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Neural Injury and Functional Reconstruction

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  • 2026 Volume 21 Issue 4
    Published: 05 May 2026
      
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  • Bilirubin Alleviates Chronic Ischemic White Matter Injury via Microglial Modulation
    MEI Zhicheng1, 2, PANG Xiaowe1, 2, CHEN Lian1, 2, CHU Yunhui1, 2, ZHOU Luoqi1, 2, QIN Chuan1, 2, TIAN Daishi1, 2
    2026, 21(4): 187-193. https://doi.org/10.16780/j.cnki.sjssgncj.20260188
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    To investigate the protective effects of bilirubin on white matter injury and cognitive impairment under chronic cerebral hypoperfusion, and to elucidate its association with the regulation of microglial functional states. Methods: A bilateral common carotid artery stenosis (BCAS) mouse model was employed to induce chronic cerebral hypoperfusion. Behavioral assessments, histological analyses, and single-cell transcriptomic profiling were integrated to systematically evaluate the effects of bilirubin on white matter integrity and the inflammatory microenvironment. Results: Bilirubin treatment significantly improved learning, memory, and recognition abilities in BCAS mice, accompanied by marked attenuation of demyelination and structural disruption in the corpus callosum. Single-cell transcriptomic and histological analyses revealed that bilirubin suppressed inflammatory and immune-response-related transcriptional programs, thereby inhibiting the inflammatory and phagocytic activation of microglia. Trajectory inference and transcription factor regulatory analyses demonstrated that bilirubin redirected microglial state transitions away from inflammation-associated terminal states toward homeostatic and repair-related phenotypes. This shift was characterized by enhanced TGF-β-associated regulatory networks and concurrent suppression of interferon signaling pathways. Conclusion: Bilirubin effectively alleviates white matter injury and cognitive dysfunction induced by chronic cerebral hypoperfusion by reshaping microglial functional states and the inflammatory microenvironment.
  • Clinical Characteristics and Treatment of Adult Non-perinatal Listeria monocytogenes Infection of the Central Nervous System
    CHEN Bin, ZHAO Yingying, QIAO Shanshan, LI Yao, WANGShuhui, XU Chunling
    2026, 21(4): 194-198. https://doi.org/10.16780/j.cnki.sjssgncj.20260256
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    To investigate the clinical features, diagnosis, treatment, and prognosis of central nervous system (CNS) infections caused by Listeria monocytogenes(LM) in non-perinatal adults. Methods: A retrospective analysis was conducted on 6 cases of non-perinatal CNS-LM infection in adults at our hospital, combined with a review of the literature. Results: Among the 6 patients, 3 were male and 3 female, with a median age of 56.5 years (range: 43-70 years). All patients presented with high fever (>39℃). Neck stiffness was observed in 5 cases, and 4 of them exhibited the classic triad of fever, impaired consciousness, and neck stiffness. Five patients had focal neurological deficits, and seizures occurred in 3. Cerebrospinal fluid (CSF) metagenomic next-generation sequencing (mNGS) was performed in 5 patients, and LM-specific sequences were detected in all. Blood culture and CSF culture were positive in 3 cases each. Neuroimaging revealed meningeal enhancement in 2 cases, rhombencephalitis in 1, hydrocephalus in 2, and concomitant lumbosacral meningeal and nerve root enhancement in 1. The median time from symptom onset to diagnosis was 12.5 days (range: 4-63 days). After diagnosis, 3 patients received first-line therapy with ampicillin (or penicillin) combined with gentamicin. Ultimately, 1 patient was cured, 3 showed clinical improvement but had residual neurological sequelae, and 2 died after withdrawal of treatment due to critical illness. A search of 317 previously reported cases of CNS-LM infection revealed that the most common manifestations were meningitis and meningoencephalitis. Among all cases, 7% presented as brainstem encephalitis and less than 1% of cases involve concurrent myelitis and radiculitis. Conclusion: The clinical presentation of CNS-LM infection in adults is highly heterogeneous. For patients presenting with brainstem symptoms or lumbosacral nerve root symptoms, the possibility of LM infection should be considered. CSF mNGS can significantly improve pathogen detection and is valuable for early diagnosis. Empirical antimicrobial therapy should cover LM. Early initiation of adequate, combination therapy with sensitive antibiotics for a sufficient duration may help improve patient prognosis.
