Temporal interference (TI) stimulation is a novel non-invasive neuromodulation technology. It generates low-frequency envelopes through the interference effect of two high-frequency alternating currents, enabling precise targeting of deep brain regions. This approach overcomes a major limitation of conventional non-invasive neuromodulation techniques, which are often ineffective in stimulating deeper brain structures. In recent years, research on TI stimulation has progressed rapidly and has become a hotspot in the field of neuromodulation. It demonstrates promising clinical potential for treating neurological disorders and may offer a non-invasive alternative for conditions involving dysfunction in deep brain circuits. This paper systematically reviews the research progress related to TI stimulation in recent years. Beginning with the principles of TI stimulation technology, it elaborates on its progress in simulation optimization and hardware development, and deeply explores its potential for the treatment of neurological diseases by incorporating clinical application cases, providing a reference for the further research and application of this technology.

To analyze pelvic asymmetry between the hemiplegic and non-hemiplegic sides in stroke patients and to analyze the progressive changes in pelvic asymmetry during continuous walking.

A total of 25 stroke patients admitted to the Neurology Department of Beijing Bo'ai Hospital, China Rehabilitation Research Center, from October 2020 to September 2022 were enrolled. All participants underwent three-dimensional gait analysis, during a task involving the maximum continuous walking distance. The entire gait cycle was divided into three phases: initial, middle, and terminal. The first three gait cycles were excluded from analysis. The pelvic angle (angle 1, A₁) in the initial phase was calcuated as the mean of the 4th to 6th gait cycles, while the terminal phase angle (A₃) represented the mean of the last three gait cycles before stopping. The middle phase angle (A₂) was defined as the mean of three consecutive pelvic angles between A₁ and A₃. Based on walking distance, patients were divided into an indoor walking group (50-200 m) and an outdoor walking group (>200 m). Differences in pelvic joint angles (X-axis: anterior/posterior tilt; Y-axis: up/down obliquity; Z-axis: internal/external rotation) between the hemiplegic and non-hemiplegic sides were analyzed. The progressive trends in pelvic joint angles during continuous walking were assessed, and differences in these trends between patients with varying walking abilities were examined. Inter-group comparisons were conducted using t-test or double-associated sample rank-sum test. The repeated measures ANOVA of variance was used to analyze the changing trends of the same index of the pelvic joint at different time points.

Significant differences were observed between the hemiplegic and non-hemiplegic sides in the following parameters: maximum pelvis anterior tilt angles [PTA_max;（31.19±0.67）° vs （31.55±0.70）°， t=2.614, P=0.011], maximum up obliquity angles [POA_max; 4.78°（3.33°，6.74°） vs 4.54°（1.77°，5.93°），Z=2.115, P=0.034], the range of motion (ROM) of pelvic tilt (PTA_ROM1) in the initial phase [（4.27±0.37）° vs （4.91±0.43）°，t=2.829, P=0.009], the ROM change of pelvic tilt between terminal and initial phases [PTA_ROM3-1; （0.50±0.15）° vs （-0.53±0.31）°，t=3.263, P=0.003]. During continuous walking, the hemiplegic side showed statistically significant progressive increases in both PTA_max (F=3.295, P=0.046) and PTA_ROM (F=4.374, P=0.018). Subgroup analysis revealed statistically significant progressive increases in PTA_max specifically in the indoor walking group (F=5.830, P=0.009), while significant progressive increases in PTA_ROM were observed in the outdoor walking group (F=3.500, P=0.046). The hemiplegic side demonstrated statistically significant progressive reductions in both maximum pelvic internal rotation (PRA_max; F=3.306, P=0.046) and the ROM of pelvic rotation (PRA_ROM; F=4.896, P=0.012), with the non-hemiplegic side also showing significant progressive decrease in PRA_ROM (F=4.454, P=0.017). Further analysis identified that the significant progressive reduction in hemiplegic-side PRA_max was particularly evident in the indoor walking group (F=3.484, P=0.048).

