Post-stroke Broca-type motor aphasia is characterized by impaired oral expression and naming function (Cătălin Jianu 2022). Single standardized speech rehabilitation requires a long period for neural remodeling and carries a high risk of long-term deterioration of language function. Jin’s tongue triple acupuncture is a targeted tongue acupuncture therapy, which is widely adopted as an adjuvant aphasia intervention in multiple rehabilitation departments nationwide. Existing relevant clinical studies have limitations including small sample sizes, single outcome indicators, lack of stratified efficacy comparison, absence of biomarker detection, and merely qualitative safety description.We performed a 1:1 propensity score-matched retrospective cohort analysis to quantify intergroup disparities in language function, peripheral neuroinflammatory mediators, and graded acupuncture-related adverse reactions. We further clarified the target population and therapeutic boundaries of Jin’s tongue triple acupuncture while avoiding overestimation of its clinical efficacy. We retrospectively retrieved consecutive inpatient rehabilitation medical records of stroke patients admitted to the Department of Rehabilitation Medicine, Jingzhou First People’s Hospital from March 2025 to March 2026. Sample size calculation was performed based on effective rates reported in previous similar studies. Of the 614 initially screened patients, 188 were excluded according to predefined inclusion and exclusion criteria. The remaining 426 eligible patients were divided into a combined group (Jin’s tongue triple acupuncture + standardized speech rehabilitation, n = 221) and a control group (standardized speech rehabilitation alone). To balance baseline confounding variables, 1:1 nearest-neighbor propensity score matching with a caliper of 0.05 was conducted; baseline covariates were regarded as balanced when the standardized mean difference (SMD) was less than 0.1. Primary outcomes covered the total score and four subscores (spontaneous speech, naming, repetition, auditory comprehension) of the Aphasia Battery of Chinese (ABC). Secondary outcomes referred to serum concentrations of BDNF, CGRP, ET-1, IL-1β and TNF-α measured via ELISA. Stratified subgroup analyses were carried out in accordance with aphasia severity, stroke subtype, age and type 2 diabetes status. All acupuncture-associated adverse reactions were counted by grading standards. Statistical analyses were completed with SPSS 26.0; propensity score matching was performed via the MatchIt package of R 4.2, and conditional logistic regression was conducted using the clogit function from the survival package Table 1. A total of 182 pairs of samples with balanced baseline data were obtained after matching. After continuous 30-day complete intervention, all ABC subscale scores were significantly improved compared with baseline in both groups. The total ABC score, spontaneous speech score and naming score in the combined group were significantly higher than those in the control group (all P < 0.001). No statistically significant intergroup differences were observed in repetition and auditory comprehension (P > 0.05, Table 2). serological detection revealed statistically significant yet moderate-magnitude changes in the expression levels of peripheral neurotrophic factors and inflammatory mediators in the combined group after intervention (all P < 0.001, Table 3). Stratified analysis revealed that Jin’s tongue triple acupuncture yielded definite clinical benefits only in patients with mild and moderate motor aphasia Fig. 4. Patients with ischemic stroke, aged ≤ 65 years and without type 2 diabetes exhibited better intervention responses Fig. 5. The total incidence of acupuncture-related adverse events was 6.59

Knee osteoarthritis (KOA) is common in older adults and may relate to cognitive decline. We explore whether changes in specific brain areas and body inflammation levels help explain this connection, focusing on the hippocampus-a memory-critical brain region. We studied 36 older adults with KOA over time. Using brain scans, we measured volumes of hippocampal subregions (especially the fimbria). Blood tests tracked six inflammation markers, including brain-derived neurotrophic factor (BDNF), interferon-gamma (IFN-γ), programmed death 1(PD-1), recombinant cannabinoid receptor 1 (CNR1), recombinant cannabinoid receptor 2 (CNR2), and T cell immunoglobulin domain and mucin domain 3 (TIM3). Memory was tested using the Wechsler Memory Scale - Chinese Revision (WMS-CR), while global cognition used the Montreal Cognitive Assessment (MoCA). Relationships between knee pain, brain structure, inflammation, and cognition were analyzed statistically. Here, we show that shrinking fimbria volume predicts cognitive decline in those developing dementia. We identify a robust correlation between fimbria volume and cognitive performance. Higher IFN-γ levels are protective against cognitive decline. Critically, fimbria volume serves as a mediator in the relationship between pain, TIM3/IFN-γ levels, and cognitive scores. Fimbria serves as a key pathway through which KOA may drive cognitive impairment, while IFN-γ could help protect memory. Monitoring these hippocampal changes and inflammation levels might help identify at-risk patients early. Knee osteoarthritis (KOA) occurs when the protective cartilage at the end of the bones wears down, and can result in inflammation of the joint. In addition to pain and stiffness, arthritis can also affect memory in older adults. We studied 36 people with KOA over 5 years and found that a part of the brain known to be involved in memory shrank. The volume of this brain area impacted the amount of knee pain experienced, levels of blood-based markers of inflammation, and extent of memory loss. Our results suggest that monitoring blood-based markers and imaging the brain could enable dementia, a condition in which people have memory issues, to be identified earlier in people with KOA. Wang, Cai, Li et al. examine how knee osteoarthritis (KOA) drives cognitive decline through hippocampal fimbria shrinkage and peripheral inflammation. Fimbria volume mediates pain-related memory loss while elevated interferon-gamma protects against dementia, enabling early risk detection.

