Functional Neurosurgery, as an important sub specialty of modern neurosurgery, has the core task of accurately intervening in specific nerve roots, neural circuits, neural population, and even the brain-wide network to correct pathological and physiological processes, remodel neural function, and ultimately restore normal life abilities to patients. With the development of modern Functional Neurosurgery, technologies such as surgical navigation systems, surgical robots, microelectrodes, and brain computer interfaces continue to iterate, assisted by spectral, vascular, magnetic resonance evaluation, and algorithm optimization, the level of disease diagnosis and treatment technology continues to improve. A platform integrating big data, artificial intelligence, brain-computer interfaces has been established, expanding the scope of disease treatment and enhancing neurological function protection through precision, minimally invasive approaches, digitalization, and intelligence. This article mainly reviews the development digitalization and intelligence in Functional Neurosurgery, aiming to provide a reference for promoting neural function remodeling and whole brain network research.

To explore the effect of transcranial alternating current stimulation combined with exercise training on functional recovery in rats with limb spasm after cerebral infarction based on hypoxic inducible factor-1α (HIF-1α)/vascular endothelial growth factor (VEGF) pathway.

Out of 50 SPF grade SD male rats, 10 rats were selected as the normal (NO) group using a random number table method, while the remaining 40 rats were used to establish rat models of limb spasm after cerebral infarction by suture method combined with internal capsule injection of N-methyl-D-aspartic acid. Among them, 30 rats were successfully prepared. The model rats were randomly divided into a normal (NO) group, a model (MO) group, a combined (UN) group, and a combined+HIF-1α/VEGF pathway inhibitor (UH) group using a random number table method, with 10 rats in each group. The UN group received transcranial alternating current stimulation combined with exercise training intervention, while the UH group received intraperitoneal injection of HIF-1α/VEGF pathway inhibitor at a dose of 16 mg/kg on top of the UN group. The NO group and MO group did not receive treatment. After the treatment, Zea-Longa score, modified Ashworth score, Feeney balance test, and screen test were used to evaluate functional recovery. HE staining was used to detect the pathological morphology of brain tissue, and RT-PCR and immunoblotting were used to detect the expression of HIF-1α/VEGF pathway in brain tissue.

The Zea-Longa score, modified Ashworth score, Feeney balance test score and screen test score were compared among the four groups of rats after intervention, and the differences were statistically significant (P<0.05); Moreover, the NO group<UN group<UH group<MO group, and the differences of pairwise comparison among four groups were statistically significant (P<0.05). The HE staining results showed that, the brain tissue structure of the NO group is intact, and the distribution of nerve cells is uniform; The brain tissue structure of the MO group was damaged, showing edema of the brain tissue, disordered distribution of nerve cells, and nuclear atrophy; Improvement of pathological structure: UN group>UH group>MO group. The mRNA and protein expression of HIF-1α and VEGF in the brain tissues of four groups of rats were compared, and the differences were statistically significant (P<0.05); The expression levels of HIF-1α/VEGF mRNA in brain tissue were compared, with MO group<NO group<UH group<UN group, and the differences of pairwise comparison among four groups were statistically significant (P<0.05); The expression levels of HIF-1α and VEGF proteins were compared, with MO group<UH group<UN group<NO group, and the differences of pairwise comparison among four groups were statistically significant (P<0.05).

Transcranial AC stimulation combined with exercise training has a significant effect on the functional recovery of rats with limb spasm after cerebral infarction, and can effectively improve the nerve function and limb function of rats, which may be related to the regulation of HIF-1α/VEGF pathway.

To investigate the clinical effect of personalized exercise prescriptions on limb function rehabilitation in stroke patients during the convalescent phase.

A total of 56 stroke patients in the convalescent phase who were treated in the Department of Rehabilitation Medicine in Shanghai General Hospital from February to August in 2024 were selected. The disease course spans 3 to 6 months. Using a randomized block design, the patients were divided into a control group and an intervention group, with 28 patients in each group. After then, one patient dropped out from the control group. The control group received basic exercise rehabilitation education and performed self-directed exercises, while the intervention group followed a personalized exercise prescription tailored to their individual needs. The intervention lasted for 3 months. Assessments were conducted before the intervention, as well as 1 month and 3 months after the intervention, using the simplified Fugl-Meyer assessment (FMA), 10 m maximum walking speed (MWS) test, medical coping modes questionnaire (MCMQ), and follow-up evaluations of exercise safety.

