PURPOSE:The current study aimed to investigate the clinical correlation of glioma-related epilepsy (GRE) in patients with IDH-mutant and 1p/19q-codeleted oligodendrogliomas. METHODS:Data from 331 oligodendroglioma patients were retrospectively analyzed. Demographic and clinical characteristics associated with GRE were explored by groupwise comparisons. Kaplan-Meier analysis and COX analysis assessed the prognostic value of preoperative GRE for survival outcomes. Binary logistic regression was applied to explore predictors of inadequate seizure control within 1 year, and a nomogram was constructed for risk stratification. RESULTS:Preoperative GRE was significantly correlated with younger age, male gender, left hemisphere tumor, and a better Karnofsky performance score (p < .05 for all). GRE showed no significant influence on overall survival or progression-free survival (p < .05 for all). Preoperative GRE was identified as the only independent risk factor for postoperative GRE within 1 year after surgery (OR 3.059, 95% CI 1.806-5.183, p < .001). CONCLUSIONS:The current study offered valuable insights into GRE in patients with oligodendroglioma, IDH-mutant, and 1p/19q-codeleted. Younger age, left hemisphere tumor, and a better Karnofsky performance score were associated with a higher incidence of preoperative GRE. Although preoperative GRE showed no significant prognostic value for survival outcomes, it was the sole independent risk factor for postoperative GRE within 1 year after surgery.

INTRODUCTION:The efficacy of awake craniotomy (AC) with intraoperative mapping for glioblastoma (GBM) in eloquent regions remains debated. This study aims to evaluate functional and survival outcomes of GBM patients undergoing AC stratified by tumor locations. METHODS:A combined retrospective (2015-2023, n = 114: 43 AC vs. 71 standard craniotomy) and prospective cohort (2023-2025, n = 28: 13 AC vs. 15 standard craniotomy) of GBM patients with motor/language-eloquent tumors was analyzed. Tumors were classified into motor subtypes (I: precentral gyrus; II: premotor/supplementary motor; III: internal capsule posterior limb; IV: other) and language subtypes (I: Broca's/precentral; II: postcentral/supramarginal gyrus; III: Wernicke's; IV: insular; V: other). Outcomes included extent of resection (EOR), postoperative motor/language recovery, overall survival (OS), and progression-free survival (PFS). RESULTS:The retrospective cohort demonstrated that AC has advantages in functional preservation across various motor/language subtypes. However, AC was associated with significantly deteriorated survival outcomes specifically in precentral gyrus GBMs. A prospective cohort study, enrolling only precentral gyrus GBMs for validation, yielded results consistent with the retrospective findings: worsened OS and PFS (OS: HR = 3.223, p = 0.0450; PFS: HR = 2.374, p = 0.0476); reduced EOR (AC: 74.3% ± 5.3%; standard craniotomy: 86.9% ± 12.3%, p = 0.0470); and better motor recovery. CONCLUSIONS:Functional preservation and survival outcomes of AC in GBM exhibited subtype-specific correlations with tumor locations. AC with intraoperative mapping effectively preserves neurological function in GBM patients. However, for tumors involving the precentral gyrus, the AC approach carries greater risks than benefits and should be considered with caution. TRIAL REGISTRATION:Strategic Intervention on Preserving Motor Function During Awake Craniotomy: NCT05143788. Strategic Intervention on Preserving Language Function During Awake Craniotomy: NCT05143775.

