The deep integration of artificial intelligence and terminal devices is driving the transformation of the full-course management of neurological disorders toward intelligence, continuity, and precision. This article reviews the applications of such terminals devices as smartphones, wearable devices, ambient intelligence, and robots in the full-course management of the diseases. It proposes a closed-loop framework centered on the “monitoring-analysis-decision-making-intervention-feedback”, and highlights the development of an integrated “hospital-community-family” service model. These approaches provide theoretical foundations and practical pathways for establishing a new paradigm of full-course closed-loop management of neurological disorders.

Objective  To understand the functional requirements, usage preferences, and potential barriers of stroke patients regarding the smartphone-based intelligent management system application in out-of-hospital care, thereby providing an evidence base for developing smartphone applications that manage out-of-hospital risk factors.
Methods  The functions of the proposed smartphone-based intelligent management system application in out-of-hospital care were described. Semi-structured interviews were conducted with 15 stroke patients and their 15 family members. The phenomenological data analysis approach within qualitative research was used to analyze and interpret the data, identify the needs of patients and their family members, and extract core themes. 
Results  The needs of the respondents included two core themes, “functional requirements and user experiences” and “data security, privacy protection, and personalized services”. Under the theme of functional requirements and user experiences, the sub-themes included personalized health monitoring guidance, medication reminders, follow-up arrangements, diet management, and rehabilitation exercise management. Under the theme of data security, privacy protection, and personalized services, the sub-themes included interface optimization, online doctor-patient interaction, and family support.
Conclusions  The smartphone-based intelligent management system application in out-of-hospital care should be optimized to balance functional practicality, technical compatibility, and data security, thereby establishing a patient-centric digital stroke rehabilitation ecosystem.

Artificial intelligence (AI) is a crucial branch of computer science, having achieved significant breakthroughs in recent years, driven by advancements in deep learning and big data processing technologies. China faces the dual challenges of uneven distribution of medical resources and the growing demands for health management. The integration of AI technology with clinical medicine provides innovative solutions for addressing these challenges. Neurological disorders pose difficulties in early diagnosis, and limitations in treatment due to their complex pathological mechanisms. The challenges in individualized diagnosis and patient management are particularly prominent. This article systematically reviews advances in AI applications in risk prediction, diagnosis, and treatment of neurological disorders, explores the technical, ethical, and data security challenges encountered in neuroscience implementations, and proposes feasible solutions. This article aims to provide references for promoting the clinical translation of AI technology in the field of neuroscience.

Objective  To construct a nomogram model for predicting survival rates in patients with aneurysmal subarachnoid hemorrhage, and to achieve individualized risk assessment for patients.
Methods  This retrospective cohort study enrolled consecutive patients diagnosed with aneurysmal subarachnoid hemorrhage at the First Affiliated Hospital of Dali University between September 1, 2016 and August 31, 2021. The clinical data and survival data were collected, with follow-up assessments conducted at 1 year, 3 years, and 5 years after onset. The median survival time of patients was estimated using the life table method, the survival curve was plotted using the Kaplan-Meier method, and the prognostic factors were analyzed using the Cox regression model to construct a nomogram model for predicting survival rates in aneurysmal subarachnoid hemorrhage patients. 
Results  A total of 441 patients were included in this study, 166 of whom were male, with a mean age of (58.0±10.4) years. The median survival time was 60 months by life table analysis, with cumulative survival probabilities of 63%, 56%, and 51% at 1-year, 3-years, and 5-years follow-up, respectively. Cox regression model results showed that advanced age, interventions (both surgical and non-surgical), prolonged time from onset to surgery, high acute-phase blood glucose level, large responsible aneurysm, prolonged duration of hyponatremia, re-ruptured aneurysm, and high Hunt-Hess grade were independent risk factors for the survival rates of aneurysmal subarachnoid hemorrhage. The nomogram model showed good discrimination and goodness of fit upon internal validation.
Conclusions  The nomogram model for survival rates in patients with aneurysmal subarachnoid hemorrhage constructed in this study can predict the survival probabilities of aSAH patients at 1 year, 3 years, and 5 years after onset and demonstrates good discrimination and goodness of fit.

