Background:Recent functional magnetic resonance imaging (fMRI) evidence suggests that pre-supplementary motor area (pre-SMA) activity supports language recovery in post-stroke aphasia (PSA). As a key hub within domain-general cognitive networks, the pre-SMA represents a promising target for individualized neuromodulation. While intermittent theta burst stimulation (iTBS) can enhance language recovery, its efficacy may be limited by generalized targeting strategies. Objective:This study aims to investigate the efficacy of fMRI-guided, neuronavigated iTBS targeting the individualized pre-SMA for promoting language recovery in subacute PSA and to elucidate its underlying neural mechanisms via functional connectivity (FC) analysis. Methods:In this single-center, randomized, double-blind, sham-controlled trial, 40 participants with early subacute PSA (1-3 months post-stroke) are allocated to receive either active or sham iTBS targeting the left or right pre-SMA, localized via individualized MRI mapping. Participants will undergo a 2-week intervention, with language and neuroimaging assessments conducted at baseline, immediately post-intervention, and at a 1-month follow-up. Primary outcome measures are the Western Aphasia Battery (WAB). Second outcomes measures will be including the Boston Naming Test (BNT), the Boston Diagnostic Aphasia Examination (BDAE), non-language cognitive assessment (NLCA), alongside functional connectivity analysis from resting-state fMRI. Expected outcomes:We anticipate that this trial demonstrates the efficacy of individualized pre-SMA iTBS in improving language recovery in PSA. Furthermore, we expect to identify treatment-induced neuroplastic changes in functional and structural brain connectivity. The findings could establish a novel precision neuromodulation approach for aphasia rehabilitation by identifying patient-specific biomarkers of treatment response. Clinical trial registration:https://www.chictr.org.cn/, ChiCTR2500108996.

Post-stroke lower limb dysfunction affects the quality of life. Previous studies have confirmed that lower limb exoskeleton robots can improve the walking ability of stroke patients. This study aims to explore the impact of the UGO220 exoskeleton rehabilitation robot on the motor function and daily living ability of chronic stroke patients and to observe changes in lower limb muscle activity by surface electromyography before and after treatment. Sixty stroke patients with hemiplegia were randomly divided into a conventional (CT, n = 30) group or a robot (RT, n = 30) group. Patients in both groups received 60 min of routine physical therapy and occupational therapy. The robot group received 30 min of lower limb exoskeleton robot-assisted gait training per day, whereas the conventional group received 30 min of physical therapist-assisted gait training per day, six days a week, for three consecutive weeks. The primary outcome was evaluated by Fugl-Meyer assessment-lower extremities (FMA-LE), and the secondary outcomes included the modified Barthel index (MBI) score, Berg balance scale (BBS), and lower extremity muscle surface electromyography (sEMG) of the rectus femoris, biceps femoris, anterior tibialis and medial gastrocnemius muscles, including the integrated EMG (iEMG) and root-mean-square (RMS) values. The robot group had significantly greater improvements in FMA-LE and MBI compared to the conventional group. The electromyography results indicated that in terms of the activation of the anterior tibial muscle, the robot group performed better than the traditional group. The UGO220 exoskeleton robot training is superior to conventional training in improving Activities of daily living and lower limb motor function. Moreover, it can better promote the improvement of the ankle dorsiflexion function. ClinicalTrials.gov (ChiCTR2500096316)(2025-01-21).