After 1 month of exercise, FMA and 10 m MWS scores in both groups improved compared to baseline, and the FMA scores in the intervention group were significantly better than those in the control group (P<0.05). After 3 months of exercise, the FMA, 10 m MWS, and MCMQ "Confrontation" scores of both groups of patients improved compared to those after 1 month of exercise, while MCMQ "Avoidance" and "Resignation" scores were lower than those after 1 month of exercise, and the intervention group showed better results in FMA, 10 m MWS, and MCMQ "Confrontation" scores than the control group, with statistically significant differences (P<0.05).

The application of personalized exercise prescriptions can significantly improve limb motor function and walking ability in stroke patients during the convalescent phase. Influencing coping styles through exercise prescriptions and enhancing cardiopulmonary and overall coordination functions may be effective strategies for further optimizing exercise regimens in stroke patients.

To observe the therapeutic effect of functional anatomy acupoint selection electroacupuncture combined with electromyographic biofeedback therapy on lower limb motor dysfunction in stroke.

A total of 96 patients with lower limb motor dysfunction after stroke admitted to the Acupuncture and Rehabilitation Department and the Neurology Department of Jiangyou Hospital of Traditional Chinese Medicine from January 2023 to October 2024 were selected as the research objects. They were divided into control group and observation group according to the random number table method, with 48 cases in each group. The control group was treated with basic treatment+myoelectric biofeedback+conventional acupoint selection electroacupuncture treatment, while the observation group was treated with basic treatment+myoelectric biofeedback+electroacupuncture based on functional anatomy acupoints treatment. The both groups were treated for 4 weeks. Before treatment and after 4 weeks of treatment, Fugl-Meyer assessment lower extremity scale (FMA-LE) score, the modified Barthel index (MBI), and the active range of motion (AROM) of the hip, knee and ankle were evaluated.

After 4 weeks of treatment, the FMA-LE, MBI, hip AROM, knee AROM, and ankle AROM indicators in both groups improved significantly compared to before treatment, and the observation group was better than the control group, with statistically significant differences (P<0.05).

The functional anatomy acupoint selection electroacupuncture combined with myoelectric biofeedback therapy is superior to conventional acupoint selection electroacupuncture therapy in FMA-LE, MBI, hip AROM, knee AROM, ankle AROM, and other aspects

To analyze the relationship between serum neurofilament light chain protein (NfL), macrophage inflammatory protein-1α (MIP-1α), leucine-rich α-2 glycoprotein 1 (LRG1) and neurological sequelae in children with viral encephalitis (VE).

One hundred and fifty VE children admitted to Pediatrics Department of Yulin Hospital, First Affiliated Hospital of Xi'an Jiaotong University from February 2020 to January 2023 were selected. After 6 months of follow-up, VE children were divided into sequelae group and non-sequelae group according to whether neurological sequelae occurred or not. Baseline data and the levels of serum NfL, MIP-1α, LRG1 of the two groups of children were compared. The related factors leading to neurological sequelae were analyzed by multivariate Logistic regression analysis, and the clinical value of serum NfL, MIP-1α, LRG1 alone and in combination in predicting neurological sequelae were analyzed by receiver operating characteristic (ROC) curve.

The levels of serum NfL, MIP-1α, LRG1 in sequelae group were higher than those in non-sequelae group (P<0.05). The proportion of children with status epilepticus and alanine aminotransferase >40 U/L in the sequelae group was higher than that in the non-sequelae group, and the PCIS score was lower than that in the non-sequelae group (P<0.05). Moreover, there were statistically significant differences in the distribution of cranial MRI grades and abnormal electroencephalogram conditions between the two groups (P<0.05). Multivariate Logistic regression analysis showed that, status convulsion, serum NfL, MIP-1α and LRG1 were independent influencing factors for neurological sequelae in VE children (P<0.05). ROC curve analysis showed that, the area under the curve (AUC) of serum NfL, MIP-1α and LRG1 alone in predicting neurological sequelae was 0.766, 0.778 and 0.807 respectively, the AUC of combined detection was 0.888, which was significantly higher than that of single detection (P<0.05).

The levels of serum NfL, MIP-1α and LRG1 in VE children are abnormally increase, and the combine detection of serum NfL, MIP-1α and LRG1 is helpful to assist the evaluation of neurological sequelae.

To investigate the impacts of Dexmedetomidine on intraoperative hemodynamics and postoperative pain in patients with chronic subdural hematoma (CSDH) undergoing surgical treatment.

A total of 96 patients undergoing surgery for CSDH admitted to the Neurosurgery Department of Langfang Aidebao Hospital from October 2020 to October 2022 were selected as the research subjects. They were randomly separated into a control group and a study group using a random number table method, with 48 patients in each group. The control group were given simple local anesthesia, while the study group were given Dexmedetomidine combined local anesthesia. The changes of mean arterial pressure (MAP) and heart rate at the time of skin incision (T1), drilling (T2), skin suture (T3), and the end of surgery (T4), and the pain and analgesia intensity at 3, 12, 24, 48, and 72 h after surgery were compared between the two groups.

