With the development of science and technology, stroke rehabilitation brain-computer interface technology has entered a critical stage of clinical translation and large-scale exploration. Currently, its application scenarios have gradually moved from the laboratory to clinical practice and will continue to expand to community and family. In the future, this technology will cover the full disease cycle of stroke patients, from the early stage of onset to their return to the family. This paper focuses on the rehabilitation brain-computer interface, explains its technical essence with active rehabilitation as the core, discusses and sorts out the development status and future development strategies of this technology in the field of stroke rehabilitation. It deeply contemplates the construction of a full-cycle model of stroke rehabilitation brain-computer interface based on the dual dimensions of the full cycle of disease and the full cycle of application scenarios, aiming to promote the application and dissemination of rehabilitation brain-computer interface technology in the full cycle of stroke rehabilitation.

Community-based stroke rehabilitation is an important stage in the full-cycle rehabilitation of stroke patients. Brain-computer interface, as an emerging rehabilitation technology, has attracted widespread attention from the society. With the development and application of diverse brain-computer interface rehabilitation technologies, a wider range of portable exoskeleton brain-computer interface devices will enter communities and homes in the future. To this end, the Hand Functional Rehabilitation Professional Committee of the Chinese Association of Rehabilitation Medicine and the Community Rehabilitation Working Committee of the Chinese Association of Rehabilitation Medicine, together with multidisciplinary experts from hand functional rehabilitation, neurological rehabilitation, and community rehabilitation, have formulated the Expert Consensus on the Application of Portable Exoskeleton Brain-Computer Interface in Upper Limb Rehabilitation of Stroke Patients at Home in the Community (2025 Edition). This consensus explores the working principles of portable exoskeleton brain-computer interface, its application in upper limb rehabilitation of stroke patients at home in the community, and related application management. It aims to provide systematic guidance for upper limb rehabilitation training based on brain-computer interface for stroke patients at home in the community, facilitate the promotion of this technology, and provide a reference for relevant research and practice.

Objective  To compare the clinical efficacy of rehabilitation brain-computer interface (BCI) and motor imagery (MI) therapy on upper limb motor function in stroke patients with the affected hand in the flaccid paralysis phase. 
Methods  Stroke patients with hand dysfunction in the flaccid paralysis phase who were admitted to the Department of Rehabilitation Medicine, The First Affiliated Hospital of Henan Medical University and The Third Affiliated Hospital of Henan Medical University from October 2023 to July 2024, were prospectively and consecutively enrolled and randomly divided into the BCI group and the MI group at a 1∶1 ratio. In addition to conventional rehabilitation training, the BCI group underwent MI-based rehabilitation BCI training, while the MI group received MI training. The training frequency for both groups was six days per week, one session per day, and 30 minutes per session, for two consecutive weeks. Before intervention, one week after intervention, and two weeks after intervention, the Fugl-Meyer motor assessment-upper extremity (FMA-UE) was used to evaluate the patients’ upper limb motor function (shoulder/elbow, wrist/hand), the modified Ashworth scale (MAS) was used to assess the muscle tone of patients’ upper limb (biceps brachii and triceps brachii), and the modified Barthel index (mBI) was used to evaluate the patients’ activities of daily living. Adverse reactions possibly related to rehabilitation BCI device use were recorded. Within-group differences across the assessment time points and between-group differences following the intervention were compared for all outcome measures.
Results  A total of 37 patients were enrolled, including 18 in the BCI group and 19 in the MI group. After two weeks of intervention, the total FMA-UE score, FMA-UE shoulder/elbow subscore, FMA-UE wrist/hand subscore, and mBI score in both groups were significantly improved compared with those before intervention, with statistically significant differences. After two weeks of intervention, the BCI group demonstrated better outcomes than the MI group in the total FMA-UE score (P=0.006), FMA-UE wrist/hand subscore (P<0.001), and mBI score (P=0.022), with statistically significant differences. 
However, no statistically significant difference was found in the FMA-UE shoulder/elbow subscore between the two groups (P=0.057). Regarding MAS grades at one week and two weeks after intervention, there were no statistically significant differences either within each group or between the two groups. No adverse reactions related to the use of the rehabilitation BCI device were reported by any patient.
Conclusions  Rehabilitation BCI can improve upper limb motor function and effectively enhance the activities of daily living in stroke patients during the flaccid paralysis phase, with good safety. Compared with conventional MI training, rehabilitation BCI training demonstrates superior efficacy in rehabilitating distal upper limb function.

