Changqing Liu

Invasive vagus nerve stimulation paired with rehabilitation improves upper-limb recovery after ischemic stroke, but clinical evidence after intracerebral hemorrhage remains limited. We evaluated the feasibility, safety, and descriptive functional signal of invasive vagus nerve stimulation-paired rehabilitation in chronic intracerebral hemorrhage. Twelve participants with chronic upper-limb motor dysfunction after intracerebral hemorrhage underwent left cervical invasive vagus nerve stimulation implantation followed by 6 weeks of supervised in-clinic rehabilitation and 90 days of home-based rehabilitation. The primary outcome was change in Fugl-Meyer Assessment Upper Extremity from baseline to day 1 after inclinic rehabilitation. Secondary and exploratory outcomes included Fugl-Meyer Assessment Upper Extremity change on day 90, Fugl-Meyer Assessment Upper Extremity subscores, modified Ashworth scale scores, quality of life, safety, and exploratory positron emission tomography/computed tomography and arterial spin labeling findings. All participants completed follow-up. Fugl-Meyer Assessment Upper Extremity increased from 23.50 ± 15.63 points at baseline to 27.58 ± 17.15 on day 1, with a mean change of 4.08 ± 3.48 points ( P = 0.002). On day 90, Fugl-Meyer Assessment Upper Extremity was 27.75 ± 17.23 points, with a mean change of 4.25 ± 3.60 points from baseline. Six participants reached the minimal clinically important difference threshold on days 1 and 90. No serious perioperative complications were observed in this small cohort. Exploratory imaging in two participants showed postoperative changes in metabolic and perfusion ratios within cortical-subcortical motor-network regions. Invasive vagus nerve stimulation-paired rehabilitation was feasible and had an acceptable safety profile in this pilot intracerebral hemorrhage cohort, with a descriptive signal of upper-limb functional improvement. This study was registered on ClinicalTrials.gov (Identifier: NCT07736573).

Introduction: Epilepsy remains a major source of chronic neurological morbidity and long-term care need. In China, its contemporary burden is likely being reshaped by population ageing and by shifts in the balance between idiopathic and secondary epilepsy, yet updated national evidence integrating subtype-specific burden, demographic decomposition, and future projections remains limited. Methods: We performed a secondary analysis of the Global Burden of Disease (GBD) Study 2023 to assess epilepsy burden in China from 1990 to 2023, using global estimates for contextual comparison. We examined prevalent cases, years lived with disability (YLD) counts, the age-standardized prevalence rate (ASPR), and the age-standardized YLD rate (ASYR) for overall epilepsy, idiopathic epilepsy, and secondary epilepsy. Temporal patterns were evaluated with Joinpoint regression and age-period-cohort modeling. We additionally assessed associations with the socio-demographic index, decomposed changes in counts into population growth, population ageing, and age-specific epidemiological change, and projected burden to 2050. Results: From 1990 to 2023, prevalent epilepsy cases in China increased from 4.84 million to 6.38 million, while the ASPR rose from 419.04 to 444.42 per 100,000, with an average annual percent change of 0.17% (95% CI 0.07–0.27). The increase was observed mainly in the aggregated GBD category of secondary epilepsy, whereas idiopathic epilepsy remained broadly stable after age standardization. In contrast, YLD counts declined from 1.77 million to 1.63 million, and the ASYR fell from 152.89 to 114.14 per 100,000, with an average annual percent change of −0.87% (95% CI −0.93 to −0.82). Decomposition analyses indicated that the rise in prevalent cases was driven chiefly by population growth and population ageing. By 2050, China is projected to have 6.19 million people living with epilepsy, with an ASPR of 436.94 per 100,000, while the age-standardized disability burden is expected to decline further. Conclusion: The burden of epilepsy in China has shifted toward a pattern characterized by prevalent case accumulation, population ageing, and a larger contribution from the aggregated GBD category of secondary epilepsy. Although age-standardized disability burden has declined, long-term epilepsy care needs are likely to remain substantial through 2050. Interpretation of secondary epilepsy should remain cautious because the available GBD estimates do not allow attribution to specific acquired causes.