IntroductionThis study employed the Diffusion Tensor Imaging Along the Perivascular Space (DTI-ALPS) index to evaluate glymphatic function in patients with Parkinson’s disease (PD) and investigated its association with cognitive and motor functions.MethodsClinical data from the PD group (n = 64) and the healthy control group (HC, n = 30), matched for age, sex, and education years, were included. Based on Montreal Cognitive Assessment (MoCA) scale, PD patients were further categorized into subgroups. All participants underwent DTI scan and scale assessments.ResultsCompared with the HC group, the PD group exhibited increased diffusivity of both the left projection (Dzzproj) and association fibers (Dzzassoc) along the z-axis (p < 0.05) and a reduced left DTI-ALPS index (p < 0.05). The left Dzzproj was negatively correlated with MoCA score (r = −0.299, p = 0.024, q = 0.048). The left Dzzassoc was negatively correlated with MoCA score (r = −0.280, p = 0.035, q = 0.035), and Movement Disorder Society-Unified Parkinson’s Disease Rating Scale III (MDS-UPDRS III) score (r = 0.333, p = 0.011, q = 0.022). The left DTI-ALPS index showed positive correlations with MoCA score (r = 0.350, p = 0.008, q = 0.015) and a negative correlation with MDS-UPDRS III score (r = −0.322, p = 0.015, q = 0.015). Within the PD subgroup analysis, when compared to the HC group, and throughout the progression from PD with cognition normal (PDCN) to PD with dementia (PDD), left Dzzproj (F = 10.240, P < 0.001), and left Dzzassoc (F = 11.060, p < 0.001) all demonstrated a stepwise increasing trend. Conversely, the MoCA total score (F = 259.985, P < 0.001) and the left DTI-ALPS index (F = 11.060, P < 0.001) exhibited a stepwise decreasing trend. Mediation analysis revealed that the left DTI-ALPS index mediated the effect of MoCA scores on MDS-UPDRS III scores.ConclusionAbnormalities in the left DTI-ALPS index and diffusivity reflect underlying glymphatic system (GS) dysfunction and white matter microstructural damage in PD patients. These neuropathological changes are significantly associated with, and collectively contribute to, the progression of motor and cognitive decline. Furthermore, the left DTI-ALPS index shows promise as a novel biomarker for identifying cognitive impairment in PD patients.

AbstractBackgroundPersistent pain is a prominent symptom of knee osteoarthritis (KOA) and has been associated with cognitive decline in individuals with KOA. The amygdala, a complex structure consisting of nine subnuclei, and programmed cell death protein‐1 (PD‐1) levels play crucial roles in pain regulation and cognitive processing. This study aims to investigate the relationships among amygdala subregion volumes, cognitive function, and PD‐1 levels to elucidate the underlying mechanism of cognitive decline in KOA.MethodsIn this cross‐sectional study, we recruited 36 patients with KOA and 25 age/gender‐matched healthy controls for neuropsychological tests, structural magnetic resonance imaging scanning, and measurement of serum PD‐1 levels. We used the atlas provided by FreeSurfer software to automatically segment the amygdala subnuclei. Subsequently, we compared the volumes of amygdala subregions between groups and explored their correlation with clinical scores and PD‐1 levels.ResultsCompared to healthy controls, individuals with KOA exhibited significantly lower scores on global cognition tasks, such as long‐delay free recall, short‐delay free recall, and immediate recall tasks. Moreover, they displayed decreased volumes in lateral nucleus basal nucleus paralaminar nucleus while showing increased volumes in accessory basal nucleus, central nucleus, medial nucleus, and cortical nucleus. Within the KOA group specifically, paralaminar volume was negatively correlated with immediate recall scores; pain scores were negatively correlated with global cognition; basal volume was negatively correlated with PD‐1 levels.ConclusionOur findings highlight those alterations in amygdala subregion volumes along with changes in serum PD‐1 levels may contribute to observe cognitive decline among individuals suffering from KOA.