  • Fostamatinib Inhibits the NLRP3 Inflammasome in Microglia and Improves Symptoms in Vascular Dementia
    DENG Zhaohong1, WANG Yafang2, 3, HE Jiayi2, 3, TIAN Daishi2, 3, WANG Wei2, 3, XU Jin1, QIN Chuan2, 3
    2026, 21(4): 199-205. https://doi.org/10.16780/j.cnki.sjssgncj.20260311
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    To investigate the mechanism underlying the effects of Fostamatinib on NLRP3 in microglia within vascular dementia (VaD). Methods: ① A bilateral common carotid artery stenosis (BCAS) mouse model was established. The cognitive impairment in mice was validated through the eight-arm maze behavioral test. Sham-operated (Sham) group, as well as multiple time points at 3 days, 1 month, and 3 months after BCAS surgery, were set up. Immunofluorescence staining and Luxol fast blue (LFB) staining were employed to evaluate the activation of microglia and the extent of white matter damage. The time point with the most pronounced damage was selected as the model establishment group. ② Control group, BCAS model group, and (BCAS + fostamatinib treatment) group were established. Immunofluorescence staining and LFB staining were utilized to investigate the effects of fostamatinib on microglia activation, white matter damage, cognitive dysfunction, and the expression of related inflammatory factors in BCAS mice. ③ An ex vivo primary microglia model with exogenous myelin stimulation was established. The cells were treated with fostamatinib or siRNA. Western blot and real-time fluorescence quantitative PCR techniques were used to detect changes in the expression of key proteins and genes in the inflammatory pathway. Results: ① Compared with the control group, the mice in the model group exhibited impaired memory function at 1 month after BCAS surgery, with the highest white matter damage score on LFB staining and the most significant reduction in the fluorescence intensity of myelin basic protein (MBP). Sholl analysis revealed the most pronounced activation of microglia. ② Compared with the model group, the fostamatinib treatment group showed improved reference memory in mice, a reduced white matter damage score, and decreased microglia activation according to Sholl analysis. Immunofluorescence staining demonstrated a significant decrease in the expression of the pro-inflammatory factors NLRP3 and SYK (P<0.05). ③ In vitro, fostamatinib treatment significantly reduced the expression of inflammatory-related factors such as NLRP3, SYK, ASC, Caspase-1, and IL-18 in microglia after myelin treatment (P<0.05). Consistent with these findings, knocking down SYK using siRNA also resulted in downregulated expression of inflammatory factors (P<0.05). Conclusion: Fostamatinib may improve the activation of the NLRP3 inflammasome inflammatory pathway in microglia by inhibiting SYK, thereby reducing neuroinflammatory responses, alleviating myelin damage, promoting structural reconstruction after cerebral white matter ischemia, and facilitating the recovery of cognitive function.
  • Impact of the Timing of Rehabilitation Training on Hindlimb Motor Recovery in Rats Following Spinal Cord Injury
    GAO Yimeng1, WU Yuanyuan1, SU Wennan1, HE Lewei1, ZHAO Can2, RAO Jiasheng1
    2026, 21(4): 206-212. https://doi.org/10.16780/j.cnki.sjssgncj.20251556
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    This study examines the effects of postoperative rehabilitation timing on gait recovery in rats with spinal cord injuries (SCI). The findings aim to provide evidence for determining the optimal time for commencing rehabilitation after SCI. Methods: Sixteen Sprague-Dawley (SD) rats were randomly allocated into four groups: the normal group (N group), injury-only group (S group), rehabilitation starting 3 days post-injury group (3 d group), and rehabilitation starting 7 days post-injury group (7 d group). After inducing a moderate spinal cord contusion in the rats, the 3 d and 7 d groups underwent 40 minutes of treadmill rehabilitation, focusing on bipedal walking, on the respective days post-injury. Gait data from the rat’s hindlimbs were captured using a high-speed camera system two weeks post-SCI. Principal component analysis (PCA) was employed to identify key gait features and behavioral indicators during walking, which were then compared across groups to assess the influence of varied training initiation times on the restoration of lower limb motor function in rats. Results: PCA indicated that, within the principal component space, the 7 d group was most similar to the normal group. This was significantly better than the 3 d group and the S group (both P<0.0001). For the PC1 score, the 7 d group outperformed both the 3 d group and the S group (both P<0.0001), while the 3 d group also surpassed the S group (P=0.0127). Regarding the PC2 score, the discrepancy between the 7 d group and the N group (P<0.05) was less pronounced than for the 3 d group (P<0.0001) and the S group (P<0.001). In key gait parameters, the forward displacement of the metatarsophalangeal (MTP) in the 7 d group was (6.610± 1.030) mm, markedly higher than in both the 3 d group (1.425±1.167) mm and the S group (1.473±1.270) mm (both P<0.0001). The peak speed of MTP in the 7 d group was (5.317 ± 1.380) mm/s, closely mirroring the healthy state (7.517±1.404) mm/s. For ankle joint forward movement, the 7 d group recorded (2.651±0.921) mm, significantly superior to the 3 d group (0.752±0.807) mm and the S group (0.572±0.352) mm (both P<0.0001). Moreover, in terms of stability and speed metrics, the 3 d group displayed the most substantial deviation from the normal, with values of (0.647±0.376) s for standing time and (2.155±1.493) s for vertical knee joint oscillation (P<0.0001). Conclusion：Rats in the 7 d group exhibited gait metrics more akin to the normal state compared to the 3d group, suggesting a superior hindlimb functional recovery.