Introduction: The aim of the study was to characterize the burden of spinal cord injury (SCI) in China from 1990 to 2023 and project it to 2050, integrating temporal trends, demographic drivers, and anatomical-level patterns. Methods: In this secondary analysis of the Global Burden of Disease (GBD) 2023 study, incidence, prevalence, and years lived with disability (YLDs) for SCI in China were analyzed by sex, age, anatomical level (cervical and below-neck), and external cause using Joinpoint regression, age-period-cohort modelling, Das Gupta decomposition, and Bayesian age-period-cohort projection. Results: From 1990 to 2023, incident SCI cases increased by 43.56%, prevalent cases by 84.83%, and YLDs by 46.22%, while the age-standardized YLD rate remained essentially stable (average annual percent change −0.03%, p = 0.743). Cervical SCI showed a rising age-standardized YLD rate, whereas below-neck SCI declined – a divergence corroborated by decomposition analyses showing opposite rate-change contributions for the two anatomical levels. Falls were the leading external cause, accounting for nearly 80% of incident cases in 2023; falls-attributable rates rose sharply during 2005–2015 and then declined after 2015, a temporal pattern inconsistent with gradual population ageing alone. Projections indicated declining age-standardized rates through 2050 but a persistently high prevalent burden of approximately 8.5 million cases at mid-century. Conclusion: The burden of SCI in China has shifted towards older adults, cervical injuries, and falls. We propose that the falls burden reflects two overlapping ageing transitions: community-dwelling population ageing superimposed on degenerative cervical spine disease and occupational ageing of China’s construction workforce during a period of rapid sector expansion. Although age-standardized rates are projected to decline, the absolute burden will remain substantial. Planning should prioritize fall prevention, occupational safety regulation in high-risk construction settings, geriatric cervical-spine care, and equitable rehabilitation capacity.

Background: Encephalitis remains a major cause of neurological morbidity and mortality worldwide, particularly in resource-limited settings. This study analyzed the long-term trends and disparities in encephalitis burden across 131 low- and middle-income countries (LMICs) from 1990 to 2023. Methods: Data were obtained from the Global Burden of Disease 2023 study for 131 LMICs. Incidence, prevalence, deaths, and disability-adjusted life years (DALYs) were analyzed using absolute counts and age-standardized rates. Trends were assessed with estimated annual percentage changes, Joinpoint regression, age-period-cohort analysis, correlations with sociodemographic index (SDI), and decomposition analysis. Results: In 2023, encephalitis in LMICs caused 1.59 million incident cases, 5.21 million prevalent cases, 70,042 deaths, and 4.07 million DALYs. From 1990 to 2023, incident cases increased by 24.7%, while the age-standardized incidence rate fell from 29.57 to 25.15 per 100,000 person-years (EAPC, −0.71; 95% CI, −0.83 to −0.59). Age-standardized mortality and DALY rates also declined, with EAPCs of −1.97 and −2.20. Incidence reached a low point around 2010 before rising again, particularly after 2019. The burden was greatest in children and older adults. Higher SDI was associated with lower age-standardized incidence, mortality, and DALY rates (ρ = −0.59, −0.41, and −0.56, respectively; all p < 0.001). Population growth accounted for most of the increase in case numbers. Conclusion: Encephalitis remains a substantial health burden in LMICs. Although age-standardized mortality and DALY rates have declined, the growing absolute number of cases, recent upward shift in incidence, and persistent concentration of burden among children, older adults, and lower-SDI settings point to continuing gaps in prevention, surveillance, diagnosis, and care.