OBJECTIVE:This study aimed to investigate the therapeutic effects and neural mechanisms of high-frequency neuro-navigated repetitive transcranial magnetic stimulation (nrTMS) targeting the hand knob in glioma patients with postoperative motor deficits, using functional gradient analysis to characterize cortical reorganization. METHODS:Thirty patients with postoperative motor deficits were randomized to receive nrTMS or sham stimulation targeting the ipsilateral hand knob. Motor function was assessed using Fugl-Meyer Assessment (FMA) and muscle strength. Resting-state fMRI was acquired to compute principal functional gradients. Control/tumor, nrTMS/sham, and Pre-TMS/Post-TMS gradient changes were analyzed. Correlation and regression analyses related to motor recovery were performed. RESULTS:The nrTMS group showed significantly greater improvement in muscle strength (Post-treatment: nrTMS: 3.533 ± 0.720, Sham: 2.067 ± 0.572, p = 0.019, d = 1.082; 3-month follow-up: nrTMS: 4.600 ± 0.408, Sham: 3.733 ± 0.609, p = 0.035, d = 1.012). Gradient analysis revealed increased sensorimotor network (SMN) gradient scores following nrTMS (Pre-TMS: -0.707 ± 0.108; Post-TMS: -0.636 ± 0.077; p = 0.016), and HH_SomMot_22 within upper limb motor cortex is most strongly correlated with motor recovery. CONCLUSIONS:High-frequency nrTMS targeting the hand knob accelerated the motor recovery. Gradient analysis findings provide novel insights into therapeutic mechanisms of nrTMS and underscore the value of the hand knob as a stimulation target.

Objective: Molecular subtypes in glioma diagnosis are gradually highlighted and thought to affect preoperative seizure occurrence. ​However, whether molecular subtypes affect postoperative seizure freedom is still unknown. Moreover, whether chromosome 1p/19q co-deletion is a risk factor for postoperative seizures that lack evidence to verify. Methods: This single-center retrospective study (including 1075 patients with primary adult-type glioma) included data from the Chinese Glioma Genome Atlas. The follow-up information on postoperative seizure control after 12 months in post-operation was collected. Binary logistic regression was applied to identify independent factors for postoperative seizure freedom based on different molecular subtypes and history of preoperative glioma-related epilepsy (GRE). Moreover, the optimal extent of tumor resection (EOR) for postoperative seizure control was evaluated by receiver operating characteristic curve and binary logistic analysis. Results: Chromosome 1p/19q co-deletion (OR: 1.555; 95%CI: 1.032–2.343; p=0.035) was independent risk for postoperative seizure freedom in patients with IDH mutation. Moreover, history of preoperative GRE (OR: 6.027; 95%CI: 3.661–9.922; p<0.001) and invasion of the temporal lobe (OR: 2.347; 95%CI: 1.430–3.853; p=0.001) were independent risks for postoperative seizure freedom in patients with IDH wild-type. Patients with oligodendroglioma and preoperative GRE had good seizure control when the EOR was ≥ 0.90 but similar as EOR was equal to 1.00. Conclusions: Chromosome 1p/19q co-deletion was only useful for patients with IDH mutation to predict bad postoperative seizure control. If without preoperative GRE, higher EOR did not contribute to postoperative seizure freedom; and if with, not pursuing total resection was only recommended in patients with oligodendroglioma.

BackgroundPrimary brainstem hemorrhage (PBSH) frequently results in prolonged disorders of consciousness (DOC). Disruption of the ascending reticular activating system (ARAS) is a central pathophysiological mechanism linking brainstem injury to secondary cortical structural and functional changes. In the current study, we employed surface-based morphometry (SBM) and electroencephalography (EEG) spectral analyses to investigate the structure–function interaction in PBSH-induced DOC within the ARAS-mesocircuit framework.MethodsWe retrospectively analyzed the data of 24 PBSH-induced DOC patients and 29 healthy controls. Cortical thickness was assessed via SBM, while EEG spectral powers across different bands were also calculated. Relationships between cortical thickness and EEG spectral metrics in patients with PBSH-induced DOC were explored using a General Linear Model. The correlations between EEG spectral powers and scores on the Chinese version of the Coma Recovery Scale-Revised (CRS-R) were also explored.ResultsPatients with PBSH-induced DOC demonstrated widespread cortical thinning compared to controls, predominantly affecting frontal and temporal regions that constitute primary cortical targets of ARAS projections (p < 0.05). Delta and theta power negatively correlated with mean cortical thickness in significant thinning clusters (delta: ρ = −0.44, p = 0.031; theta: ρ = −0.55, p = 0.005), with prominent involvement of inferior temporal/fusiform (delta) and superior temporal/postcentral (theta) areas. Higher theta power correlated with lower CRS-R total scores (ρ = −0.58, p = 0.043), while alpha power showed a similar correlation (ρ = −0.61, p = 0.020).ConclusionThis study demonstrates that PBSH-induced DOC is associated with widespread cortical thinning, particularly in ARAS-dependent frontal and temporal regions, and that these structural alterations are reflected in characteristic EEG spectral signatures. These findings offer novel insights into the ARAS-mediated pathophysiological mechanisms underlying PBSH-induced DOC and may inform the development of structure-informed diagnostic and therapeutic biomarkers.

