Disorders of consciousness are a heterogeneous mixture of different diseases or injuries. Although some indicators and models have been proposed for prognostication, any single method when used alone carries a high risk of false prediction. This study aimed to develop a multidomain prognostic model that combines resting state functional MRI with three clinical characteristics to predict one year-outcomes at the single-subject level. The model discriminated between patients who would later recover consciousness and those who would not with an accuracy of around 88% on three datasets from two medical centers. It was also able to identify the prognostic importance of different predictors, including brain functions and clinical characteristics. To our knowledge, this is the first reported implementation of a multidomain prognostic model that is based on resting state functional MRI and clinical characteristics in chronic disorders of consciousness, which we suggest is accurate, robust, and interpretable.

High-grade gliomas—particularly glioblastoma (GBM)—remain refractory to standard-of-care surgery followed by chemoradiation, with a median overall survival of ~15 months. Oncolytic viruses (OVs), which selectively infect and lyse tumor cells while engaging antitumor immunity, offer a mechanistically distinct therapeutic modality. This review synthesizes clinical progress of OVs in GBM, with emphasis on oncolytic herpes simplex virus (oHSV) and coverage of other vectors (adenovirus, reovirus, Newcastle disease virus, vaccinia virus) across phase I–III trials, focusing on efficacy and safety. Key observations include the encouraging clinical trajectory of oHSV exemplars—T-VEC (approved for melanoma) and G47Δ (approved in Japan for recurrent GBM)—the multi-center exploration of the adenovirus DNX-2401 combined with programmed death-1 (PD-1) blockade, and the early-stage status of reovirus (pelareorep) and Newcastle disease virus programs. Emerging evidence indicates that oHSV therapy augments immune infiltration within the tumor microenvironment and alleviates immunosuppression, with synergy when combined with chemotherapy or immune checkpoint inhibitors. Persistent challenges include GBM’s inherently immunosuppressive milieu, limitations imposed by the blood–brain barrier, intrapatient viral delivery and biodistribution, and concerns about viral shedding. Future directions encompass programmable vector design, optimization of systemic delivery, biomarker-guided patient selection, and rational combination immunotherapy. Collectively, OVs represent a promising immunotherapeutic strategy in GBM; further gains will hinge on vector engineering and precision combinations to translate mechanistic promise into durable clinical benefit.

Background: Although chronic subdural hematoma (CSDH) has been known for over several hundred years, the etiology and pathogenesis of it are still not completely understood. Neurosurgical procedures resulting in CSDH are a rare clinical complication, and there was no report about how subdural effusion (SDE) evolves into CSDH after deep brain stimulation (DBS) surgery. The formation mechanism of CSDH after surgery, especially in DBS surgery, and the effect of recovery, need to be explored. Methods: We present two cases, complicated with SDE after DBS surgery, serious dysfunction complications such as hemiplegia and aphasia occurred on the postoperative day 36 and 49 individually, and images showed CSDH. Fusion image showed the bilateral electrodes were significantly shifted. Then, they were performed to drill craniotomy with a closed system drainage. Result: The symptoms of hemiplegia and aphasia caused by CSDH were completely recovered, and the follow-up images showed CSDH was disappeared. However, DBS stimulation is poorly effective, it cannot reach the preoperative level, especially in the ipsilateral side of CSDH. Conclusions: The iatrogenic SDE that evolved into CSDH in the present two cases shows that SDE is one of the causes of CSDH. Patients develop SDE after DBS, which increases the risk of developing CSDH. CSDH after DBS can be successfully treated. however, the postoperative efficacy of DBS will decline.

Background: Tuberous sclerosis complex (TSC) frequently causes epilepsy, but cell-type-specific molecular alterations in human lesions remain incompletely understood. Methods: We performed single-nucleus RNA sequencing of cortical tissue from three TSC and three surgical control donors, with single-nucleus chromatin accessibility profiling in two donors per group from the same cohort. Donor-level pseudobulk differential analyses were combined with functional enrichment, inferred cell communication, and motif analyses. Results: Among the six cell types displayed in the main comparison, microglia had the most differentially expressed genes (872; 282 upregulated and 590 downregulated). Downregulated genes were enriched for lysosomal and lipid-storage processes. Inferred APP-CD74 input to microglia was higher for most source cell types, whereas APP-SORL1 changes varied by source. Chromatin analysis identified 9283 differentially accessible regions. Predicted regions linked to ABCA1, ATP6V0A1, and GPNMB showed decreased accessibility, concordant with lower RNA expression. Donor-averaged TFEB- and TFE3-associated chromatin variation across regions (chromVAR) scores were lower in TSC. Conclusions: These exploratory findings suggest microglial remodeling involving lysosomal and lipid-storage processes. It may provide a molecular basis for further investigation of microglia in epileptogenesis.

Fearful-expression recognition is vital for survival, yet how human amygdala subregions differentially support its distinct cognitive components, including rapid threat detection and fine-grained face processing, remains unclear. Here, we recorded intracranial EEG from lateral and medial amygdala in epilepsy patients performing an emotional face-matching task. Using multivariate decoding, time-frequency and directed-connectivity analyses with intracranial stimulation, we found that the lateral subregion exhibited early, fear-specific responses with higher decoding accuracy and elevated theta/alpha-band (4-12 Hz) power, and transmitted this fear-specific information to the medial subregion, which showed delayed and sustained activation. By contrast, the medial subregion encoded face-specific information at later stage in the 2-16 Hz band with superior decoding accuracy and power, and then relayed this information back to the lateral subregion to complete processing. Further, intracranial stimulation produced behaviorally selective effects, with lateral stimulation disrupting fear detection while medial stimulation accelerated face recognition. Together, our study reveals that functional specialization and frequency-specific dynamic interaction among human amygdala subregions underlie distinct cognitive components of fearful-expression recognition.