BACKGROUND:This study aims to investigate whether intermittent theta-burst stimulation (iTBS) over the cerebellar vermis enhances balance recovery in subacute stroke, and examine the underlying neural mechanisms. METHODS:Fifty-two patients with subacute stroke and balance impairment were randomized to receive either three weeks of iTBS (n = 26) or sham stimulation (n = 26). The primary outcome was the Berg Balance Scale (BBS). Secondary outcomes included additional motor function measures and surface electromyography (sEMG). Clinical assessments were conducted at baseline and at weeks 1, 2, 3, and 6 after treatment onset. sEMG and resting-state functional MRI were acquired before and after the intervention. Seed-based functional connectivity (FC) of the cerebellar vermis was analyzed using a 2 × 2 mixed-effects ANOVA. Associations between changes in BBS (ΔBBS) and FC alterations were examined using Pearson correlation analyses. Patients were further stratified into subgroups based on the direction of FC change (increase vs. decrease) to characterize distinct clinical and neural response patterns. RESULTS:Compared with the sham group, patients receiving iTBS showed significantly greater improvements in balance, accompanied by increased sEMG activation of trunk and proximal lower-limb muscles, with effects sustained at follow-up. FC analyses revealed enhanced connectivity between Vermis X and bilateral occipitotemporal cortices, which was positively correlated with balance improvement (ΔBBS). Subgroup analyses identified distinct clinical and neural profiles: the FC-increase subgroup demonstrated sustained functional gains and enhanced cerebello-frontal connectivity, whereas the FC-decrease subgroup exhibited short-term improvement and reduced intracerebellar connectivity. DISCUSSION:These findings indicate that cerebellar vermis-targeted iTBS facilitates balance recovery after subacute stroke through reorganization of cerebello-visual networks. Subgroup-specific patterns further highlight heterogeneous intracerebellar and cerebello-frontal plasticity, supporting the notion of patient-specific network pathways underlying the therapeutic effects of cerebellar stimulation.

IntroductionMajor depressive disorder (MDD) is a prevalent psychiatric condition associated with significant suicide risk. Sequential accelerated theta-burst stimulation (aTBS), which integrates time-efficient stimulation with sequential modulation of multiple targets, represents a promising neuromodulation strategy. However, the efficacy and safety of sequential aTBS in adults with MDD and active suicidal ideation remain unexplored. This study aims to evaluate the therapeutic safety and effect of sequential aTBS on suicidal ideation in adults with MDD, and to explore its associated neurophysiological mechanisms using electroencephalography-derived P300 event-related potentials.Methods and analysisThis study is a single-blind, randomized controlled trial. Fifty-six adults with MDD will be recruited and randomly assigned (1:1) to receive either active sequential bilateral Dorsolateral Prefrontal Cortex (DLPFC) aTBS (10 weekday sessions; 3600 pulses per session) consisting of continuous theta-burst stimulation (cTBS) applied to the right DLPFC followed by intermittent theta-burst stimulation (iTBS) applied to the left DLPFC, or sham stimulation. The primary outcomes will be response and remission rates based on the 17-item Hamilton Depression Rating Scale (HAMD-17). Secondary outcomes will include the Beck Depression Inventory-II (BDI-II), the Columbia Suicide Severity Rating Scale (C-SSRS), and electroencephalography (EEG)-derived electrophysiological markers of cognitive processing (P300). Safety and tolerability will be systematically evaluated throughout the study using the Treatment Emergent Symptom Scale (TESS) to record stimulation-related adverse events. Outcome measures will be assessed at baseline, immediately after the 10-day intervention, and at 2-week and 4-week follow-ups to evaluate the short-term sustainability of treatment effects.DiscussionThe results of this study will provide information regarding the efficacy and safety of sequential aTBS for MDD, evaluating its feasibility and thereby laying a foundation for future clinical interventions and scientific research.Clinical Trial Registrationhttps://www.medicalresearch.org.cn/index, identifier ChiCTR2500109181.

BACKGROUND:Cerebellum has been a emerging target for non-invasive brain stimulation (NIBS) on post-stroke patients in recent years. While research is emerging on the impact of cerebellar repetitive transcranial magnetic stimulation (rTMS) on post-stroke patients, and its integrated effect remain unclear. OBJECTIVES:The objective of this review is to evaluate the efficacy of cerebellar rTMS on stroke rehabilitation. METHODS:We searched PubMed, EMBASE, and Web of Science databases from inception to 31 March 2024 for randomized controlled trials (RCTs) and case studies reporting effects of cerebellar rTMS on patients with stroke. RESULTS:This review included 18 studies (n = 638 participants), consisting of 14 RCTs and 4 case reports. A total of 6 studies focused on post-stroke dysphagia, while 12 studies investigated post-stroke motor dysfunction. Comparative analysis between treatment and control groups revealed statistically significant improvements in swallowing function, as measured by the Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS) (P = 0.02), the Penetration Aspiration Scale (PAS) (P < 0.001), and the Standardised Swallowing Assessment (SSA) (P < 0.001). Moreover, cerebellar rTMS treatment showed significant enhancements in balance abilities and activity of daily living among stroke patients, as indicated by significant increases in the Berg Balance Scale (BBS) (P = 0.003) and the Barthel Index (BI) (P = 0.04) compared to the control group. CONCLUSIONS:Existing evidence suggests that cerebellar rTMS holds promise in mitigating post-stroke swallowing dysfunction and motor dysfunction. Stimulation by cerebellar rTMS appears to be an efficacious technique for enhancing stroke rehabilitation.

