Alzheimer’s disease (AD) is characterized by amyloid-β (Aβ) deposition, chronic neuroinflammation, and dysregulation of the cAMP/PKA/CREB pathway that impairs synaptic plasticity. PF-04957325 (PF), a selective PDE8B inhibitor, elevates intracellular cAMP; however, its systems-level effects and mechanisms in Aβ-driven AD are unclear. Here, we evaluate PF in an Aβ1–42 mouse model and delineate its modulation of cAMP/PKA/CREB and TLR4/MyD88/NF-κB signaling. An AD model was induced by intracerebroventricular injection of Aβ1–42, followed by oral PF administration (0.1 mg/kg/day). Cognitive performance was evaluated with the Morris water maze. Hippocampal pathology, Aβ burden, and apoptosis were assessed by H E, immunohistochemistry, and TUNEL assays. IL-1β and IL-6 were measured by ELISA in hippocampal tissue and BV2 supernatants. Western blotting quantified APP, p-tau, and pathway proteins. BV2 cells and si-PDE8B served to validate mechanisms in vitro. PF significantly shortened escape latency (p < 0.01) and increased both platform crossings and target-quadrant dwell time (p < 0.01). It alleviated hippocampal neuronal injury, reduced Aβ burden, and decreased TUNEL-positive cells. Molecularly, PF elevated cAMP and increased p-PKA/PKA and p-CREB/CREB ratios (p < 0.01), while decreasing TLR4, MyD88, and p-NF-κB p65/NF-κB p65 (p < 0.01). PF also lowered IL-1β and IL-6 levels in hippocampal tissue and BV2 supernatants (both p < 0.01). In vitro, 300 nM PF phenocopied PDE8B knockdown, restoring cAMP/PKA/CREB activity and suppressing TLR4/MyD88/NF-κB activation. PF exerts dual protective effects by activating cAMP/PKA/CREB to enhance synaptic plasticity and survival, while inhibiting TLR4/MyD88/NF-κB to mitigate neuroinflammation. These findings highlight PDE8B inhibition as a promising therapeutic strategy for AD.

Objective:To observe the effects of ZHU Lian's excitation-type acupuncture manipulation on limb function and serum oxidative stress indexes, and angiogenic factors in patients with ischemic stroke during the recovery period. Methods:A total of 84 patients with ischemic stroke during the recovery period were randomly divided into a ZHU Lian acupuncture group (42 cases, 5 cases dropped out) and a conventional acupuncture group (42 cases, 8 cases dropped out). On the basis of routine treatment, the ZHU Lian acupuncture group received ZHU Lian's excitation-type acupuncture manipulation, while the conventional acupuncture group received conventional acupuncture treatment. Acupoints on the affected side were selected, including Fengchi (GB20), Jianyu (LI15), Quchi (LI11), Waiguan (TE5), Xinshe (Extra), Jianliao(TE14), Xinyi (Extra), Hegu (LI4), etc. Treatments were administered once daily for 3 weeks in both groups. The Fugl-Meyer assessment (FMA), Berg balance scale (BBS), modified Barthel index (MBI) scores and serum levels of superoxide dismutase(SOD), malondialdehyde (MDA), reduced glutathione (GSH), vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), endothelin-1 (ET-1) were observed before and after treatment in both groups. Results:Compared with before treatment, the FMA, BBS, MBI scores and serum levels of SOD, GSH, VEGF, bFGF after treatment were increased in both groups (P<0.001, P<0.05, P<0.01), and serum levels of MDA and ET-1 were decreased (P<0.001); after treatment,the FMA, BBS, MBI scores and serum levels of SOD, GSH, VEGF, bFGF in the ZHU Lian acupuncture group were higher than those in the conventional acupuncture group (P<0.05, P<0.001), and serum levels of MDA and ET-1 in the ZHU Lian acupuncture group were lower than those in the conventional acupuncture group (P<0.001, P<0.01). Conclusion:ZHU Lian's excitation-type acupuncture manipulation may exert neuroprotective effects in patients with ischemic stroke during the recovery period by modulating antioxidant capacity and angiogenesis, thereby improving limb function.