Purpose: Angiocentric glioma (AG), a benign tumor identified within the last two decades, was officially included in the 2007 WHO Classification of Tumors of the Central Nervous System, WHO grade I. The tumor is relatively rare, with only approximately 100 cases reported. We aim to complement the characteristics and long-term prognosis of AG, as well as to detect MYB-QKI fusions. Methods: The characteristics of all cases collected between 1 March 2009 and 1 March 2023 at the Beijing Sanbo Brain Hospital, Capital Medical University, were summarized and analyzed. Additionally, all fourteen patients were tested for MYB-QKI fusions. Results: AG more predominantly occurs in adolescents (median age 16.5-year-old), and commonly presents with drug-resistant epilepsy. AG is frequently localized in the supratentorial regions and only one patient is in the brainstem. Brain parenchyma atrophy, and stalk-like signs can observe in imaging. Pathologically, tumor cells are perivascular pseudorosettes, presenting immunoreactivity for GFAP, S-100, Vimentin, “dot-like” staining for EMA, and low proliferative activity. Focal cortex dysplasia was observed in four patients. Twelve of fourteen (85.7%) patients were found with MYB-QKI fusions. Completely surgical resection typically has a satisfactory prognosis with long-term follow-up. Conclusion: AG is a rare benign tumor with a favorable prognosis after complete resection, characterized by refractory epilepsy, frequently occurring in adolescents. MYB-QKI fusions were detected in most AG patients, as a good defining genetic alteration pathologically. The potential presence of focal cortical dysplasia (FCD) may affect the prognosis of epilepsy.

Background: Dystonia is a condition that affects the ability to control the movement and function of the body’s muscles. It can cause not only physical problems, but also mental problems, resulting in impaired health-related quality of life (HRQoL). However, the effect of deep brain stimulation on quality of life in acquired dystonia remains unclear. Methods: We conducted a systematic literature review from January 2000 to October 2022，determined the eligible studies, and performed a meta-analysis of HRQoL outcomes based on the Short-Form Health Survey-36 (SF-36) after DBS to evaluate the effects of DBS on physical and mental QoL. Results: A total of 14 studies met the inclusion criteria and were systematically reviewed. A comprehensive meta-analysis was performed for 9 studies that reported physical and psychological data or physical component summary (PCS), or mental component summary (MCS) for SF-36. The mean (SD) age at DBS implantation was 34.29 (10.3) years, and the follow-up period after implantation was 2.21 (2.80) years. The random effects model meta-analysis revealed that both physical and mental domains of the SF-36 improved following DBS. There was no statistically significant difference between the physical domains (effect size=1.34; pp<0.0001). Conclusion: This is the first meta-analysis that demonstrates significant benefits in HRQoL following DBS in patients with acquired dystonia. There were significant improvements in both physical QoL and mental QoL.

Objective: To determine the predictors and the long-term outcomes of patients with seizures following surgery for dysembryoplastic neuroepithelial tumors (DNTs); Methods: Clinical data were collected from medical records of consecutive patients of the Department of Neurosurgery of Sanbo Brain Hospital of Capital Medical University with a pathological diagnosis of DNT and who underwent surgery from January 2008 to July 2021. All patients were followed up after surgery for at least one year. We estimated the cumulative rate of seizure recurrence-free and generated survival curves. A log-rank (Mantel–Cox) test and a Cox proportional hazard model were performed for univariate and multivariate analysis to analyze influential predictors; Results: 63 patients (33 males and 30 females) were included in this study. At the final follow-up, 49 patients (77.8%) were seizure-free. The cumulative rate of seizure recurrence-free was 82.5% (95% confidence interval (CI) 71.8–91.3%), 79.0% (95% CI 67.8–88.6%) and 76.5% (95% CI 64.8–87.0%) at 2, 5, and 10 years, respectively. The mean time for seizure recurrence-free was 6.892 ± 0.501 years (95% CI 5.91–7.87). Gross total removal of the tumor and a short epilepsy duration were significant predictors of seizure freedom. Younger age of seizure onset, bilateral interictal epileptiform discharges, and MRI type 3 tumors were risk factors for poor prognosis; Conclusions: A favorable long-term seizure outcome was observed for patients with DNT after surgical resection. Predictor analysis could effectively guide the clinical work and evaluate the prognosis of patients with DNT associated with epilepsy.