Stroke patients demonstrate asymmetric alterations in pelvic tilt and obliquity between the hemiplegic and non-hemiplegic sides during the entire gait cycle. During continuous walking, progressive changes occur in anterior pelvic tilt, range of motion of pelvic tilt, and internal rotation on the hemiplegic side, without corresponding symmetrical changes on the non-hemiplegic side. Patients with poorer walking ability demonstrate more significant changes in pelvic asymmetry during continuous walking.

To evaluate the clinical efficacy of different frequencies of repetitive transcranial magnetic stimulation (rTMS) combined with lower-limb robotic training on cortical excitability and motor function in stroke patients.

Ninety patients with stroke hospitalized in the Affiliated Hospital of Jining Medical University from January 2024 to January 2025 were randomly assigned to Groups A (n=30), B (n=30) and C (n=30). All groups received conventional rehabilitation therapy. Concurrently, Group A underwent lower limb robotic training; Group B received low-frequency (1 Hz) rTMS combined with lower-limb robotic training; and Group C received high-frequency (10 Hz) rTMS combined with robotic training. The treatment cycle lasted four weeks. Cortical excitability was assessed before and after treatment by measuring motor evoked potential (MEP) latency and central motor conduction time (CMCT). Motor function was evaluated using the Berg balance scale (BBS), Pro-kin balance tester (measuring trajectory length and ellipse area), Fugl-Meyer assessment for lower extremity (FMA-LE), and functional ambulation category (FAC) scale. The one-way ANOVA and χ² test were used for intergroup comparisons.

(1) After 4 weeks of treatment, all three groups demonstrated significant improvements in MEP latency and CMCT compared to baseline (all P<0.05). Intergroup comparisons revealed that both Group B and Group C patients showed significantly better MEP latency and CMCT than Group A, while Group B patients exhibited significantly better MEP latency and CMCT than Group C. All differences were statistically significant (all P<0.05). (2) After 4 weeks of treatment, all three groups demonstrated significant improvements in motor function outcomes——BBS scores, gait path length, gait ellipse area, FMA-LE, and FAC compared to baseline (all P<0.05). Groups B and C showed significantly superior outcomes across these measures compared to Group A (all P<0.05), though no statistically significant differences were observed between Groups B and C in any motor function measure (all P>0.05).

The short-term efficacy of low-frequency and high-frequency rTMS combined with lower limb robotic therapy on motor function in stroke patients is comparable. However, low-frequency rTMS demonstrates more effective capacity than high-frequency rTMS in enhancing cortical excitability on the lesion side. Clinically, low-frequency rTMS combined with lower-limb robotic therapy is recommended for improving motor function in stroke patients.

To investigate the understanding of minor ischemic stroke (MIS) among clinicians involved in acute ischemic stroke (AIS) care in Beijing and to identify the key factors influencing their decision-making regarding intravenous thrombolysis (IVT) for these patients.

An online questionnaire survey was conducted among clinicians participating in AIS treatment in Beijing from April to June 2023 by SoJump. Statistical analysis was performed using SPSS 20.0 software, focusing on: 1) knowledge of MIS prevalence, definition, and classification; 2) guideline recommendations for IVT in MIS; 3) factors influencing IVT decision-making.