Diffuse glioma-related epilepsy (dGRE) frequently presents with epilepsy as the initial symptom and is closely associated with tumor progression or recurrence, imposing significant social and psychological burdens on patients. The pathogenesis of dGRE is highly complex, involving both peritumoral microenvironmental mechanisms and tumor-intrinsic factors. Diagnosis requires a comprehensive approach integrating neuroimaging, EEG, molecular biomarkers, and spatial correlation between the tumor and the epileptogenic zone. Management aims to control seizures and improve prognosis. Non-enzyme-inducing anti-seizure medications (ASMs), such as levetiracetam and lacosamide, are recommended as first-line therapy, while valproic acid serves mainly as a second-line agent. Surgical resection, particularly maximal safe and supratotal removal guided by electrophysiological monitoring, significantly improves seizure outcomes. Radiotherapy, chemotherapy, and targeted agents further contribute to seizure control. The updated 2025 Chinese clinical practice guidelines incorporate recent advances in ASM use, postoperative withdrawal strategies, and multidisciplinary treatment algorithms. These updates provide an evidence-based reference for standardized diagnosis and management of dGRE.

Objective To investigate the differences in the correlation between the disappearance or persistence of lateral spread response (LSR) recorded by two stimulation methods (zygomatic branch stimulation vs. marginal mandibular branch stimulation) during facial nerve microvascular decompression (MVD) and the occurrence of hemifacial spasm (HFS). Methods Clinical data of 94 patients with HFS who underwent MVD at Beijing Tiantan Hospital, Capital Medical University from June 2024 to June 2025 were retrospectively analyzed. Intraoperatively, LSR monitoring was performed using both zygomatic branch stimulation and marginal mandibular branch stimulation. The elicitation rate and disappearance/persistence status of LSR were recorded for each method. Patients were followed up for HFS residual rate and recurrence rate at postoperative 1 d and 3 months. Results With zygomatic branch stimulation, LSR was successfully elicited in 91 cases (elicitation rate 96.81%), of which it disappeared in 69 cases (75.82%) and persisted in 22 cases (24.18%). With marginal mandibular branch stimulation, LSR was successfully elicited in 85 cases (elicitation rate 90.43%), disappeared in 74 cases (87.06%) and persisted in 11 cases (12.94%). On postoperative 1d, HFS residual rate in the non-disappearance cases was higher for both the zygomatic branch stimulation method (χ2=5.440, P=0.020) and the marginal mandibular branch stimulation method (Fisher's exact probability: P=0.005) compared to the disappearance cases. At 3 months postoperatively, the HFS recurrence rate was higher in the zygomatic branch stimulation (Fisher's exact probability: P=0.000) or mandibular branch stimulation (Fisher's exact probability: P=0.000) that did not resolve compared to the resolved cases. Conclusions Both zygomatic branch stimulation and marginal mandibular branch stimulation can reflect the risk of postoperative HFS through LSR monitoring during facial nerve MVD. The zygomatic branch stimulation has a higher successful elicitation rate and is suitable as routine monitoring. The non-disappearing state of the LSR may exhibit higher sensitivity in identifying patients at high risk for early HFS. Their combined application can provide complementary information for postoperative prognosis assessment and clinical intervention.

