OBJECTIVE:To investigate brain activation and functional connectivity in the prefrontal and motor regions during observation, imagery and execution tasks of Tai Chi Yunshou in healthy adults using functional near-infrared spectroscopy (fNIRS). METHODS:This cross-sectional study enrolled 100 healthy adults (48 males and 52 females; aged 26.23 ± 6.84 years) without a history of neurological, psychiatric or chronic diseases. All participants completed observation, imagery and execution tasks of Tai Chi Yunshou: (1) in the observation task, participants watched videos of the Tai Chi Yunshou movement; (2) in the imagery task, participants repeatedly imagined performing the Tai Chi Yunshou movement following verbal instructions; and (3) in the execution task, participants physically performed the Tai Chi Yunshou movement. The forty-channel wearable fNIRS system was utilized to evaluate the real-time cortical responses during the tasks. Cortical activation was analyzed using a general linear model, functional connectivity was assessed by Pearson correlation, and directional interactions between brain regions were examined using Granger causality analysis (GCA). RESULTS:During the observation task, right dorsolateral prefrontal cortex (DLPFC) and frontopolar area (FPA) were deactivated (P < 0.05). During the imagery task, right DLPFC, primary motor cortex (PMC) and premotor and supplementary motor cortex (PSMC) areas were activated. The bilateral Broca's areas, bilateral DLPFC, bilateral orbitofrontal areas, right FPA, right PMC, right PSMC and right primary somatosensory cortex were activated during the execution task. Execution of Tai Chi Yunshou showed strong functional connectivity within prefrontal cortex (PFC), within sensorimotor area as well as between PFC and sensorimotor area. The results of GCA suggested that Tai Chi Yunshou execution engaged more robust and widespread causal interactions among cortical areas compared to observation and imagery tasks. CONCLUSION:Different activation patterns were found among observation, imagery and execution of Tai Chi Yunshou. Compared with observation and imagery of Tai Chi Yunshou, execution of Tai Chi Yunshou activated and coordinated more brain regions in the PFC and sensorimotor areas, offering evidence that the practice of Tai Chi has the effect of harmonizing both the body and the mind. Please cite this article as: Fu H, Fan J, Liu XB, Li YX, Zhang JM, Xue C, Zhang J, Xie C, Zheng Z, Jiang LB, Li J, Zhong DL, Jin RJ. Brain cortical activation and functional connection of Tai Chi Yunshou during different tasks: An fNIRS study. J Integr Med. 2026; Epub ahead of print.

Background Recent studies using transcranial magnetic stimulation and electroencephalography (TMS-EEG) have revealed abnormal changes in the temporal and frequency domains associated with depression. In this cross-sectional study, we employed microstate analysis to investigate the spatio-temporal features of TMS-induced EEG signals in depressive patients. Our goal was to identify more robust and clinically relevant EEG characterizations associated with depressive states. Methods EEG microstate analysis was conducted on 60 patients with depression and 60 healthy controls. Depressive symptoms were assessed using the 24-item Hamilton Depression Scale (HAMD-24), while anxiety and sleep quality were evaluated with the Hamilton Anxiety Scale (HAMA) and the Pittsburgh Sleep Quality Index (PSQI), respectively. TMS-EEG data, recorded from 46 channels over a 4-minute duration, were subjected to microstate analysis using the Microstate EEGLAB toolbox 1.0. Microstate properties were compared between the groups and correlated with depressive symptoms in patients with depression. Results Microstate analysis identified four classes (MS1-MS4) across all participants. Depressed individuals exhibited a significant increase in both the coverage and duration of MS1 as well as the duration of MS4 (p < 0.05), while the coverage, duration, and occurrence of MS3 were notably reduced compared to healthy controls (p < 0.05). Additionally, HAMD-24 scores and factor scores were negatively correlated with MS3 parameters in patients with depression. Conclusion Our findings suggest that alterations in EEG microstates during TMS are closely linked to depressive symptoms, reflecting changes in large-scale brain dynamics in individuals with depression. TMS-EEG microstate analysis holds potential as a valuable tool for evaluating depressive symptoms and offers new insights into the neuro-electrophysiological mechanisms underlying depression.