OBJECTIVE:To identify baseline factors linked to a positive response to intermittent theta-burst stimulation (iTBS) in individuals with stroke. DESIGN:Secondary analysis of a randomized controlled trial. SETTING:A single rehabilitation hospital. PARTICIPANTS:Sixty stroke patients (N=60) (mean age, 61.48±8.91y; 48 men), including both ischemic and hemorrhagic stroke types. INTERVENTIONS:iTBS combined with routine rehabilitation. MAIN OUTCOME MEASURES:Responders were defined as patients with a ≥7-point improvement in the Fugl-Meyer Assessment of the Upper Extremity. Baseline variables included demographics, stroke-related factors, and initial motor assessments. Uni- and multivariate logistic regression analyses were conducted to identify predictors of treatment response. A receiver operating characteristic curve was used to determine the optimal time window poststroke for intervention. RESULTS:Among the 60 patients, 34 (56.7%) were classified as responders. Univariate analyses identified several baseline predictors of treatment response, including time since stroke onset, intervention type, Fugl-Meyer Assessment of the Upper Extremity, Motricity Index-Upper Extremity, and Shoulder Abduction and Finger Extension score. In the whole sample, multivariate logistic regression identified time since stroke onset as an independent predictor (odds ratio [OR], 0.963; P=.042). Notably, time since onset remained significant in the iTBS group (OR, 0.920; P=.016). Patients treated within the first month poststroke were more likely to respond (χ2=4.884; P=.027). Receiver operating characteristic analysis identified an optimal cutoff of 37.5 days poststroke (area under the curve=0.734). CONCLUSIONS:Earlier poststroke administration of the iTBS intervention yielded greater improvements in upper limb motor function. Incorporating a preconditioning iTBS protocol may enhance treatment outcomes, guiding clinicians in optimizing stroke rehabilitation strategies.

The brain-computer interface-based soft robotic glove (BCI-SRG) holds promise for upper limb rehabilitation in subacute stroke patients, yet its efficacy and neural mechanisms are unclear. This study aimed to investigate the therapeutic effects and neural mechanisms of BCI-SRGs by functional near-infrared spectroscopy (fNIRS). Forty subacute stroke patients with left-sided hemiparesis were randomized into the BCI-SRG (n = 20) and soft robotic glove (SRG) (n = 20) groups. Both groups received 20 sessions of intervention over 4 weeks in addition to conventional rehabilitation. The BCI-SRG group was trained using a soft robotic glove controlled by a brain‒computer interface (BCI), whereas the SRG group used the same soft robotic glove without BCI control. The clinical outcomes included the Action Research Arm Test (ARAT), the Fugl-Meyer Assessment Upper Limb (FMA-UL), and Modified Barthel Index (MBI) scores. In addition, fNIRS was used to explore potential clinical brain mechanisms. All assessments were performed before treatment and after 4 weeks of treatment. A total of 39 participants completed the intervention and clinical assessments (BCI-SRG: n = 20; SRG: n = 19). Compared with the SRG group, the BCI-SRG group showed greater improvements in the ARAT (Z = − 2.139, P = 0.032) and FMA-UL (Z = − 2.588, P = 0.010), with no notable difference in the MBI (Z = − 1.843, P = 0.065). fNIRS data were available for 35 participants (BCI-SRG: n = 17; SRG: n = 18). Within-group comparisons revealed significant postintervention increases in cortical activation in the bilateral sensorimotor cortex (SMC) and medial prefrontal cortex (MPFC) in the BCI-SRG group, whereas no significant changes were observed in the SRG group. Between-group comparisons further revealed significantly greater changes in HbO concentrations in the BCI-SRG group than in the SRG group across the same cortical regions. Moreover, changes in prefrontal activation (post–pre) were positively correlated with improvements in ARAT scores, with significant correlations observed in the left dorsal lateral prefrontal cortex (LDLPFC) (Ch9, r = 0.592, P = 0.012; Ch25, r = 0.488, P = 0.047) and right dorsal lateral prefrontal cortex (RDLPFC) (Ch19, r = 0.671, P = 0.003). BCI-SRG training significantly enhances upper limb function and facilitates bilateral motor and sensory cortical reorganization. PFC activation is correlated with functional improvements, suggesting a potential mechanism underlying the benefits of rehabilitation in stroke patients. This trial was registered under the Chinese Clinical Trial Registry (ChiCTR2400082786) and was retrospectively registered on April 8, 2024.

