Central paralysis is caused by damage to motor conduction pathways in the brain or spinal cord， most commonly due to stroke or spinal cord injury. It often results in motor dysfunction，spasticity， and sensory abnormalities， severely impairing patients' quality of life and imposing a substantial societal burden. In recent years， neuromodulation techniques， particularly spinal cord stimulation （SCS）， have attracted increasing attention due to their minimally invasive and reversible nature. SCS delivers electrical pulses to the dorsal spinal cord via epidural electrodes， thereby reducing muscle tone， alleviating spasticity and pain， and promoting motor recovery. Its therapeutic mechanisms involve modulation of neural plasticity， sensory afferent input， excitability of spinal motor neurons， and neurotransmitter release. Compared with traditional surgery and other neuromodulation approaches， SCS offers non-destructive， direct action with a wide range of potential benefits， including improvements in consciousness and autonomic dysfunction. Future development of SCS is expected to incorporate multichannel electrodes， intelligent algorithms， closed-loop control， and robot-assisted rehabilitation，enhancing both precision and efficacy. This article reviews the current situation， surgical indications and contraindications， surgical methods， postoperative management and therapeutic outcomes of SCS in the treatment of central paralysis.
To analyze the interactions between 5-hydroxytryptamine （5-HT） related gene expression and immune cell abundance in the plasma of patients with diabetes mellitus and diabetic peripheral neuropathy （DPN）， and to explore their potential mechanisms in the pathogenesis of DPN.
Methods
Thirty three patients with DPN who were scheduled to undergo peripheral nerve decompression surgery in the Neurosurgery Department of China-Japan Friendship Hospital from January to September 2023 were selected as the DPN group， and 20 patients with type 2 diabetes in the community near China-Japan Friendship Hospital were recruited as the diabetes group from March to September 2023.Transcriptomic sequencing was conducted on plasma samples from patients with diabetes mellitus and DPN to evaluate differences in 5-HT-related gene expression. The CIBERSORTx algorithm was utilized to predict the abundance of 22 types of immune cells in both groups of patients. Elastic net regression analysis was employed to identify 5-HT-related genes significantly associated with immune cell abundance， followed by an assessment of their roles in DPN development.
Results
The expression of 23 5-HT-related genes in the plasma of patients with DPN was significantly different from that of patients with diabetes （P＜0.05）. These genes were highly correlated with differences in immune cell abundance between the two groups. Elastic net regression analysis identified 6 key 5-HT-related genes： IL6R，MAPK1， TLR4， F2RL1， ZC3H13， and RPS6KB1， which showed the most significant impact on immune cell abundance and demonstrated strong correlations with clinical symptoms in DPN patients.Furthermore， initial CD4 T cells and neutrophils were found to be significantly reduced， while regulatory T cell proportions were increased in DPN patients. These immunocyte alterations exhibited associations with DPN clinical manifestations.
Conclusions
These findings highlight the critical roles of plasma 5-HT-related gene expression levels and immune cell abundance in DPN development， offering potential molecular biomarkers for early warning and intervention strategies for DPN.
To investigate the effect of radical nerve resection on intractable auriculotemporal migraine.
Methods
The clinical data of 32 patients with intractable auriculotemporal neurogenic migraine who underwent radical auriculotemporal neuroresection treatment in the Department of Neurosurgery of China-Japan Friendship Hospital from January 2022 to January 2023 were retrospectively analyzed. All patients were followed up for 2 years after surgery. Pre- and postoperative comparisons were made regarding pain relief， numbness status， overall surgical satisfaction， as well as symptom recurrence and outcomes.
Results
（1） Pain score： The numerical rating scale （NRS） score immediately after surgery was 0.5 （0， 2）， which was significantly lower than the preoperative NRS score of 8 （8， 9）， and the difference was statistically significant （P＜0.05）； After 2 years of follow-up， the NRS score was 0 （0， 1） points. （2） Numbness score： The visual analogue scale （VAS） score of 6 （5， 7） immediately after surgery was significantly higher than that of 0 （0， 0） before surgery， and the difference was statistically significant （P＜0.05）； After 2 years of follow-up， the VAS score was 3 （2， 3.75）. （3） Overall satisfaction： The postoperative satisfaction rate was 34.38% （11/32）， and after 3 months， the surgical satisfaction rate increased to 84.38% （27/32）. After 2 years of follow-up， the surgical satisfaction rate was 93.75% （30/32）. （4） There was one recurrence 1 year after operation， which was the formation of a small neuroma at the nerve stump. After the second operation， the symptoms were relieved.