Objective  To explore the effects of enlarged perivascular spaces (EPVS) on white matter hyperintensity (WMH) and cognitive impairment in patients with cerebral small vessel disease (CSVD).
Methods  Consecutive patients with CSVD confirmed by neuroimaging examinations were retrospectively enrolled at the Department of Neurology, Hebei Medical University Third Hospital from October 2022 to June 2024. Patients were divided into the cognitive impairment group (0-25 points) and the cognitively normal group (26-30 points) according to their MoCA scores. The clinical baseline data were compared between the two groups, and the influencing factors of cognitive impairment in CSVD patients were analyzed by multivariate logistic regression. Spearman correlation analysis was used to evaluate the relationship between basal ganglia enlarged perivascular space (BG-EPVS) and scores of different cognitive domains of MoCA. Partial correlation analysis was applied to assess the correlations of WMH volume with BG-EPVS and the total score of MoCA. Furthermore, mediation analysis was used to explore the role of WMH volume in the relationship between BG-EPVS and cognitive impairment. 
Results  A total of 207 patients with CSVD were enrolled in this study, including 143 patients in the cognitive impairment group and 64 patients in the cognitively normal group. Multivariate logistic regression analysis revealed that after adjusting for confounding factors such as age, cerebral microbleeds, and hyperhomocysteinemia, hypertension (OR 2.208, 95%CI 1.070-4.555, P=0.032), the numbers of BG-EPVS (OR 1.060, 95%CI  1.011-1.111, P=0.016), and WMH volume (OR 1.044, 95%CI 1.008-1.082, P=0.016) were independently correlated with cognitive impairment. Spearman correlation analysis showed that the numbers of BG-EPVS were negatively correlated with visuospatial and executive function (r=－0.388, P<0.001), attention (r=－0.319, P<0.001), and delayed recall (r=－0.302, P<0.001). Partial correlation analysis showed that WMH volume was positively correlated with the numbers of BG-EPVS (r=0.260, P<0.001) and negatively correlated with global cognitive function (r=-0.338, P<0.001). Further mediation analysis showed that the effect of BG-EPVS on cognitive function was partially mediated by WMH volume, with a mediation effect of 33.3%.
Conclusions  Hypertension, the numbers of BG-EPVS, and WMH volume are independently correlated with cognitive impairment in CSVD patients. The effect of BG-EPVS on cognitive function is partially mediated by WMH volume.

Objective  To assess the effects of the C-reactive protein-triglyceride glucose index (CTI) on progressive stroke, and to provide new evidence and guidance for the comprehensive management of inflammation, blood glucose, and lipid levels in such patients. 
Methods  This study included 1355 patients with ischemic stroke who were admitted to the Cangzhou People’s Hospital from January 2019 to December 2024. The endpoint event was the occurrence of a progressive stroke during hospitalization. Logistic regression analysis, subgroup analysis, and the ROC curve were used to investigate the relationship between the CTI and progressive stroke.
Results  A total of 365 patients (26.94%) experienced progressive stroke. After adjusting for confounding factors, multivariate logistic regression analysis revealed that CTI (OR 2.230, 95%CI 1.957-2.542, P<0.001) was an independent risk factor for progressive stroke. The risk of progressive stroke in the highest quartile range was 3.016-fold higher than that in the lowest quartile range (OR 4.016, 95%CI 1.946-8.290, P<0.001). The subgroup analysis revealed that CTI maintained this relationship in subgroups of age, gender, history of smoking, history of drinking, history of hypertension, history of diabetes mellitus, and history of coronary heart disease, and showed interaction with age, history of hypertension, and history of diabetes mellitus. ROC curve analysis showed that the AUC of C-reactive protein (CRP) for predicting progressive stroke was 0.690 (95%CI 0.660-0.720), that of the triglyceride-glucose (TyG) index was 0.614 (95%CI 0.588-0.640), and that of CTI was 0.711 (95%CI 0.686-0.735). The predictive value of CTI was higher than that of CRP (Z=1.958, P=0.043) and TyG (Z=6.565, P<0.001). 
Conclusions  CTI has a certain independent predictive value for progressive stroke. This integrated indicator, which combines inflammation, blood glucose, and lipid levels, can further improve the accuracy of predicting progressive stroke, and thus has better prospects for clinical application.