Study Design: Retrospective cohort study. Objective: To evaluate the predictive value of intraoperative bulbocavernosus reflex (BCR) monitoring for postoperative bowel dysfunction (PBD) following conus medullaris and cauda equina tumor (CMCET) resection. Methods: A total of 118 patients were analyzed. Neurogenic Bowel Dysfunction Scores >6 at 1 month and 6 months postoperatively defined short- and long-term PBD. The amplitude reduction ratio (ARR) was calculated from bilateral BCR waveforms using the worst-side ARR for analysis. Multivariate logistic regression and ROC curve analysis determined independent predictors and optimal thresholds. Stratified 10-fold cross-validation confirmed threshold stability. Results: Patients with short-term or long-term PBD had significantly higher ARRs than those without (P < 0.001 for both comparisons, Mann-Whitney U test). Furthermore, ARR emerged as the only independent predictor for either short-term (OR 1.287, 95% CI 1.018-1.627, P = 0.035) or long-term PBD (OR 1.153, 95% CI 1.055-1.261, P = 0.002). The threshold values of ARR for predicting short-term and long-term PBD were 59.6% (AUC = 0.991, 95% CI 0.974-1.000, P < 0.001) and 63.6% (AUC = 0.988, 95% CI 0.971-1.000, P < 0.001), respectively. Cross-validation confirmed these thresholds, with mean AUC values of 0.992 and 0.993 for short-term and long-term PBD, respectively. Conclusions: The ARR of the intraoperative BCR waveform showed a high predictive value for PBD in patients with CMCET. We propose a 60% ARR reduction on either side of the BCR waveforms as an exploratory, hypothesis-generating early warning criterion for BCR monitoring during CMCET surgery, pending external validation in independent prospective cohorts before clinical implementation.

BackgroundRecurrent craniopharyngiomas pose high risks of postoperative visual dysfunction (POVD) during surgery. The current study aimed to explore the application value of intraoperative visual evoked potential (VEP) monitoring during the extended endonasal endoscopic approach (EEEA) for recurrent craniopharyngiomas. MethodsA total of 42 patients with recurrent craniopharyngiomas undergoing EEEA with VEP monitoring were analyzed. The amplitude reduction ratios of N75-P100 and P100-N145 were calculated, and their predictive values for POVD were evaluated using group comparisons, receiver operating characteristic (ROC) curve analysis, and binary logistic regression analysis. ResultsPOVD was observed in 8 eyes (8/84, 9.52%) from 7 patients (7/42, 16.67%). Eyes with POVD exhibited significantly greater N75-P100 and P100-N145 amplitude reduction ratios than those without (p < 0.001 and p = 0.002, respectively). The threshold values of the two ratios for predicting POVD were 36.59% (AUC 0.862, p < 0.001) and 36.65% (AUC 0.791, p=0.007), respectively. Multivariate analysis identified that abnormal N75-P100 change was the sole independent predictor of POVD (Odds ratio 9.257, 95% Confidence interval 1.124-76.263; p = 0.039). ConclusionsIntraoperative VEP monitoring was particularly recommended for patients undergoing EEEA for recurrent craniopharyngiomas. A one-third reduction in N75-P100 amplitude was proposed as an early warning criterion for VEP monitoring in this patient population.

Background Microvascular decompression (MVD) is the current definitive treatment for achieving a radical cure of primary hemifacial spasm (pHFS). The current study aimed to integrate blink reflex (BR) monitoring into MVD for pHFS to assess surgical efficacy and explore its predictive value for postoperative spasm when combining with lateral spread response (LSR) monitoring.Methods A prospective cohort study included 105 patients with pHFS undergoing MVD. Intraoperative zygomatic LSR (ZYG-LSR), mandibular LSR (MAN-LSR), and BR were monitored. Multivariate logistic regression was used to assess independent predictors of postoperative spasm at 3 months after surgery. Two predictive models (Model 1: LSR; Model 2: LSR plus BR) for postoperative spasm were compared using Receiver Operating Characteristic (ROC) curve analysis at four postoperative time points: 1 day, 1 week, 1 month, and 3 months, with the area under the curve (AUC) quantifying overall accuracy and the DeLong test for comparison.Results BR showed a higher elicitation rate (99.0%) than ZYG-LSR (97.1%) and MAN-LSR (91.4%). Persistent ZYG-LSR (odds ratio 28.99), MAN-LSR (odds ratio 12.06), and BR (odds ratio 10.38) were identified as independent predictors for postoperative spasm at 3 months after surgery (all p < 0.05). Regarding the two predictive models, their performance improved over time. At 3 months, Model 2 showed a numerically higher AUC than Model 1 (0.955 versus 0.901), while the DeLong test still did not reach statistical significance (p = 0.083).Conclusion In conclusion, intraoperative BR monitoring appears to be a feasible and potentially useful adjunct to conventional LSR monitoring in MVD for pHFS, and warrants further evaluation in larger studies.

