With the rapid development of society and economy and the acceleration of population aging, the global disease spectrum has undergone profound changes. Neurological diseases, especially brain functional disorders, have become major threats to human health. Neuromodulation technique, as a critical means to address this challenge, has opened new avenues for the treatment of brain functional disorders and has become one of the three innovative technologies in modern neurosurgery. This paper systematically elaborates on the concept, classification, and technological evolution of neuromodulation, focusing on the clinical application progress of invasive neuromodulation technique. It analyzes their efficacy and potential in the fields of movement disorders, epilepsy, pain, cognitive impairment, and neurorehabilitation. Additionally, it explores the integration trend between neuromodulation and brain-computer interface (BCI), pointing out that closed-loop neuromodulation has become an important component of BCI, providing new approaches for precise treatment and individualized modulation. Finally, it proposes future development directions in the field of neuromodulation, including expanding new indications, innovating target exploration models, updating treatment concepts, and conducting high-quality evidence-based medical research. Looking ahead, Chinese neuromodulation endeavors should seize current opportunities, achieve a leap from following to leading through continuous exploration and innovation, and make greater contributions to global brain health.

With its high positioning accuracy, transcranial magnetic stimulation (TMS) has become an important means of non-invasive neuromodulation technique. This article analyzes the current status and challenges of precise positioning navigation technology, points out that the current navigation equipment is expensive and caliper-based simplified precision positioning method is difficult to monitor head movements in real time, and proposes the necessity of developing low-cost, high-precision navigation technology. Focus on the precise positioning technology of TMS and its application in clinical treatment and cognitive function positioning. Finally, the application prospects of precise positioning TMS in clinical treatment and cognitive function positioning are discussed, and it is pointed out that future research directions should focus on comparative studies of precise positioning and non - precise positioning treatment, as well as in - depth exploration of the precise positioning TMS treatment mechanism guided by fiber connections.

The rapid development of neurosurgery robots and navigation systems has significantly enhanced surgical precision and safety. Neurosurgery robots, based on stereotactic technology, achieve submillimeter-level positioning through multi-modal image fusion and non-invasive registration techniques. Equipped with high-degree-of-freedom robotic arms and integrated sensors, they precisely perform complex procedures such as stereo-electroencephalography (SEEG) electrode implantation, deep brain stimulation (DBS) device placement, and magnetic resonance-guided laser interstitial thermal therapy (MRgLITT). Navigation systems employ optical or electromagnetic tracking technologies combined with multi-modal imaging to assist surgeons in tracking important structures and target lesion tissue precisely. Future advancements may autonomously generate personalized surgical plans to reduce human error, while flexible robotic arms and novel endoscope-holding robots could expand endoscopic applications. Furthermore, the integration of multiple technologies will broaden neurosurgical applications. These innovations not only minimize complication risks and shorten treatment periods, but also propel the field toward intelligent, minimally invasive neurosurgery.

Traditional treatment methods for mental disorders include pharmacotherapy and psychotherapy. However, some patients are unable to effectively control their symptoms. Neuromodulation technique, which can be implemented through invasive or non-invasive approaches, have shown promise in improving the psychiatric symptoms of individuals with mental illnesses by intervening in neural circuits. This paper summarizes the current applications of neuromodulation technique for various mental disorders, including obsessive-compulsive disorder, depression, Tourette's syndrome, bipolar affective disorder, autism spectrum disorder, substance dependence and schizophrenia. Additionally, it analyzes the prospects and challenges of neuromodulation technique in the treatment of mental disorders, with the aim of guiding future neuromodulation therapy for mental disorders.

As a mature neuromodulation technique, deep brain stimulation (DBS) has been widely used in the treatment of various neurological and psychiatric disorders. Parkinson's disease (PD) is one of the earliest indications for DBS and has received the most treatment so far. It has attracted extensive attention and in-depth research from the academic community for a long time, and has made remarkable progress in multiple fields. This review highlights the optimization of DBS for PD, focusing on two key directions: surgical technology innovation and neural circuit mechanism research. It explores the surgical technology innovation, equipment innovation, and programming strategy improvement of DBS, as well as the recognition and application of neural circuit markers. These studies not only significantly improve the efficacy of PD treatment, but also provide valuable ideas and scientific basis for the future development of neuromodulation technique.

Epilepsy is a common chronic neurological disorder that severely impacts the quality of life and social functioning. Approximately 1/3 of patients are diagnosed with drug-resistant epilepsy (DRE), for which conventional antiepileptic seizure medicine (ASM) and traditional surgery have limited efficacy. In recent years, responsive neurostimulation (RNS), as a closed-loop neuromodulation technique, has provided a novel treatment option for DRE. The RNS utilizes invasived electrodes to monitor brain activity in real time, detect seizure precursors, and deliver electrical stimulation, effectively reducing the frequency and severity of DRE. This paper aims to review the composition of the RNS, optimization and dyanmic adjustment of stimulation parameters, long-term data recording and analysis, fusion with machine learning, clinical efficacy, and comparison with vagus nerve stimulation (VNS). It also explores the technical challenges and discusses future development directions. RNS holds promise for providing personalized and precise treatment to more DRE and expanding its application to other neurological disorders.

