BackgroundChildren who have first-degree relatives diagnosed with substance use disorders and/or severe mental illnesses show altered prefrontal cortical development and an elevated risk of executive function impairment. fNIRS-based neurofeedback (NF) is a portable, child-tolerant technique for the modulation of cortical hemodynamics, with preliminary evidence of dlPFC-dependent cognitive benefits in adult populations. However, evidence evaluating its efficacy in pediatric at-risk cohorts from the Indian subcontinent is currently lacking.MethodsThis single-arm, uncontrolled proof-of-concept study evaluated the feasibility and tolerability of an eight-session, fNIRS-based NF protocol targeting two right dlPFC channels (Ch10, Ch15) in 11 children (aged 6–12 years), recruited from an inpatient psychiatric unit and an addiction treatment facility. Real-time oxygenated hemoglobin (HbO) feedback was provided via Turbo-Satori BCI. Session-wise HbO amplitude and Ch10↔Ch15 functional connectivity (FC) were extracted for all 11 children. Participants completed pre- and postintervention assessments of executive function. Exploratory Spearman correlations examined the associations between dlPFC HbO modulation and pre–post behavioral changes.ResultsAll 11 children completed the protocol without adverse events. The ROI-averaged right dlPFC HbO amplitude showed a positive session-wise increase that did not reach conventional significance (β = 0.00003, t(950) = 1.90, p = 0.058). Individual channel slopes were positive but non-significant after FDR correction. Inter-channel FC increased from session 1 (r = 0.21) to session 4 (r = 0.41) before declining by session 8 (r = 0.18), with no significant linear trend. Behavioral measures showed numerically higher accuracy across tasks, and both the Raven’s CPM and the Stroop task showed shorter reaction times postintervention, but none of the comparisons survived Bonferroni correction. A moderate-to-strong correlation was observed between right dlPFC HbO change and Stroop incongruent accuracy improvement, but it was non-significant (ρ = 0.679, p = 0.094), with no significant associations for the N-back or CPM outcomes.ConclusionThis eight-session right dlPFC fNIRS–NF protocol in children with elevated familial risk was feasible and well tolerated. It showed a positive, but not statistically significant, increase in HbO amplitude. The connectivity between targeted channels and behavioral scores showed a positive correlation, but it was not statistically significant. A strong-to-medium correlation was observed between right dlPFC HbO change and Stroop incongruent accuracy scores. These findings provide preliminary effect-size estimates to inform the design of future sham-controlled trials in this underrepresented pediatric population.
ObjectiveTo investigate the effects of different motor skills (open and closed) on the cognitive switching function and hemodynamic response characteristics of the prefrontal cortex in male athletes, providing a neurocognitive basis for the scientific selection of high-level athletes and the development of personalized cross-training programs.MethodsThis study recruited a total of 31 male Level 2 athletes, who were divided into an open-skill group (n = 16) and a closed-skill group (n = 15) based on the specific sports they had been practicing for a long time. Functional near-infrared spectroscopy (fNIRS) combined with a more-odd shift cognitive switching task was used to monitor changes in the oxyhemoglobin (HbO2) concentration in the dorsolateral prefrontal cortex (DLPFC), frontal pole (FPC), orbitofrontal cortex (OFC), and inferior frontal gyrus (IFG) in real time while the subjects performed the task in a natural state. Mixed-design ANOVA and independent samples T tests were used to systematically compare the behavioral performance (reaction time, accuracy, and switching cost) and brain region activation characteristics between the two groups.Results1. Behavioral Results: Although there were no significant differences in overall accuracy or reaction time between the two groups, the interaction effect between group and condition was significant for reaction time. Under the premise of equal accuracy, the reaction time conversion cost of the open skill group (126.26 ± 92.26 ms) was significantly lower than that of the closed skill group (230.72 ± 143.03 ms), indicating higher cognitive conversion efficiency.2. HbO₂ Activation Results: During the cognitive conversion task, compared with the open skill group, the closed skill group had significantly higher HbO2 activation levels in the DLPFC (p = 0.001), FPC (p = 0.004), and OFC (p = 0.001). There was no significant difference in activation levels in the IFG between the two groups (p > 0.05). 3. HbR Activation Results: There were no significant intergroup differences in deoxygenated hemoglobin (HbR) levels across the four brain regions (IFG, DLPFC, FPC, and OFC) (p > 0.05)0.4. HbT Activation Results: Total hemoglobin (HbT) activation in the DLPFC (p = 0.008), FPC (p = 0.009), and OFC (p = 0.009) was significantly higher in the closed skill group than in the open skill group. There was no significant difference in HbT activation levels in the IFG between the two groups (p > 0.05)0.5. Correlation Results: Pearson correlation analysis revealed that there was no significant linear correlation between behavioral switching costs and cortical activation levels in any of the four brain regions for either the open or closed motor skill group (p > 0.05).ConclusionLong-term open-skill training in dynamic, unpredictable contexts may enhance athletes’ cognitive flexibility and promote more efficient cortical resource allocation in critical cognitive control regions (DLPFC, FPC, and OFC). This study empirically validates the “neural efficiency hypothesis” and the “broad transfer hypothesis” from a neuroimaging standpoint. This study preliminarily indicates that moderate integration of open-skill cross-training into closed-skill programs may optimize the executive control network; however, the actual advantages of this method require validation through future extensive longitudinal intervention studies.