BACKGROUND:China has approximately 10 million people with epilepsy, with western and rural regions facing substantial treatment gaps. The China Association Against Epilepsy launched the Western China Epilepsy Initiative (WCEI) in 2013 to improve epilepsy care in underserved hospitals. OBJECTIVE:To evaluate the impact of the WCEI on epilepsy care capacity at assisted hospitals and professional development of participating experts. METHODS:A nationwide cross-sectional survey was conducted targeting 115 hospitals that received WCEI assistance (2013-2025) and 96 expert team members. The hospital survey collected data on epilepsy center establishment, workforce certification, equipment, patient volumes, surgical capacity, and the use of unauthorized therapies. An interrupted time series analysis using linear mixed-effects models assessed pre- versus post-intervention trends on four key indicators. RESULTS:Among the 115 assisted hospitals, 49 (42.6%) were in western China. A total of 54 hospitals (47.0%) had established formal epilepsy centers, of which 43 (79.6%) were established after WCEI participation. Significant post-intervention acceleration was observed in EEG technician certifications (β2 = 10.2%/year, p = 0.007), epileptologist certifications (β2 = 14.9%/year, p < 0.001), and epilepsy patient visits (β2 = 4.7%/year, p = 0.001). Among 101 hospitals (87.8%) reporting a decline in the use of unauthorized therapies, the median decline was 15% (IQR 8-25%). Over 90% of expert respondents reported gains in clinical competence and professional fulfillment. CONCLUSIONS:The WCEI may have contributed to improvements in epilepsy care capacity in underserved Chinese hospitals, demonstrating a replicable model that can serve as a feasible strategy for narrowing the epilepsy treatment gap.

Facial synkinesis is a distressing late-onset complication of vestibular schwannoma (VS) surgery. The current study aimed to explore the predictive value of intraoperative facial nerve motor evoked potential (FNMEP) monitoring for postoperative facial synkinesis in VS patients. The data of 170 VS patients were retrospectively analyzed. The final-to-baseline amplitude ratio (FBR) of mentalis FNMEP was selected as a representative metric to assess FNMEP alterations before and after tumor resection. The presence of facial synkinesis was evaluated one year after surgery. Group comparison and logistic regression analysis were performed to assess the predictive value of mentalis FBR for synkinesis. A predictive nomogram was subsequently established. The optimal FBR threshold for predicting synkinesis was obtained by the receiver operating characteristic curve analysis. Among the cohort, 44.12

The 2021 classification of central nervous system tumors significantly alters the defined category of glioblastoma (GBM). This study aims to evaluate the clinical relevance of glioma-related epilepsy (GRE) in patients with the newly classified GBM, IDH-wildtype. A single-center retrospective cohort study was performed. The correlation of GRE with clinicopathological features was explored via appropriate inter-group statistical methods. Kaplan-Meier analysis was employed to assess the prognostic value of preoperative GRE with respect to overall survival (OS) and progression-free survival (PFS). Multivariate binary logistic regression analysis was carried out to identify potential risk factors associated with inadequate seizure control. The final cohort included 294 patients. Preoperative GRE was observed in 22.4