Essential tremor (ET) is the most common movement disorder in clinical practice. Some patients' daily activities are affected because of the serious tremor. The current drug treatment for this disease is not effective, but the neuromodulation technique such as deep brain stimulation (DBS) is effective. This article provides a review of the latest developments in neuromodulation for the treatment of ET, including clinical trails on magnetic resonance-guided focused ultrasound (MRgFUS), directional-DBS and percept -DBS, as well as the optimal stimulation targets for DBS, in order to provide a reference for the treatment of ET.

Sacral neuromodulation (SNM) as an advanced form of neuromodulation technique, which has demonstrated significant efficacy in alleviating clinical symptoms for patients with pelvic floor dysfunction (PFD) who do not respond to conventional treatments. This paper provides a comprehensive review of the application and progress of SNM in the treatment of PFD. It covers its historical development, mechanisms of action, clinical applications, optimization of stimulation parameters, and several technological innovations that have facilitated its clinical adoption. The aim is to promote wider clinical application of SNM and offer more precise treatment options for patients.

Non-invasive neuromodulation techniques have achieved remarkable advancements in the field of neuroscience in recent years, emerging as a crucial tool for researching and treating numerous neuropsychiatric disorders. The primary methods of non-invasive neuromodulation techniques, including transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), have increasingly been incorporated into clinical practice and demonstrated impressive outcomes in depression, anxiety, and chronic pain. However, the application of non-invasive neuromodulation techniques still encounter several challenges, such as significant individual response variations, limited duration of therapeutic effects, and issues with standardizing stimulation parameters. This paper provides a comprehensive review of the primary non-invasive neuromodulation techniques and their current applications in brain functional diseases, analyzes the efficacy evaluation and future development direction to provide reference for further exploring their expanded applications in brain functional diseases and neural functions.

Neuromodulation has emerged as a significant clinical treatment modality for patients with prolonged disorders of consciousness (pDOC), encompassing both non-invasive and invasive neuromodulation techniques. This paper integrates an overview of the neural mechanisms underlying consciousness, neurofunctional assessments, and categorizes the current applications and recent research findings in non-invasive and invasive neuromodulation techniques. The aim is to enhance the scientific rigor and efficacy of neuromodulation, provide robust support for the treatment of pDOC.

Dystonia is a group of movement disorders characterized by continuous or intermittent muscle contraction, causing abnormal movements and/or repetitive postures. It has the characteristics of diverse causes and complex clinical symptoms. As a reversible neurosurgical therapy, neuromodulation technique has achieved remarkable results in the clinical treatment of dystonia. This article reviews common neuromodulation technique in treatment of dystonia and looks forward to the technological innovation, multidisciplinary integration and clinical promotion prospects of neuromodulation, so as to provide a theoretical basis and new ideas for subsequent research and clinical application.

The high heterogeneity and resistance of glioma present significant challenges in clinical treatment. The rapid development of multi-omics technologies has greatly advanced the understanding of the molecular mechanisms, resistance characteristics, and potential new drug targets in glioma. Building on this, multi-omics data is now being used for drug screening, mechanism exploration, and clinical trial guidance, thereby accelerating the translation of novel therapies and precision medicine strategies into clinical applications for the treatment of glioma. This review focuses on the latest advancements in the application of multi-omics technologies in glioma drug research and development, highlighting how insights into genetic mutations, gene expression, protein functions, and metabolic reprogramming can aid in understanding the molecular mechanisms, resistance, and complexity of the tumor microenvironment. Furthermore, it provides critical support for the identification of new drug targets, the development of personalized treatment plans, and drug screening, thus advancing the field of personalized and precision medicine in the treatment of glioma.

In 2024, significant advancements were made in the diagnosis, treatment, and research of glioma in China, reflecting a comprehensive innovation in basic research, diagnostic technologies, surgical techniques, targeted therapies, immunotherapies, and integrated management. This development showcases China's increasing capabilities in translating basic research into clinical applications, advancing the precision and intelligence of glioma care. Key achievements include the major academic organizations had played pivotal roles in glioma research and clinical practice. Notably, the establishment of the Glioma MDT Specialist Alliance under the National Center for Neurological Disorders had enhanced resource integration, promoted multidisciplinary collaboration, and accelerated knowledge sharing and clinical translation. The approval of mesenchymal - epithelial transition (MET) inhibitors for glioma harboring the PTPRZ1-MET fusion gene marked a milestone in precision oncology. Artificial intelligence (AI) has been widely adopted in glioma research. Breakthroughs in rapid intraoperative molecular diagnostics, combined with AI-powered imaging analysis and clustered regularly interspaced short palindromic repeats (CRISPR), were poised to revolutionize precision diagnosis and treatment. These developments underscore China's growing leadership in integrating cutting-edge technologies to address complex challenges in neuro-oncology.