PurposeThe present study investigates the overlap between arithmetic and literacy, by examining arithmetic performance in children with combined reading and spelling deficits, isolated reading or spelling deficits and age-appropriate (typically developing) reading and spelling skills. We also examine whether controlling for literacy predictors (RAN, phonological awareness) explains group differences in arithmetic performance.MethodsOne hundred sixty-one elementary school children from Grades 2–5 participated in our study. We classified children based on their reading fluency and spelling performance. Children scoring below the 20th percentile were classified as impaired. In addition to the reading and spelling tasks, children completed a timed arithmetic task, as well as a verbal phonological awareness and a computerized RAN task with letters.ResultsChildren with combined reading and spelling deficits demonstrated poorer arithmetic performance than children with isolated spelling deficit and typically developing peers. However, these differences disappeared after controlling for phonological awareness and RAN alone or together. Bayesian analyses supported the null model when linguistic predictors were included.ConclusionThe results confirm the overlap between literacy and numeracy difficulties, suggesting that children with combined reading and spelling deficits are at greater risk of also having an arithmetic difficulty than children with isolated literacy problems. Underlying language skills, particularly RAN and phonological awareness, account for the overlapping deficits.
IntroductionSensorimotor rhythm (SMR) neurofeedback has attracted growing interest for improving performance in precision sports; however, inter-individual variability in responsiveness remains poorly understood, and its associations with autonomic regulation and shooting performance have not been examined within a single-session paradigm. Because a substantial proportion of trainees show limited ability to self-regulate EEG activity (“non-responders”), characterizing responsiveness is important for developing personalized protocols. This exploratory study aimed to characterize individual differences in SMR neurofeedback responsiveness during a single session and examine their associations with post-training autonomic regulation and shooting performance in elite air rifle athletes.MethodsThirteen elite air rifle shooters completed a single 10-min SMR (12–15 Hz) neurofeedback session at electrode site Cz. Heart rate variability (HRV) was recorded at four timepoints spanning pre- and post-shooting and pre- and post-training rest. Shooting performance was assessed via the SCATT system across two 30-shot blocks. Individual SMR regulation trajectories were indexed as linear amplitude slopes across five training blocks. Athletes were classified as Responders (slope > 0; n = 9) or Non-Responders (slope ≤0; n = 4) reflecting whether SMR amplitude showed a net increase or decrease across training.ResultsSMR slope showed the strongest associations with changes in shooting score (r = 0.623) and logLF (r = −0.636), though neither survived Benjamini–Hochberg FDR correction (both q = 0.248). Responders exhibited larger post-training increases in DFA α2 (a long-term scaling exponent derived from detrended fluctuation analysis reflecting autonomic regulatory complexity; d = 1.688, p = 0.017) and larger decreases in logLF (d = 1.654, p = 0.019) than Non-Responders, though neither survived FDR correction. No baseline HRV (all p > 0.09) or subjective engagement (all p > 0.21) differences were observed between groups.DiscussionThese preliminary, exploratory findings suggest that individual SMR regulatory capacity may relate to post-training autonomic modulation and shooting performance, and that SMR amplitude slope may represent a promising index of neurofeedback learning. Given the small and unequal responder groups (n = 9 vs. 4) and the absence of a sham or control condition, these associations should be interpreted as hypothesis-generating rather than confirmatory, warranting replication in larger, controlled samples.