Object Limited evidence exists regarding negative attentional bias toward threatening stimuli in patients with major depressive disorder (MDD). This cross-sectional study aimed to explore attentional bias toward threatening stimuli in patients with MDD. Method Hamilton Depression Scale-24 items (HAMD-24) and Hamilton Anxiety Scale (HAMA) were used to assess all participants. The MDD and healthy participants freely viewed images with positive, threatening, and neutral valence for 1000 ms, during which eye movements were recorded with the Eyelink system. Eye-tracking metrics including the mean fixation duration, mean fixation counts, mean saccade counts, mean saccade velocity, mean saccade amplitude, and mean pupil diameter were compared between MDD and healthy groups. Correlations between eye-tracking variables and both HAMD-24 total scores and factor scores were analyzed. Results The study included 100 MDD participants and 100 matched healthy controls. The MDD patients had longer mean fixation duration and reduced saccade counts on threatening and neutral images compared to the healthy controls. Additionally, the MDD patients showed prolonged mean fixation duration and reduced mean fixation counts and saccade counts when viewing threatening images compared to positive images. In contrast, no bias was observed in the healthy controls. Regarding mean pupil diameter, MDD participants showed greater mean pupil diameter for threatening images compared to neutral and positive images. No significant differences were observed in mean saccade velocity and saccade amplitude between the groups. There were positive correlations between mean fixation duration on threatening stimuli and retardation factor scores of HAMD-24. Conclusion Patients with MDD exhibit abnormal attentional bias toward threatening stimuli, which is associated with the severity of retardation symptoms in MDD.

BACKGROUND:Generalized anxiety disorder (GAD) is a chronic disorder characterized by uncontrollable, excessive, widespread anxiety lasting for over six months. Repetitive transcranial magnetic stimulation (rTMS) has been used in treating anxiety disorders, but previous studies have yielded contradictory results. We performed a meta-analysis and trial sequential analysis to investigate the effectiveness and safety of rTMS for GAD and explore the optimal treatment protocol of rTMS for GAD. METHODS:Eight databases were systematically searched to identify randomized controlled trials (RCTs) of rTMS for GAD. The primary outcome was the Hamilton Anxiety Scale. Secondary outcomes included a self-rating anxiety scale, clinical global impression-severity of illness, and incidence of adverse events. Data synthesis was conducted using Review Manager (version 5.4) and Stata software (version 12.0). RESULTS:A total of 29 eligible trials were included. The rTMS combined with medication was more effective than the medication alone in alleviating symptoms of patients with GAD (mean difference [MD] = -3.38, 95 % confidence interval [CI]: from -4.47 to -2.28). Compared with sham-rTMS combined with medication, rTMS combined with medication exhibited a significant effect in improving symptoms of GAD (MD = -2.80, 95 % CI: from -3.71 to -1.89). No serious adverse events were reported between rTMS treatment and medication therapy. CONCLUSION:The rTMS could be an effective and safe treatment for patients with GAD. However, these findings should be interpreted with caution due to high heterogeneity and limited number of RCTs.

OBJECTIVE:This study aims to characterize the time-domain features and functional network properties from Tai Chi Yunshou across four states (rest, observation, imagination, and motion) using functional near-infrared spectroscopy (fNIRS), thereby discriminating the neural mechanisms underlying the mental regulation and integrative body-mind harmony of Tai Chi Yunshou. METHODS:100 healthy participants were included and administered with rest, observation, imagination and motion states of Tai Chi Yunshou. The forty-channel wearable fNIRS system was utilized to evaluate the real-time cortical responses during four states. Brain network properties were analyzed with MATLAB and the GRETNA toolbox. Machine learning models, including random forest, AdaBoost, and gradient boosting, were applied for classification. RESULTS:Small-world network properties (γ>1 and λ≈1) across four states were detected. Compared to states of rest and observation, the motion state exhibited significantly higher γ, λ, Cp, and Eloc (P < 0.01). Additionally, λ and Cp were significantly greater in the motion state than that of the imagination state (P < 0.01). The motion state had increased betweenness centrality and nodal efficiency hubs of the dorsolateral prefrontal cortex and frontopolar area. Gradient boosting outperformed both AdaBoost and random forest across all evaluation metric. CONCLUSION:The motion of Tai Chi Yunshou enhances regulatory capacity in the dorsolateral prefrontal cortex and frontopolar area, boosts local brain processing, and improves network integration. Machine learning models can effectively capture and differentiate the neural features between mental regulation and integrative body-mind harmony.