Intraoperative ultrasound (iUS) is a low-cost, portable and user-friendly auxiliary tool in brain tumor surgery, yet there is a lack of standardized operational guidelines. This review begins with the ultrasound physics and summarizes the workflow of iUS, followed by a grading system for ultrasonographic visibility of intracerebral lesions, iUS in assessing brain tumor resection, the limitations of iUS-guided brain tumor resection, multimodal ultrasound imaging, and the application of artificial intelligence (AI) in iUS. This review shows the clinical practice of iUS in brain tumor surgery from multiple perspectives and proposes practical standards.

Post-stroke functional impairments place a significant psychological and economic burden on patients' families and society. Neuromodulation technique involves invasive or non-invasive methods to regulate neural system activity for the treatment or improvement of various neurological disorders or diseases. This article aims to review the mechanisms of different types of neuromodulation technique and their application in combination with rehabilitation therapies to improve stroke patient function, providing theoretical guidance for the application of neuromodulation technique in rehabilitation of stroke.

Objective: To explore the influencing factors for subcutaneous effusion (SCE) after cranioplasty. Methods: Total of 111 patients with skull defect who underwent cranioplasty from January 2019 to June 2024 in Beijing Rehabilitation Hospital, Capital Medical University were analyzed retrospectively. All the patients were devided into SCE group (n = 29) and non-SCE group (n = 82) according to whether they had SCE after cranioplasty. Univariate and multivariate Logistic regression analyses were applied to explore the influencing factors for SCE after cranioplasty. Results: Among 111 patients, 29 had SCE after cranioplasty, with an incidence of 26.13%. All the 29 patients recovered and there was no bleeding, scalp damage, implant exposure, poor wound healing and intracranial infection after the treatment. Logistic regression analysis showed that age increase (OR = 1.075, 95%CI: 1.027-1.126; P = 0.002), polyether-ether-ketone (PEEK) repair material (OR = 7.673, 95%CI: 2.227-26.435; P = 0.001) and 24 h drainage increase before drain removal (OR = 1.026, 95%CI: 1.008-1.044; P = 0.004) were risk factors for SCE after cranioplasty. Conclusions: Age increase, PEEK repair material and 24 h drainage increase before drain removal were risk factors for SCE after cranioplasty. Timely and effective interventions should be taken according to individual condition.

High performance computing (HPC) is transforming the field of large-scale brain simulation by enabling the integration of multi-scale computational modeling with massive neuroscience data. With advanced HPC resources, researchers can simulate neural activities from ion-channel dynamics to whole-brain network interactions, thereby illuminating the mechanisms underlying cognition, neural disorders, and emerging neuromorphic intelligence. This review examines the theoretical principles and technical foundations of supercomputer brain simulation, including distributed parallel algorithms, graphics processing unit (GPU)-based acceleration, and multimodal data management. It also surveys prominent simulation platforms such as NEST, NEURON, and The Virtual Brain (TVB), highlighting their strengths in modeling spiking neuronal network (SNN), multicompartmental neurons, and large-scale functional connectivity, respectively. Furthermore, we discuss the practical applications of these simulations in elucidating disease mechanisms in Alzheimer's disease (AD), Parkinson's disease (PD), autism spectrum disorder (ASD), schizophrenia, and epilepsy. Special emphasis is placed on how supercomputer brain simulation assists in virtual drug screening, optimizing deep brain stimulation parameters, and supporting digital twin approaches for personalized medicine. Finally, we address the critical challenges and future directions in this rapidly evolving domain, including the trade-off between computational cost and biological realism, data integration and validation, and the necessity for interdisciplinary collaboration. The advent of exascale supercomputers and the convergence of neuroinformatics and machine learning (ML) are poised to propel brain simulation research toward unprecedented clinical and scientific breakthroughs.

Functional tic-like behaviors (FTLBs) is a kind of rare clinical phenotype of functional neurological disorder (FND), its etiology and pathogenesis have not been fully defined, and the clinical understanding of it is not comprehensive. This paper systematically reviews the relevant studies of FTLBs in recent years, and analyzes and summarizes its clinical characteristics, influencing factors, comorbidities, diagnosis, treatment and prognosis, aiming to provide theoretical reference for the subsequent diagnosis and treatment of FTLBs.