Mitochondrial defects are early pathological changes in neurodegenerative disease (ND). Homocysteine (Hcy) is an independent risk factor for ND. However, whether and how Hcy induces mitochondrial defects during the process of neurodegeneration is unclear. Here, we revealed that Hcy interfered with mitochondrial oxidative phosphorylation (OXPHOS) by inhibiting the mitochondrial electron transport chain (ETC) complex I, resulting in increased levels of reactive oxygen species (ROS) in the hippocampus of rats. Specifically, Hcy suppressed Ndufa1 expression, which is essential for complex I assembly and activation, by interfering with its transcription factor Creb1. Moreover, we found that Hcy induced neurodegeneration-like pathological changes in mitochondria in the brain via the inhibition of the NAD+/Sirt1 pathway, including defects in mitochondrial morphology, mitochondrial biogenesis, and mitophagy, ultimately leading to impairments in synapses and cognition, all of which were reversed by Ndufa1 upregulation. Thus, Ndufa1 is a key molecular switch of Hcy-induced mitochondrial damage, and appropriately targeting Ndufa1 or NAD+ replenishment may serve as a novel therapeutic strategy for Hcy-induced neurodegeneration and cognitive impairment.

ObjectivePost-stroke aphasia (PSA) is one of the most common complications after stroke, seriously affecting survivors' quality of life. While long noncoding RNAs (lncRNAs) are linked to stroke, their role in PSA remains unclear. This study explored PSA-associated lncRNA expression to identify potential biomarkers.MethodsLncRNA expression profiles were analyzed via high-throughput RNA sequencing (RNA-seq) with subsequent quantitative polymerase chain reaction (qPCR) validation. Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment, and correlations with language behaviors were assessed.ResultsInitial analyses comparing PSA and stroke patients revealed 797 significantly differentially expressed lncRNAs (69 upregulated, 728 downregulated), linked to several metabolic pathways. qPCR confirmed upregulation of lncRNA RP11-227G15.3 in PSA. A negative correlation with oral spelling scores was observed in 12 PSA patients (p = 0.04), but this did not survive Bonferroni correction, with no significance for other language measures.ConclusionThis is an exploratory pilot study. LncRNA RP11-227G15.3 represents a candidate biomarker requiring validation for PSA, though its preliminary association with oral spelling scores requires validation in larger, independent cohorts before any clinical application.

BACKGROUND:The pre-supplementary motor area (preSMA) is a critical region within domain-general networks involved in speech production. However, the impact of post-stroke aphasia (PSA) on functional reorganization in this area remains unclear. OBJECTIVE:This study aimed to investigate alterations in functional connectivity (FC) of the preSMA in patients with PSA and their relationships with neurotransmitters and speech production recovery. METHODS:We conducted language assessments using the Western Aphasia Battery (WAB) on 31 patients with left hemisphere strokes at approximately 28 days and 3 months post-stroke. Functional magnetic resonance imaging (fMRI) was performed on all PSA patients and 22 normal controls (NCs) at baseline. We compared the FC of the bilateral preSMA between the two groups. RESULTS:Compared to NCs, PSA patients exhibited decreased FC between the ipsilesional preSMA and the prefrontal-cingulate cortex, insula, and caudate, as well as between the contralesional preSMA and the prefrontal cortex and caudate. These FC changes were significantly associated with various neurotransmitters, particularly metabotropic glutamate, kappa opioid receptor, and cannabinoid receptor. Moreover, FC between the preSMA and the prefrontal-cingulate cortex showed negative correlation trends with changes in WAB-AQ and WAB subtests (naming, auditory comprehension, and repetition) at the three-month assessment. These findings were partially validated in an independent dataset (patients: N = 17; controls: N = 22). CONCLUSION:Our results suggest that functional connections of the preSMA are disrupted in PSA patients, which may be associated with neurotransmitter activity.