ABSTRACTAimThis cross‐sectional study aims to identify the characteristic changes of prefrontal and motor areas during a tai chi chuan task in patients with Type 2 diabetes mellitus (T2DM) and major depressive disorder (MDD) using wearable functional near‐infrared spectroscopy (fNIRS).MethodsThree parallel groups (T2DM with DD group, T2DM group, and healthy group) were recruited from December 10, 2022, to May 31, 2023. Participants in three groups conducted a motor task of tai chi chuan designed by Eprime 3.0, and fNIRS was used to monitor the brain activation, functional connectivity (FC), and lateralization of prefrontal and motor areas. Correlation analyses were performed to examine the relationship between depressive symptoms and the function of prefrontal and motor areas.ResultsNinety elder adults (aged ≥ 60), including 30 patients with T2DM and MDD, 30 patients with T2DM, and 30 healthy subjects, were enrolled. In contrast with the patients with T2DM and healthy subjects, the patients with T2DM and MDD had decreased activation and abnormal lateralization in prefrontal and motor areas and decreased FC among supplementary motor area, motor area, and dorsolateral prefrontal cortex (DLPFC). Furthermore, the oxyhemoglobin (HbO2) concentration value of DLPFC in patients with T2DM and MDD was negatively associated with scores of Hamilton Depression Scale‐24 (HAMD‐24).ConclusionsPatients with T2DM and MDD had characteristic functional changes in prefrontal and motor areas. DLPFC may be a potential target of diagnosis and intervention for patients with T2DM and MDD.

INTRODUCTION:Type 2 diabetes mellitus (T2DM) and major depressive disorder (MDD) together occur frequently among the elderly population. However, the inconsistency in assessments and limited medical resources in the community make it challenging to identify depression in patients with T2DM. This cross-sectional study aimed to investigate the activation pattern and network connectivity of prefrontal cortex (PFC) during a verbal fluency task (VFT) in patients with T2DM and MDD using functional near-infrared spectroscopy (fNIRS). METHODS:Three parallel groups (T2DM with MDD group, T2DM group, and healthy group) with 100 participants in each group were included in the study. Recruitment took place from August 1, 2020, to December 31, 2023. Due to the close association between the PFC and depressive emotions, fNIRS was used to monitor brain activation and network connectivity of PFC in all participants during a task of Chinese-language phonological VFT. Network-based statistic prediction was adopted as data analysis method. RESULTS:Patients in the T2DM with MDD group showed characteristic activation pattern and network connectivity in contrast with patients with T2DM and healthy controls, including decreased activation in PFC, and decreased network connectivity of right dorsolateral prefrontal cortex (DLPFC). Furthermore, the network connectivity of the right DLPFC in patients with T2DM and MDD was negatively correlated with scores of Hamilton Depression Scale-24 (HAMD-24). CONCLUSIONS:There was a distinctive activation pattern and network connectivity of the PFC in patients with T2DM and MDD. The right DLPFC could serve as a potential target for the diagnosis and intervention of MDD in patients with T2DM.