Conclusions
Radical neurotomy is an effective method for the treatment of intractable auriculotemporal neurogenic migraine.
Peripheral neuropathic pain （PNP） is a common and complex neurological disorder with diverse symptoms that significantly impact patients' quality of life. In recent years， peripheral nerve stimulation （PNS）， as a minimally invasive， safe， and effective neuromodulation therapy， has been widely used in the treatment of various types of PNP， such as post-herpetic neuralgia， trigeminal neuralgia，diabetic peripheral neuropathy， and migraine. Especially for refractory PNP that is difficult to alleviate with traditional medications or surgery， PNS has demonstrated remarkable therapeutic effects and unique advantages. This article mainly focuses on the specific application of PNS in the treatment of PNP， aiming to provide references for the further promotion and clinical application of this technology， and promote its broader attention and application in the field of PNP treatment.
Microvascular decompression （MVD） is the preferred surgical approach for treating neurovascular compression syndromes. However， the limited visual field in conventional microscopic surgery may hinder comprehensive anatomical assessment of neurovascular structures and the precision of decompression procedures. In recent years， the advancement of neuroendoscopic technology has provided a wider surgical view and a more refined operating space for MVD， potentially enhancing its safety and efficacy. This review summarizes the current applications of neuroendoscopy in MVD， focusing on key technical aspects， safety， efficacy， and limitations， while also exploring future directions to provide insights for further research and clinical practice in this field.
To explore the regulatory effects of Tera Hertz （THz） stimulation on brain function under anesthesia using a non-human primate （rhesus monkey） model， and systematically evaluate the impact of different stimulation parameters on global brain functional networks， aiming to provide experimental evidence for developing precise deep brain modulation methods.
Methods
THz radiation intervention was applied to the Centromedian-Parafascicular complex of the thalamus in 3 anesthetized rhesus monkeys （totaling 6 experiments） using hard-channel fiber optic implantation technology.Stimulation parameters included different power levels （1， 5， 10， 30， 50， 90 mW） and durations （5， 10， 60，100， 300 s）. During the experiments， stereotactic electroencephalography and electrocorticography were used to record brain signals. Time-frequency maps were constructed for seven characteristic frequency bands （δ， θ， α， β， full-band， low-γ， high-γ）， and wavelet transform was employed to calculate power spectral density to analyze changes in the average power spectrum across different frequency bands.Additionally， phase-locking value matrices were used to quantify dynamic changes in global brain functional connectivity.
Results
THz stimulation exhibited intensity- and duration-dependent regulatory effects on brain electrical activity and network connectivity. Specifically， γ-band （30-80 Hz）power significantly increased under 1 mW and 10 mW stimulation， while 90 mW stimulation did not produce consistent changes. Furthermore， 10 mW stimulation significantly enhanced global connectivity in the 0.5-30 Hz frequency range， whereas 50 mW stimulation reduced connectivity in this range. The effects of different stimulation durations varied considerably， with the 10 mW-60 s parameter combination showing optimal performance in enhancing γ oscillations and global synchrony. Post-stimulation imaging review revealed no significant brain tissue edema or hemorrhage， indicating good biosafety of the stimulation method.
Conclusions
THz stimulation can bidirectionally modulate global brain functional connectivity in anesthetized rhesus monkeys in a dose-dependent manner， demonstrating significant neurobiological effects. The 10 mW-60 s parameter combination showed the best performance in promoting γ oscillations and global synchrony， suggesting that THz neuromodulation technology has the potential to become a novel， safe， and effective method for brain function modulation.
To investigate the relationship between peripheral blood CC chemokine ligand 20 （CCL20）， CC chemokine ligand 23 （CCL23） and secondary massive cerebral infarction in patients with severe traumatic brain injury （sTBI）.