Objectives : Although alterations in brain structure and function have been implicated in both post-stroke aphasia (PSA) and motor deficits, how structural-functional coupling (SFC) is affected in stroke patients with and without aphasia (nonPSA) remains unclear. This study aimed to characterize SFC alterations in PSA and examine their associations with neurotransmitter systems. Methods: Fifty-two patients with left-hemisphere stroke (PSA: n = 29; nonPSA: n = 23) and 19 demographically matched healthy controls were enrolled. Language function in PSA patients was assessed approximately 28 days and 3 months post-stroke using the Western Aphasia Battery (WAB). All participants underwent T1-weighted and resting-state functional MRI at baseline. Region-wise SFC was computed as the correlation between gray matter volume and the fractional amplitude of low-frequency fluctuations (fALFF). Group differences were assessed using one-way analyses of covariance. Relationships among SFC alterations, language outcomes, and lesion-derived neurotransmitter-informed network damage were further evaluated. Results: Group comparisons revealed distinct SFC alterations associated with motor and language deficits in PSA. Language-specific decoupling was observed in the contralesional putamen, middle temporal pole, and posterior cerebellum, whereasmotor-specific decoupling occurred in the contralesional prefrontal cortex, superior parietal lobule, precuneus, and inferior/superior temporal cortices, extending into cerebellar regions. Both domains shared a common decoupling pattern in the ipsilesional posterior cerebellum. Reduced SFC in the contralesional middle temporal pole correlated with poorer spontaneous speech performance. Compared with nonPSA, PSA patients exhibited greater lesion load, network disconnections, and pre-/post-synaptic disruption ratio associated with poorer aphasia recovery relative to nonPSA in several neurotransmitter systems, especially serotonergic system. Mediation analysis further indicated that SFC in the contralesional caudate partially mediated the relationship between neurotransmitter disruption and aphasia severity. Conclusions: Our findings suggest distinct and shared structural-functional decoupling for language and motor dysfunctions in the patients with aphasia after stroke, which was associated with specific neurotransmitter systems.

Transcranial direct current stimulation (tDCS) is clinically effective in treating treatment-resistant depression (TRD), as measured by response, symptom improvement, and disease remission. However, the feasibility and underlying mechanism of tDCS treatment in individuals with TRD during acute psychiatric hospitalization remain poorly characterized. This paper outlines the protocol that aims to investigate the feasibility of implementing a 5-day tDCS treatment in hospitalized patients with TRD and secondarily explore the effects on depression and cognition, and neurophysiological mechanisms underlying tDCS. Current study will enroll ten participants who are diagnosed with TRD and are hospitalized in psychiatric units. Participants will receive a 5-day tDCS treatment protocol, with each treatment session lasting for 30 minutes, delivered twice daily, for a total of 10 stimulations over 5 days. The primary outcomes are the feasibility, acceptability, and tolerability of administering a 5-day tDCS treatment protocol in acutely hospitalized TRD patients. Exploratory outcomes pre- and post-tDCS include measures of depression (Montgomery-Asberg Depression Rating Scale (MADRS)) and cognition (Stroop Test, Revised Hopkins Verbal Learning Test (HVLT-R), Digital Symbol Coding Test (DSCT)), EEG changes in peak alpha frequency (PAF), and cerebral hemodynamic changes by functional near-infrared spectroscopy (fNIRS). This protocol would provide feasibility evidence for tDCS as an add-on to the standard of care treatment of TRD in hospitalized patients. Upon completion of the protocol, the preliminary effects of the 5-day tDCS treatment protocol regarding depression and cognitive symptoms and its neurophysiological mechanisms will be identified to guide the design and delivery of a randomized controlled study. Trial registration: National Institute of Health Clinicaltrials.gov (NCT06236711) and protocol ID: 23-003274.