BACKGROUND:Several studies have suggested an association between major depressive disorder (MDD) and abnormal brain structure. However, it is unclear whether MDD affects cortical gray matter volume, a common indicator of cognitive function. We aimed to determine whether MDD was associated with decreased cortical gray matter volume (GMV) through a Mendelian randomization (MR) study. METHODS:We obtained summary genetic data from a study conducted by the Psychiatric Genomics Consortium, which recruited a total of 480,359 participants (135,458 cases and 344,901 controls). Genetic tools-single nucleotide polymorphisms (SNPs)-of MDD were extracted from the study and their effects on gray matter volumes of the cortex and total brain were evaluated in a large cohort from the UK Biobank (n = 8427). The effects of the SNPs were pooled using inverse variance weighted (IVW) analysis and further tested in several sensitivity analyses. We tested whether C-reactive protein (CRP) levels and interleukin-6 signaling were the mediators of the effects using a multivariate MR model. RESULTS:Thirty-three SNPs were identified and adopted as genetic tools for predicting MDD. IVW analysis showed that MDD was associated with lower overall GMV (beta value -0.106, 95%CI -0.188 to -0.023, p = 0.011) in the frontal pole (left frontal pole, -0.152, 95%CI -0.177 to -0.127, p = 0.013; right frontal pole, -0.133, 95%CI -0.253 to -0.013, p = 0.028). Multivariate and mediation analysis showed that interleukin-6 was an important mediator of GMV reduction. Reverse causality analysis found no evidence that total GMV affected the risk of MDD, but showed that increased left precuneus cortex volume and left posterior cingulate cortex volume were associated with increased risk of MDD. LIMITATIONS:Potential pleiotropic effects and overestimation of real-world effects. Key assumptions for MR analysis may not be satisfactorily met. CONCLUSION:MDD was associated with a reduced GMV, and interleukin-6 might be a mediator of GMV reduction.

背景:眼动技术因其能客观及时且无创地反映自闭症患者的眼球运动和注意特征,较好地弥补了传统测量方法缺乏的客观性,得到了中国学者的关注,目前尚无针对眼动技术研究自闭症患者的可视化分析.目的:利用文献计量学方法对自闭症眼动研究的相关中英文文献进行可视化分析,了解中国和国际上该领域的研究概况、热点及趋势.方法:检索Web of Science核心合集数据库、中国知网数据库中收录的自闭症患者眼动研究的相关文献,检索时间跨度为各数据库建库至2021-11-05,使用CiteSpace(R5.8.R1)软件对文献中的关键节点信息开展文献计量及可视化分析.主要观察指标为节点的中心度、共现频次或共被引频次以及突现时间等.结果 与结论:Web of Science核心合集数据库共纳入1458篇文献,首篇文献发表在1994年,中国知网数据库共纳入210篇文献,首篇文献发表在2007年.①国际发文量最多的作者是来自英国伦敦大学伯克贝克学院大脑与认知发展中心的JOHNSON MH,发文量最多的机构是伦敦大学学院.②中国发文量最多的作者是来自闽南师范大学应用心理研究所的陈顺森,发文量最多的机构是闽南师范大学应用心理研究所.③国际与中国研究热点存在一定差异,中国研究学者多集中于儿童自闭症患者对外部社会性线索的注意偏向行为模式的研究,研究成果主要是自闭症儿童存在负性情绪线索注意偏向和眼部注意偏向;国际研究学者不仅聚焦于儿童及婴幼儿自闭症患者处理社会性线索视觉模式,同时还结合脑影像技术研究引起视觉行为模式异常的潜在神经机制,研究成果主要是自闭症患者的异常注意模式主要与杏仁核、枕颞叶以及梭状回等相关脑区的激活程度相关.④未来研究学者们还需进一步探索与自闭症有关的生物标志物,为自闭症患者的早期诊断及干预提供生物预测模型.