Objective  To explore the effect of motor imagery-based rehabilitation brain-computer interface combined with repetitive peripheral magnetic stimulation on upper limb  motor function in patients with convalescent phase after stroke.
Methods  Patients in the convalescent phase after stroke who were hospitalized in the Department of Rehabilitation Medicine, Affiliated Hospital of Chengdu University from May to August 2025 were prospectively and consecutively enrolled. They were randomly divided into the experimental group and the control group. Both groups received 4 weeks of conventional rehabilitation training and repetitive peripheral magnetic stimulation therapy. On this basis, the experimental group received 4 weeks of motor imagery-based rehabilitation brain-computer interface therapy (5 days a week, once a day, 30 minutes per session). Upper limb motor function was evaluated by the Fugl-Meyer motor assessment-upper extremity (FMA-UE) before and after the intervention. Surface electromyography signals were collected from the extensor carpi muscles on the affected side, and the root mean square (RMS) and integrated electromyography (iEMG) values were recorded to evaluate the degree of motor unit recruitment. 
Results  A total of 30 patients in the convalescent phase after stroke were included, with 15 cases in both the experimental group and the control group. Before intervention, there were no statistically significant differences between the two groups in the total score of FMA-UE, FMA-UE shoulder/elbow subscore, FMA-UE wrist/hand subscore, RMS value, and iEMG value. After 4 weeks of intervention, the experimental group showed better results than the control group in the total score of FMA-UE [(39.9±7.8) points vs. (30.7±7.8) points, P=0.003], FMA-UE wrist/hand subscore [(14.5±3.5) points vs. (9.3±3.1) points, P<0.001], RMS value [(47.90±14.94) μV vs. (32.33±7.84) μV, P=0.002], and iEMG value [(82.69±14.32) μV vs. (66.22±10.88) μV, P=0.001], and the differences were statistically significant. 
Conclusions  Motor imagery-based rehabilitation brain-computer interface combined with repetitive peripheral magnetic stimulation can effectively improve upper limb motor function in patients with convalescent phase after stroke, and this protocol has a better effect on improving distal upper limb motor function.

As a new technology for clinical rehabilitation training, the exploration and development of clinical application paradigms of the rehabilitation brain-computer interface have become a key focus for clinicians and therapists. This article reports a case of an ischemic stroke patient whose upper limb and hand function were effectively improved after receiving personalized brain-computer interface training based on the hand-brain perception paradigm. It aims to share the application insights of this paradigm in upper limb function rehabilitation for stroke patients and provide a reference for clinical rehabilitation training.

Upper limb motor dysfunction is common in patients in the acute phase of stroke, which can significantly affect their activity of daily living. Conventional upper limb functional rehabilitation in the acute phase of stroke primarily focuses on peripheral intervention, resulting in insufficient time for patients to engage in active training. This article reports a case of a stroke patient with left-sided limb paralysis caused by acute large vessel occlusion. Early after endovascular thrombectomy, the patient received active rehabilitation training centered on motor imagery-based brain-computer interface. The patient initiated rehabilitation training 3 days after stroke onset. After completing 9 sessions of bedside rehabilitation brain-computer interface training, both the patient’s upper limb motor function and activity of daily living showed improvement. By analyzing the patient’s functional changes before and after rehabilitation brain-computer interface training, this article aims to provide new insights into rehabilitation treatment approach for patients in the acute phase of stroke, so as to more effectively promote the recovery of their upper limb motor function.