OBJECTIVES:Geriatric depression is a significant public health burden and is challenging to treat. The current study aimed to examine the effectiveness of transcranial direct current stimulation (tDCS) as a nonpharmacologic intervention approach for depression in older adults. METHODS:We performed a systematic review of 24 studies across 13 countries including a total of 1,277 participants. Excluding six studies with incomplete data, we performed a metaanalysis of 18 randomized clinical trials (RCTs) involving 912 patients (502 active tDCS, 410 sham control tDCS). RESULTS:Results revealed a large effect size favouring active tDCS for depressive symptoms (SMD = -0.96, 95% CI -1.56 to -0.37), though with high heterogeneity (I2 = 89%). Large effect sizes favouring active tDCS were demonstrated in clinician-administered depression measures (Hamilton Depression Rating Scale [HDRS], Montgomery-Åsberg Depression Rating Scale [MADRS], Cornell Scale for Depression in Dementia [CSDD]) as well as in self-report measures (Beck Depression Inventory [BDI], Zung Self-Rating Depression Scale [SDS]). Subgroup analyses showed a nonsignificant effect in studies focused solely on major depressive disorder (MDD) and a large, though preliminary, effect in studies limited to adults aged 65 and older. CONCLUSIONS:These findings suggest that tDCS may be a promising nonpharmacological treatment option for depression in older adults, particularly in the context of comorbid conditions. However, further high-quality research specifically targeting this population is needed to validate its efficacy and optimize treatment protocols.

Background: Major depressive disorder (MDD) is a complex condition characterized by persistent depressed mood, loss of interest or pleasure, loss of energy or fatigue, and, in severe case, recurrent thoughts of death. Despite its prevalence, reliable diagnostic biomarkers for MDD remain elusive. Identifying peripheral biomarkers for MDD is crucial for early diagnosis, timely intervention, and ultimately reducing the risk of suicide. Metabolic changes in peripheral blood mononuclear cells (PBMCs) have been observed in animal models of depression, suggesting that PBMC could serve as a valuable matrix for exploring potential peripheral biomarkers in MDD. Methods: We performed a transcriptomic analysis of PBMCs from patients with MDD and age- and sex-matched healthy controls (n = 20 per group). Results: Our analysis identified 270 differentially expressed genes in PBMCs from MDD patients compared to controls, which correlated with the Hamilton Depression Rating Scale scores. These genes are involved in several KEGG pathways, including the herpes simplex virus 1 infection pathway, NOD-like receptor signaling pathway, antigen processing and presentation, and glycerophospholipid metabolism-all of which are linked to various aspects of the immune response. Further machine learning analysis and quantitative real-time PCR (qPCR) validation identified three key genes-TRPV2, ZNF713, and CTSL-that effectively distinguish MDD patients from healthy controls. Conclusions: The immune dysregulation observed in PBMCs is closely related to the pathogenesis of MDD. The candidate biomarkers TRPV2, ZNF713, and CTSL, identified and validated through machine learning and qPCR, hold promise for the objective diagnosis of MDD. Trial Registration: Clinical Trial Registry identifier: ChiCTR2300076589.

Background Preconditioning with cathodal high-definition transcranial direct current stimulation (HD-tDCS) can potentiate cortical plasticity induced by intermittent theta burst stimulation (iTBS) and enhance the after-effects of iTBS in healthy people. However, it is unclear whether this multi-modal protocol can enhance upper limb function in patients with stroke. Objective The aim of this study was to investigate whether priming iTBS with cathodal HD-tDCS over the ipsilesional M1 can augment upper limb motor recovery in poststroke patients. Methods A total of 66 patients with subacute stroke were randomly allocated into 3 groups. Group 1 received priming iTBS with HD-tDCS (referred to as the tDCS + iTBS group), Group 2 received non-priming iTBS (the iTBS group), and Group 3 received sham stimulation applied to the ipsilesional M1. One session was performed per day, 5 days per week, for 3 consecutive weeks. In Group 1, iTBS was preceded by a 20-minute session of cathodal HD-tDCS at a 10-minute interval. The primary outcome measure was the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score. Moreover, the secondary outcome measures for muscle strength and spasticity were the Motricity Index-Upper Extremity (MI-UE) and the Modified Ashworth Scale Upper-Extremity (MAS-UE), respectively, and the Hong Kong Version of the Functional Test for the Hemiplegic Upper Extremity (FTHUE-HK) and the Modified Barthel Index (MBI) for activity and participation. Results Significant differences were detected in the changes in FMA-UE, MI-UE, and MBI scores between the 3 groups from baseline to post-intervention (χ 2 FMA-UE = 10.856, P = .004; χ 2 MI-UE = 6.783, P = .034; χ 2 MBI = 9.608, P = .008). Post hoc comparisons revealed that the priming iTBS group demonstrated substantial improvements in FMA-UE ( P = .004), MI-UE ( P = .028), and MBI ( P = 0.006) compared with those in the sham group. However, no significant difference was observed between the iTBS group and the sham group. Moreover, no significant differences were found in the changes in MAS-UE or FTHUE-HK between the groups. Conclusions Priming iTBS with HD-tDCS over the ipsilesional M1 cortex had beneficial effects on augmenting upper limb motor recovery and enhancing daily participation among subacute stroke patients.