背景:神经肌肉电刺激疗法目前已被广泛应用于康复领域.目的:阐述神经肌肉电刺激疗法在国内外研究的热点和趋势,分析研究发展构架,为该领域的进一步研究与应用提供参考.方法:检索中国知网和Web of Science核心合集数据库中2010-01-01/2020-10-07的文献.中文检索词为"神经肌肉电刺激""神经肌肉电刺激疗法",英文检索词为"neuromuscular electrical stimulation,NMES".应用CiteSpace V软件对纳人文献的发文量、国家、作者、机构、被引文献及关键词进行可视化分析,并绘制相应图谱.结果 与结论:①最终纳入2453篇相关文献,其中中国知网数据库618篇,Web of Science核心集数据库1835篇.②中国发文量最高的作者是广西科技大学第一附属医院的兰小曼,发文量最高的机构是中山大学附属第五医院康复医学科,中国研究关键词以脑卒中、吞咽障碍等词出现频次较高,相互间连线多而紧密;国外发文量最高的作者是加拿大卡尔加里大学的GUILLAUMEY MILLET,发文量最高的机构是美国凯斯西储大学,国外研究关键词以"脑卒中、骨骼肌、运动"出现频次较高.③详细分析上述数据后发现,近年来神经肌肉电刺激疗法整体研究热度保持稳定,国际研究热点主要集中于脑卒中后的功能障碍研究;中国此类研究倾向于神经肌肉电刺激疗法治疗盆底功能障碍以及联合针刺治疗卒中后的吞咽障碍,国际此类研究趋势集中于神经肌肉电刺激疗法对神经肌肉功能的机制探讨以及与磁刺激治疗结合的临床研究.④神经肌肉电刺激疗法针对吞咽功能、盆底功能障碍的作用机制及其的临床应用范围仍有待于未来的进一步研究.

目的:已有相关Meta分析报道了抑郁患者存在显著的负性注视模式,但此模式影响的大小及不同类型刺激下注视指标的差异尚不清楚.为此,文章系统评价抑郁症患者在不同情绪任务刺激下眼动追踪的注视特征,为临床病情转归及预后评估提供参考依据.方法:计算机检索PubMed、The Cochrane Library、EMbase、Web of Science、CBM、中国知网、万方数据和维普数据库,纳入关于抑郁症患者眼动追踪的病例-对照研究,检索时限均为数据库建库至2021-09-05.由2名研究者独立筛选文献、提取资料,采用NOS量表评估纳入研究的文献质量,使用RevMan 5.4软件进行Meta分析.结果:共纳入12项病例-对照研究,包括病例组(抑郁症患者)231例,对照组307例.纳入研究的NOS评分均在5分以上,文献质量较高.Meta分析结果显示:①对于不同刺激类型,在注视时间上,与对照组相比,抑郁症患者在正性刺激下的注视时间显著减少(SMD正性=-1.00,95％CI:-1.88至-0.12,P=0.03),在负性刺激下的注视时间显著增加(SMD负性=0.77,95％CI:0.50-1.04,P<0.00001),在中性刺激下的注视时间则不存在显著性差异(SMD中性=-0.17,95％CI:-0.48-0.14,P=0.28);②在首视时间上,抑郁症患者与对照组差异均无显著性意义(SMD正性=0.18,95％CI:-0.25-0.61,P=0.42;SMD中性=-0.19,95％CI:-0.46-0.08,P=0.17;SMD负性=0.24,95％CI:-0.04-0.52,P=0.09);③在注视次数上,与对照组相比,抑郁症患者在正性和中性刺激下的注视次数显著减少(SMD正性=-3.65,95％CI:-4.59至-2.71,P<0.00001;SMD中性=-1.08,95％CI:-1.61至-0.56,P<0.0001),在负性刺激下的注视次数显著增加(SMD负性=1.32,95％CI:0.78-1.86,P<0.00001).结论:抑郁症与健康个体的注视模式存在显著性差异,其差异主要表现在注视时间和注视次数上,未来的研究可选取其他眼动指标作为观察变量,进一步探索抑郁症患者的注视模式特征.

