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.

Objective: To investigate the correlation between phosphorylated Tau at threonine 181 (p-Tau 181) in peripheral blood and brain injury in premature infants.

Methods: The p-Tau 181 level in the peripheral blood of premature infants was retrospectively analyzed. Twenty-eight premature infants were selected, including 13 in the brain injury group and 15 in the control group. The level of p-Tau 181 in peripheral blood was detected by Simoa assay.

Results: The plasma level of p-Tau 181 in the brain injury group was significantly higher than that in the control group (P < 0.05). The result of logistic regression analysis revealed that the elevated level of p-Tau 181 in plasma was an independent risk factor of brain injury.

Conclusion: There may be overexpression of p-Tau 181 in plasma in premature infants with brain injury.

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 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.

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.

Objective: To investigate the efficacy of group art therapy on clinical symptoms and empathy ability in patients with first-episodic remission schizophrenia.

Methods: 60 patients with first-episode remission schizophrenia were included and randomly divided into study group and control group, with 30 patients in each group. The control group was given routine rehabilitation treatment on the basis of drug treatment, while the research group was intervened by group art therapy in addition to the drug and routine rehabilitation treatment for 15 weeks. Before and after the intervention, both groups completed the assessment of Positive And Negative Syndrome Scale (PANSS), Interpersonal Reactivity Index-C (IRI-C), and Personal and Social Performance scale (PSP).

Results: The changes in the scores of the negative symptom factor before and after the intervention in the research group was statistically significant compared with those in the control group (P < 0.001). After the intervention, the changes were superior to those in the control group in terms of the IRI-C total score, perspective taking (PT), imagination (FS), empathic concern (EC), personal distress (PD), and the total score of PSP (P < 0.05).

Conclusion: As a rehabilitation training method, group art therapy can effectively improve the empathy ability of patients with first-episode schizophrenia in remission, reduce clinical symptoms, and improve social function.

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.

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.

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.

Objective: To construct an item response theory (IRT) model for functional assessment of non-acute stroke patients based on the international classification of functioning, disability and health (ICF) for functional assessment, verification of its reliability and validity, and exploration of the overall benefit index and interrelationships of functional items through graphical models (GMs).

Methods: A cross-sectional study was conducted, enrolling non-acute stroke patients admitted by the First Rehabilitation Hospital of Shanghai from July 2023 to December 2023. Assessments included the Mini-Mental State Examination (MMSE), Functional Independence Measure (FIM), Stroke Social Network Scale (SSNS), and ICF Rehabilitation Set (ICF-RS). Based on the Mokken assumption, nonparametric IRT (npIRT) was applied to the ICF-RS items through Mokken Scale Analysis (MSA), by which items suitable for a parametric IRT model (pIRM) were identified, and person-item maps were generated to compare patient's abilities with the difficulty levels of functional items. Based on Bayesian learning, the benefit values of the items and the network parameters of the functional items were estimated using the Ising model, and a maximum spanning tree was generated to visualize the distribution of functional items and the potential intervention pathways.

Results: Adhering to the maximum heterogeneity sampling, a total of 100 non-acute stroke patients (males = 70, females = 30) were included, yielding a Rasch scale containing 22 ICF items with a latent class reliability coefficient (LCRC) of 0.959. The dichotomized Rasch model scores significantly correlated strongly with FIM scores (P < 0.001, r= 0.89). The most difficult items included "b455 Exercise tolerance", "d660 Assisting others" and "d640 Doing housework". The easiest item was "d550 Eating". By integrating IRT and GM, the item "d420 Moving oneself" was identified as a functional item that, although within the patient's ability range, still presents impairments, and its improvement may serve as a "bridge" for alleviating other functional impairments. The Ising model indicated that enhancing the ability of patients in "d510 Washing oneself" would yield the greatest overall functional benefit.

Conclusion: Based on pIRM, a Rasch model with good reliability and validity can be extracted for functional assessment of patients with non-acute phase of stroke, and the application of the IRT model and Ising network analysis can customize personalized rehabilitation goals for patients.

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.