Objective  To investigate the relationship between non-linguistic cognitive function and language impairment in patients with post-stroke Wernicke’s aphasia (WA).
Methods  A prospective cohort of patients with post-ischemic stroke WA was consecutively enrolled from the Department of Rehabilitation Medicine, Beijing Tiantan Hospital, Capital Medical University from March 2021 to March 2024. Linguistic function was assessed using the western aphasia battery-revised (WAB-R), including spontaneous speech, auditory comprehension, repetition, and naming. Non-linguistic cognitive function was evaluated using the Loewenstein occupational therapy cognitive assessment (LOTCA), covering orientation, visual perception, spatial perception, motor application, visuomotor organization, thinking operations, and attention. Spearman correlation analysis was used to explore the relationships between various subtests of linguistic functions and non-linguistic cognitive functions. Linear regression analysis was performed with auditory comprehension and naming scores from the WAB-R as dependent variables respectively, and the scores of each LOTCA subtest as independent variables, to assess the influence of non-linguistic cognitive functions on auditory comprehension and naming abilities.
Results  A total of 25 patients with WA aged 27 to 73 years were included in this study. Spearman correlation analysis showed that scores of orientation, spatial perception, and motor application in LOTCA were positively correlated with auditory comprehension and naming scores in WAB-R. Linear regression analysis revealed that orientation scores in LOTCA were positively correlated with auditory comprehension scores in WAB-R (P=0.048), visual perception scores in LOTCA were negatively correlated with auditory comprehension scores in WAB-R (P=0.041). 
Conclusions  In WA patients, non-linguistic cognitive functions such as orientation, spatial perception, and application are positively correlated with language functions like auditory comprehension and naming, while visual perception is negatively correlated with auditory comprehension.

Objective  To explore the efficacy and safety of aspiration thrombectomy and stent retriever thrombectomy in the treatment of acute ischemic stroke (AIS). 
Methods  Chinese and English databases, including PubMed, Cochrane Library, Embase, CNKI, Wanfang, and VIP, were searched to screen studies comparing the efficacy of aspiration thrombectomy and stent retriever thrombectomy in AIS. The efficacy indicators included 90-day mRS score, successful recanalization, and puncture-to-recanalization time. The safety indicators included hemorrhagic transformation, 90-day all-cause mortality, and other complications (vascular perforation/dissection, vasospasm, and new-onset embolism). The funnel plot was used to assess the risk of bias among the included studies. Meta-analysis was performed using RevMan 5.3 software.
Results  A total of 35 studies involving 4865 patients were included. In terms of efficacy, the aspiration thrombectomy group demonstrated superior 90-day mRS scores than the stent retriever thrombectomy group (OR 1.44, 95%CI 1.03-2.00, P=0.030), higher successful recanalization rates than the stent retriever thrombectomy group (OR 1.50, 95%CI 1.18-1.92, P<0.001), and shorter puncture-to-recanalization time than the stent retriever thrombectomy group [standardized mean difference (SMD) -6.57, 95%CI -7.80--5.34, P<0.001]. In terms of safety, there were no statistically significant differences between the two techniques in hemorrhagic transformation rate (OR 0.92, 95%CI 0.76-1.12, P=0.410), 90-day all-cause mortality (OR 0.86, 95%CI 0.64-1.16, P=0.310), and the rates of other complications (OR 0.91, 95%CI 0.75-1.09, P=0.330).
Conclusions  Compared with stent retriever thrombectomy, aspiration thrombectomy has similar safety for treating AIS, but has certain advantages in the successful recanalization rate and short-term prognosis, with a shorter puncture-to-recanalization time.