Abstract Knee osteoarthritis (KOA) patients often suffer from cognitive decline. This study aims to investigate the relationship between cognitive decline, hippocampal subregions, and serum inflammatory cytokines levels in KOA. Their correlation and mediating effects were analyzed. Cognitive function declined at follow-up, and the decline was more pronounced in the AD8>1 group. The fimbria volume decreased in the AD8>1 group, while increased in the AD8≤1 group. The fimbria volume was correlated with cognitive performance in both group. Brain-derived neurotrophic factor (BDNF) levels were negatively correlated with the Montreal Cognitive Assessment_Language (MoCA_Language) subscore change in the AD8≤1 group and Recombinant Cannabinoid Receptor 2 (CNR2) levels were negatively correlated with the Wechsler Memory Scale – Chinese Revision_1-100 (WMS-CR_1-100) subscore change in the AD8>1 group. In addition, the serum Interferon-gamma (IFN-γ) level was a protective factor against cognitive decline and the fimbria volume played a mediating role between pain, T cell immunoglobulin domain and mucin domain 3 (TIM3) /IFN-γ levels, and the WMS-CR_1-100 subscore. Our results suggested that the fimbria was an important mediator of cognitive decline in KOA, and CNR1, CNR2, and BDNF were strongly associated with cognitive decline while IFN-γ levels may be a protective factor against cognitive progression in KOA. Clinical trial registration number: ChiCTR-IOR-16009308

Objective This study aims to explore whether body mass index (BMI) level affects the executive function and hippocampal subregion volume of subjective cognitive decline (SCD). Materials and methods A total of 111 participants were included in the analysis, including SCD (38 of normal BMI, 27 of overweight and obesity) and normal cognitive control (NC) (29 of normal BMI, 17 of overweight and obesity). All subjects underwent the Chinese version of the Stroop Color-Word Test (SCWT) to measure the executive function and a high-resolution 3D T1 structural image acquisition. Two-way ANOVA was used to examine the differences in executive function and gray matter volume in hippocampal subregions under different BMI levels between the SCD and NC. Result The subdimensions of executive function in which different BMI levels interact with SCD and NC include inhibition control function [SCWT C-B reaction time(s): F (1,104) = 5.732, p = 0.018], and the hippocampal subregion volume of CA1 [ F (1,99) = 8.607, p = 0.004], hippocampal tail [ F (1,99) = 4.077, p = 0.046], and molecular layer [ F (1,99) = 6.309, p = 0.014]. After correction by Bonferroni method, the population × BMI interaction only had a significant effect on the CA1 ( p = 0.004). Further analysis found that the SCWT C-B reaction time of SCD was significantly longer than NC no matter whether it is at the normal BMI level [ F (1,104) = 4.325, p = 0.040] or the high BMI level [ F (1,104) = 21.530, p < 0.001], and the inhibitory control function of SCD was worse than that of NC. In the normal BMI group, gray matter volume in the hippocampal subregion (CA1) of SCD was significantly smaller than that of NC [ F (1,99) = 4.938, p = 0.029]. For patients with SCD, the high BMI group had worse inhibitory control function [ F (1,104) = 13.499, p < 0.001] and greater CA1 volume compared with the normal BMI group [ F (1,99) = 7.619, p = 0.007]. Conclusion The BMI level is related to the inhibition control function and the gray matter volume of CA1 subregion in SCD. Overweight seems to increase the gray matter volume of CA1 in the elderly with SCD, but it is not enough to compensate for the damage to executive function caused by the disease. These data provide new insights into the relationship between BMI level and executive function of SCD from the perspective of imaging.