  • Analysis of Influencing Factors for Short-term Prognosis in Patients with Acute Cerebral Infarction Aged Over Sixty
    Zhao Yuan, Yi li, Shen Shen, Yang Liu, ZHANG Yongbo
    2026, 21(4): 213-216. https://doi.org/10.16780/j.cnki.sjssgncj.20250238
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    To investigate the impact of age at onset, National Institutes of Health Stroke Scale (NIHSS) score at admission, and the C-reactive protein to albumin ratio (CAR) on the short-term prognosis of patients with acute cerebral infarction (ACI) aged over 60 years. Methods: This study employed a retrospective cohort design. Patients with ACI aged over 60 who were admitted to the Department of Neurology at Beijing Friendship Hospital, Capital Medical University, between January 2021 and December 2021 and met the inclusion and exclusion criteria were enrolled. Demographic data, risk factors, admission National Institutes of Health stroke scale (NIHSS) scores, etiology of cerebral infarction, and hematological and biochemical indicators were collected, and the CAR was calculated. Prognosis was assessed using the modified Rankin Scale (mRS) score at discharge (mRS score >2 indicated poor prognosis, while a score ≤2 indicated good prognosis). Logistic regression analysis was used to identify the influencing factors of patient prognosis. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of age, baseline NIHSS score at admission, and CAR for the short-term prognosis of ACI patients aged over 60. Results: A total of 276 eligible patients were included, comprising 94 with poor short-term prognosis (poor prognosis group) and 182 with good short-term prognosis (good prognosis group). Logistic regression and correlation analyses revealed that age at admission (OR 1.080, 95% CI 1.031-1.132, P=0.001), admission NIHSS score (OR 1.768, 95% CI 1.494-2.092, P<0.001), and CAR (OR 4.294, 95%CI1.747-10.558, P=0.001) were positively correlated with the short-term prognosis of ACI patients aged over 60. ROC curve analysis demonstrated that the combination of admission NIHSS score and CAR provided higher accuracy in evaluating the short-term prognosis of ACI patients aged over 60 compared to using baseline NIHSS or CAR alone. Conclusion: Age at onset, admission NIHSS score, and CAR are positively correlated with the short-term prognosis at discharge in ACI patients aged over 60. The combination of baseline NIHSS score and CAR demonstrates high accuracy in assessing the short-term prognosis of these patients.
  • Surgical Outcomes and Prognosis of Chronic Subdural Hematoma with Acute Hemorrhage at Initial Presentation
    SHEN Xiaoyan1, ZHAO Ximin1, MAO Qing2
    2026, 21(4): 217-221. https://doi.org/10.16780/j.cnki.sjssgncj.20240562
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    To explore the surgical outcomes and prognosis of chronical subdural hematoma (CSDH) with acute hemorrhage at the initial presentation. Methods: A retrospective analysis was conducted on the clinical data of 166 patients with CSDH who underwent surgical treatment in a single center. Among them, 28 cases were diagnosed with acute-on-chronic subdural hematoma (acSDH), and the surgical outcomes and prognosis of this special type of CSDH were explored. Results: Acute chronic subdural hematomas (acSDH) accounted for 16.87% of all chronic subdural hematomas (CSDH) during the same period. Compared to CSDH without acute hemorrhage, patients with acSDH exhibited significantly higher postoperative complication rates (P<0.05). However, no statistically significant differences were observed between the two groups in terms of recurrence rate, total hospital stay duration, discharge modified Rankin scale (mRS) scores, or favorable surgical outcome rates (P>0.05). Although mortality rates at both 30 days and 1 year were numerically higher for acSDH cases, these differences did not reach statistical significance (P>0.05). Kaplan-Meier survival analysis revealed overlapping survival curves for both cohorts, with no significant intergroup difference in survival probability (P> 0.05). Conclusion: Patients initially diagnosed with acSDH experience higher postoperative complication rates compared to those without acute hemorrhage, yet exhibit similar recurrence rates. Surgical treatment for acSDH yields favorable outcomes.