A total of 303 valid questionnaires were collected from 80 hospitals, with a valid questionnaire rate of 100%. The proportions of clinicians who believed that MIS accounted for less than 30%, 30%-<40% and 40%- <50% in AIS were 15.84%, 38.61% and 17.49%, respectively. Concerning guideline recommendation, 87.13% of clinicians approved of "thrombolytic therapy for mild disability patients", while only 48.51% of clinicians approved of "no thrombolysis for mild non-disabling patients". Among the factors considered by clinicians in supporting MIS IVT, from the patient's perspective, the top three in descending orders were "symptom disability" (95.38%), "gradual/rapid progression of symptoms "(94.06%) and "impact on daily work and life" (90.76%); From the perspective of clinicians themselves, the top three in descending orders were "possibility of worsening or progression of the condition" (97.03%), "disability of patient symptoms" (93.73%), and "low risk of MIS thrombolysis bleeding" (72.94%). Among the factors considered by clinicians who did not support MIS IVT, from the patient's perspective, they were "comorbidity with high-risk bleeding diseases" (90.10%), "patient and family members not actively/difficult to communicate" (86.14%), and "comorbidity with multiple other diseases" (81.52%). From the perspective of clinicians themselves, the following were: "patients had relative contraindications" (67.99%), "some patients were non-disabled" (56.44%), and "concerns about bleeding risk" (41.91%). The proportion of clinicians who believed that the risk of (syndrome intracerebral hemorrhage) sICH during MIS intravenous thrombolysis was <1.0%, 1.0%-<2.0%, 2.0%-<3.0%, 3.0%-<4.0% and 4.0%-<5.0% were 43.56%, 20.46%, 14.85%, 9.57%, 2.64%, and 8.91%, respectively.

"Symptom disability" was the primary factor motivating IVT use for MIS. Knowledge gaps exist among clinicians regarding MIS epidemiology, prognosis, and thrombolysis risks, with a tendency to overestimate sICH risk. Enhanced evidence-based guidance, academic training, and updated diagnostic and therapeutic concepts are needed to ensure appropriate MIS patients receive timely, scientific treatment.

To evaluate the safety and efficacy of endovascular treatment for patients with acute severe cerebral venous sinus thrombosis.

Clinical data were collected from 3 patients diagnosed with acute severe cerebral venous sinus thrombosis who underwent with endovascular treatment at the First Affiliated Hospital, Air Force Medical University from February 1 to June 1, 2024. A retrospective analysis was conducted on their clinical manifestations, imaging characteristics, surgical techniques and devices used, medication regimens, and follow-up outcomes, supplemented by a review of relevant literature.

The cohort consisted of two female patients (one in early pregnancy and one postpartum) and one male patient. All three exhibited clinical manifestations of intracranial hypertension and hemiplegia, with one case showing conscious disturbance and two experiencing epileptic seizures. Cranial imaging revealed venous cerebral infarction in all patients, involving the superior sagittal sinus and bilateral transverse sinuses, with two cases showing hemorrhagic transformation. All patients underwent thrombectomy using Solitaire (6 mm×30 mm) stents-retriever combined with intermediate catheter retrieval technique, achieving partial recanalization. Subsequent catheter-directed intravenous thrombolysis resulted in satisfactory recanalization outcomes and rapid clinical improvement.

Endovascular treatment demonstrates both safety and efficacy in the management of acute severe cerebral venous sinus thrombosis.

To analyze the changes in intravenous thrombolysis (IVT) indicators at secondary and tertiary stroke centers in Kunming City, to evaluate the progress of stroke center development, and provide evidence for optimizing IVT quality control.

Clinical data and IVT indicators were retrospectively analyzed from acute ischemic stroke (AIS) patients admitted to 6 tertiary and 16 secondary hospital stroke centers in Kunming from January 1, 2019, to December 31, 2022. The χ² test and Mann-Whitney U test were used to compare IVT rates and clinical characteristics between hospital tiers. The χ² test and Kruskal-Wallis test were applied to assess annual variations in IVT rates, onset-to-needle time (ONT), and door-to-needle time (DNT).

From 2019 to 2022, IVT rates at tertiary and secondary hospitals were 5.90% and 15.69%, respectively ( χ²=1100.068, P<0.001). The overall IVT rates exhibited a steady increase (4.63% in 2019, 9.50% in 2020, 8.81% in 2021, and 11.33% in 2022; χ²=314.581, P<0.001). Tertiary hospitals demonstrated significantly longer median ONT [166 ( 116, 225) min vs 154 (105, 212) min, Z=4.613, P<0.001] and DNT [47 (35, 71) min vs 45 (35, 59) min, Z=2.731, P=0.006] compared to secondary hospitals. The complication rate of IVT was lower in tertiary hospitals (14.65% vs 17.46%; χ²=5.687, P=0.017).