Children with ADHD often experience difficulties in mathematics, but the mechanisms underlying these difficulties remain unclear. One possibility is that they reflect a basic impairment in the “number sense,” that is, the ability to approximate the number of objects and temporal events without counting. Here, we tested this hypothesis by asking children with ADHD (N = 20) and typically developing controls (N = 43) to verbally estimate briefly presented dot arrays, temporal sequences of flashes, and self–generated hand actions (button presses). Performance was quantified in terms of precision (Weber fraction) and accuracy (absolute bias). In the unadjusted analysis, children with ADHD showed lower overall estimation precision than controls. The group difference disappeared after adjustment for age, reasoning abilities, and mathematical performance. No group differences emerged for estimation accuracy. Taken together, these findings provide no clear evidence of impaired approximate numerosity processing in ADHD and are consistent with the possibility that mathematical difficulties do not primarily arise from a core deficit in the non–symbolic number sense.
Sex differences in mental rotation represent one of the most consistently reported behavioural sex differences. Identifying the neurophysiological mechanisms underlying spatial cognition may contribute to a more comprehensive understanding of cognitive processing in males and females. The present review synthesises evidence from event-related potential (ERP) studies and identifies sex-related neurophysiological differences across ERP correlates of mental rotation in healthy young adults. Behavioural evidence was also synthesised to examine its relationship to ERP findings. A structured search of PubMed, Scopus, and Web of Science identified studies published between January 1987 and February 2026. Twelve studies met the inclusion criteria, all involving young adult participants. The evidence suggests that young males may show higher mental rotation performance, accompanied by sex-related differences in ERP amplitude, latency, global field power, and topographic patterns. Early and later ERP differences suggest sex-related differences in neurophysiological processing, although the underlying mechanisms remain uncertain. ERP differences may also occur without behavioural effects, suggesting greater sensitivity of neurophysiological measures. The most consistent finding across studies is that behavioural and neurophysiological sex differences become more pronounced as task difficulty increases, particularly with larger rotation angles and more complex, three-dimensional, less familiar, or less nameable stimuli. In contrast, evidence regarding the effects of response format, stimulus presentation, time constraints, and specific cognitive strategies remains limited or inconsistent. Given the limited number of studies, methodological heterogeneity, and small sample sizes, these findings should be interpreted with caution.
BackgroundNeuromuscular control is essential for maintaining posture and performing motor tasks. Real-time visual feedback provides sensory information that may influence central neural processing and lower-limb muscle coordination during balance tasks. This study investigated the effects of visual feedback on neuromuscular control in healthy adults.MethodsThirty healthy adults aged 18–40 years completed four randomized balance conditions with or without real-time visual feedback. Physical activity and sports participation were assessed using the Tegner Activity Scale. Static and dynamic balance asymmetry were evaluated using the Prokin Balance System and Y-Balance Test, respectively. Prefrontal cortical activity was recorded using functional near-infrared spectroscopy (fNIRS), and lower-limb muscle activation was assessed using surface electromyography (sEMG).ResultsAmong participants with lower physical activity levels (Tegner score < 5), left prefrontal cortex (lPFC) activation was significantly higher with visual feedback than without feedback. Among participants with greater bilateral balance asymmetry, right prefrontal cortex (rPFC) activation was significantly higher during cross-body X-shaped arm movements performed with visual feedback. Exploratory sEMG data from seven eligible participants further showed a higher relative activation ratio of the left posterior to anterior thigh muscles during visual-feedback tasks in participants with lower physical activity and poorer balance symmetry.ConclusionVisual feedback was associated with altered prefrontal activation and reorganization of lower-limb muscle coordination during motor tasks in healthy adults.
IntroductionAnorexia Nervosa (AN) patients exhibit cognitive and neural disturbances during food processing, yet underlying mechanisms remain unclear. Our study investigated whether AN and Atypical AN (AAN) patients show altered neural, cognitive, and behavioral responses to high and low-calorie food stimuli, and whether these effects appear largely food-specific.MethodsSeventeen AN/AAN, 17 HCs, and 17 overweight/obese females viewed high and low-calorie food stimuli, rated palatability (yes/no), and completed an emotional picture viewing task (IAPS) while high-density EEG was recorded.ResultsPalatability ratings did not differ significantly among groups; however, exploratory analyses suggested that patients with the restricting subtype (AN-R; n = 6) rated high-calorie foods as less palatable than low-calorie foods compared to other groups. EEG findings revealed significant but modest group-specific modulation (N400; 388–418 ms; p = 0.049; Cluster size = 97 voxels; Peak statistic X = 9.78): HCs showed enhanced responses to high-calorie food, whereas AN/AAN and overweight/obese participants showed greater responses to low-calorie food. Source localization implicated the right fusiform gyrus and inferior-medial temporal cortices. No comparable effects occurred during the IAPS task.ConclusionAN/AAN individuals exhibit disrupted calorie-dependent semantic processing in right inferior temporal regions, indicating altered food evaluation. These findings provide a neural basis for restrictive eating in AN/AAN, highlighting the role of semantic processing in disorder-specific food disturbances.