Objective  To decipher the immune characteristics of atherosclerotic ischemic stroke using multi-omics data. 
Methods  Atherosclerotic ischemic stroke-related genes were identified by integrating Mendelian randomization with transcriptomic data. Pathway functions were elucidated through gene set enrichment analysis and gene set variation analysis. The protein-protein interaction networks were constructed using the search tool for the retrieval of interacting genes/proteins (STRING) database, and hub genes were subsequently screened with Cytoscape software. Cell differentiation trajectories and communication networks were analyzed by combining single-cell sequencing data (using the SingleR and CellChat packages). Based on transcriptome data, the cell-type identification by estimating relative subsets of ribonucleic acid transcripts (CIBERSORT) algorithm was used to infer immune cell composition and quantify the relative abundance of different immune cell subsets. 
Results  A total of 133 atherosclerotic ischemic stroke-related genes were identified, with functional enrichment analysis indicating their involvement in vascular smooth muscle development (gene ontology: 0097084). Cell communication analysis revealed that these genes regulate interactions among immune cells (such as microglia and monocytes) through eight ligand-receptor pairs of the secreted phosphoprotein 1 and galectin pathway. In the protein-protein interaction network, hub genes including senataxin (SETX), valosin containing protein (VCP), Fc fragment of IgG receptor Ⅱb (FCGR2B), cluster of differentiation 44 (CD44) (OR>1, positive causal relationship), C-X-C motif chemokine receptor 2 (CXCR2), and sequestosome 1 (SQSTM1) (OR<1, negative causal relationship) were found to regulate immune cell differentiation and influence biological processes such as T help cells 2 cell regulation and suppression of inflammatory antigen response. CIBERSORT evaluation showed that CD8+ T cells, activated natural killer (NK) cells, macrophages M0, resting mast cells, and neutrophils were associated with atherosclerotic ischemic stroke. Specifically, SETX expression was positively correlated with neutrophil infiltration (ρ=0.29), CD44 expression was positively correlated with infiltration of activated NK cells (ρ=0.29) and negatively correlated with neutrophil infiltration (ρ=–0.41). 
Conclusions  Hub genes such as SETX, VCP, FCGR2B, CD44, CXCR2, and SQSTM1 contribute to the pathological process of atherosclerotic ischemic stroke by regulating the differentiation of central and peripheral immune cells and vascular smooth muscle function, making them potential biomarkers.

Objective  To evaluate the correlation between blood pressure variability (BPV) across all phases (acute phase, subacute phase, and home blood pressure monitoring phase) and functional outcomes in acute ischemic stroke (AIS) patients after reperfusion therapy. 
Methods   AIS patients who underwent reperfusion therapy (intravenous thrombolysis and/or endovascular treatment) at the Department of Neurology, Beijing Daxing District People’s Hospital were prospectively and consecutively enrolled from July 2022 to October 2023. Demographic information, medical history, pre-onset mRS scores, admission NIHSS scores, onset-to-treatment time, and in-hospital treatment details were collected. Blood pressure was monitored from admission to 3 months after reperfusion therapy, and BPV indicators for each phase were calculated. Based on the 3-month mRS scores, patients were divided into a good functional outcome group (mRS score 0-2) and a poor functional outcome group (mRS score 3-6). Baseline characteristics and BPV indicators were compared between the two groups. Multivariate logistic regression analysis was performed to evaluate the effects of BPV at each phase on the functional outcomes of AIS patients.
Results  A total of 218 patients were enrolled, including 156 males (71.6%), with a mean age of (63±12) years. There were 180 patients in the good functional outcome group and 38 patients in the poor functional outcome group. Compared with the good functional outcome group, the poor functional outcome group had a higher systolic blood pressure standard deviation in the acute phase [12.51 (10.99-14.41) mmHg vs. 9.92 (8.40-11.59) mmHg, P<0.001], a higher systolic blood pressure standard deviation in the subacute phase [12.52 (10.67-13.92) mmHg vs. 10.49 (8.73-12.36) mmHg, P<0.001], a higher systolic blood pressure standard deviation during the home blood pressure monitoring phase [9.02 (8.11-12.61) mmHg vs. 6.61 (5.53-7.92) mmHg, P<0.001], and a higher diastolic blood pressure standard deviation during the home blood pressure monitoring phase [6.16 (4.67-7.66) mmHg vs. 5.17 (4.28-6.03) mmHg, P=0.005]. After adjusting for confounding factors, multivariate logistic regression analysis showed that increased systolic blood pressure standard deviation at each phase was associated with poor functional outcomes at 3 months: systolic blood pressure standard deviation in the acute phase (adjusted OR 1.17, 95%CI 1.04-1.31, P=0.008), systolic blood pressure standard deviation in the subacute phase (adjusted OR 1.29, 95%CI 1.06-1.57, P=0.013), and systolic blood pressure standard deviation during the home blood pressure monitoring phase (adjusted OR 2.35, 95%CI 1.54-3.59, P＜0.001). All differences were statistically significant. An increased diastolic blood pressure standard deviation during the home blood pressure monitoring phase was also associated with poor functional outcomes at 3 months (adjusted OR 1.85, 95%CI 1.20-2.84, P=0.005). The results were consistent across multiple BPV indicators.
Conclusions  Increased systolic blood pressure variability during the acute, subacute, and home blood pressure monitoring phases may increase the risk of poor functional outcomes at 3 months in AIS patients after reperfusion therapy.