From 2019 to 2022, IVT rates increased and ONT/DNT decreased across Kunming's stroke centers, indicating tangible progress in stroke care quality. However, significant disparities persist between tertiary and secondary hospitals, necessitating further optimization of stroke management protocols.

To investigate the effects of metacognition training combined with pharmacotherapy treatment on cognitive function and mobility in patients with ischemic stroke (IS).

A retrospective study was conducted on IS patients admitted to the Affiliated Hospital of Yangzhou University from February 2020 to December 2024. After screening according to inclusion and exclusion criteria, patients were divided into two groups according to treatment modality: a combination group (receiving metacognitive training plus pharmacotherapy) and a control group (receiving conventional treatment). Using propensity score matching (1∶1) to minimize confounding factors, 26 patients were included in each group. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), daily living activities with the modified Barthel index (MBI), sleep quality with the Pittsburgh sleep quality index (PSQI), and quality of life with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Assessments were performed at baseline and after 1, 2, and 3 months of treatment. Repeated measures ANOVA was used to compare cognitive and mobility outcomes, independent t-tests for sleep and quality of life scores, and chi-square tests for intergroup therapeutic effects.

No significant between-group differences in MoCA scores were observed at baseline (P>0.05). After 1, 2 and 3 months of treatment, the combination group showed significantly higher MoCA scores (16.54±3.55, 19.85±3.22, 22.46±4.07) than the control group (13.96±3.08, 15.54±3.16, 19.87±3.54). The group × time interaction, time effect, and group effect were statistically significant (F=3.765, 22.472, 58.201, respectively; all P<0.05). Similarly, while baseline MBI scores did not differ (P>0.05), the combination group demonstrated significantly higher MBI scores at 1, 2, and 3 months (70.70±9.42, 78.58±8.87, 84.33±8.61) compared to the control group (65.54±8.54, 69.67±7.98, 74.14±9.33), with significant interaction, time, and group effects (F=165.208, 58.366, 231.291, respectively; all P<0.05). Baseline PSQI and EORTC QLQ-C30 scores were comparable (all P>0.05). After treatment, the combination group showed significantly better EORTC QLQ-C30 scores (62.73±10.49 vs 46.20±8.36, t=6.284, P<0.001) and lower PSQI scores (1.26±0.36 vs 2.73±0.49, t=12.328, P<0.001). After treatment, the combination group also had a significantly higher excellent/good response rate (88.46% vs 50.00%, χ²=9.028, P=0.003).

Metacognition training combined with pharmacotherapy can effectively improve the cognitive function, mobility, sleep quality, and quality of life in patients with IS.

To investigate the serum expression levels of long non-coding RNA (LncRNA) ZEB1-AS1 in patients with ischemic stroke undergoing dual antiplatelet therapy, and to evaluate its predictive value for stroke recurrence.

The study included 280 ischemic stroke patients treated with clopidogrel and aspirin (the treatment group) and 100 healthy physical examination participants (the control group) between January 2023 and December 2024 at Beijing rehabilitation hospital affiliated to capital medical university. Serum samples were collected and the expression levels of LncRNA ZEB1-AS1 were determined. Neurological function was assessed using the National Institutes of Health stroke scale (NIHSS), consciousness impairment with the Glasgow Coma scale (GCS), and daily living ability with the modified Rankin scale (mRS). Patients were followed for 6 months to record stroke recurrence and were subsequently categorized into recurrence and non-recurrence groups based on follow-up outcomes. The correlation between LncRNA ZEB1-AS1 expression levels and stroke recurrence and prognosis was thoroughly examined. The t-test was used to compare the differences in the expression levels of LncRNA ZEB1-AS1 between different groups. Pearson correlation analysis was used to assess the relationship between serum ZEB1-AS1 levels and clinical scale scores. Logistic regression was used to identify the risk factors for ischemic stroke recurrence, while ROC curve analysis was used to analyze the predictive efficacy of serum ZEB1-AS1 expression levels for stroke recurrence after dual antiplatelet therapy in patients with ischemic stroke.