ObjectiveTo describe a brief and easily applicable electroneurographic (ENG) maneuver that can reveal ulnar-evoked motor activity detectable over the abducto’r pollicis brevis (APB) region in selected carpal tunnel syndrome (CTS) cases. The aim is to illustrate how targeted ulnar stimulation may complement routine CTS evaluation, rather than to redefine severity grading or clinical decision making.MethodsRoutine upper-limb nerve conduction studies were supplemented with targeted motor stimulation of the ulnar nerve at the wrist, elbow, and above the elbow while recording over the APB region. From a larger CTS cohort, three illustrative cases with distinct electrophysiological patterns were retrospectively selected to demonstrate ulnar-evoked activity detectable at the APB recording site across selected CTS severity categories.ResultsIn all three cases, ulnar nerve stimulation elicited reproducible compound muscle action potentials recorded over the APB region, including situations where median-evoked APB responses were markedly reduced or absent. Latency characteristics and proximodistal consistency were compatible with known patterns of median–ulnar motor communication and demonstrated how ulnar-evoked activity detectable at the APB site may appear across the chosen CTS severity categories.ConclusionThis preliminary case series shows that targeted ulnar stimulation can reveal ulnar-evoked motor activity detectable over the APB recording site in selected CTS patients. These descriptive findings raise the hypothesis that median motor parameters alone may not fully reflect the pattern of motor activity measurable at the APB region in all individuals.SignificanceThe maneuver is simple and quick, and may provide supplementary neurophysiological information in CTS—particularly in cases with reduced or absent median-evoked APB responses. Larger studies are required to determine its reproducibility, prevalence, and clinical relevance.
IntroductionMany people with aphasia experience concomitant executive functioning deficits, and the literature supports a role of executive functioning in treatment response. However, the optimal executive functioning assessment for measuring this impact is unclear, as is the extent to which outcomes (e.g., acquisition, generalization) may be impacted differently. The present retrospective study aimed to determine the degree to which nonverbal fluency, one measure of executive functioning with minimal language demand, was associated with naming treatment acquisition, stimulus generalization, and response generalization in people with chronic aphasia. We hypothesized that nonverbal fluency would be positively associated with treatment acquisition and both forms of generalization, based on the existing literature.MethodsThis retrospective study included 13 participants with chronic, post-stroke aphasia from a completed clinical trial. Participants completed 2 weeks of a cued picture-naming treatment. Using linear regression, we examined the association between baseline nonverbal fluency and Tau-U treatment effect size for trained (acquisition) and untrained items (response generalization) and percent stimulus generalization (definition naming).ResultsControlling for aphasia severity, nonverbal fluency was a small but significant correlate of response and stimulus generalization, but not of treatment acquisition.DiscussionNonverbal fluency may be associated with generalization, whereby executive functioning abilities may support generalizing aphasia interventions beyond trained items and contexts. However, more research is needed to investigate the potential association between executive functioning and various treatment outcomes as well as its clinical utility.
IntroductionSensory processing sensitivity (SPS) is a personality trait that has both positive features (SPS+) such as sensitivity to subtle cues, and negative features (SPS−) such as sensitivity to unpleasant stimuli or situations. Both SPS feature clusters are related to empathy. This study examined the neural correlates of SPS as it relates to empathy in the brain at rest.MethodsIn a sample of university students (N = 172), we identified links between SPS facets and multiple aspects of empathy measured via self-report. Subsequently, resting-state functional magnetic resonance imaging scans from 40 of these participants (Mage = 21.10 years; 22 females) were analyzed, using neural regions associated with empathy as seeds. Second-level correlation analyses identified associations between functional connectivity (FC) for each seed-to-voxel connection and each facet of SPS.ResultsSPS+ was associated with increased FC between medial prefrontal cortex (mPFC) and left superior parietal lobule, right intracalcarine cortex, and bilateral lateral occipital cortex (LOC). SPS− was associated with increased FC between the left inferior frontal gyrus and right frontal pole; right insula and primary somatosensory cortex; mPFC and left LOC; and precuneus and left frontal pole. SPS− was also associated with decreased FC between the left inferior frontal gyrus and left LOC; left insula and brainstem; precuneus and left occipital pole; and precuneus and right cerebellum.ConclusionThese patterns may relate to specific features of SPS including enhanced visual processing, deeper processing of information, and heightened interoceptive and emotional processing, which may contribute to the strong feelings of empathy reported by individuals with SPS, and to emotion dysregulation that may exacerbate feelings of personal distress in those possessing strong SPS− traits when witnessing others’ suffering.