Recent functional MRI studies have implicated the cerebellum in working memory (WM) alongside the prefrontal cortex. Some findings indicate that the right cerebellum is activated during verbal tasks, while the left is engaged during visuospatial tasks, suggesting cerebellar lateralization in WM function. The cerebellum could be a potential target for non-invasive brain stimulation (NIBS) to enhance WM function in cognitive disorders. However, the comprehensive influence of cerebellar lateralization on different types of WM and the effect of stimulation over the unilateral or bilateral cerebellum remain uncertain. This study was to investigate the cerebellum’s functional lateralization and its specific impact on various aspects of WM in a causal manner using unilateral or bilateral cerebellar continuous theta burst stimulation (cTBS), a form of inhibitroy NIBS. Twenty-four healthy participants underwent four sessions of cTBS targeting the left, right, or bilateral Crus I of the cerebellum, or a sham condition, in a controlled cross-over design. WM performance was assessed pre- and post-stimulation using neuropsychological tests, including the 3-back task, spatial WM task, and digit span task. Results indicated that cTBS over the bilateral and right cerebellum both led to a greater improvement in 3-back task performance compared to sham stimulation. Additionally, active cTBS over the bilateral cerebellum yielded better performance in the spatial WM task than sham stimulation. However, no significant differences were observed between stimulation conditions for the auditory digit span task. This study may provide novel causal evidence highlighting the specific involvement of the right and bilateral cerebellum in various types of WM. Specifically, the right cerebellum appears crucial for updating and tracking 3-back WM content, while spatial WM processes require the coordinated engagement of both cerebellar hemispheres.

Transcranial direct current stimulation (tDCS) and aerobic exercise (AE) have been demonstrated to enhance inhibitory control function in healthy individuals separately. However, the potential benefits of combining these two interventions have yet to be fully explored. In this study, we aimed to use multiple event-related potential (ERP) components (P200, N200, and N450) to investigate the combined effects of tDCS and AE on the improvement of inhibitory control ability in healthy young adults. We evaluated the influence of this combined intervention on cognitive tasks involving inhibitory control function and basic information processing by performing the Stroop Word Color task. Our results showed that compared to the application of tDCS or AE alone, the combined intervention of tDCS and AE had a greater effect on improving inhibitory control function in healthy young adults. The amplitude of P200, N200, and N450 ERP components also changed more significantly during the Stroop Word Color task. We concluded that the mechanism of tDCS combined with AE in improving inhibitory control ability may involve synergistic effects on brain structures at different levels, such as regulating interactions at the reticular activating system level and activating corresponding brain regions at the medial frontal lobe and frontal lobe levels.

Far-field detection has been widely used in biomedical diagnosis, security inspection, such as MRI, ultrasonic, SPECT, X-ray, etc. However, the near-field detection has yet to be well established. This paper proposed a sensor structure with series inductance and capacitor. The inductance is a differential-transformer-type inductor formed by winding two spiral inductors. The interdigital capacitor is redesigned and placed inside the inductor to reduce its overall size. With the presence of the digital capacitor, the resonance shifts to the lower frequency, and the amplitude of return loss is increased. The micro-fabricated resonator was realized through integrated passive device technology for sensitive detection and characterization of glucose. The experimental results verified the performance of the proposed biosensor as the radio frequency multi-parameter bio-detector, such as the resonance frequency and the reflection coefficient. The detection results vary in response to deionized water, following by the iterative measurements of the changing glucose concentrations (from 50 to 150 mg $\cdot $ dL $^{-1}$ ). The concentration of glucose solution changes from 50 mg $\cdot $ dL $^{-1}$ to 150 mg $\cdot $ dL $^{-1}$ . The experimental results show that the amplitude changes 32.1 dB, and the phase changes 60.88° at 1 GHz. The results indicate the proposed microwave sensor has an excellent biosensing performance.