BACKGROUND:A mobile cognition scale for community screening in cognitive impairment with rigorous validation is in paucity. We aimed to develop a digital scale that overcame low education for community screening for mild cognitive impairment (MCI) due to Alzheimer's disease (AD) and AD. METHODS:A mobile cognitive self-assessment scale (CogSAS) was designed through the Delphi process, which is feasible for the older population with low education. In Phase 1, 518 clinically diagnosed participants were subjected to optimise the items. In Phase 2, the scale was validated in 358 participants with cognitively unimpaired and 396 participants of clinically diagnosed MCI and dementia for reliability, validity and diagnostic accuracy. In Phase 3, specificity and sensitivity were tested for biologically diagnosed participants of 38 with cognitively unimpaired and 45 with MCI and dementia due to AD according to the amyloid, tau, neurodegeneration classification system. RESULTS:The CogSAS was a three-task mobile scale testing memory and executive function. In Phase 2, the internal consistency was 0.81, and the test-retest reliability was 0.82. The construct validity was 0.74, and the criterion validity was 0.77. The sensitivity and specificity for discriminating clinically diagnosed participants with MCI and dementia from cognitively unimpaired were 0.90 and 0.67, respectively. For discriminating biologically diagnosed MCI and dementia due to AD from cognitively unimpaired, the sensitivity and specificity were 1.00 and 0.78, respectively. CONCLUSIONS:The CogSAS has good reliability, validity and feasibility, showing a high sensitivity and specificity both in the community and the clinic, identifying biologically diagnosed MCI and dementia due to AD.

BACKGROUND:Chronic cerebral hypoperfusion (CCH) contributes significantly to white matter injury (WMI) and cognitive impairment, often leading to vascular dementia (VaD). Inefficient clearance of myelin debris by microglia impedes white matter repair, making microglia-mediated myelin clearance a promising therapeutic strategy for WMI. Puerarin (Pu), an isoflavonoid monomer from Pueraria lobata, is known for its neuroprotective, anti-inflammatory, and immunoregulatory properties. However, its effects and underlying mechanisms in counteracting CCH-induced damage remain unclear. In this study, we aimed to investigate the therapeutic effects and underlying mechanisms of puerarin in a CCH mouse model. METHODS:Right unilateral common carotid artery occlusion (rUCCAO) was used to model CCH in C57BL/6J mice. Puerarin (400 mg/kg/day) was administered intraperitoneally for 10 consecutive days starting immediately post-surgery. Cognitive function was assessed by the Morris Water Maze (MWM) test. WMI, remyelination, neuroinflammation, and microglial phagocytosis were evaluated by western blotting, immunofluorescence staining, RT-PCR, or flow cytometry both in vivo and in vitro. RESULTS:Puerarin treatment significantly improved cognitive performance and mitigated WMI in rUCCAO mice. These effects were associated with enhanced microglial phagocytosis and remyelination, reduced neuroinflammation, and increased CD36 expression. Additionally, puerarin also increased the levels of IL-10 and phosphorylated STAT3 (p-STAT3) in brain tissues. Notably, IL-10 neutralization reversed these benefits effects by reducing microglial myelin debris uptake, downregulating STAT3 phosphorylation and CD36 expression. CONCLUSIONS:Our findings demonstrate that puerarin has significant therapeutic potential in treating CCH-related cognitive impairments and WMI by modulating CD36-mediated microglial myelin clearance through the IL-10/STAT3 pathway. However, our study was reliant on preclinical animal models, further studies are needed to explore applicability in human subjects.

OBJECTIVE:Investigating structural changes in the cervical spinal cord and brain in children with complete thoracolumbar spinal cord injury (TLSCI) and their correlation with clinical function may provide objective imaging indicators for functional evaluation. METHODS:Twenty-one children with complete TLSCI and twenty-one typically developing (TD) children were enrolled in this study. All participants underwent whole-brain and upper cervical spinal cord sagittal 3D T1-weighted and whole-brain axial diffusion tensor imaging scans using a 3.0T MRI scanner. Utilizing the Spinal Cord Toolbox, cervical spinal cord morphological parameters were obtained. Brain structure changes were analyzed with voxel-based morphometry (VBM) and voxel-based analysis (VBA). RESULTS:Compared to TD children, children with TLSCI showed significant reductions in the CSA (P = .011) and APW (P = .002) at the C2/3 level, as well as significant atrophy in the gray matter volume (GMV) of the left thalamus (P = .026), and bilateral paracentral lobule (PCL, P = .002). There was a significant positive correlation (r = 0.540, P = .017) between GMV of bilateral PCL and sensory scores. The VBA results showed a significant increase in fractional anisotropy values in the right posterior limb of the internal capsule, posterior thalamic radiation, and superior longitudinal fasciculus (SLF, P = .045), the mean diffusivity value of the right SLF was significantly decreased (P = .049) in children with TLSCI. CONCLUSIONS:In children with complete TLSCI, specific structural changes in the cervical spinal cord and brain were observed. A significant correlation between GMV of bilateral PCL and sensory scores may provide imaging biomarkers for assessing neurologic function and therapeutic efficacy (Ethics No: [2020] 003).