Hemorrhagic transformation (HT) is one of the severe complications of ischemic stroke, which may occur either during the natural course or as a consequence of treatments such as thrombolysis and thrombectomy. HT is associated with poor prognosis after ischemic stroke and influences clinical treatment decisions. Disruption of blood-brain barrier (BBB) has been demonstrated as the main mechanism underlying HT. Inflammatory responses contribute to this process by activating endothelial cells, recruiting immune cells such as neutrophils and macrophages, and releasing inflammatory mediators including proteases and reactive oxygen species, which further exacerbate vascular injury and BBB permeability, thereby promoting HT. Blood inflammatory markers may reflect these pathological processes and offer valuable biological information for early identification and risk stratification of HT. Classical inflammatory markers, such as matrix metalloproteinase-9 (MMP-9) and ferritin, have been demonstrated predictive value for HT. Recently increasing attention has been paid to investigate the mechanism and predictive potential of novel markers, such as neutrophil gelatinase-associated lipocalin (NGAL), high-mobility group box 1 (HMGB1) and nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammasome, for predicting HT. This review focuses on the novel blood inflammatory markers and systematically describes their correlation with HT, with the aim of providing a scientific basis for the mechanism investigation, accurate prediction and individualized therapeutic strategies of HT.

The application and development of digital intelligence technology in the field of neuroscience have provided powerful tools for fundamental research on brain functions, as well as for the diagnosis, treatment and rehabilitation of neurological disorders. This article reviews the latest advancements in the application of digital intelligence technology in basic brain function research, neurosurgery, neurology and neurorehabilitation, while also addressing the challenges and future development trends in the field. The aim is to provide new insights for the advancement of digital intelligence technology in neurology.

Spinal cord stimulation (SCS) is a minimally invasive neuromodulation technique that has been widely applied and recognized for its efficacy in peripheral neuropathy such as diabetic peripheral neuropathy (DPN), trigeminal neuralgia (TN), trigeminal postherpetic neuralgia, chemotherapy-induced peripheral neuropathy (CIPN), chronic groin pain, and lumbosacral radiculopathy syndrome. This article reviews the basic principles of SCS and its latest applications in peripheral neuropathy to promote its clinical application in peripheral neuropathy.

Objective: To explore the efficacy and prognosis of endovascular treatment for severe cerebral venous sinus thrombosis (CVST), providing new insights for the treatment of CVST. Methods: The clinical course of 31 severe CVST patients admitted to The First Hospital of China Medical University and Shengjing Hospital of China Medical University from October 2017 to December 2024 was analyzed retrospectively. The condition of venous sinus recanalization was assessed through immediately postoperative DSA examination, and the prognosis was evaluated based on criteria such as perioperative complication rate, mortality rate during follow‐up, and modified Rankin Scale (mRS) score at the last follow‐ up. Results: A combination of multiple endovascular treatment techniques was used. Immediately after the operation, 7 patients (22.58%) achieved complete recanalization of the venous sinus and 24 patients (77.42%) achieved partial recanalization. The incidence of perioperative complication rate was 6.45% (2/31), and there was no new cerebral infarction. The average follow ‐ up period was (6.60 ± 3.40) months. No deaths were reported during the follow ‐ up period. At the last follow ‐ up, 28 patients (90.32%) had a good prognosis (mRS score ≤ 2). Conclusions: Endovascular treatment can effectively reduce the mortality rate and improve the prognosis of patients with severe CVST, but individualized assessment is required, and indications must be strictly controlled.

Cerebral venous system diseases can lead to idiopathic intracranial hypertension (IIH), cerebral venous thrombosis (CVT) and pulsatile tinnitus (PT), and accurate evaluation of cerebral venous sinus hemodynamics is very important for the diagnosis and treatment of these diseases. In recent years, with the rapid development of hemodynamics research software and brain imaging technology, computational fluid dynamics (CFD), 4D Flow MRI, vitro simulation and transcranial Doppler ultrasonography (TCD) provide a multi-dimensional tool for the study of hemodynamics. In this paper, we will comprehensively introduce the research progress of above methods in the field of cerebral venous sinus hemodynamics, and provide innovative solutions for subsequent research of cerebral venous system diseases.