ABSTRACT Background Long linear scars in cross‐sectional regions can adversely affect facial aesthetics and functionality, leading to substantial psychological distress. Early intervention with carbon dioxide ablative fractional laser (CO 2 ‐AFL) and 595‐nm pulsed dye laser (PDL) has shown promise in mitigating post‐surgical scarring. However, the effectiveness of this treatment for extensive facial scars across different areas remains unclear. Methods We reviewed medical records of 39 patients with long scars from facial trauma between January 2022 and October 2023. Treatment commenced with two sessions of PDL and three sessions of CO 2 ‐AFL 1 week post‐suture removal. Outcomes were assessed using Antera 3D imaging and the Patient and Observer Scar Assessment Scale (POSAS 3.0). Quality of life improvements were measured using the Short Form‐36 Health Survey (SF‐36). Results All patients completed five sessions of laser treatment. Significant reductions were noted in Patient and Observer scores on the POSAS ( p < 0.05). Antera 3D analysis revealed substantial improvements in average roughness, depression depth, and elevation depth across facial regions. The significance of improvements in color variation, texture elevation span, melanin hyperconcentration, and hemoglobin hyperconcentration varied by area. Patients also showed significant improvements in SF‐36 scores for physical role limitations, social functioning, and emotional well‐being compared to pre‐treatment levels ( p < 0.05). Conclusions Early sequential treatment with PDL and CO 2 ‐AFL effectively improves long scars in various facial areas.

It has been five years since the last version of the clinical practice guidelines for the management of adult diffuse gliomas was published by the Asian Glioma Genome Atlas (AGGA). Significant progress and revisions have occurred in the diagnosis and treatment of adult diffuse gliomas in recent years. In response to these updates, the joint guideline committee of the Chinese Glioma Cooperative Group (CGCG), the Society for Neuro-Oncology of China (SNO-China), and the Chinese Brain Cancer Association (CBCA) has revised the clinical practice guidelines. This updated guideline emphasizes molecular and pathological diagnostics, as well as the primary treatment modalities of surgery, radiotherapy, chemotherapy, and targeted therapy. Additionally, we have incorporated findings from recent clinical trials of new therapies to align with cutting-edge treatment strategies. This guideline is designed to serve as a practical resource for all professionals involved in managing adult diffuse glioma patients, while also providing valuable information for insurance companies and other institutions responsible for regulating cancer care costs in China and beyond.

Supramaximal resection in glioblastoma, concerning non-contrast-enhancing (nCE) tumors, exhibited additional survival benefits. However, whether all patients can benefit from supramaximal resection of nCE tumors and the optimal resection target remains unclear, especially for the glioblastoma, IDH-wildtype under the new WHO CNS tumor classification. Clinical and surgical characteristics were collected from 155 patients with newly diagnosed glioblastoma, IDH-wildtype from the Chinese Glioma Genome Atlas, and a prospective cohort of 128 patients was enrolled for external validation. Recursive partitioning analysis was used to identify risk groups considering the effects of residual nCE tumor volume (RnTV) and clinical factors on overall survival (OS). Age, preoperative Karnofsky Performance Score (KPS), MGMT promoter status, and postoperative RnTV were independently associated with patient survival. Four risk groups with distinct prognoses were identified: Group 1 (median OS: 13.4 months), RnTV >43.27 ml; Group 2 (median OS: 17.8 months), RnTV <= 43.27 ml, KPS <= 90, and age >= 60; Group 3 (median OS: 22.3 months), RnTV 5.27-43.27 ml, age <60; Group 4 (median OS: 38.2 months) including 4a, KPS 100 and RnTV <= 43.27 ml; and 4b, KPS <= 90, age <60, and RnTV <= 5.27 ml. These results were retained regardless of MGMT promoter methylation status and validated in the external prospective validation cohort. Supramaximal nCE tumor resection enhances survival outcomes in glioblastoma, IDH-wildtype, but depending on clinical characteristics. In young symptomatic patients, supramaximal resection should be recommended with the RnTV <= 5.27 ml; in symptomless patients or elder patients, keeping the RnTV <= 43.27 is recommended to obtain the survival benefit from tumor resection surgery.