Traumatic complete spinal cord injury (CSCI) leads to severe impairment of sensory-motor function, and patients often suffer from neuropsychological deficits such as anxiety, depression, and cognitive deficits, which involve different brain functional modules. However, the alterations in modular organization and the interactions between these modules in pediatric patients with CSCI remain unclear. In this study, a total of 70 participants, including 34 pediatric CSCI patients and 36 healthy controls (HCs) aged 6 to 12 years, underwent whole-brain resting-state functional MRI. The functional networks were analyzed via a graph theory approach based on the 90-region Automated Anatomical Labeling (AAL 90) atlas, generating a 90 × 90 correlation matrix. Metrics for nodal, global, and modular scales were calculated to evaluate alterations in the network's topology. Between-group comparisons and partial correlation analysis were performed. Compared to HCs, pediatric CSCI patients exhibited significant decreases in nodal metrics, particularly in subcortical networks (SN) like the bilateral thalamus. Besides, the distribution of core nodes changed, with five newly added core nodes primarily located in the regions of the default mode network (DMN). For modular interactions, patients group presented increased connectivity within the DMN and between the DMN and the attention network (AN) but reduced connectivity between DMN and SN, DMN and vision network (VN), and AN and SN. Notably, the participation coefficient (Pc) of the TPOmid.L (left temporal pole: middle temporal gyrus) was positively correlated with motor scores, suggesting its potential as an indicator for evaluating the motor function in pediatric CSCI patients. Additionally, the patients demonstrated a different modular structure with significantly lower modularity. These findings suggest that functional network and modular alterations chiefly occur in emotional cognition and vision-associated regions, emphasizing the importance to focus on their psychocognitive well-being and providing evidence for visual-feedback related rehabilitation strategies.

BackgroundAlzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by significant cognitive and behavioral impairments. Near-infrared (NIR) light treatment has shown potential in cognitive improvement in previous studies. However, clinical trials of NIR for AD remain limited.ObjectiveThis study investigated the safety and effects of whole-head 810 nm NIR therapy in AD patients, including long-term efficacy.MethodsAn open-label pilot study on whole-head NIR treatment for AD patients was conducted. Nine AD patients completed 4-month treatment (810 nm, 100 mW/cm², 30 min/session, 6 sessions weekly). Safety and efficacy were evaluated at baseline, months 2 and 4, and 2-month post-treatment.ResultsAfter four months of whole-head NIR treatment, mean changes from baseline on the Mini-Mental State Examination were 3.2 (p = 0.02). Mean changes from baseline on the Alzheimer's Disease Assessment Scale-Cognitive were -5.0 (p = 0.05), mean changes from baseline on the Montreal Cognitive Assessment were 1.9 (p = 0.12). Mean changes from baseline on the Neuropsychiatric Inventory were -4.2 (p = 0.47). These benefits were sustained two months at least. With no device-related adverse effects were reported.ConclusionsWhole-head 810 nm NIR light is safe and offers promising benefits for AD patients. To fully confirm its efficacy, durability, and underlying mechanisms, further large-scale randomized controlled trials are necessary.