Objective: To summarize the clinical, electrophysiological and genetic characteristics of a pedigree with myotonic dystrophy (DM). Methods and Results: The 25-year-old male proband exhibited an occult onset, characterized by a distinctive "hatchet face" and alopecia, limb muscle weakness, amyotrophy, and damages of various systems, including the endocrine system and heart damage. Notably, the third aunt, the fourth uncle and the first brother of proband also exhibited similar clinical symptoms. Gene detection revealed both the proband, his aunt and his cousin had CTG repeats exceeding 100 times in the DMPK gene. Electromyography (EMG) studies conducted on the proband, his aunt and his cousin showed the coexistence of myotonic potential and myogenic damage. In the proband, the amplitude of the motor nerve conduction velocity of the left common peroneal nerve was decreased with a slight reduction in velocity, while the sensory nerve conduction velocity was also slowed. The proband, his aunt and his cousin were diagnosed with myotonic dystrophy type 1 (MD1). It was evident that the pedigree has myotonic dystrophy. Conclusions: Myotonic dystrophy is a rare autosomal dominant inheritance disorder characterized by myasthenia, myotonia and amyotrophy, which affects multiple systems. The clinical manifestations of this disease are diverse and relatively uncommon. In clinical practice, it is crucial to pay attention to the patient's family history, clinical signs and electrophysiological data, with particular emphasis on the identification of myotonic potential. Gene detection is of great significance for the diagnosis and differential diagnosis of myotonic dystrophy.

Cerebral small vessel disease (CSVD) is a major cause of stroke and dementia, with its treatment paradigm shifting from conventional risk factor management to targeted pathophysiological interventions. This article reviews the current landscape and key challenges in CSVD treatment research, focusing on patient selection, optimization of study endpoints, and development of targeted therapeutic strategies. Additionally, it explores the FINESSE framework, which aims to refine CSVD clinical trial design and accelerate advancements in treatment.

Neurosurgery is entering an era of intelligent and personalized precision. The new generation of neurosurgeons needs not only superb surgical skills, but also the ability to master computer technology, imaging technology and neuromodulation. The application of artificial intelligence (AI) technology in neurosurgery includes machine learning (ML), deep learning (DL) and large language model (LLM). This article introduces specific cases in neurological tumors, spinal diseases, epilepsy and cerebrovascular diseases. Digit-intelligent neurosurgery focuses on the deep integration of digitalization and intelligentization in the field of neurosurgery. Digit-intelligent neurosurgery should establish a technical system of intelligent perception, intelligent cognition, intelligent decision-making and intelligent operation. With the deep integration of digitalization and intelligentization, neurosurgery will usher in unprecedented technological changes.

Objective: To summarize the clinical experience of supratentorial tumor resection using a wireless head - mounted display (HMD) - based holographic mixed reality navigation system (MRN). Methods: A analysis was performed on 5 patients undergoing supratentorial tumor resection using holographic MRN at Zhuhai People's Hospital from March to September 2024. Preoperative imaging data were imported into 3D Slicer software to generate holograms of lesions, anatomical landmarks, and adjacent structures, which were subsequently integrated into the holographic MRN and projected onto the patient's head for preoperative incision planning and intraoperative tumor resection guidance. The convenience and stability of holographic MRN were evaluated by assessing navigation registration time, navigation application time, and registration attempts. Accuracy, efficacy, and safety of holographic MRN were analyzed through evaluation of bone window extent, tumor - to - surrounding structure relationships, modeling time tumor localization, Karnofsky Performance Status (KPS) scores, and surgical indicators. Results: Preoperative modeling was all successfully completed, with an average modeling time (25.20 ± 1.60) min, and average registration time (3.20 ± 0.05) min. The mean preoperative and intraoperative navigation application times were (12.74 ± 1.09) and (8.17 ± 0.81) min, respectively. All registrations were successful on the first attempt. All lesions were entirely within the planned bone window boundaries, with no under - or over - exposure. Holographic projections of tumors fully overlapped with actual intraoperative lesions. All 5 cases achieved Simpson grade Ⅰ resection. The average KPS score at 72 h after surgery was 94.00 ± 4.90. Conclusions: This study confirms the convenience, stability, accuracy, efficacy, and safety of holographic MRN in clinical practice, demonstrating its value as an adjunctive tool for supratentorial tumor craniotomy.

The pathogenesis of Rasmussen encephalitis (RE) remains unclear. Current theories suggest that viral infection, antibody-mediated humoral immune mechanisms, T lymphocytes mediated cellular immunity, and microglia mediated neurodegeneration may all be involved in disease onset and progression. In the early stage of disease, immunotherapy targeting induced by T lymphocytes and microglia could slow down disease progression of some patients. This review summarizes the latest research on the main pathogenic hypotheses and treatment strategies for RE, aiming to enhance clinical understanding of the disease and provide guidance for therapeutic interventions.

Central pain often arises as a sequela of lesions in the central somatosensory nervous system, and the intensity of pain is generally severe, significantly impacting patients' quality of life. Conventional pharmacological therapies usually have limited efficacy. In recent years, neuromodulation technique mainly including spinal cord stimulation (SCS) and motor cortex stimulation (MCS), which have been widely applied in the treatment of central pain. This review provides an overview of the two techniques in terms of their principles, clinical applications and adverse effects, and analyze the future research directions, aiming to guide the application of neuromodulation technique in central pain.