背景:经颅磁刺激技术因其无痛、无创、有效及安全性好等优势,在神经心理科、康复医学科及儿科等各个方面得到了广泛应用,但目前尚无针对经颅磁刺激治疗脑卒中领域的可视化分析.目的:客观分析近10年国内外经颅磁刺激治疗脑卒中患者的文献研究,总结该领域近期研究方向及梳理国内外知识结构.方法:基于中国知网和Web of Science数据库中关于经颅磁刺激治疗脑卒中后患者的相关文献,运用Citespace软件对经颅磁刺激治疗脑卒中这一研究领域进行可视化分析.分别对此研究的相关文献的数量、国家、作者、研究机构、关键词、被引文献及期刊、基金支持进行分析,探索此领域研究热点及发展趋势.结果 与结论:①Web of Science数据库中共纳入1729篇文献.发文最多的机构是哈佛大学医学院,发文最多的国家是美国,中国的发文量占据第2位,中国在国际上的基金支持排名首位,热点关键词是康复、兴奋性和运动皮质等,有代表性的经典英文研究是发现了以1 Hz的频率对脑卒中患者进行经颅磁刺激治疗能更大程度的改善患者的运动功能;②中国知网数据库中共纳入分析455篇文献,其中发文量最多的机构是复旦大学附属华山医院康复医学科,热点关键词是康复、抑郁、运动功能和失语症等,有代表性的中文经典研究是发现了高频经颅磁刺激较低频经颅磁刺激对改善卒中后抑郁及日常生活能力的效果更明显;③总体分析得出结论,国际上应用经颅磁刺激治疗脑卒中的近10年研究热点主要集中在经颅磁刺激对大脑皮质运动区的作用机制的探讨,以及经颅磁刺激与其他康复疗法(如运动学习和镜像疗法等)相结合治疗脑卒中后各种功能障碍的疗效研究方面;而中国近10年研究热点主要集中于经颅磁刺激治疗脑卒后抑郁和运动功能方面.

This paper analyzed literatures on the specificity study of electroencephalogram (EEG) in the diagnosis of depression since 2010 to 2020, summarized the recent research directions in this field and prospected the future research hotspots at home and abroad. Based on databases of China National Knowledge Infrastructure (CNKI) and the core collection of Web of Science (WOS), CiteSpace software was used to analyze the relevant literatures in this research field. The number of relevant literatures, countries, authors, research institutions, key words, cited literatures and periodicals related to this research were analyzed, respectively, to explore research hotspots and development trends in this field. A total of 2 155 articles were included in the WOS database. The most published institution was the University of Toronto, the most published country was the United States, China occupied the third place, and the hot keywords were anxiety, disorder, brain and so on. A total of 529 literatures were included and analyzed in CNKI database. The institution with the most publications was the Mental Health Center of West China Hospital of Sichuan University, and the hot keywords were EEG signal, event-related potential, convolutional neural network, schizophrenia, etc . This study finds that EEG study of depression is developing rapidly at home and abroad. Research directions in the world mainly focus on exploring the characteristics of spontaneous EEG rhythm and nonlinear dynamic parameters during sleep in depressed patients. In addition, synchronous transcranial magnetic stimulation (TMS) and EEG technologies also attract much attention abroad, and the future research hotspot will be on the mechanism of EEG on patients with major depression. Domestic research directions mainly focus on the classification of resting EEG and the control study of resting EEG power spectrum entropy in patients with schizophrenia and depression, and future research hotspot is the basic and clinical EEG study of depressed patients complicated with anxiety.

目的 评价老年抗感染领域药物干预系统评价纳入的随机对照试验(randomized controlled trial,RCT)的方法学质量.方法 计算机检索PubMed、EMbase、CNKI、The Cochrane Library、WanFang Data、VIP和CBM数据库,搜集国内外老年抗感染领域的系统评价或Meta分析,检索时限均为建库至2020年2月17日.对纳入的系统评价/Meta分析中RCT的方法学质量进行分析.结果 共纳入8篇系统评价,包括19篇RCT,6 735例老年人.纳入RCT的样本量为23～2 538例,发表时间为1980～2020年.RCT关注疾病涉及老年人术后感染、泌尿道感染、艰难梭状芽胞杆菌感染等.纳入的RCT均不同程度存在方法学质量问题,其中选择性偏倚(随机序列生成)、选择性偏倚(分配隐藏)维度的低风险评价比例最低(47.4％、36.8％)且评价结果为不清楚的比例(42.1％、52.6％)最高.测量偏倚和实施偏倚维度的高风险评价比例最高,均为21.1％.结论 老年抗感染领域RCT质量有待进一步提升,今后应开展高质量的老年抗感染RCT,以更好地指导临床实践.