of life and requires effective treatment methods. Deep brain stimulation (DBS), as a mature neuromodulation technique, has shown significant potential in promoting the recovery of motor function after stroke in recent years. This article systematically reviews the mechanism of action of DBS in the treatment of motor dysfunction after stroke, especially summarizing the preclinical and clinical studies on the dentate nucleus of the cerebellum deep brain stimulation (DN-DBS), to provide scientific evidence and new therapeutic perspectives for clinical practice.

Deep brain stimulation (DBS), a reversible and adjustable neuromodulation technique, has expanded from its initial application in movement disorders to the treatment of mental disease. This review systematically summarizes the current applications and research progress of DBS in treatment-resistant obsessive-compulsive disorder (TR-OCD), treatment-resistant depression (TRD), anorexia nervosa (AN), substance use disorder (SUD), and treatment-resistant schizophrenia (TRS). Evidence indicates that DBS modulates dysfunctional neural circuits [e. g., cortito-striato-thalamo-cortical (CSTC) loop, reward system] and significantly alleviates symptoms, particularly showing high response and remission rates in TR- OCD. However, challenges remain, including interindividual variability in target selection, lack of predictive biomarkers, long-term safety concerns, and ethical issues. Future directions involve closed-loop stimulation, tractography-based targeting, and personalized medicine approaches to facilitate the transition of DBS from experimental therapy to clinical practice.

Spinal cord stimulation (SCS) is a non-pharmacological neuromodulation technique used to treat various neurological disorders. It functions by delivering electrical impulses to specific areas of the dorsal columns of the spinal cord, thereby modulating abnormal neural signal transduction to alleviate symptoms. In recent years, the clinical applications of SCS have significantly expanded beyond its primary indication for refractory chronic pain. It is now increasingly utilized in diverse areas, including functional recovery in central paralysis, improvement of lower limb blood perfusion, intervention for diabetic foot pain and dysfunction, and promotion of arousal in consciousness disorder patients. This review summarizes recent clinical advances and mechanistic explorations of SCS in these expanding indications. It emphasizes the critical importance of postoperative programming management for optimizing therapeutic outcomes. Finally, the review discusses current challenge and future direction.

Vagus nerve stimulation (VNS) as an established neuromodulation technique, has seen a continuous expansion in its range of approved indications since its initial approval for the adjunctive treatment of drug-resistant epilepsy. As of 2025, the Food and Drug Administration (FDA) has approved VNS for drug-resistant epilepsy, treatment-resistant depression, obesity, and post- stroke upper limb motor rehabilitation. Furthermore, it has demonstrated therapeutic potential in areas such as cardiovascular diseases and inflammatory disorders. This narrative review examines the current clinical applications of implantable VNS, with a focus on evaluating the evidence for its efficacy in core indications including drug- resistant epilepsy, depression, and obesity. It also explores the underlying mechanisms of action and discusses future directions for the expansion of indications as well as the associated challenges. The aim is to provide a theoretical foundation and clinical reference for optimizing treatment strategies and advancing research in this field.

Transcranial alternating current stimulation (tACS) is a non-invasive neuromodulation technique that applies low -intensity sinusoidal currents at specific frequencies to interact with endogenous neural oscillations. By modulating neuronal firing synchrony, tACS can improve neural functions. In recent years, this technique has shown potential in the treatment of depression. This article reviews advances in the application of various tACS modalities in depression, discusses optimization strategies and future directions, and provides insights for clinical practice and further research.