Objective  To explore the protective effects and regulatory mechanisms of 3-N-butylphthalide (NBP) against oxidative stress in astrocytes subjected to oxygen-glucose deprivation.
Methods  The oxygen-glucose deprivation model was established using CTX TNA2 rat astrocytes. Cell viability was assessed using the cell counting kit-8. Superoxide dismutase (SOD) activity and malondialdehyde (MDA) content were measured to evaluate oxidative stress levels. Real time fluorogenic quantitative PCR was used to detect the changes in the mRNA expression of pyroptosis-related genes [cysteine aspartic acid specific protease (caspase)-1, nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 (NLRP3), IL-1β, and IL-18]. Additionally, the expression changes of genes associated with the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway [Nrf2 and its downstream molecule heme oxygenase (HO)-1], were analyzed to explore their regulatory mechanisms.
Results  Compared with the control group, the oxygen-glucose deprivation group exhibited significantly reduced cell viability (P=0.009) and SOD activity (P=0.013), alongside significantly elevated MDA content (P=0.001). The mRNA levels of caspase-1 (P=0.018), NLRP3 (P=0.021), IL-1β (P=0.004), and IL-18 (P<0.001) were significantly increased, whereas Nrf2 (P=0.035) and HO-1 (P=0.023) expression was significantly decreased. Compared with the oxygen-glucose deprivation group, the NBP-treated group demonstrated significantly increased cell viability (P=0.015) and SOD activity (P=0.013), with decreased MDA content (P=0.002). Concurrently, mRNA levels of caspase-1 (P=0.002), NLRP3 (P=0.009), IL-1β (P=0.004), and IL-18 (P=0.004) decreased, while Nrf2 (P=0.027) and HO-1 (P=0.001) expression increased.
Conclusions  NBP can ameliorate oxygen-glucose deprivation-induced oxidative damage in astrocytes, potentially by activating the Nrf2 antioxidant pathway and inhibiting pyroptosis signaling, thereby alleviating oxygen-glucose deprivation-induced oxidative stress damage, and exerting a potential cytoprotective effects.

Stroke has a long course and is affected by multiple factors. In-depth exploration of the effects of different intervention measures on the disease course and prognosis can provide critical evidence for developing precision intervention strategies. The Markov model, by calculating the probabilities of state transitions in a disease over a certain period, can effectively simulate disease progression and clearly compare the effects of different intervention measures across various stages, thereby enhancing the precision in predicting stroke prognosis and improving its outcomes. Based on these advantages, this study reviews the definition, principles, and construction methods of Markov models and their applications in stroke clinical decision-making, aiming to provide valuable insights for related research in China.

Since its initial introduction in 1989, the NIHSS has remained a core tool in stroke assessment. Currently, it has become the “gold standard” for evaluating stroke severity. This article comprehensively reviews the birth and development of the NIHSS, its current status of clinical applications, and limitations, and introduces five modified versions of the NIHSS. The aim is to optimize the learning pathway for NIHSS, enhance the proficiency of neurologists in applying this scale in clinical practice, and offer insights for the refinement and application of the NIHSS.

The mRS is a commonly used endpoint assessment tool in stroke clinical trials. However, many current clinical trials still lack standardized definitions of health conditions corresponding to different mRS cut-off points, and the statistical analysis methods applicable to mRS also vary in different clinical trials. This article aims to provide an overview of the application of mRS in stroke clinical trials and discusses the recommended terminology and statistical analysis methods of mRS.

Spontaneous intracerebral hemorrhage is a stroke subtype characterized by high morbidity and mortality. It encompasses hypertensive cerebral hemorrhage, cerebral amyloid angiopathy-related intracerebral hemorrhage, and cryptogenic intracerebral hemorrhage. Hematoma expansion is considered one of the risk factors for poor prognosis in patients with spontaneous intracerebral hemorrhage. Prophylactic treatment for spontaneous intracerebral hemorrhage patients at risk of hematoma expansion may improve their outcomes. Therefore, reliable imaging biomarkers for the rapid screening of high-risk patients with hematoma expansion have become a focus in clinical research. In recent years, a large number of clinical studies have shown that heterogeneous hematoma density on head non-contrast computed tomography is a predictor of hematoma expansion and poor prognosis in patients with spontaneous intracerebral hemorrhage. However, this conclusion remains controversial. This article systematically reviews and summarizes the related research progress, aiming to provide references for clinical diagnosis and treatment.