Traditional pharmacological treatments for rare movement disorders have limited efficacy. However, the emergence of neuromodulation technique such as deep brain stimulation (DBS), spinal cord stimulation (SCS), transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS) and electroconvulsive therapy (ECT) offers new hope for patients with rare movement disorders. This review systematically summarizes the application and efficacy of both invasived and non-invasived neuromodulation techniques in treating various rare movement disorders, including spinocerebellar ataxia (SCA), Huntington's disease (HD), and neuroacanthocytosis (NA), etc.. The aim is to provide guidance for the application of neuromodulation technique in rare movement disorders.

Severe cerebral venous thrombosis (CVT) is associated with serious clinical manifestations and poor prognosis, and current therapeutic strategies fail to substantially improve outcomes, necessitating exploration of novel therapeutic approaches. The latest studies have shown that inflammation is closely associated with the severity and poor prognosis of severe CVT, and anti?inflammatory therapy may be a very promising treatment. Despite ongoing debate regarding the role of glucocorticoids in severe CVT, recent studies indicate that short? term glucocorticoids pulse therapy may be a safe and effective intervention in acute/subacute severe CVT, which are likely due to suppression of the inflammatory response. This paper focuses on the latest research progress of glucocorticoids therapy for severe CVT, and points out that anti?inflammatory therapy targeting inflammation has great research potential in improving the prognosis of severe CVT. We wish to provide a novel, accessible, effective and safe anti? inflammatory therapy for patients with severe CVT.

Cerebral venous thrombosis (CVT) is a relatively uncommon but serious cerebrovascular disease. Anticoagulation therapy is the preferred treatment. In recent years, significant progress has been made in venous sinus mechanical thrombectomy. However, there is no consensus on mechanical thrombectomy in clinical practice. Issues such as how to bridge thrombectomy with anticoagulation therapy, the definition of severe CVT, and the determination of the mechanical thrombectomy "time window" need further exploration. This paper reviews the progress on anticoagulantion therapy and mechanical thrombectomy for CVT in recent years, and introduces the concept of the "time window" for mechanical thrombectomy, with the aim of providing some inspiration for future clinical research and practice.

Objective: To investigate the short -term efficacy, long -term outcome and safety of recanalization treatment in patients with acute ischemic stroke presenting with large infarct core caused by intracranial atherosclerotic stenosis (ICAS) versus cardiac embolism (CE). Methods: A total of 96 acute ischemic stroke patients with large infarct core who underwent recanalization treatment at The People's Hospital of Anyang City from January 2022 to January 2023 were enrolled. Based on etiology, patients were divided into ICAS group (n = 52) and CE group (n = 44). Short-term efficacy was assessed using the National Institutes of Health Stroke Scale (NIHSS) at 14 d postoperatively, while long -term outcome was evaluated using the modified Rankin Scale (mRS) at 90 d postoperatively. Safety outcome included rate of symptomatic intracranial hemorrhage (sICH), intracranial hemorrhage, cerebral herniation within 24 h postoperatively, and fatality rate at 90 d postoperatively. Results: A statistically significant difference in NIHSS score was observed between the ICAS group and the CE group (F = 5.821, P = 0.023), with the CE group having higher NIHSS score than the ICAS group at admission (t = -2.324, P = 0.022). Both groups showed significant differences in NIHSS score between admission and 14 d postoperatively (F = 589.322, P = 0.000), with the CE group demonstrating lower NIHSS score at 14 d postoperatively compared to admission (t = 4.173, P = 0.001). The ICAS group exhibited a higher rate of favorable outcome at 90 d postoperatively [44.23% (23/52) vs. 25% (11/44); χ² = 3.853, P = 0.050]. No significant differences were observed between the 2 groups in sICH, intracranial hemorrhage, cerebral herniation rate, or 90 d fatality rate (P > 0.05, for all). Conclusions: Recanalization treatment for acute ischemic stroke patients with large infarct core caused by CE demonstrates more pronounced short-term efficacy, while ICAS presenting with better long-term outcome, and there is no significant difference in safety between the 2 groups.