The MAP and heart rate of patients in the study group were significantly higher than those in the control group at time points T1, T2, T3, and T4 (P<0.05); at 3, 12, 24, 48 and 72 h after surgery, the visual analogue scale (VAS) of the study group was lower than that of the control group (P<0.05); at 12, 24, 48, and 72 h after surgery, the Ramsay scores of patients in the study group were higher than those in the control group (P<0.05); the incidence of adverse reactions during anesthesia in the study group was lower than that in the control group (P<0.05).

Dexmedetomidine has a good anesthetic effect in patients undergoing surgical treatment for CSDH. It can help maintain hemodynamic stability during surgery, enhance analgesic and sedative effects, and reduce adverse reactions.

Severe stroke patients often suffer from dysphagia, which severely impedes their recovery and affects their quality of life. As a new non-invasive neuromodulation technique, pharyngeal electrical stimulation (PES) has shown significant clinical value in the treatment of post stroke dysphagia, which can improve swallowing function, shorten hospital stay and reduce related complications. However, there are still some controversies about this treatment, such as the standard of care, the population to be treated and the long-term effects. This review summarizes and discusses the mechanism of action and progress in the application of PES in the treatment of dysphagia in severe stroke patients, with the aim of providing a reference for clinical management and future research.

Protein kinase R-like endoplasmic reticulum kinase (PERK) can regulate the inactivation of the eukaryotic initiation factor 2 signalling cascade in response to cellular stress. Cellular and endoplasmic reticulum (ER) stress activates the unfolded protein response (UPR) signalling pathway, and ER dysfunction leads to abnormal protein folding and aggregation, causing synaptic and neuronal dysfunction. Abnormal protein aggregation induces an ER stress state, promoting the UPR to shift towards apoptosis, resulting in neurodegeneration. The mitochondrial membrane is connected to the ER membrane, and ER stress activates PERK to regulate mitochondrial dynamics adaptation; PERK activation induces mitochondrial fusion; PERK activation increases the formation of mitochondrial cristae and respiratory chain complexes. Mitochondrial damage and oxidative stress are closely related to the pathogenesis of neurodegene-rative diseases such as Alzheimer disease, Parkinson disease, Huntington disease, and multiple sclerosis. This article reviews the mechanisms of PERK in neurodegene-rative diseases, aiming to provide theoretical basis for the treatment of neurodegene-rative diseases.

Neuropathic pain (NP) has emerged as a major threat to human health, yet its underlying mechanisms remain incompletely understood. Current therapeutic approaches for NP are suboptimal, underscoring the urgency to decipher its potential mechanisms and identify novel therapeutic targets and strategies. Recently, increasing evidence suggests that various immune cells and associated cytokines attach great importance to inhibit nociception and promote the resolution of NP. As a subtype of CD4⁺T lymphocytes, regulatory T (Treg) cells exert analgesic effects on NP by secreting inhibitory mediators, suppressing effector cells, and other mechanisms. This review synthesizes the latest advances in Treg cells, their cellular mediators, and their interactions in the context of NP, offering new directions and targets for mechanistic research and therapeutic development in this field.

Stroke is characterized by high incidence and recurrence rates, ranking among the leading causes of mortality and disability. Currently, diagnostic and assessment approaches for stroke are associated with certain limitations, and existing clinical therapeutic strategies fail to fully address disease-specific requirements. Accumulating evidence has demonstrated that exosomes act as critical carriers mediating information transmission and targeted regulation in the pathophysiological processes of stroke. Exosomes hold promise as specific biomarkers for stroke diagnosis and prognostic assessment, while also exerting a positive therapeutic effect during disease initiation and progression. Moreover, the technology of engineered exosomes has opened a new path for the treatment of stroke, and this concept also provides new insights and methods for exerting and revealing acupuncture effects. This review summarizes fundamental research on exosomes in the context of stroke diagnosis, assessment, and relevant therapeutic mechanisms, aiming to provide insights for future investigations into stroke diagnosis and treatment.

Acute massive hypertensive intracerebral hemorrhage can lead to brain herniation, endangering the patient's life. The basal ganglia region is the most common site of hemorrhage. Minimally invasive craniotomy using neuroendoscopy to evacuate intracranial hematomas has been widely adopted, achieving favorable therapeutic outcomes. This article systematically reviews the background, surgical indications, treatment strategies, procedural steps, postoperative management considerations, and efficacy of neuroendoscopy for basal ganglia hemorrhage, and provides a technical summary, aiming to provide reference for clinical treatment.