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

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

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

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

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

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.

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.

Objective: To explore the effect of mirror therapy on patients with dysphagia in the poststroke pharyngeal phase under embodied cognition theory.

Methods: 40 patients with pharyngeal dysphagia after stroke were randomly divided into 2 groups according to random number table method, with 20 cases in each group. There were no statistically significant differences in gender, age, stroke type, and disease duration ratio. Each group received routine swallowing treatment, and each group received different intervention training on the basis of routine. The control group received static mirror therapy, and the observation group received dynamic mirror therapy. The swallowing function of the patients was evaluated by the Fujijima swallowing efficacy evaluation scale, the Kubota water swallowing test (WST), and the video fluoroscopic swallowing study (VFSS) before and after treatment, and the total effective rate was compared by WST grading.

Results: After treatment, the scores of Fujijima swallowing efficacy evaluation scale and VFSS in 2 groups were significantly improved compared with those before treatment (P values <0.001), and the observation group was significantly improved compared with the control group (P values of 0.020 and <0.001, respectively). After treatment, the WST grade score of the two groups decreased, and the decrease of the observation group was more obvious than that of the control group, the difference was statistically significant (P＝0.044). After treatment, the comprehensive effective rate of the 2 groups was significantly different (P＝0.045).

Conclusion: Both dynamic mirror therapy and static mirror therapy can improve the swallowing function of patients with pharyngeal dysphagia after stroke, and the therapeutic effect of dynamic mirror therapy based on embodied cognition theory is superior to static mirror therapy.

Objective: To clarify the effect of comprehensive rehabilitation treatment on the improvement of the activities of daily living (ADL) of stroke patients during a single hospitalization period, and to explore the influencing factors of the improvement of ADL at the time of discharge.

Methods: This study was a retrospective study. A total of 320 stroke patients with hemiplegia admitted to the Rehabilitation Medicine Center of The First Affiliated Hospital of Nanjing Medical University, from January 2022 to December 2024 were selected as the research objects. Descriptive statistical analysis was used to analyze the improvement of ADL of stroke patients at the time of discharge. The patients were grouped according to the minimal clinically important difference (MCID), which was defined as an increase of more than 10 points in the Barthel index (BI). Univariate and multivariate analyses were used to screen the influencing factors of ADL improvement.

Results: The comprehensive rehabilitation treatment during a single hospitalization period increased the average BI score of the patients by 12.86 points. Univariate analysis showed that the course of disease, BI score at admission, standing balance, walking ability, cognitive impairment, and emotional disorder were significantly correlated with ADL improvement (P<0.05). Multivariate Logistic regression analysis indicated that the course of disease (OR＝ 0.996, P＝0.041), concurrent hypertension (OR＝0.558, P＝0.050), and walking function (OR＝0.716, P＝0.000) were independent predictive factors for ADL improvement.

Conclusion: Comprehensive rehabilitation therapy during a single hospitalization cycle resulted in clinically significant improvement in ADL in 45.9% of stroke patients. The course of disease, concurrent hypertension, and walking function at admission might be the main factors affecting the improvement of ADL. Early intervention of rehabilitation, prevention and management of underlying diseases, and the formulation of appropriate rehabilitation goals would help improve the patients' ability of ADL and further enhance their quality of life.

Objective: To investigate the effects of aerobic exercise on clinical symptoms and gut microbiota in Parkinson’s disease (PD) patients of different age groups.

Methods: This study included 21 PD patients, divided into age groups of <60 years and ≥60 years, and underwent an 8-week moderate intensity aerobic exercise intervention. Assess patients with relevant scales before and after intervention, and collect their feces for 16S ribosomal RNA amplicon sequencing and statistical analysis.