Objective: To develop a dual-layer feature distillation multiple instance learning (DLFD- MIL) model integrating MRI and whole slide image (WSI) features for precise prediction of IDH1 mutation, 1p/19q codeletion, and World Health Organization (WHO) grading in adult-type diffuse gliomas. Methods: A retrospective cohort of 212 adult-type diffuse gliomas patients from Huashan Hospital, Fudan University (January 2021 to June 2024) and 42 cases from The Cancer Genome Atlas (TCGA) were included. Preoperative T₂-FLAIR and postoperative WSI data were jointly analyzed. The DLFD-MIL model addressed the lack of instance - level labels in weakly supervised WSI learning via a pseudo - bag generation strategy. Multimodal feature fusion was achieved through Concat. Diagnostic performance for molecular subtyping and WHO grading was evaluated by comparing area under the curve (AUC) of receiver operating characteristic (ROC) curve between single - mode (WSI or MRI) and multi - mode. Results: In the IDH1 mutation prediction task, AUC of the multi - mode feature fusion model surpassed single - mode WSI model (Z = 2.752, P = 0.006) and single-mode T₂ -FLAIR model (Z = 5.662, P = 0.000). In the 1p/19q codeletion prediction task, no statistically significant differences in AUC were observed between the multi-mode feature fusion model and either single-mode WSI model (Z = - 0.245, P = 0.806) or T₂-FLAIR model (Z = 0.781, P = 0.435). In the WHO grading prediction task, the multi - mode feature fusion model showed no significant differences in AUC compared to single - mode WSI model (Z = 1.739, P = 0.082), however its AUC was significantly higher than single -mode T₂ -FLAIR model (Z = 4.830, P = 0.000). Conclusions: Multi-mode fusion of macro - and micro - imaging features improves prediction accuracy for IDH1 genotyping and WHO grading in gliomas, providing a reliable artificial intelligence (AI) decision - support tool for personalized clinical management.

Objective: To investigate the correlation between vestibular symptoms and balance/walking function in patients with acute brain stem infarction. Methods: Fifty-one patients with acute brain stem infarction with a Functional Ambulation Category Scale (FAC) grade > 3 admitted to Tianjin Huanhu Hospital between November 2023 and December 2024 were included. The subjective visual vertical skew angle was measured using the Bucket Test. The degree of dizziness/vertigo was evaluated by the Visual Analogue Scales (VAS). The vestibulo-ocular reflex function was assessed by dynamic visual acuity (DVA). The Activities-Specific Balance Confidence Scale (ABC) was used to evaluate the balance confidence during performing various tasks, and the Dynamic Gait Index (DGI) was applied to assess the objective dynamic balance function. Results: Spearman rank correlation analysis showed that the ABC score was negatively correlated with the subjective visual vertical skew angle (r_s = -0.414, P = 0.003) and dizziness/vertigo VAS score (r_s = -0.463, P = 0.000), and the DGI index was negatively correlated with subjective visual vertical skew angle (r_s = -0.347, P = 0.012), dizziness/vertigo VAS score (r_s = -0.472, P = 0.000) and the number of rows lost in the yaw plane of DVA (r_s = -0.326, P = 0.019). Multifactor linear stepwise regression analysis showed that the strength of the effect of dizziness/vertigo VAS score (standardized partial regression coefficient = -0.593, P = 0.000) on ABC score was approximately 2.21 times greater than that of the subjective visual vertical skew angle (standardized partial regression coefficient = -0.268, P = 0.015); the effect of dizziness/vertigo VAS score (standardized partial regression coefficient = -0.666, P = 0.000) was 2.53 times stronger on the DGI index than the number of rows lost in the yaw plane of DVA (standardized partial regression coefficient = -0.263, P = 0.010). Further Spearman rank correlation analysis showed a positive correlation between dizziness/vertigo VAS score and the proportion of the stance phase time of gait parameter (r_s = 0.289, P = 0.039). Conclusions: Dynamic balance function in patients with acute brain stem infarction is mainly affected by the dizziness/vertigo severity. Furthermore, the degree of dizziness/vertigo shows a positive correlation with the proportion of stance phase duration during walking, which warrants heightened attention from both clinicians and rehabilitation therapists.

Objective: To analyze the distribution characteristics of imaging biomarkers in cerebral small vessel disease (CSVD) in high - altitude plateau, investigate interrelationships among imaging features, and identify influencing risk factors for high CSVD burden. Methods: A total of 131 CSVD patients diagnosed and treated at People's Hospital of Xizang Autonomous Region between January 2021 and December 2022 were enrolled. Clinical data were collected, and brain MRI was performed to assess white matter hyperintensity (WMH), lacunar infarcts (LACI), cerebral microbleeds (CMBs), and enlarged perivascular space (EPVS), with subsequent calculation of the total CSVD burden score. The distribution patterns of CSVD imaging markers were analyzed. Spearman rank correlation analysis was used to investigate the association among imaging biomakers, including WMH, LACI, CMBs and EPVS. Univariate and multivariate Logistic regression analyses were applied to examine risk factors for high CSVD burden. Results: Total 131 patients with CSVD were divided into high CSVD burden group (1-4 points, n = 85) and low CSVD burden group (0 point, n = 46) according to total CSVD burden score. Compared to the low CSVD burden group, the high CSVD burden group exhibited significantly older age (t = - 5.410, P = 0.000) and a higher prevalence of hypertension (χ² = 14.853, P = 0.000). Among patients with CSVD in high-altitude plateau, the prevalence of WMH was 95.42% (125/131); LACI accounted for 34.35% (45/131), and were commonly located in the basal ganglia region; CMBs were predominantly of the mixed type (40.54%, 15/37); the prevalence of EPVS was 54.96% (72/131). Spearman rank correlation analysis revealed that CMBs were positively correlated with WMH (r_s = 0.255, P = 0.003) and LACI (r_s = 0.289, P = 0.001). Logistic regression analysis revealed that older age (OR = 1.056, 95%CI: 1.026- 1.088; P = 0.000) and hypertension (OR = 2.482, 95%CI: 1.071 -5.753; P = 0.034) were risk factors for high CSVD burden. Conclusions: Prevention and management strategies for CSVD in these populations should prioritize elderly individuals and hypertensive patients. While high-altitude environment may exacerbate cerebrovascular pathology, their specific mechanistic roles require further investigation.