Objective  To investigate the relationship between the triglyceride-glucose (TyG) index and moyamoya disease (MMD) as well as its clinical manifestations.
Methods  Patients with MMD who were hospitalized in the Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, and healthy controls during the same period were retrospectively and consecutively enrolled between August 2022 and May 2024. Propensity score matching for sex and age was performed, and the matched MMD patients were assigned to the MMD group, while the healthy controls were assigned to the control group. Demographic data, laboratory test results, and imaging data were collected for the MMD patients, and the TyG index was calculated. Logistic regression analysis was performed to explore the relationship between the TyG index and Suzuki stages as well as clinical manifestations of MMD. 
Results  A total of 205 patients with MMD and 231 healthy controls were enrolled. After propensity score matching, 187 patients in the MMD group and 187 healthy controls were finally matched. The TyG index was higher in the MMD group compared to the control group [8.54 (8.12-8.95) vs. 8.05 (7.81-8.42), P<0.001]. There were no significant differences in the TyG index among different Suzuki stages and clinical manifestations within the MMD group. Correlation analysis showed that the TyG index was positively correlated with age in both the MMD group (r=0.31, P<0.001) and the control group (r=0.28, P<0.001). Moreover, within the same age range, the TyG index was higher in the MMD group than in the control group. Logistic regression analysis showed that elevated TyG index was not significantly associated with Suzuki stages or clinical manifestations. 
Conclusions  The TyG index can reflect the glucose and lipid metabolic disturbances associated with insulin resistance in patients with MMD. In the future, it may be used to assess individual metabolic characteristics of MMD, providing a reference for personalized precision interventions.

The Chinese Expert Consensus on Neurointerventional Diagnosis and Treatment of Carotid Artery Calcification Lesions was developed by experts organized jointly by the Pan-Vascular Disease Branch of Beijing Neurology Society and Chinese Interventional Neuroradiology Society of Chinese Stroke Association, based on the latest advances and evidence-based medical data in the diagnosis and treatment of carotid artery calcification lesions. This consensus comprehensively outlines the epidemiological characteristics, pathological mechanisms, and multi-modal imaging assessment methods (including carotid ultrasound, CTA, MRA, DSA, and optical coherence tomography) for carotid artery calcification lesions, and establishes quantitative criteria for the degree of arterial stenosis. For treatment, the consensus not only discusses strategies such as non-surgical management, carotid endarterectomy, and transcarotid artery revascularization but also specifically standardizes key aspects of carotid artery stenting. These include its indications, contraindications, procedural timing, procedural steps, stent selection, perioperative management, and long-term postoperative follow-up. The consensus aims to establish a standardized neurointerventional framework for clinicians, improve the treatment outcomes and prognosis these patients, reduce their cardiovascular and cerebrovascular risks, and serve as a vital reference for healthcare professionals, social workers, government agencies, healthcare administrators, and pharmaceutical enterprises.

Hypertrophic olivary degeneration is relatively rare in clinical practice, with typical clinical manifestations including palatal myoclonus, ataxia, hoarseness, and ocular symptoms. Patients presenting with paroxysmal limb tremor as the prominent manifestation are even rarer, and such patients are prone to missed diagnosis and misdiagnosis. This article reports a case of hypertrophic olivary degeneration secondary to brainstem hemorrhage (involving the right pons and midbrain) presenting with prominent paroxysmal limb tremor, and describes its diagnosis, treatment, and follow-up. Combined with relevant literature, it discusses the clinical characteristics of such patients and summarizes the key points of its anatomical basis, imaging manifestations, diagnosis, and treatment. The aim is to enhance clinicians’ understanding of this disease and avoid missed diagnosis and misdiagnosis.

Transthyretin cardiac amyloidosis (ATTR-CA) is a rare and fatal cardiomyopathy caused by the deposition of misfolded transthyretin in the myocardial interstitium. ATTR-CA is often complicated by atrial fibrillation and intracardiac thrombosis, which can lead to cardiogenic cerebral embolism. Additionally, abnormal transthyretin can deposit in the walls of small blood vessels of the leptomeninges, resulting in cerebral amyloid angiopathy, which may subsequently cause intracerebral hemorrhage, subarachnoid hemorrhage, or cerebral infarction. This article reports a case of ATTR-CA presenting as acute multiple cerebral infarctions. During the diagnosis and treatment process, cerebral infarction and bleeding occurred repeatedly. The cause was considered to be transthyretin amyloidosis of the small blood vessels of the leptomeninges. By integrating a literature review, this article aims to elucidate the pathogenesis, clinical characteristics, and treatment outcomes of ATTR-CA complicated by stroke, providing a reference for clinical diagnosis and management.