ABSTRACT Background The thalamus plays a pivotal role in functional brain networks, yet its contribution to motor function recovery following stroke remains elusive. We aim to explore changes in thalamocortical functional connectivity poststroke and its correlation with motor function. Methods Thirty‐nine subacute ischemic stroke patients and 32 healthy individuals underwent resting‐state functional magnetic resonance imaging (MRI). The Fugl–Meyer Assessment (FMA) was employed to evaluate upper and lower extremity motor function before and 1 year after stroke rehabilitation. The ipsilesional thalamus and contralesional thalamus were parceled into functional regions of interest (ROIs) based on connectivity with six cortical ROIs: prefrontal, motor, temporal, posterior parietal, somatosensory, and occipital cortex. Functional connectivity between each cortical ROI and its corresponding thalamic ROI was calculated and compared between groups. Differences identified in the ROI‐to‐ROI analysis were further investigated through seed‐to‐voxel whole‐brain connectivity analyses to pinpoint thalamic dysconnectivity. Correlations with upper and lower extremity motor function were also analyzed. Results Significant changes in thalamocortical functional connectivity were observed after stroke in ROI‐to‐ROI analysis, with bilateral somatosensory‐thalamic connectivity decreased and ipsilesional temporal‐thalamic and bilateral occipital‐thalamic connectivity increased. Seed‐to‐voxel analysis localized ipsilesional thalamic hypoconnectivity to the ipsilesional rolandic operculum and ipsilesional precentral gyrus. Ipsilesional somatosensory‐thalamic connectivity was positively correlated with baseline upper extremity FMA scores and negatively correlated with upper extremity motor function change rate at 1‐year postdischarge. Conclusions This study provides new insights into the role of the thalamus in motor function recovery after stroke, offering preliminary evidence for its potential as a therapeutic target in poststroke rehabilitation.

To develop an automated method for quantifying right ventricular parameters from CTPA in pulmonary embolism (PE). In this study, a U-Net based deep learning model was employed to perform automatic segmentation of the right ventricular, left ventricular, ascending aorta, and pulmonary arteries on CTPA images of patients with PE. The right ventricular to left ventricular diameter ratio (RV/LV), main pulmonary artery to ascending aorta diameter ratio (PA/AA), and ventricular septal angle (SA) were automatically calculated using a deep learning model based on anatomical structures. Additionally, two senior radiologists manually annotated the three sets of features to serve as the gold standard. Intra-class Correlation Coefficients (ICCs) were calculated to assess the inter-observer reliability of the proposed method by comparing the three sets of automatically derived measurements with the manual annotations. The calculated ICCs between automatically derived and manually annotated results demonstrated overall high consistency across the three parameters: RV/LV: 0.76 (95

Objective:To observe the effects of the ZHU Lian's acupuncture stimulation method on neurological function and miR-34a-5p/tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein γ (YWHAG) pathway in rats with ischemic stroke (IS), and to explore its mechanism in alleviating neurological impairment in IS. Methods:A total of 72 clean-grade male SD rats, with 10 rats were randomly selected as the sham operation group, and the remaining rats were subjected to suture occlusion method to establish an IS model. Fifty successfully modeled rats were randomly divided into a model group, an acupuncture group, a positive drug group, an acupuncture+agonist control group, and an acupuncture+agonist group, with 10 rats in each group. The rats in the acupuncture group were treated with ZHU Lian's acupuncture stimulation method at "Shuigou" (GV26), "Baihui" (GV20), "Dazhui" (GV14), and bilateral "Neiguan" (PC6) and "Hegu" (LI4). The rats in the positive drug group were treated with 10.8 mg/kg nimodipine via gavage. The rats in the acupuncture+agonist group and acupuncture+agonist control group were treated with intracerebroventricular injections of miR-34a-5p agonist (miR-34a-5p agomir) and negative control (agomir NC), respectively, at a dose of 5μL, followed by the same acupuncture protocol. All treatments were performed once daily for 5 days, followed by 2 days off, continuing for 21 days. After intervention, neurological deficits were evaluated using the Zea-Longa score. The infarct volume percentage was measured by TTC staining. Neuronal damage and Nissl bodies in the ischemic cortex were observed by Nissl staining. Neuronal apoptosis rate in the ischemic cortex was assessed by TUNEL staining. Relative expression levels of miR-34a-5p and YWHAG mRNA in the ischemic cortex were measured by RT-qPCR. Protein levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and YWHAG were detected by Western blot. A dual-luciferase assay was used to verify the relationship between miR-34a-5p and YWHAG. Results:Compared with the sham operation group, the Zea-Longa scores, the percentage of cerebral infarct volume, the neuronal apoptosis rate in the ischemic cortical tissue, the expression levels of IL-6, TNF-α, and miR-34a-5p mRNA in the model group were increased (P<0.05), and the expression of YWHAG mRNA and protein was decreased (P<0.05). Compared with the model group, the Zea-Longa scores, the percentage of cerebral infarct volume, the neuronal apoptosis rate in the ischemic cortical tissue, the expression levels of IL-6, TNF-α, and miR-34a-5p mRNA in the acupuncture group, the positive drug group, and the acupuncture+agonist control group were decreased (P<0.05), and the expression of YWHAG mRNA and protein was increased (P<0.05). Compared with the acupuncture+agonist control group, the Zea-Longa scores, the percentage of cerebral infarct volume, the neuronal apoptosis rate in the ischemic cortical tissue, the expression levels of IL-6, TNF-α, and miR-34a-5p mRNA in the acupuncture+ agonist group were increased (P<0.05), and the expression of YWHAG mRNA and protein was decreased (P<0.05). In addition, the miR-34a-5p and YWHAG have a targeted regulatory relationship (P<0.05). Conclusion:The ZHU Lian 's acupuncture stimulation method could improve neurological function in IS model rats, possibly by modulating the miR-34a-5p/YWHAG pathway.