During the 6-month follow-up, 78 of 280 ischemic stroke patients experienced recurrence (recurrence group), while 202 did not (non-recurrence group). Serum ZEB1-AS1 expression was significantly higher in the recurrence group (0.96±0.18) than in the non-recurrence group (0.82±0.14; t=7.168, P<0.001). The control group showed significantly lower expression (0.52±0.10) than both the recurrence and non-recurrence groups (t=20.535 and 18.419, respectively; both P<0.001). Pearson correlation analysis showed that positive correlations between serum ZEB1-AS1 levels and NIHSS (r=0.55) and mRS scores (r=0.57), and a negative correlation with GCS scores (r=-0.52; all P<0.001). Logistic regression identified serum ZEB1-AS1 as an independent risk factor for stroke recurrence (OR=20.311, 95%CI: 1.309-315.057; P<0.05). ROC curve analysis showed that serum ZEB1-AS1 expression predicted the AUC of stroke recurrence after double-antibody therapy was 0.77.

In patients with ischemic stroke undergoing dual antiplatelet therapy, serum lncRNA ZEB1-AS1 levels are significantly associated with stroke recurrence, suggesting its potential value as a prognostic biomarker for predicting recurrence.

To explore the protective effects of transcutaneous auricular vagus nerve stimulation (taVNS) against neurological functional impairment caused by cerebral ischemia-reperfusion injury, and to investigate the underlying mechanisms using proteomics approaches.

　Forty-eight male SD rats were randomly divided into three groups: model group [transient middle cerebral artery occlusion (tMCAO) group, n=16], Sham group (n=16), and taVNS group (n=16). The taVNS group received a single taVNS intervention 30 minutes after cerebral ischemia induction, prior to reperfusion. After 90 minutes of ischemia, blood flow was restored. At 24 hours after reperfusion, neurological impairment was assessed using the modified Neurological Severity Score (mNSS), forelimb muscle strength was measured with a grip strength meter, and cerebral infarction area was visualized with 2,3,5-triphenyltetrazolium chloride (TTC) staining. Additionally, data-independent acquisition (DIA) proteomics analysis was conducted, and Western blotting was performed to detect changes in the expression of apoptosis-related proteins including cleaved Caspase-3, B-cell lymphoma-2 (Bcl-2) and Bcl-2 associated X protein (Bax). Enzyme-linked immunosorbent assay (ELISA) was used to measure the expression levels of interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α. Statistical analyses included independent samples t-test for intergroup comparisons, paired t-test for intragroup temporal comparisons, one-way ANOVA for multi-group comparisons, and LSD-t test for post-hoc pairwise analyses.

In the taVNS group, the mNSS score after 24 h of ischemia-reperfusion was significantly lower than that after 3 h of ischemia-reperfusion [(8.67±1.21) points vs (10.00±0.63) points, t=4.029, P=0.010]. Compared to the tMCAO group, the taVNS group exhibited significantly greater forelimb grip strength [(15.43±2.57)N vs (11.50±1.80)N, t=3.060, P=0.012], significantly reduced cerebral infarct area [(14.46±3.71)% vs (33.08±4.19)%, t=8.146, P<0.001], and significantly decreased protein expression levels of cleaved Caspase-3 and Bax (all P<0.05). Conversely, the expression level of Bcl-2 was significantly increased (P<0.05). Additionally, the levels of IL-1β, IL-6 , and TNF-α were significantly reduced in the taVNS group (all P<0.05). DIA proteomics results suggested that the neuroprotective effects of ultra-early taVNS in ischemic stroke rats may be mediated through the regulation of apoptotic signaling networks and inflammation-related pathways.