Methods
One hundred and seventy-eight sTBI patients who underwent craniotomy surgery in the Neurosurgery Department of Handan Central Hospital from September 2020 to September 2023 were selected， follow up for 6 months after surgery， patients were divided into occurrence group and non occurrence group based on whether secondary massive cerebral infarction occurred. Clinical data between two groups were collected， the levels of peripheral blood CCL20 and CCL23 were detected， the factors affecting secondary massive cerebral infarction in sTBI patients within 6 months after operation were analyzed by multivariate Logistic regression analysis， the value of peripheral blood CCL20 and CCL23 in predicting secondary massive cerebral infarction in sTBI patients within 6 months after operation were analyzed by receiver operating characteristic （ROC） curve.
Results
Follow up for 6 months after surgery， 30 out of 178 sTBI patients developed secondary massive cerebral infarction （occurrence group）， with an incidence rate of 16.85%， the remaining 148 patients were included in non occurrence group. The levels of peripheral blood CCL20 and CCL23 in the occurrence group were higher than those in the non occurrence group， and the differences were statistically significant （P＜0.05）. Multivariate Logistic regression model showed that， cerebral hernia， subarachnoid hemorrhage， elevated CCL20 and elevated CCL23 were independent risk factors for secondary massive cerebral infarction in sTBI patients within 6 months after operation （P＜0.05）. ROC curve showed that， the area under the curve of cerebral hernia， subarachnoid hemorrhage， peripheral blood CCL20， CCL23 and their combination in predicting the occurrence of secondary massive cerebral infarction in sTBI patients within 6 months after operation were 0.766， 0.806， 0.760， 0.732， 0.879， respectively， the combined prediction efficiency of the four was the highest and which was higher than that in the single prediction of each index （P＜0.05）.
Conclusions
CCL20 and CCL23 are involved in the occurrence and progression of secondary massive cerebral infarction in sTBI patients after surgery. The combination of cerebral herniation， subarachnoid hemorrhage， and peripheral blood CCL20 and CCL23 levels can help identify，predict， and evaluate the occurrence of secondary massive cerebral infarction in sTBI patients early， and improve patient prognosis.
To investigate the relationship between plasma monocyte chemoattractant protein-1 （MCP-1）， chitinase protein-40 （YKL-40） and poor cerebral collateral circulation in patients with acute ischemic stroke （AIS） with severe stenosis or occlusion of unilateral symptomatic middle cerebral artery （MCA）-M1 segment.
Methods
A total of 150 AIS patients with unilateral symptomatic severe stenosis or occlusion of unilateral symptomatic MCA-M1 segment admitted to Brain Disease Department of Enshi Tujia and Miao Autonomous Prefecture Central Hospital from June 2020 to June 2023 were selected. According to the formation of cerebral collateral circulation， they were divided into good group and poor group. The levels of plasma MCP-1 and YKL-40 were detected and compared between the two groups. The risk factors of poor cerebral collateral circulation were analyzed by multivariate Logistic regression model. The receiver operating characteristic （ROC） curve was used to analyze the predictive value of plasma MCP-1 and YKL-40 for poor collateral circulation in patients.
Results
Among 150 AIS patients with unilateral symptomatic severe stenosis or occlusion of unilateral symptomatic MCA-M1 segment， 63 patients had poor collateral circulation （poor group）， and the remaining 87 patients were included in the good group. The levels of plasma MCP-1 and YKL-40 in the poor group were higher than those in the good group， and the differences were statistically significant （P＜0.05）. High levels of TC （≥4.5 mmol/L）， Hcy （≥20 mmol/L）， MCP-1 （≥160 μg/L） and YKL-40 （≥150 pg/mL） were independent risk factors for poor cerebral collateral circulation in AIS patients with severe stenosis or occlusion of unilateral symptomatic MCA-M1 segment （P＜0.05）. The area under curve （AUC） of plasma MCP-1， YKL-40 alone and combined prediction of poor cerebral collateral circulation in patients was 0.875， 0.869 and 0.947，respectively， and the combined prediction effect was the best.
Conclusions
The levels of plasma MCP-1 and YKL-40 are increased in AIS patients with severe stenosis or occlusion of unilateral symptomatic MCA-M1 segment， and the increased levels of MCP-1 and YKL-40 are independent risk factors for poor cerebral collateral circulation. The combined detection has a higher predictive value for poor cerebral collateral circulation in AIS patients with severe stenosis or occlusion of unilateral symptomatic MCA-M1 segment.