ObjectiveA recent meta-meta-analysis concluded that the average effect of exercise on memory is near zero after correcting for publication bias (SMD = 0.027). We tested whether this null finding reflects excessive aggregation rather than a genuine absence of effect.MethodsWe conducted a focused reanalysis a publicly available meta-meta-analytic database, applying a theoretically motivated outcome reclassification protocol to isolate verbal declarative memory (VDM). From 2,239 effect-size estimates spanning 215 meta-analyses, k = 37 VDM-specific estimates were synthesized using a random-effects model. Publication bias was assessed via Egger’s test, PET-PEESE, and trim-and-fill.ResultsThe pooled effect was g = 0.216 [95% CI (0.075, 0.357), p = 0.003], approximately eight times larger than the aggregate estimate of 0.027. Moderate heterogeneity was observed (I2 = 56.1%), with no significant funnel plot asymmetry (p = 0.458). Aerobic exercise produced the most robust benefit (g = 0.229, k = 27).ConclusionThe null aggregate memory effect masks a meaningful signal for verbal declarative memory. The findings support domain-specific exercise prescriptions: for hippocampus-dependent verbal memory, moderate-intensity aerobic exercise represents an evidence-supported strategy for enhancing retention.
Among sensory inputs, auditory information plays a significant role. Neural entrainment may establish a bridge for the brain’s perception of rhythmic sound signals. It refers to the synchronization of ongoing neuronal activity with internal and external rhythmic stimuli, demonstrating the brain’s plasticity and adaptive dynamics. Across canonical EEG bands, delta activity is associated with temporal prediction and hierarchical auditory processing over longer time scales; theta activity with speech parsing, audiovisual integration, and memory-related timing; alpha activity with cross-modal information processing; beta activity with predictive timing and auditory-motor coordination; and gamma-range responses with fine temporal encoding and steady-state activity. These associations overlap rather than represent one-to-one functional mappings. This mini review included studies based on speech, music, pure tones, and other natural or artificial auditory stimuli. We explored the functional roles of these oscillatory activities and their interactions. Finally, we prudently reviewed the emerging applications of auditory neural entrainment for brain diseases. These explorations have yielded some exciting results, but the evidence remains in its early stages and shows heterogeneity. It is also limited by small sample sizes and short study periods. Moreover, many music- and rhythm-based interventions have shown symptom improvement, but most provide only indirect evidence. Therefore, we emphasize that future studies should more deeply explore the relationship between neural entrainment and proven therapeutic benefits, while also attending to safety, individual differences, and the adequacy of control groups in sham interventions.
The neuro-endocrine-immune (NEI) network is a key regulatory network that maintains organismal homeostasis and participates in stress responses. Its function depends on the dynamic coupling among the nervous, endocrine, and immune systems. Astrocytes, as abundant and functionally diverse glial cells in the central nervous system, are increasingly recognized as important participants in the NEI network. Growing evidence indicates that astrocytes do not merely provide structural support in the traditional sense, but also exhibit marked regional heterogeneity and functional diversity. Through broad sensing of neural, endocrine, and immune signals, gliotransmitter release, metabolic regulation, extracellular vesicle-mediated communication, and interactions with neurons, glial cells, the glymphatic system, and endocrine axes, astrocytes actively participate in the integration of neural activity, the regulation of endocrine homeostasis, and immune responses. Under physiological conditions, astrocytes contribute to the dynamic balance of the NEI network by integrating multisource signals derived from neurons, endocrine factors, and immune molecules. Under pathological conditions, such as inflammation, ischemia, and neurodegenerative diseases, the phenotype and function of astrocytes undergo substantial remodeling, thereby contributing to NEI network dysregulation and disease progression. In this structured narrative review, literature published between 2016 and 2026 was retrieved from the PubMed and Web of Science databases using “astrocytes,” “nervous,” “endocrine,” and “immune” as search terms. It summarizes the structural and functional basis of astrocytes and the mechanisms by which they regulate the NEI network, with the aim of systematically elucidating the physiological and pathological significance of astrocytes in NEI network integration and providing a theoretical basis for mechanistic studies and targeted intervention strategies for related diseases.
