Swallowing is a complex process requiring precise coordination of numerous muscles in the head and neck to smoothly guide ingested material from the mouth to the stomach. Animal and human studies have revealed a complex network of neurons in the brainstem, cortex, and cerebellum that coordinate normal swallowing. The interactions between these regions ensure smooth and efficient swallowing. However, the current understanding of the neurophysiological mechanisms involved in post-stroke dysphagia (PSD) is incomplete, and complete functional connectivity for swallowing recovery remains understudied and requires further exploration. In this review, we discussed the neuroanatomy of swallowing and the pathogenesis of PSD and summarized the factors affecting PSD recovery. We also described the plasticity of neural networks affecting PSD, including enhancing activation of neural pathways, cortical reorganization, regulation of extracellular matrix dynamics and its components, modulation of neurotransmitter delivery, and identification of potential therapeutic targets for functional recovery in PSD. Finally, we discussed the therapeutic strategies based on functional compensation and motor learning. This review aimed to provide a reference for clinicians and researchers to promote the optimization of PSD treatments and explore future research directions.

There has been a significant amount of interest in the past two decades in the study of the evolution of the gut microbiota, its internal and external impacts on the gut, and risk factors for cerebrovascular disorders such as cerebral ischemic stroke. The network of bidirectional communication between gut microorganisms and their host is known as the microbiota-gut-brain axis (MGBA). There is mounting evidence that maintaining gut microbiota homeostasis can frequently enhance the effectiveness of ischemic stroke treatment by modulating immune, metabolic, and inflammatory responses through MGBA. To effectively monitor and cure ischemic stroke, restoring a healthy microbial ecology in the gut may be a critical therapeutic focus. This review highlights mechanistic insights on the MGBA in disease pathophysiology. This review summarizes the role of MGBA signaling in the development of stroke risk factors such as aging, hypertension, obesity, diabetes, and atherosclerosis, as well as changes in the microbiota in experimental or clinical populations. In addition, this review also examines dietary changes, the administration of probiotics and prebiotics, and fecal microbiota transplantation as treatment options for ischemic stroke as potential health benefits. It will become more apparent how the MGBA affects human health and disease with continuing advancements in this emerging field of biomedical sciences.

Parkinson’s disease (PD) is the second most common neurodegenerative disorder worldwide, and the mainstay of treatment is dopamine replacement therapy; however, its beneficial effects tend to wane over time as the disease progresses. Many patients seek complementary therapies to alleviate motor and nonmotor symptoms associated with PD, and the efficacy of acupuncture as a commonly used complementary and alternative therapy for PD remains controversial. In this review, we systematically examine randomized controlled trials and mechanistic studies on acupuncture for PD over the past 12 years. The findings indicate that acupuncture improves both motor and nonmotor symptoms. We also found that the mechanisms underlying the effects of acupuncture on PD may involve connectomics, modulation of dopamine and glutamate systems, regulation of the gut–brain axis, organelle homeostasis, and molecular and signaling pathway modulation. This review proposes a multitarget neuroprotection hypothesis to provide a theoretical basis for standardized acupuncture research.

Introduction: Observational studies suggest a strong association between gut microbiota and frailty, but the underlying mechanisms remain unclear. This study aimed to investigate potential causal links and biological pathways linking gut microbiota and frailty. Methods: We utilized summary‐level data of gut microbiota and frailty data from MiBioGen and a genome‐wide association meta‐analysis. A bidirectional, two‐sample Mendelian randomization (MR) analysis was performed to investigate the causal relationship between gut microbiota and frailty. Additional genetic and genomic analyses were conducted to identify common biological pathways. Results: We identified eight causal relationships between the gut microbiota composition and frailty. Inverse‐variance weighting suggested that genetic liability for the class Betaproteobacteria and genera Allisonella , Bifidobacterium , Clostridium innocuum , and Eubacterium coprostanoligenes was associated with increased frailty risk. In contrast, the class Bacteroidia, genus Eubacterium ruminantium , and the order Bacteroidales were associated with decreased risk. Reverse MR analysis provided no evidence for a causal effect of frailty on gut microbiota composition. In addition, TET2 was identified as a key hub gene associated with frailty, potentially linking gut microbiota to immune dysregulation and aging‐related inflammatory pathways. Conclusions: Our findings provide genetic evidence that gut microbiota composition influences frailty risk and highlight TET2 as a potential mechanistic link via immune dysregulation. These results suggest that microbiota‐targeted interventions may offer novel strategies for the prevention and management of frailty in older adults.

Purpose: To compare the efficacy differences between acupuncture and sham acupuncture in adult primary insomnia through Bayesian network meta-analysis, analyze the impact of different types of sham acupuncture on efficacy, and explore the basis for the control setting. Methods: A literature search of seven databases, including PubMed and Embase, until April 23, 2025, included randomized controlled trials (RCTs) comparing AT with noninvasive sham acupuncture (NISA), superficial acupuncture (SA), and non-acupuncture therapy (NAT) for treating PI in adults. The statistical analyses were conducted using R (version 4.4.1) and Stata (version 15.1). The protocol was registered with the International Prospective Register of Systematic Reviews (CRD420251012912). Results: This meta-analysis incorporated 33 RCTs encompassing 3004 participants, with most studies originating from China. The results showed that at the treatment endpoint and after 4 weeks, AT significantly improved subjective sleep quality (Pittsburgh Sleep Quality Index, PSQI) compared to SA and NISA, exceeding the minimum clinically important difference (MCID: 2.5 points). Specifically, at the endpoint, AT vs SA (MD: − 3.66; 95% CI: − 4.48 to − 2.84) and AT vs NISA (MD: − 4.35; 95% CI: − 5.67 to − 3) were significant, while differences among SA, NISA, and NAT were not. Based on the surface under the cumulative rank curve (SUCRA), AT ranked first (99.9%), followed by SA (47.8%), NAT (31.9%), and NISA (20.4%). No significant differences were found between AT, NISA, and SA regarding objective sleep parameters. Conclusion: AT significantly improved subjective sleep quality in patients with PI, though its impact on objective sleep measures was limited. When designing RCTs of acupuncture for PI, NISA is recommended as the sham acupuncture control. However, due to geographical limitations, the study results may be difficult to generalize. Future research should focus on monitoring objective sleep parameters and conducting international, multicenter RCTs involving diverse cultural populations.

Background: Kaixinsan (KXS) decoction is a traditional Chinese herbal formulation commonly used to treat depression. This study aimed to evaluate the efficacy and safety of KXS, which is widely used, alone and in combination with other therapies, for the treatment of depression. The main objective was to assess the efficacy and safety of KXS in the treatment of depression as a single agent or in combination with other methods. Methods: Randomized controlled trials of KXS in the treatment of depression were systematically searched from several Chinese and English databases with no language restriction. Patients in these studies met the relevant diagnostic criteria for depression. Data on HAMD, SDS, practical situations, and occurrence of side effects in the studies were extracted. Finally, the methodological quality and risk of bias of the included studies were assessed using the Jadad scale and Cochrane bias evaluation tool. Results: Twelve studies with 1034 patients were included after screening. The Jadad scale and Cochrane bias evaluation tool indicated that the quality of the studies ranged from fair to good, with 41.7% categorized as good and 58.3% as poor. Egger test and funnel plots showed that the publication bias remain low. Conclusion: The results showed that the frequency of side effects in the control group was higher than that in the treatment group, and there was a statistically significant difference. KXS was comparable or superior to antidepressants in treating depression and has fewer side effects. The data analysis showed that effectiveness and other indicators differed significantly by geographic area and dosage form, which has implications for future clinical work.