Endovascular treatment, as the first-line treatment for acute ischemic stroke with large vessel occlusion, achieves a successful recanalization rate of over 80%, yet half failed to achieve good functional outcome at 90 days, indicating the prevalence of futile recanalization. No-reflow phenomenon and early arterial reocclusion, both closely associated with post-procedural thrombotic burden, are the core mechanisms underlying futile recanalization after endovascular treatment. Intra-arterial thrombolysis after endovascular treatment can clear residual thrombi and improve microcirculatory perfusion in brain tissue, holding promise for further enhancing functional outcomes in acute ischemic stroke with large vessel occlusion patients. In 2022, after the publication of the chemical optimization of cerebral embolectomy in patients with acute stroke treated with mechanical thrombectomy (CHOICE) trial, subsequent studies exploring the efficacy of intra-arterial thrombolysis after endovascular treatment or the optimal dosage of thrombolytic agents have been initiated. However, due to differences in key design elements across these studies, their results exhibit significant heterogeneity. This article reviews the research progress on intra-arterial thrombolysis after endovascular treatment, discusses its potential value in improving the functional outcomes of patients with acute ischemic stroke with large vessel occlusion, and aims to provide clinicians and researchers with a reference for clinical decision-making and insights for relevant research design.

Carotid atherosclerotic vulnerable plaques are one of the major etiologies of ischemic stroke. Their rupture and detachment play a crucial role in the development and progression of ischemic stroke. Early identification of the degree of carotid artery stenosis and compositional characteristics of vulnerable plaques can improve patient prognosis. Multimodal MRI can not only clearly depict the morphology and size of carotid atherosclerotic vulnerable plaques but also utilize multi-parametric imaging techniques to assess plaque composition, inflammatory response, and hemodynamic parameters, thereby enabling a comprehensive assessment of the plaques. This review summarizes the application progress of multimodal MRI in the assessment of carotid atherosclerotic vulnerable plaques, analyzes the effect of plaque characteristics on ischemic stroke, discusses current challenges in plaque imaging, and provides an outlook on its future research directions.

Objective  To investigate the status of job burnout among neurology residents, analyze its relationship with social support, and identify the independent influencing factors of job burnout.
Methods  This study employed a cluster sampling method in March 2024 to select neurology residents participating in standardized residency training from 2021 to 2023 at Beijing Tiantan Hospital, Capital Medical University. A questionnaire was used to assess job burnout scale and social support scale. The questionnaire consisted of three parts: personal general information, the job burnout scale, and the social support scale. Personal general information included gender, age, grade, possession of a practicing physician qualification certificate, marital status, and monthly income. The job burnout scale comprised three dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. The social support scale included three dimensions: objective support, subjective support, and utilization of support. Intergroup comparisons were conducted on the scores of the three dimensions of job burnout among the respondents. Correlation analysis was performed between the three dimensions scores of job burnout and the three dimensions scores of social support, and multiple linear regression was used to analyze the influencing factors of the dimensions scores of job burnout. 
Results  A total of 124 neurology residents participated in the survey. Among them, 98 (79.0%) were female, 44 (35.5%) were aged≤25 years old, and 88 (71.0%) had obtained a practicing physician qualification certificate. Univariate analysis revealed that the scores of emotional exhaustion dimension were significantly higher in females (P=0.035), residents enrolled in 2022, and those with a monthly income of≤3000 yuan (P=0.007). The scores of depersonalization dimension were significantly higher in females (P=0.001) and residents enrolled in 2023. The scores of reduced personal accomplishment dimension were significantly higher in males (P=0.001), those>25 years old (P=0.001), and those with a monthly income of≤3000 yuan (P=0.008). Correlation analysis revealed that the scores of emotional exhaustion and depersonalization were negatively correlated with the scores of all dimensions and the total score of social support, while the scores of reduced personal accomplishment were positively correlated with the scores of all dimensions and the total score of social support (all P<0.05). Multiple linear regression analysis indicated that grade, monthly income, and the scores of all dimensions of social support were independent influencing factors for the scores of emotional exhaustion (all P<0.05). Grade, the scores of subjective support, and the scores of utilization of support were independent influencing factors for the scores of depersonalization (all P<0.05). Gender, age, grade, and the scores of subjective support were independent influencing factors for the scores of reduced personal accomplishment (all P<0.05). 
Conclusions  Job burnout among neurology residents is influenced by demographic characteristics such as gender, age, grade, and monthly income. social support has a significant regulatory effect on job burnout.