Migraine is a chronic headache disease, which ranks second in years lost due to disability. However, the mechanism of migraines is still not clear. In migraine patients, fasting can trigger headache attacks. We explored the probable mechanism of why fasting can induce headaches. Nitroglycerin (NTG) was used to induce acute migraine attacks in mice. Primary astrocytes were used to study the pathophysiological mechanism and a Seahorse analyzer was used to detect mitochondrial function. NTG induced more serious headaches in the fasting group. Both the head-scratching times and climbing-cage times in the fasting group were higher than those in normal-diet group. More ROS and inflammatory factors, such as IL-6 and IL-1β, were induced in low-glucose conditions. Seahorse showed that the basal oxygen consumption rate (OCR) and OCR for ATP production were lower in mice who had received NTG with low glucose levels than in other groups. The activity of AMPK was inhibited in this group, which may explain the Seahorse results. We concluded that in the low-glucose state, astrocytes produce more inflammatory factors, ROS, which may be a result of mitochondrial metabolism dysfunction. Improving mitochondrial function and supplying enough substrates may be an option for relieving migraine attacks.

Purpose: Acute ischemic stroke (AIS) is a leading cause of disability and mortality, with poor functional outcomes often linked to autonomic dysfunction. Deceleration capacity (DC), a marker of vagal activity, has been shown to predict cardiovascular outcomes, but its prognostic value in AIS remains underexplored. This study investigates the role of DC in predicting stroke recovery at 2 weeks and 3 months post-stroke.Patients and methods: This prospective study included 423 AIS patients treated at a single center between January 2022 and December 2023. Cardiac autonomic function was assessed using DC and heart rate variability (HRV) parameters (SDNN, SDANN, RMSSD), derived from 24-hour Holter ECG monitoring. Patients were categorized into two groups based on DC: DC > 4.5 ms and DC ≤ 4.5 ms. Functional outcomes were measured using the modified Rankin Scale (mRS) at 2 weeks and 3 months post-stroke. Logistic regression models and Restricted Cubic Splines (RCS) were used to analyze the relationship between DC and stroke outcomes.Results: Patients with lower DC (≤4.5ms) had significantly worse functional outcomes, as indicated by higher mRS scores at both 2 weeks and 3 months. The DC ≤ 4.5 ms group also had a higher prevalence of comorbidities such as diabetes and hypertension. RCS analysis revealed a non-linear relationship between DC and stroke outcomes, with a significant threshold at DC = 4.5 ms. The 3-month outcome model, including age and DC, demonstrated strong predictive ability with an AUC of 0.744.Conclusions: This study highlights the importance of DC as a prognostic marker for short-term stroke recovery. Lower DC values are associated with worse outcomes, suggesting that DC may serve as an early predictor of stroke prognosis. Future research should focus on validating these findings in larger, multicenter cohorts and exploring interventions targeting autonomic dysfunction to improve stroke recovery.

Severe fever with thrombocytopenia syndrome (SFTS) is a natural infectious disease caused by severe fever with thrombocytopenia syndrome virus (SFTSV). Central nervous system (CNS) involvement is not rare in SFTS. In this work, we report a case of SFTS with CNS symptom onset and the metagenomic next-generation sequencing of cerebrospinal fluid (CSF), confirming invasion of SFTSV into the CNS. The case’s lumbar puncture indicated an exceptionally low CSF opening pressure—an uncommon finding in other CNS infections and in case reports of SFTS. A spontaneous subdural effusion was observed on the fourth day of hospitalization. Moreover, a flow cytometry analysis of bone marrow revealed a restricted expression of the lambda light chain in monoclonal B cells and plasma cells. The patient succumbed to their severe illness. The early recognition of the disease may be crucial for prognosis despite the disease’s current lack of specific treatments.