Ultra-early taVNS exerts neuroprotective effects by against ischemic brain injury in rats, potentially through suppression of ischemia-induced apoptosis and inflammatory responses.

To elucidate the mechanism of constraint-induced movement therapy (CIMT) improves motor function after stroke by examining its effects of CIMT on the bilateral cortical neurons activation patterns and collapsin response mediator protein 2 phosphorylation (CRMP2).

In this study, a left middle cerebral artery occlusion (MCAO) rat model was established using the "thread embolization method", and the rats were randomly divided into a CIMT group (n=7) or a control group (n=6). Starting on day 8 after modeling, the CIMT group underwent 2 weeks of CIMT training, while the control group was allowed to move freely in the cage. The motor function of the right forelimb was evaluated using the Footfault assessment system at baseline (D0), day 7 (D7), day 14 (D14), and day 21 (D21) post-surgery. On days 16 and 21 after MCAO, the contents of ΔFosB and CRMP2 in the bilateral sensorimotor cortex were detected to analyze activation patterns of the left and right brain during CIMT and evalute the effect of CIMT on CRMP2 and phosphorylated CRMP2 (p-CRMP2). Group comparisons were performed using independent samples t-test (for homogeneous variances) or Welch's corrected t-test (for heterogeneous variances).

The Footfault effective placement rates were significantly higher in the CIMT group than in the control group at D14 (0.43±0.05 vs 0.30±0.06, t=3.971, P=0.002) and D21 (0.56±0.08 vs 0.31±0.07, t=6.161, P<0.001). On day 16 post-MCAO, the ΔFosB content in the left (infarcted side) sensorimotor cortex of the CIMT group was significantly higher than that of the control group (0.064±0.009 vs 0.036±0.004, t=2.947, P=0.026). On day 21, both p-CRMP2 levels and the p-CRMP2/CRMP2 ratio in the infarcted sensorimotor cortex were significantly lower in the CIMT group (0.371±0.095 vs 0.786±0.096, t=2.987, P=0.014; 0.263±0.063 vs 0.567±0.094, t=2.792, P=0.019).

CIMT enhances activation of the residual ipsilesional cortex and suppresses CRMP2 phosphorylation in the ischemic hemisphere suggesting that the residual cortex on the affected side plays an important role in neural remodeling during post-stroke recovery.

To investigate the effect of Chuanzhi Tongluo caspules on the cognitive function in a mouse model of chronic cerebral hypoperfusion.

Mice were randomly divided into a sham-operated group (n=15) and an operation group. Chronic cerebral hypoperfusion was induced in the operation group (n=40) via bilateral common carotid artery stenosis (BCAS). The operation group was further randomized into a model group (n=15) and a treatment group (n=15). Starting 2 days after BCAS surgery, the treatment group received 0.2 mL of drug solution daily by gavage for 56 days, while the sham and model groups received equal volumes of 0.9% sodium chloride solution. Cognitive function was assessed using the Morris water maze test, measuring total swimming distance and escape latency on days 1-5, and recording platform crossings on day 6 after platform removal. Cerebral blood flow was measured using laser speckle contrast imaging in 5 randomly selected mice per group at 1, 28, and 56 days post-gavage. Statistical analyses included one-way ANOVA, Welch's ANOVA, or non-parametric tests for between-group comparisons.