Background:To investigate the relationship between hypertension status, hippocampus/hippocampal subregion structural alteration, and cognitive performance in subjective cognitive decline (SCD).Methods:All participants were divided into two groups according to blood pressure status: SCD without hypertension and SCD with hypertension. The cognitive assessments and T1-MPRAGE brain MRI were performed to measure the cognitive function and the volume of the hippocampus and hippocampal subregions. Association and mediating/moderating effects were analyzed between the volume of hippocampus/hippocampal subregions and cognitive scores.Results:Compared to the SCD without hypertension, we found (1) increased reaction time (RT) of the Go/No go test, compatible test, and divided attention visual task and (2) decreased volume of the left whole hippocampal/left subiculum/left CA1/left presubiculum/left parasubiculum/left molecular layer HP/left GC-ML-DG/left HATA in SCD with hypertension. There was a significant negative association between the volume of the left GC-ML-DG and Go/No go test RT in SCD without hypertension. A significant moderating effect of hypertension status on the relationship between the volume of the left GC-ML-DG and Go/No go test RT was found.Conclusion:The results suggested that hypertension status affects inhibitory control function and visual divided attention which may be related to the reduction of hippocampus/hippocampal subregion volume in SCD. Limitations. The study has several limitations. First, this study does not include a healthy control group. In further studies, healthy controls may need to assess the interaction between hypertension status and disease status on cognitive function. Second, we defined the hypertension status using with or without hypertension disease. More detailed parameters of hypertension status need to be further studied. Third, our study was a small number of participants/single-center and cross-sectional study, which may hinder its generalization. A large-sample/multicenter, longitudinal study is helpful to comprehensively understand the relationship between hypertension status and cognitive function in SCD patients.

Purpose The aim of the study was to develop a comprehensive questionnaire for assessing resilience in patients with stroke during rehabilitation and examine the questionnaire's reliability and validity. Design A four-phased design was used to develop and validate the questionnaire. Methods The preliminary items of the Resilience Questionnaire for Stroke Rehabilitation (RQSR) were generated through a literature review and a qualitative study. Twenty experts were consulted for content validation and modification of the questionnaire. A pilot study was conducted with 55 patients with stroke. A total of 510 participants from seven rehabilitation centers or hospitals were subsequently recruited to examine the psychometric properties of the RQSR. Results The RQSR consists of 35 items within three dimensions. Dimensions include effective rehabilitation training, accessible support system, and appropriate self-regulation. The content validity index of the total questionnaire was .9335. Seven factors were derived through factor analysis, and cumulative contribution rate of variance was 65.455%. Cronbach's alpha of the total questionnaire was .957, with each dimension ranging from .731 to .918, demonstrating high levels of reliability. Conclusion The RQSR has sound reliability and validity and can be used as an appropriate tool for assessing resilience for patients with stroke during rehabilitation to facilitate effective interventions.

Objective: This study aims to determine the relationship between education level, memory function, and hippocampus functional and structural alterations in subjective cognitive decline (SCD). Methods: Seventy-five participants with SCD were divided into high education (HE) and low education (LE) level groups. A Wechsler Memory Scale–Chinese Revision test and functional and structural MRI were performed within 1 week after participant recruitment. The bilateral hippocampus resting-state functional connectivity (rsFC), gray matter volume (GMV) of brain regions identified by rsFC analysis, and moderating and mediating effects were assessed. Results: Compared with the LE group, HE individuals showed 1) higher memory quotient (MQ) and Digit Span subscore, 2) decreased hippocampal rsFC with the right medial prefrontal cortex (mPFC) and dorsolateral prefrontal cortex (DLPFC), and 3) increased GMV in the right mPFC and DLPFC. The bilateral hippocampus–right DLPFC rsFC significantly associated with the MQ and the bilateral hippocampus–right mPFCrsFC with the Digit Span subscore in each group. The bilateral hippocampus–right DLPFC rsFC moderated the relationship between the education level and MQ. The bilateral hippocampus–right mPFC rsFC mediated the relationship between the education level and Digit Span subscore in all subjects. Conclusion: The hippocampal rsFC with the right mPFC and DLPFC contributes to the education level effect on memory function in SCD.

The default mode network (DMN) plays an important role in age-related cognitive decline. This study aims to explore the modulation effect of two mind-body interventions (Tai Chi Chuan and Baduanjin) on DMN in elderly individuals. Participants between 50 and 70 years old were recruited and randomized into a Tai Chi Chuan, Baduanjin or control group. The Wechsler Memory Scale-Chinese Revision and resting-state fMRI scans were administered at baseline and following 12 weeks of exercise. Seed-based resting-state functional connectivity (rsFC) was calculated. We found that (i) compared to the Baduanjin group, Tai Chi Chuan was significantly associated with increased rsFC between the medial prefrontal cortex (mPFC) and right putamen/caudate and (ii) compared to the control group, Tai Chi Chuan increased posterior cingulate cortex rsFC with the right putamen/caudate, while Baduanjin decreased rsFC between the mPFC and orbital prefrontal gyrus/putamen. Baseline mPFC rsFC with orbital prefrontal gyrus was negatively correlated with visual reproduction subscore. These results suggest that both Tai Chi Chuan and Baduanjin can modulate the DMN, but through different pathways. Elucidating the mechanisms underlying different mind-body interventions may shed light on the development of new methods to prevent age-related diseases as well as other disorders associated with disrupted DMN.