Surgical treatment of spontaneous intracerebral hemorrhage (sICH) is increasingly oriented toward minimally invasive, precise, and safe, with growing emphasis on disease and prognostic assessment, and perioperative monitoring. As a medical image processing software, 3D Slicer has been gradually applied in the diagnosis and treatment of sICH. It enables precise quantification of hematoma-related pathological changes, assists in preoperative trajectory simulation and intraoperative localization, greatly enriching the approaches for sICH evaluation, monitoring, and treatment. This article reviews the use of 3D Slicer software in sICH monitoring and prognostic evaluation, preoperative pathway planning and surgical simulation, intraoperative localization and puncture guidance, and the design and use of postoperative neuroprotective devices, aiming to provide novel insights to advance clinical practice.

Objective: To summarize the clinical manifestations and genetic characteristics of patients with Charcot-Marie-Tooth disease (CMT) caused by ARSs gene variation. Methods and Results: A total of 12 probands with clinical diagnosis of CMT were selected from The First Affiliated Hospital of Fujian Medical University from January 1997 to February 2024 and included in the clinical registration cohort of the hospital. Clinical symptoms: 10 patients had normal proximal limb muscle strength, while the distal limb muscle strength was seriously involved. Most muscular atrophy occurred below ankle joint and wrist joint. Two patients had subjective numbness of limbs, and one patient had reduced symmetry sensation on superficial sensory examination. Tendon reflexes were normal in only one patient. EMG characteristics: for the 11 probands, the median nerve motor nerve conduction velocity (MNCV) ranged from 0 to 65.70 m/s, with an average of 36.67 m/s, and the median nerve compound muscle action potential (CMAP) ranged from 0 to 19.50 mV, with an average of 5.42 mV. ARSs gene variation analysis: there were 4 ARSs gene variants, including GARS1, YARS1, AARS1 and SARS1. Among the 8 GARS1 gene mutation sites (c.1235G > A, c.598G > C, c.362G > A, c.1415A > G, c.637C > T, c.374A > G, c.722G > T, c.1000A > T), c. 598G > C and c. 722G > T had not been reported at home and abroad. EMG showed 5 probands were intermediate CMT (ICMT) and 3 were CMT₂. Among the 2 YARS1 gene mutation sites (c. 1333A > G, c. 787T > C), C. 787T > C has not been reported at home and abroad, and the 2 probands were CMT1 and ICMT. One proband with AARS1 gene mutation (c.896C > T), the EMG showed CMT₂; and there was one proband with SARS1 gene mutation (c.1187C > T), and the EMG showed ICMT. Conclusions: CMT caused by ARSs gene variation mainly causes hereditary motor neuropathy with or without sensory involvement, and the main clinical phenotypes are CMT₂ and ICMT. Different ARSs gene variation-related CMT patients have different clinical manifestations, and gene detection should be performed to confirm the diagnosis. The genetic spectrum of CMT was expanded to provide a basis for disease diagnosis and genetic counseling.

Intracranial pressure (ICP) monitoring serves as a critical component in the management of neurocritical care patients. Hydraulic-coupled intracranial pressure monitoring via external ventricular drainage (EVD-ICP) monitoring offers a clinically practical approach that enables both dynamic physiological assessment and therapeutic intervention, and has gained widespread adoption. However, the significant variability persists across healthcare institutions regarding the procedural standardization and the implementation of systematic management protocols. Building upon evidence-based medical principles and multidisciplinary expert consensus, this "Chinese expert consensus on the management of hydraulic-coupled intracranial pressure monitoring via external ventricular drainage" synthesizes key aspects of EVD-ICP monitoring, including clinical indications, procedural workflows, trouble shooting strategies, monitoring duration, complication prevention and management. The expert consensus aims to standard the technique and management of EVD-ICP monitoring, enhance diagnostic and therapeutic outcomes in the neurocritical care patients, and promote the standardized, precise and efficient application of this technology across clinical settings.