Background:Continuous theta burst stimulation (cTBS) is a specific paradigm of repetitive transcranial magnetic stimulation (rTMS) with an inhibitory effect on cortical excitability for up to 60 min after less than 1 min of stimulation. The right posterior superior temporal gyrus (pSTG), homotopic to Wernicke's area in the left hemisphere, may be a potential stimulation target based on its critical role in semantic processing. The objective of this study was to explore whether cTBS over the right pSTG can promote language improvements in aphasic patients and the underlying mechanism. Methods:A total of 34 subjects with aphasia were randomly assigned to undergo 15 sessions of either 40-s inhibitory cTBS over the right pSTG (the cTBS group) or sham stimulation (the sham group), followed by 30 min of speech and language therapy. Subjects underwent resting-state functional magnetic resonance imaging (rs-fMRI), and the aphasia quotient (AQ) of the Chinese version of the Western Aphasia Battery (WAB) was calculated before and after the intervention. This randomized controlled trial was registered in the Chinese Clinical Trial Registry (No. ChiCTR210052962). Results:After treatment, the language performance of the cTBS group was higher than that of the sham group in terms of the WAB-AQ score (p = 0.010) and the WAB scores for auditory comprehension (p = 0.022) and repetition (p = 0.035). The fractional amplitude of low-frequency fluctuations (fALFF) was significantly decreased in the pars triangularis of the inferior frontal gyrus (IFG), right middle frontal gyrus, right thalamus, and left cerebellar crus I. Clusters in the left orbitofrontal cortex exhibited increased fALFF. The change in WAB comprehension scores were significantly correlated with the change in the fALFF of the right IFG pars triangularis in both groups. Greatly increased functional connectivity was observed between the right pars triangularis and left paracingulate gyrus and between the right pSTG and right angular gyrus and the posterior cingulate gyrus with pre-and post-treatment between the two groups. Conclusion:Our findings indicate that cTBS of the right pSTG may improve language production by suppressing intrinsic activity of the right fronto-thalamic-cerebellar circuit and enhancing the involvement of the right temporoparietal region.

Objective: This research explored the combined effects of transcranial direct current stimulation (tDCS) and aerobic exercise (AE) on executive function and specific serum biomarkers in healthy adults.Methods: Sixty healthy young adults were randomly assigned into tDCS+AE, tDCS only, or AE only groups. In-terventions were carried out for 20 days. Executive functions were evaluated using tasks such as the 2,3-back task, the spatial working memory task, the Stroop test, T test, and hexagonal obstacle jump task. Serum bio-markers, including brain-derived neurotrophic factor (BDNF), malondialdehyde (MDA), superoxide dismutase (SOD), glutamate, glutathione peroxidase 4 (GPX4) and iron ion, were analyzed pre-and post-intervention.Results: The tDCS+AE group showed superior enhancements in executive function, evidenced by improved ac-curacy rates in 2,3-back tasks, better performance in the staircase task, and reduced reaction times in the incongruent reaction time of the Stroop task compared to other groups. Importantly, we found substantial changes in serum biomarkers: increased levels of BDNF and SOD, and decreased levels of MDA and glutamate in the tDCS+AE group. These changes were significantly different when compared with the tDCS and AE only groups. Notably, these alterations in serum biomarkers were correlated with improvements in executive function tasks, thus offering a potential physiological basis for the cognitive improvements witnessed.Conclusion: The combined tDCS and AE intervention effectively improved executive function in healthy young adults, with the improvements linked to changes in key serum biomarkers. The results emphasize the potential of combined tDCS and AE interventions in engaging multiple physiological pathways to enhance executive function.