Brain–computer interface (BCI) technology based on motor imagery (MI) or motor attempt (MA) has shown promise in enhancing motor function recovery in stroke patients. This study aimed to evaluate the effectiveness of BCI-based rehabilitation in improving motor function through multimodal assessment, and to explore the potential neuroplastic changes resulting from this intervention. We conducted a randomized double-blind controlled clinical trial with multimodal assessment to evaluate the efficacy of a BCI system for enhancing motor recovery. A total of 48 ischemic stroke patients completed the study (25 BCI, 23 control). The BCI group used an 8-electrode electroencephalogram (EEG) system, a virtual reality training module, and a rehabilitation training robot for real-time motor intention-based feedback. The control group used identical BCI devices but without displaying real-time data and feedback. Participants underwent 20-minute upper and lower limb training sessions for two weeks. Motor function (Fugl-Meyer Extremity scale), electromyography (EMG), and functional near-infrared spectroscopy (fNIRS) were assessed pre- and post-intervention. The BCI group demonstrated significantly greater improvement in upper extremity motor function compared to the control group (ΔFMA-UE: 4.0 vs. 2.0, p = 0.046). EEG results of the BCI group showed a significant decrease in both DAR (p = 0.031) and DABR (p < 0.001) compared to baseline. EMG analysis revealed that BCI treatment resulted in significant increases in deltoid and bicipital muscle activity during both shoulder and elbow flexion movements compared to baseline (p < 0.01). fNIRS results indicated enhanced functional connectivity and activation in key motor-related brain regions, including the prefrontal cortex, supplementary motor area, and primary motor cortex in the BCI group. BCI-based rehabilitation using an attention-motor dual-task paradigm significantly improved upper limb motor function and enhanced motor and cognitive network activity in stroke patients. Multimodal assessment supports the potential of BCI rehabilitation as an effective tool for leveraging neuroplasticity and promoting motor recovery.

Constipation as a most common non-motor symptom of Parkinson's disease (PD), has a higher prevalence compared to the general population. The etiologies of constipation in PD are diverse. In addition to physical weakness and other factors of disease, the lifestyles and eating habits are also important factors. Therefore, the prevalence and influencing factors of constipation may vary among different populations. To determine the prevalence of constipation and analyze relative factors in a cohort of Chinese patients with PD. All the patients diagnosed with PD according to the movement disorders society criteria were consecutively collected by a self-developed questionnaire. Rome III diagnostic criteria were used to assess functional constipation and Wexner score was used to estimate the severity of constipation. Non-motor symptoms (NMS) were assessed with the non-motor symptoms assessment scale (NMSS). Unified Parkinson's disease Rating Scale III (UPDRS III) was used to evaluate the severity of motor symptoms. The modified Hoehn-Yahr stage was used to evaluate the severity of PD. Cognitive function was assessed using Montreal cognitive assessment (MoCA). Depression and anxiety were rated with the Hamilton depression scale (HAMD) and the Hamilton anxiety scale (HAMA). Quality of life was assessed using the Parkinson’s disease Questionnaire-39 items (PDQ-39). Of 166 patients enrolled, 87 (52.41%) were accompanied with constipation, and 30 (34.48%) experienced constipation for 6.30 ± 5.06 years before motor symptoms occurred. Age, Hoehn-Yahr stage, disease duration, levodopa medication times, incidence of motor complications, the scores of UPDRS total, UPDRS III, NMSS, HAMD, HAMA, and PDQ-39 in the constipation group were higher than those in the non-constipation group (P < 0.05), but there was no difference in the scores of MoCA, clinical types, or medications between the two groups (P > 0.05). There was a higher incidence of depression in patients with constipation (P < 0.05), but there were no difference in the incidence of anxiety and cognitive impairment between the two groups (P > 0.05). As Hoehn-Yahr stages increased, the severity of constipation increased (P < 0.05), but not the incidence of constipation (P > 0.05). Pearson correlation analysis showed that constipation was moderately positively correlated with age, Hoehn-Yahr stage, and scores of NMSS, UPDRS III, UPDRS total, PDQ-39, HAMD, and HAMA (r = 0.255, 0.172, 0.361, 0.194, 0.221, 0.237, 0.238, and 0.207, P < 0.05). Logistic regression analysis showed that only NMSS score was an independent risk factor for constipation (P < 0.001). Our findings confirm that constipation has a relatively high frequency in patients with PD. PD patients with constipation have a higher incidence of depression, which leads to worse quality of life.