Morris water maze results showed that compared with the sham group, mice in the model group swam significantly longer distances on days 3-5 [day 3: (8803.63±1742.95) mm vs (6398.75±2305.12) mm, t=3.071, P=0.004; day 4: (8564.95±1995.25) mm vs (5507.28±3222.72) mm, t=3.067, P=0.004; day 5: 9409.64 (8294.94, 9856.15) mm vs 5010.19(4265.66, 6574.47) mm, H=4.226, P<0.001], had significantly longer escape latencies on days 1-5 [day 1: 60.00(60.00, 60.00) s vs 49.69(44.4700, 60.00) s, H=3.207, P=0.004; day 2: 60.00(45.82, 60.00) s vs 42.61(27.83, 46.94) s, H=3.532, P=0.001; day 3: 52.78(47.21,60.00) s vs 28.19(24.44,38.18) s, H=4.512, P<0.001; day 4: 54.16(42.63, 60.00) s vs 25.09(17.73, 32.38) s, H=3.894, P<0.001; day 5: (51.54±6.27) s vs (30.18±10.34) s, t=5.825, P<0.001], and crossed platforms significantly fewer times on day 6 [ 0.33(0.33, 0.67) times vs 1.67(1.33, 2.00) times, H=4.758, P<0.001]. Compared with the model group mice, mice in the treatment group had significantly shorter distances on day 2 and day 5 [ Day 2: (8306.97±1453.64) mm vs (9632.02±1269.81) mm, t=2.659, P=0.033; Day 5: 5833.10(3777.55, 7606.50) mm vs 9409.64(8294.94, 9856.15) mm, H=3.447, P=0.002], significantly shorter mean escape latencies on day 5 [(34.73±12.51) s vs (51.54±6.27) s, t=5.128, P<0.001], and higher times of crossing the platform on day 6 [1.33(0.67, 1.33) times vs 0.33(0.33, 0.67) times, H=2.579, P=0.030]. The results of laser speckle contrast imaging showed that compared with the sham group, cerebral blood flow was reduced in the model group of mice on days 1, 28, and 56 of gavage [day 1: (65.07±15.85) PU vs (162.20±15.86) PU, t=8.770, P<0.001; day 28: (106.51±23.35) PU vs (192.89±16.46) PU, t=7.943, P<0.001; day 56: 108.72(90.35, 121.28) PU vs 170.75(141.07, 180.06) PU, H=2.616, P=0.027]. The percentage of cerebral hypoperfused area were all significantly higher [day 1: (59.43±12.82)% vs (23.26±2.08)%, t=2.641, P=0.006; day 28: (44.12±3.38)% vs (17.33±1.65)%, t=17.327, P<0.001; day 56: 35.06%(31.78%, 40.26%) vs 22.54%(19.21%,23.08%), H=3.394, P=0.002]. The percentage of cerebral hypoperfused area in mice in the treatment group was significantly less than that in the model group on day 28 [(33.37±1.95)% vs (44.12±3.38)%, t=6.952, P<0.001].

Chuanzhi Tongluo caspules can ameliorate the chronic cerebral hypoperfusion state and cognitive dysfunction in mice after BCAS.

The brain extracellular space (ECS) is a crucial component of the brain, serving as the immediate environment supporting neuronal survival and function. However, its full significance—particularly in the context of cerebrovascular diseases—remains underexplored and underutilized. This review summarizes recent advances in brain ECS research, highlights current detection techniques, and explores its emerging applications in the diagnosis and treatment of cerebrovascular disorders. Notably, as research in this field deepens, Chinese scientists have begun to investigate innovative approaches, such as utilizing the ECS for drug delivery and enhancing metabolic waste clearance via surgical interventions. These developments offer promising avenues for advancing the management of cerebrovascular diseases in the future.

Cerebrovascular dysfunction serves as a critical pathological basis for cerebrovascular diseases, characterized by high disability and mortality rates. Astrocyte-derived extracellular vesicle (AC-EV), which mediate intercellular communication by transporting bioactive substances such as proteins and nucleic acids, play a pivotal role in regulating cerebrovascular function under both physiological and pathological conditions. Recent studies have revealed that AC-EV not only participate in cerebrovascular homeostasis but also exhibit altered composition and function closely linked to the pathogenesis and progression of multiple cerebrovascular disorders, including stroke, Alzheimer's disease, and Parkinson's disease. As a result, they have emerged as promising diagnostic and therapeutic targets. This review systematically summarizes the mechanisms by which AC-EV regulate cerebrovascular function and explores their clinical prospects in disease diagnosis and treatment, aiming to provide a theoretical foundation for developing precise intervention strategies against cerebrovascular dysfunction.