OBJECTIVE:Executive dysfunction after stroke greatly affects stroke prognosis, so clinicians need to urgently focus on screening for it. This study aims to offer valuable data for research on post-stroke executive dysfunction by evaluating the test-retest reliability of the Shape Trail Test (STT) and the influence of the practice effect on scores among stroke patients. METHODS:A total of 75 subacute stroke patients were included in the study. Based on the cutoff value for mild cognitive impairment(MCI) in the Chinese version of the Montreal Cognitive Assessment-Basic, the patients were divided into an MCI group and a cognitively normal (CN) group. The patients were asked to complete the Shape Trail Test (STT) on two different occasions within three days. The time taken to complete Part A and Part B were denoted as STT-A and STT-B respectively. The intraclass correlation coefficient(ICC), Pearson and Spearman correlation coefficients were used as metrics, and a paired t test was employed to evaluate the practice effect. RESULTS:(1) The actual number of patients who completed the research was 71. The STT showed great test-retest reliability in stroke patients (ICC, STTA: 0.927 VS STTB: 0.881; Spearman, STTA: 0.824 VS STTB: 0.713, n = 71). The test-retest reliability of STTA is higher than that of STTB (ICC, STTA = 0.927＞STTB = 0.881; Spearman, STTA = 0.824＞STTB = 0.713; n = 71). The reliability of the MCI group was higher than that of the CN group (ICC, STTA:MCI = 0.94＞CN = 0.71; STTB:MCI = 0.87＞CN = 0.64). (2) Subgroup analysis revealed distinct practice effects between the MCI and CN groups. The MCI group showed no practice effect, while the CN group had a partial one. In the CN group, practice did not significantly impact STT-A scores (p = 0.782), but did affect STT-B scores (p = 0.035). In contrast, in the MCI group, no significant practice effects on the STT were observed (p > 0.05). CONCLUSIONS:STT's test-retest reliability was moderate to high in stroke patients and varied by cognitive function. Subgroup analyses should precede assessments of STT's test-retest reliability in stroke patients. Patients with cognitive dysfunction showed no significant practice effects. Given that this research is carried out specifically within the Chinese context, extreme care should be taken in extending the study's findings to other populations. REGISTRATION:URL: http://www.clinicaltrials.gov. Unique identifier: NCT01322607.

AIMS:To investigate the alterations in effective brain connectivity in pediatric patients with spinal cord injury (SCI), to reveal the mechanism of brain network reorganization and to identify potential key targets for therapeutic neuromodulation interventions. METHODS:This study enrolled 37 pediatric patients with SCI (24 with complete SCI, 13 with incomplete SCI) and 37 matched healthy controls. All participants underwent resting-state functional MRI. Independent component analysis was conducted to identify intrinsic brain networks and obtain key regions of interest. Dynamic causal modeling (DCM) was applied to further analyze the effective connectivity (EC). RESULTS:Patients with SCI showed significantly reduced connectivity between the default mode network (DMN) and the salience network (SAN). DCM revealed that the posterior cingulate cortex (PCC) was a key upstream regulator, exerting enhanced inhibitory influence on the medial prefrontal cortex, bilateral insula, and bilateral inferior parietal lobule. Subgroup analyses revealed that complete SCI was associated with increased excitatory drive from the DMN to the SAN, but enhanced inhibitory influence in the reverse pathway compared to incomplete SCI. CONCLUSION:The PCC is a pivotal node in post-SCI brain reorganization, suggesting it as a potential neuromodulation target. The bidirectional DMN-SAN regulatory imbalance is closely related to SCI severity.