Objectives: Post-stroke depression (PSD) may be associated with the altered brain network property. This study aimed at exploring the brain network characteristics of PSD under the classic cognitive task, i.e., the oddball task, in order to promote our understanding of the pathogenesis and the diagnosis of PSD.Methods: Nineteen stroke survivors with PSD and 18 stroke survivors with no PSD (non-PSD) were recruited. The functional near-infrared spectroscopy (fNIRS) covering the dorsolateral prefrontal cortex was recorded during the oddball task state and the resting state. The brain network characteristics were extracted using the graph theory and compared between the PSD and the non-PSD subjects. In addition, the classification performance between the PSD and non-PSD subjects was evaluated using features in the resting and the task state, respectively.Results: Compared with the resting state, more brain network characteristics in the task state showed significant differences between the PSD and non-PSD groups, resulting in better classification performance. In the task state, the assortativity, clustering coefficient, characteristic path length, and local efficiency of the PSD subjects was larger compared with the non-PSD subjects while the global efficiency of the PSD subjects was smaller than that of the non-PSD subjects.Conclusion: The altered brain network properties associated with PSD in the cognitive task state were more distinct compared with the resting state, and the ability of the brain network to resist attack and transmit information was reduced in PSD patients in the task state.Significance: This study demonstrated the feasibility and superiority of investigating brain network properties in the task state for the exploration of the pathogenesis and new diagnosis methods for PSD.

Background: There was a reorganization of the brain network after stroke. Some studies have compared the characteristics of activation or functional connectivity (FC) of cortical and subcortical regions between the dominant and non-dominant hemisphere stroke.Objectives: To analyze hemispheric dominance differences in task-state motor network properties in subacute stroke by functional near-infrared spectroscopy (fNIRS).Materials and Methods: Patients with first ischemic stroke in the basal ganglia within 1–3 months after onset and age- and sex-matched right-handed healthy subjects (HS) were enrolled. fNIRS with 29 channels was used to detect the oxyhemoglobin concentration changes when performing the hand grasping task. Activation patterns of motor cortex and two macroscale and two mesoscale brain network indicators based on graph theory were compared between dominant and non-dominant hemisphere stroke.Results: We enrolled 17 subjects in each of left hemisphere stroke (LHS), right hemisphere stroke (RHS), and HS groups. Both patient groups showed bilateral activation. The average weighted clustering coefficient and global efficiency of patients were lower than those of healthy people, and the inter-density was higher than that of the HS group, but the significance was different between LHS and RHS groups. The intra-density changes in the RHS group were opposite to those in the LHS group. The correlation between mesoscale indicators and motor function differed between dominant and non-dominant hemisphere stroke.Conclusion: The changes in macroscale cortical network indicators were similar between the two patient groups, while those of the mesoscale indicators were different. The mesoscale brain network characteristics were affected by the severity of dysfunction to varying degrees in the LHS and RHS patients.

To explore the correlation of vascular risk factors for Alzheimer’s disease (AD) in Chinese population. A total of 123 outpatients with probable AD followed up for 3 years were investigated. Severity of cognitive impairment and functional ability was assessed using Mini-Mental State Examination (MMSE) and modified activities of daily living (ADLs), respectively. The incidence of vascular risk factors was studied in patients with AD. Univariate analysis showed significance difference in MMSE and ADL scores between patients with and without vascular risk factors (P < .05). Multiple regression analysis showed age, education, hyperhomocysteinemia, and hypertension were significant variables associated with annual MMSE, while there were no significant correlations between annual MMSE and sex, initial MMSE, diabetes, and so on. Vascular risk factors are common comorbidities in patients with AD in China, with younger, better educated ones showing faster cognitive decline. Hypertension and hyperhomocysteinemia may also aggravate the progression, and it is important to prevent and treat patients with AD.

Stroke is the leading cause of disability globally in need of novel and effective methods of rehabilitation. Intermittent theta burst stimulation (iTBS) has been adopted as a Level B recommendation for lower limb spasticity in guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS). Nonetheless, the methodological differences and deficits of existing work bring about heterogenous results and therefore limit the universal clinical use of rTMS in lower extremity (LE) rehabilitation. The variation of stimulated targets across motor cortex contributes mainly to these heterogeneities. This narrative review includes studies of rTMS on LE motor function rehabilitation in patients after stroke until now. Some analyses of brain imaging and electromagnetic simulation and quantification through computational modeling were also performed. rTMS appears capable of fostering LE motor rehabilitation after stroke, but the actually stimulated targets are considerably bias making it difficult to confirm effectiveness. The main reason for this phenomenon is probably inaccurate targeting of motor cortical leg representation. An underlying updated method is proposed as Individual‐Target TMS (IT‐TMS) combined with brain imaging. rTMS is a promising validated method for LE function regaining. Future studies should systematically compare the effects of IT‐TMS with traditional rTMS using large samples in random clinical trials.This article is categorized under: Neuroscience > Clinical Neuroscience