BACKGROUND:Knee osteoarthritis is a prevalent disorder with unsatisfactory treatment options. Both physical and mindful exercises may be able to relieve its pain symptoms. We compared the modulatory effects of different exercise modalities on the periaqueductal grey (PAG) and ventral tegmental area (VTA), which play important roles in descending opioidergic pathways and reward/motivation systems in patients with knee osteoarthritis. METHODS:We recruited and randomised 140 patients into Tai Chi, Baduanjin, stationary cycling, and health education control groups for 12 weeks. Knee injury and Osteoarthritis Outcome Score (KOOS), functional and structural MRI, and blood biomarkers were measured at the beginning and end of the experiment. We used the PAG and VTA as seeds in resting-state functional connectivity (rsFC) analysis. RESULTS:Compared with the control group: (i) all exercises significantly increased KOOS pain sub-scores (pain reduction) and serum programmed death 1 (PD-1) concentrations; (ii) all exercises decreased right PAG rsFC with the medial orbital prefrontal cortex, and the decreased rsFC was associated with improvements in knee pain; and (iii) grey matter volume in the medial orbital prefrontal cortex was significantly increased in all exercise groups. There was also significantly decreased rsFC between the left VTA and the medial orbital prefrontal cortex in the Tai Chi and Baduanjin groups. CONCLUSIONS:Exercise can simultaneously modulate the rsFC of the descending opioidergic pathway and reward/motivation system and blood inflammation markers. Elucidating the shared and unique mechanisms of different exercise modalities may facilitate the development of exercise-based interventions for chronic pain. CLINICAL TRIAL REGISTRATION:ChiCTR-IOR-16009308.

The aim of this study is to investigate and compare how 12-weeks of Tai Chi Chuan and Baduanjin exercise can modulate brain structure and memory function in older adults. Magnetic resonance imaging and memory function measurements (Wechsler Memory Scale-Chinese revised, WMS-CR) were applied at both the beginning and end of the study. Results showed that both Tai Chi Chuan and Baduanjin could significantly increase grey matter volume (GMV) in the insula, medial temporal lobe, and putamen after 12-weeks of exercise. No significant differences were observed in GMV between the Tai Chi Chuan and Baduanjin groups. We also found that compared to healthy controls, Tai Chi Chuan and Baduanjin significantly improved visual reproduction subscores on the WMS-CR. Baduanjin also improved mental control, recognition, touch, and comprehension memory subscores of the WMS-CR compared to the control group. Memory quotient and visual reproduction subscores were both associated with GMV increases in the putamen and hippocampus. Our results demonstrate the potential of Tai Chi Chuan and Baduanjin exercise for the prevention of memory deficits in older adults.

Age-related cognitive decline is a significant public health concern. Recently, non-pharmacological methods, such as physical activity and mental training practices, have emerged as promising low-cost methods to slow the progression of age-related memory decline. In this study, we investigated if Tai Chi Chuan (TCC) and Baduanjin modulated the fractional amplitude of low-frequency fluctuations (fALFF) in different frequency bands (low-frequency: 0.01–0.08 Hz; slow-5: 0.01–0.027 Hz; slow-4: 0.027–0.073 Hz) and improved memory function. Older adults were recruited for the randomized study. Participants in the TCC and Baduanjin groups received 12 weeks of training (1 h/day for 5 days/week). Participants in the control group received basic health education. Each subject participated in memory tests and fMRI scans at the beginning and end of the experiment. We found that compared to the control group: (1) TCC and Baduanjin groups demonstrated significant improvements in memory function; (2) TCC increased fALFF in the dorsolateral prefrontal cortex (DLPFC) in the slow-5 and low-frequency bands; and (3) Baduanjin increased fALFF in the medial PFC in the slow-5 and low-frequency bands. This increase was positively associated with memory function improvement in the slow-5 and low-frequency bands across the TCC and Baduanjin groups. Our results suggest that TCC and Baduanjin may work through different brain mechanisms to prevent memory decline due to aging.