Context In type 2 diabetes mellitus (T2DM), orthostatic hypotension (OH) is associated with cognition, but the mechanisms governing the link between OH and cognition are still unclear.Objective We sought to analyze Alzheimer's disease (AD) biomarkers and the part of complement proteins in modulating the association of OH with cognitive impairment and examine whether OH could accelerate the clinical progression of mild cognitive impairment (MCI) to dementia in T2DM.Methods We recruited patients with T2DM with MCI and collected general healthy information and blood samples. Complement proteins of astrocyte-derived exosomes were isolated and AD biomarkers of neuronal cell-derived exosomes isolated were quantified by enzyme-linked immunosorbent assay. Cognitive assessments were performed at patient enrollment and follow-up.Results Mediation analysis showed that the influence of OH on cognition in T2DM was partly mediated by baseline AD biomarkers and complement proteins. Cox proportional-hazards regression proved the OH group had a higher risk of developing dementia compared to the T2DM without OH group.Conclusion In T2DM with MCI patients, AD biomarkers and complement proteins mediate the effects of OH on cognitive impairment and OH may be a risk factor of progression from MCI to dementia in T2DM.

The Beijing Healthy Aging Cohort Study (BHACS) was established to supplement the limited data of a large representative cohort of older people based on the general population and was designed to evaluate the prevalence, incidence, and natural history of cognitive decline, functional disability, and conventional vascular risk factors. The aim was to determine the evolution of these conditions by estimating the rates and determinants of progression and regression to adverse outcomes, including dementia, cardiovascular events, cancer, and all-cause death. It can therefore provide evidence to help policy makers develop better policies to promote healthy aging in China. BHACS consisted of three cohorts (BLSA, CCHS-Beijing, and BECHCS) in Beijing with a total population of 11 235 (6281 in urban and 4954 in rural areas) and an age range of 55 years or older (55–101 years) with a mean age of 70.35 ± 7.71 years (70.69 ± 7.62 years in urban and 69.92 ± 7.80 years in rural areas). BHACS-BLSA conducted the baseline survey in 2009 with a multistage stratification-random clustering procedure for people aged 55 years or older; BHACS-CCHS-Beijing conducted the baseline survey in 2013–2015 with a stratified multistage cluster random sampling method for people aged 55 years or older; and BHACS-BECHCS conducted the baseline survey in 2010–2014 with two-stage cluster random sampling method for people aged 60 years or older. Data were collected through questionnaires, physical measurements, and laboratory analyses. Topics covered by BHACS include a wide range of physical and mental health indicators, lifestyles and personal, family, and socio-economic determinants of health. There are no immediate plans to make the cohort data freely available to the public, but specific proposals for further collaboration are welcome. For further information and collaboration, please contact the corresponding author Yao He (e-mail: yhe301@x263.net).

Neuropathic pain (NP) is a common and persistent disease that leads to immense suffering and serious social burden. Incomplete understanding of the underlying neural basis makes it difficult to achieve significant breakthroughs in the treatment of NP. We aimed to review the functional and structural brain topological properties in patients with NP and consider how graph measures reveal potential mechanisms and are applied to clinical practice. Related studies were searched in PubMed and Web of Science databases. Topological property changes in patients with NP, including small-worldness, functional separation, integration, and centrality metrics, were reviewed. The findings suggest that NP was characterized by retained but declined small-worldness, indicating an insidious imbalance between network integration and segregation. The global-level measures revealed decreased global and local efficiency in the NP, implying decreased information transfer efficiency for both long- and short-range connections. Altered nodal centrality measures involve various brain regions, mostly those associated with pain, cognition, and emotion. Graph theory is a powerful tool for identifying topological properties of patients with NP. These specific brain changes in patients with NP are very helpful in revealing the potential mechanisms of NP, developing new treatment strategies, and evaluating the efficacy and prognosis of NP.