Results: Only UPDRS-III on-off and total scores showed statistically significant improvement in <60 years old PD patients after aerobic exercise intervention (P＝0.042, P＝ 0.021); UPDRS-II, UPDRS-III on, UPDRS-III off, UPDRS total scores, Berg Balance Scale (BBS) and Tinetti Performance Oriented Mobility Assessment (Tinetti POMA) improved in ≥60 years old PD patients (the P values were 0.029, <0.001, 0.025, <0.001, 0.008 and 0.023 respectively). In addition, after aerobic exercise intervention, the Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), PD Questionnaire 39 (PDQ- 39), Rapid Eye Movement Sleep Behavior Disorder Screening Questionnaire (RBDSQ), Scales for Outcomes in PD Autonomous (SCOPA-AUT), Gastrointestinal Dysfunction Score (Gastrointestinal Dysfunction Score), Gastrointestinal Dysfunction Score (GIDS), Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD) and Non Motor Symptoms Scale (NMSS) scores were improved in ≥60 years old PD patients (P values were 0.002, 0.006, 0.002, 0.016, 0.007, 0.029, 0.002, 0.008, and 0.003, respectively). The NMSS score of PD patients in the <60 age group improved and the difference was statistically significant (P＝0.044) after intervention. Gut microbiota analysis revealed the relative abundance of Fusicatenibacter and Erysipelotrichaceae_UCG-003 were increased in the PD group aged <60 years after aerobic exercise intervention, and the difference was statistically significant compared with the pre-intervention period (Z values were －2.201 and －2.207, and P values were 0.028 and 0.027, respectively).

Conclusion: Moderate-intensity aerobic exercise can improve motor symptoms as well as non-motor symptoms such as cognition, quality of life, sleep, autonomic function, anxiety and depression in PD patients of different age groups. Notably, moderate-intensity aerobic exercise can improve the relative abundance of beneficial gut microbiota, particularly in <60 years old patients .

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.

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.

Schizophrenia is a severe mental illness, with patients exhibiting an average lifespan reduction of 10-15 years compared to the general population. The main causes of death in schizophrenia patients include cardiovascular disease, suicide, and accidental injury. As a non-invasive examination method, fundus photography can effectively assess microvascular lesions, thereby predicting the risk of cardiovascular disease. Given that cardiovascular disease is a common comorbidity in schizophrenia patients and is closely related to their high mortality rate, the application of fundus photography in schizophrenia patients not only facilitates early identification of potential cardiovascular problems, but also provides important reference for predicting the patient's life expectancy. Consequently, non-invasive fundus photography holds promise for enhancing monitoring approaches and treatment strategies for schizophrenia patients, ultimately contributing to extended lifespan.

Stroke is characterized by high incidence, high mortality, and high disability rates. A series of functional impairments caused by stroke are the primary reasons for patient disability, making stroke rehabilitation a research hotspot in cerebrovascular disease recovery. The pathogenesis is characterized by underlying deficiency and manifesting excess, The occurrence of stroke is closely related to microcirculatory disorders and abnormal energy metabolism, while traditional Chinese medicine theory attributes its pathogenesis to “deficiency in origin and excess in manifestation”. For patients with ischemic stroke (IS) of the “qi deficiency and blood stasis”, rehabilitation strategies primarily focus on restoring neurological function, regulating neural reflexes, and promoting brain functional remodeling. Both traditional Chinese medicine and western medicine have shown favorable clinical efficacy in treating IS patients. Western medicine focusing on reperfusion after ischemia. However, its clinical outcomes are limited by the “no reflow” phenomenon after revascularization and controversies surrounding the efficacy of neuroprotective agents. Traditional Chinese medicine demonstrates unique advantages through tonifying qi and activating blood circulation, regulating gut microbiota-brain axis, and other holistic interventions. This article primarily discusses the clinical approaches for the synergistic intervention of traditional Chinese medicine and western medicine in “qi deficiency and blood stasis” type IS, systematically reviews the mechanisms and clinical evidences of both treatments, and explores synergistic enhancement pathways of them. By integrating clinical trials, basic research, and guideline consensus from the past five years, this review aims to provide new ideas and methods for the integrated traditional Chinese and western medicine therapy of “qi deficiency and blood stasis” type IS. It also seeks to offer a scientific basis for optimizing individualized treatment plans and advancing the internationalization of the integration traditional Chinese and western medicine.

This case reports a young woman presenting with headache and blurred vision, with imaging revealing multiple ring-enhancing micronodules diffusely distributed throughout the brain, exhibiting a starry sky pattern. The patient had a history of medication abortion 3 weeks prior. Laboratory tests showed significantly elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), strongly positive serum T-cell spot test (T-SPOT), and chest CT demonstrating miliary nodules in both lungs. Integrated with the laboratory findings and imaging features, the patient was ultimately diagnosed with miliary cerebral tuberculosis complicated by pulmonary tuberculosis. Symptoms markedly improved after antitubercular therapy. This article reviews and discusses the differential diagnostic approach to intracranial multiple ring-enhancing lesions (starry sky sign).