While previous studies have identified motor dysfunction in individuals with Mild Cognitive Impairment (MCI), the experimental tasks investigated to date have remained relatively limited. This study compared multi-finger force production in individuals with MCI and healthy controls (HC), employing a task designed to comprehensively reflect the complexities of neural integrity. Participants were instructed to match a target force using the net force of five fingers with real-time visual feedback, while individual finger forces were also measured. The analyses were conducted at two levels: net force level and individual finger force level. In addition, linear and non-linear approaches were utilized to examine spatial and temporal structures. At the net force level, the MCI group exhibited diminished accuracy (RMSE), increased fluctuation (CV), and lower adaptability (SampEn) in force patterns. Furthermore, the MCI group demonstrated significantly lower spatial (ΔVZ) and temporal stability (MLE) at individual finger level. These findings suggest that multi-finger tasks may reflect subclinical motor alterations associated with cognitive decline. Consequently, this research offers a valuable evidence-base for the potential development of non-invasive behavioral markers for MCI screening.
Background:Post-stroke dysphagia is a common and serious complication. Neurorehabilitation strategies include peripheral neuromuscular electrical stimulation (NMES) and central transcranial direct current stimulation (tDCS), which operate via distinct bottom-up and top-down mechanisms, respectively. However, their differential effects on cortical hemodynamic responses during functionally distinct swallowing tasks remain poorly understood. This pilot study aimed to investigate the immediate modulatory effects of NMES and tDCS on cortical hemodynamics during different swallowing tasks in post-stroke patients using functional near-infrared spectroscopy (fNIRS). Methods:Eleven patients with post-stroke dysphagia participated in this exploratory, within-subject, repeated-measures pilot study. A minimum 24-h washout period was maintained between sessions, and the order of intervention conditions was randomized using a computer-generated sequence. Cortical hemodynamic responses, measured by changes in oxygenated hemoglobin (ΔHbO₂), were monitored using a 56-channel fNIRS system. Each participant performed both water swallowing and saliva swallowing tasks under three randomized conditions: a no-stimulation baseline, peripheral stimulation (NMES applied to suprahyoid muscles), and central stimulation (bilateral anodal tDCS over the primary motor cortex). Task-related cortical hemodynamic responses and hemispheric lateralization were analyzed for key regions of interest. Results:The primary analysis identified significant Stimulation × Task interactions in the bilateral frontopolar cortex (FPC), including the ipsilesional FPC, F(2, 20) = 8.44, raw p = 0.002, q = 0.031, partial η2 = 0.458, and the contralesional FPC, F(2, 20) = 7.42, raw p = 0.004, q = 0.031, partial η2 = 0.426. Bonferroni-adjusted simple-effects analyses showed that, under tDCS, water swallowing elicited greater FPC responses than saliva swallowing in both the ipsilesional (p_adj = 0.020) and contralesional (p_adj = 0.008) FPC. During water swallowing, tDCS produced greater contralesional FPC responses than no stimulation (p_adj = 0.006), whereas during saliva swallowing, no stimulation produced greater bilateral FPC responses than tDCS (I-FPC: p_adj = 0.008; C-FPC: p_adj = 0.034) and greater ipsilesional FPC responses than NMES (p_adj = 0.043). Exploratory paired comparisons, with FDR correction applied within each comparison family, further showed that under the no-stimulation condition, saliva swallowing elicited greater bilateral FPC responses than water swallowing (I-FPC: q = 0.018; C-FPC: q = 0.024). Under NMES, water swallowing elicited greater ipsilesional FPC responses than saliva swallowing (q = 0.002). During saliva swallowing, tDCS was associated with greater ipsilesional SMA/PMC responses than NMES (q = 0.014). Conclusion:Acute cortical hemodynamic responses varied according to the combination of stimulation condition and swallowing task, with the strongest evidence arising from the bilateral FPC Stimulation × Task interaction. These findings indicate task-dependent prefrontal hemodynamic responses but do not establish stimulation-specific efficacy, hemispheric reorganization, neuroplasticity, or therapeutic superiority. Larger sham-controlled studies are required to determine the reproducibility and clinical relevance of these acute fNIRS findings. Clinical trial registration:The trial is registered at the International Traditional Medicine Clinical Trial Registry (ITMCTR), Available at: https://itmctr.ccebtcm.org.cn/en/index.html, Identifier ITMCTR2025001814.