Visual feedback training (VFT) plays an important role in the motor rehabilitation of patients with spinal cord injury (SCI). However, the neural mechanisms are unclear. We aimed to investigate the changes in dynamic functional network connectivity (FNC) related to visual networks (VN) in patients with SCI and to reveal the neural mechanism of VFT promoting motor function rehabilitation. Dynamic FNC and the sliding window method were performed in 18 complete SCI (CSCI), 16 patients with incomplete SCI (ISCI), and 42 healthy controls (HCs). Then, k-mean clustering was implemented to identify discrete FNC states, and temporal properties were computed. The correlations between these dynamic features and neurological parameters in all patients with SCI were calculated. The majority of aberrant FNC was manifested between VN and executive control network (ECN). In addition, compared with HCs, temporal metrics derived from state transition vectors were decreased in patients with CSCI including the mean dwell time and the fraction of time spent in state 3. Furthermore, the disrupted FNC between salience network and ECN in state 2 and the number of transitions were all positively correlated with neurological scores in patients with SCI. Our findings indicated that SCI could result in VN-related FNC alterations, revealing the possible mechanism for VFT in rehabilitation of patients with SCI and increasing the training efficacy and promoting rehabilitation for SCI.

OBJECTIVE:The objective of this study was the measurement of the test-retest reliability of n-back in Chinese stroke patients. METHODS:Seventy-five sub-acute stroke patients performed n-back twice in three days. The test-retest reliability of n-back was analyzed by correlation coefficient. RESULTS:The n-back had excellent test-retest reliability in stroke patients. Pearson or Spearman coefficients ranged from 0.81 to 0.88. The intra-class correlation coefficients ranged from 0.72 to 0.87. The Chinese version of Montreal Cognitive Assessment-Basic (MoCA-BC) score was significantly correlated with the performance of n-back. MoCA-BC and n-back accuracy were significantly related in the Mild Cognitive Impairment (MCI) group (r = 0.60 in 1-back, p = .002; r = 0.43 in 2-back, p = .040). However, MoCA-BC was correlated with reaction time (RT) in the Cognitively Normal (CN) group (r = -0.44 in 1-back, p = .003; r = -0.36 in 2-back, p = .018). The test-retest reliability of CN group was mostly higher than that of MCI group RT: 0.71-0.76 in MCI, 0.80-0.88 in CN; accuracy: 0.80-0.85 in MCI, 0.75-0.86 in CN). The practice effect was observed in the CN group instead of the MCI group. CONCLUSIONS:This study indicated that the test-retest reliability of n-back was high in stroke patients. N-back was correlated with cognition. It was preferable to conduct subgroup analyses according to the level of cognitive assessment of patients with stroke.

Study design Cross-sectional study.Objectives To study the relationship between the structural changes in the cervical spinal cord (C2/3 level) and the sensorimotor function of children with traumatic thoracolumbar spinal cord injury (TLSCI) and to discover objective imaging biomarkers to evaluate its functional status.Setting Xuanwu Hospital, Capital Medical University, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, China.Methods 30 children (age range 5-13 years) with TLSCI and 11 typically developing (TD) children (age range 6-12 years) were recruited in this study. Based on whether there is preserved motor function below the neurological level of injury (NLI), the children with TLSCI are divided into the AIS A/B group (motor complete) and the AIS C/D group (motor incomplete). A Siemens Verio 3.0 T MR scanner was used to acquire 3D high-resolution anatomic scans covering the head and upper cervical spinal cord. Morphologic parameters of the spinal cord at the C2/3 level, including cross-sectional area (CSA), anterior-posterior width (APW), and left-right width (LRW) were obtained using the spinal cord toolbox (SCT; https://www.nitrc.org/projects/sct). Correlation analyses were performed to compare the morphologic spinal cord parameters and clinical scores determined by the International Standard for Neurological Classification of Spinal Cord Injuries (ISNCSCI) examination.Results CSA and LRW in the AIS A/B group were significantly lower than those in the TD group and the AIS C/D group. LRW was the most sensitive imaging biomarker to differentiate the AIS A/B group from the AIS C/D group. Both CSA and APW were positively correlated with ISNCSCI sensory scores.Conclusions Quantitative measurement of the morphologic spinal cord parameters of the cervical spinal cord can be used as an objective imaging biomarker to evaluate the neurological function of children with TLSCI. Cervical spinal cord atrophy in children after TLSCI was correlated with clinical grading; CSA and APW can reflect sensory function. Meanwhile, LRW has the potential to be an objective imaging biomarker for evaluating motor function preservation.