Intravenous thrombolytic therapy has become the primary measure for restoring cerebral blood perfusion in patients with acute cerebral infarction. Guidelines recommend the use of antiplatelet drugs 24 hours after the end of intravenous thrombolytic therapy in patients with acute cerebral infarction. However, studies indicate that patients with acute cerebral infarction remain at risk of symptom aggravation and disease recurrence between intravenous thrombolysis and secondary prevention initiation. For patients with acute cerebral infarction who still show disease progression after intravenous thrombolysis, early initiation of secondary prevention, including antiplatelet therapy, is expected to improve their prognosis. This article reviews the relevant studies on antiplatelet therapy initiation within 24 hours after intravenous thrombolysis in patients with acute cerebral infarction in recent years, aiming to provide a reference for the treatment of patients with cerebral infarction after thrombolysis.

Cerebral microbleeds (CMBs) are subclinical parenchymal lesions and serve as an important imaging marker of cerebral small vessel disease (CSVD). Based on their distribution patterns, CMBs can be classified into lobar-cortical type, deep-type, and mixed-type. CMBs frequently coexist with ischemic stroke (IS). Among them, lobar-cortical type CMBs are associated with cerebral amyloid angiopathy and predispose IS patients to subcortical cognitive impairment. Deep-type CMBs are linked to hypertensive arteriopathy, more commonly inducing subcortical cognitive impairment and dyskinesia in IS patients, and are closely related to the risk and mortality of IS. Mixed-type CMBs exhibit more complex pathological mechanisms, typically accompanied by more severe cognitive impairment, dyskinesia, and poorer prognosis. Different distribution patterns of CMBs may influence the outcomes of antithrombotic and reperfusion therapy in IS patients. However, whether the presence and distribution patterns of CMBs should be considered as contraindications for these treatments remains controversial. Further research is needed to clarify the specific mechanisms by which CMBs affect antithrombotic and reperfusion therapy, in order to optimize individualized treatment strategies.

PANoptosis, a novel form of inflammatory programmed cell death, is regulated and activated by the PANoptosome complex and possesses the main characteristics of pyroptosis, apoptosis, and necroptosis. PANoptosis plays a self-defense role in viral, bacterial, and fungal infectious diseases, while it exacerbates disease damage in inflammatory diseases. This article summarizes the definition and molecular regulatory mechanisms of PANoptosis, explores the crosstalk and correlations among various forms of cell death, and elaborates on the mechanisms of PANoptosis in central nervous system diseases such as stroke, brain tumors, sepsis-related encephalopathy, and epilepsy, aiming to provide new ideas for the clinical treatment of central nervous system diseases.

Objective  To explore the relationship between BMI and in-hospital outcomes in hospitalized patients with acute ischemic stroke (AIS) treated with intravenous thrombolysis.
Methods  Based on the China Stroke Center Alliance (CSCA) registry database, AIS patients who received intravenous thrombolysis from August 2015 to December 2022 were included as the study subjects to analyze the trends in BMI and body weight. According to their BMI, the patients were divided into four groups: the underweight (BMI＜18.5 kg/m2) group, the normal weight (18.5 kg/m2≤BMI＜24 kg/m2) group, the overweight (24 kg/m2≤BMI＜28 kg/m2) group, and the obese (BMI≥28 kg/m2) group. The relationship between BMI and in-hospital outcomes (ischemic stroke recurrence and all-cause mortality) was analyzed.
Results  A total of 154 503 hospitalized AIS patients who received intravenous thrombolysis were included in this study, with an average body weight of (65.23±12.46) kg and an average BMI of (23.67±4.27) kg/m2. Among them, 67 760 (43.86%) patients were classified as overweight or obesity. Multivariate logistic regression analysis showed that underweight was an independent risk factor for in-hospital death in AIS patients. Compared with normal weight patients, underweight patients had an increased risk of in-hospital death (adjusted OR 1.160, 95%CI 1.057-1.273, P=0.002). There was no statistically significant difference in in-hospital death rates among the overweight group, the obese group, and the normal weight group. Additionally, there was no statistically significant difference in in-hospital recurrence rates among different BMI groups.
Conclusions  In this study, AIS patients receiving intravenous thrombolysis exhibited a high rate of overweight or obesity. Moreover, underweight was an independent risk factor for in-hospital death.