In this study, we aimed to screen the risk factors for delayed extubation after surgery for Ebstein’s anomaly (EA), determine the diagnostic cut-off values, and develop a prediction equation to accurately encourage rapid recovery after surgery. The perioperative data of 76 pediatric patients undergoing EA surgery in the Surgical Department of the Pediatric Heart Center of Anzhen Hospital from September 2013 to September 2021 were retrospectively analyzed. Among these cases, 37 (48.6

PURPOSE:Gliomas present a significant public health challenge owing to their complex management and poor prognosis. Robust real-world datasets are essential for advancing glioma research and informing clinical practice. To address limitations of existing resources, we established the China National Glioma Registry (CNGR), a comprehensive, glioma-specific registry designed to systematically capture multidimensional data. METHODS:The CNGR is a prospective, longitudinal, observational registry initiated at Beijing Tiantan Hospital. Adult-type diffuse glioma patients are consecutively enrolled following informed consent. Clinical, pathological, imaging, functional, and long-term follow-up data are collected at predefined time points by trained specialists using standardized procedures and recorded in a secure electronic data capture system. All aspects of data acquisition and quality control are overseen by a dedicated multidisciplinary team to ensure accuracy, consistency, and integrity. The study protocol has been approved by the Ethics Committee of Beijing Tiantan Hospital and registered with the Chinese Clinical Trial Registry. CONCLUSION:The CNGR offers a structured framework for high-quality real-world data acquisition across the glioma disease trajectory. Although currently single-center, its nationwide recruitment ensures cohort diversity and broad applicability. The CNGR is intended to serve as a scalable model for future multi-center studies in neuro-oncology and as a robust research infrastructure to enhance diagnostic precision, inform therapeutic decision-making, and support prognostic evaluation. It is poised to become a valuable resource for translational research, evidence-based practice, and the development of personalized treatment strategies in glioma care. TRIAL REGISTRATION:Chinese Clinical Trial Registry (Clinical Trial Number: ChiCTR2400094600 , Date of Registration: 2024-12-25).

AIMS:The current study aimed to investigate brain network abnormalities in glioma-related epilepsy (gre) patients through high-density electroencephalography (eeg) data analysis. METHODS:The study included 35 patients with newly diagnosed frontal gliomas. All participants underwent 128-channel resting-state EEG recordings before surgery. Afterward, graph theory and microstate analyses were performed, and the resulting metrics were compared between patients with GRE and those without GRE. RESULTS:The network topology analysis demonstrated that the GRE group had a higher clustering coefficient, global efficiency, and local efficiency; a lower characteristic path length; and a higher small-worldness coefficient than the non-GRE group (adjusted p < 0.05 for all). Additionally, the microstate analysis indicated that the GRE group had lower occurrence and global explained variance of microstate E and higher global explained variance of microstate D (adjusted p < 0.05 for all). Moreover, the occurrence of microstate D was significantly negatively correlated with the maximum tumor diameter in the non-GRE group (r = -0.542, p = 0.009). CONCLUSION:The current study revealed specific brain network abnormalities in GRE patients based on graph theory and microstate analyses of resting-state high-density EEG data. These findings can enhance our comprehension of the mechanisms behind GRE and offer potential biomarkers for improving individualized management of glioma patients.

The application value of intraoperative lateral spreading response (LSR) during microvascular decompression (MVD) is always disputed. The current study aimed to explore the predictive value of intraoperative LSR monitoring for the long-term outcome in patients with primary hemifacial spasm (pHFS). The data from 312 pHFS patients were retrospectively reviewed. The zygomatic LSR (ZYG-LSR) and mandibular LSR (MAN-LSR) monitoring were performed during surgery. The correlations of ZYG-LSR and MAN-LSR disappearances with patients’ long-term outcomes (one year after surgery) were retrospectively investigated. Consequently, binary logistic regression analysis was applied to explore their predictive value. Finally, the implications of their combined utilization for predicting the long-term outcome were explored. Patients with either persistent ZYG-LSR or MAN-LSR exhibited a higher incidence of spasms one year after surgery (p < 0.001). Persistent ZYG-LSR (odds ratio 7.721, p < 0.001) and MAN-LSR (odds ratio 10.729, p < 0.001) were both identified as independent predictive factors for an unfavorable long-term outcome. Taking both ZYG-LSR and MAN-LSR into consideration, patients with simultaneously disappeared two waves had the highest long-term recovery rate (97.2