  • Exploration of the Pathological Mechanism of Venous Injury in Cerebral Amyloid Angiopathy
    LIU Xin, YE Xiaodong, HUANG Shanshan, ZHU Suiqiang
    2026, 21(4): 222-226. https://doi.org/10.16780/j.cnki.sjssgncj.20251495
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    Cerebral amyloid angiopathy (CAA) is a common cerebral small vessel disease in the elderly, characterized primarily by the deposition of amyloid β (Aβ) in the leptomeninges and small vessels of the cortex. Although the presence of Aβ has been confirmed in the venules of both CAA patients and animal models, current research on CAA mainly focuses on the deposition of Aβ in arteries and capillaries, with relatively little attention given to veins. Recently, as research has advanced, the potential pathological role of veins in Alzheimer’s disease and cerebral small vessel diseases has gradually gained recognition. However, the pathological mechanisms by which veins contribute to the formation and progression of CAA remain unclear. Therefore, this review will provide an in-depth analysis of the clinical manifestations and potential pathological mechanisms of CAA from the perspective of veins, aiming to offer new insights for early clinical intervention in CAA.
  • Advances in Research on the Mechanisms of Gut Microbiota Dysbiosis in the Pathogenesis of Drug-Resistant Epilepsy
    LIU Qian, ZHANG Xinxin, JIN Wen, HAN Jing, WANG Qian, LI Zaiwang
    2026, 21(4): 227-232. https://doi.org/10.16780/j.cnki.sjssgncj.20251227
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    Drug-resistant epilepsy (DRE) is a chronic brain disorder that is difficult to effectively control with antiepileptic drugs, accounting for nearly one-third of the global epilepsy patient population. Recent studies have revealed significant differences in the gut microbiota (GM) composition between DRE patients and healthy individuals, suggesting that the gut microbiota may influence and regulate neurotransmitter metabolism, inflammatory responses, and blood-brain barrier function through the microbiota-gut-brain axis (MGBA), thereby participating in the modulation of seizure activity. This article systematically reviews the research progress on the mechanisms underlying the regulation of gut microbiota for the treatment of DRE, aiming to provide a theoretical basis for the development of novel therapeutic strategies for DRE.
  • Research Progress on the Mechanism of Heat Shock Proteins in Regulating Parkinson's Disease
    FU Xiayan1 ，DONG Hong2 ，LI Xiang3 ，LIU Jinlong1
    2026, 21(4): 233-237. https://doi.org/10.16780/j.cnki.sjssgncj.20251022
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    Heat Shock Proteins (HSPs), as a crucial class of molecular chaperones in the human body, participate in the regulation of various pathophysiological processes and play a vital role in maintaining human health. With the deepening of research, HSPs have been found to exert significant regulatory effects in Parkinson's disease (PD), gradually emerging as a key therapeutic target for this neurodegenerative disorder. This article summarizes the pathological mechanisms through which HSPs are involved in PD by influencing alpha-synuclein ( α-Syn) aggregation, mitochondrial function and oxidative stress, cellular autophagy, apoptosis, and neuroinflammation, aiming to provide new research and clinical application directions for PD treatment.
  • Clinical Research Progress of Repetitive Transcranial Magnetic Stimulation in the Treatment of Neurogenic Bladder
    MA Liqian1 ，YU Yanlan2 ，GONG Peng3 ，LIU Yuan3 ，LIN Xianming1,3
    2026, 21(4): 238-241. https://doi.org/10.16780/j.cnki.sjssgncj.20251254
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    Neurogenic bladder (NB) has complex and diverse etiologies, with a wide range of impacts. Although there are numerous existing treatment methods, their effects vary, and they are subject to many limitations. Repetitive transcranial magnetic stimulation (rTMS), as a non-invasive neuromodulation technique, has demonstrated potential in the treatment of NB in recent years. However, the treatment protocol has not yet been unified, and a standard consensus is lacking. This review summarizes the application of rTMS in NB, discussing the selection of rTMS parameters and the combined treatment approaches with rTMS for NB. We found that the intervention timing and duration of rTMS treatment for NB remain unclear, but there has been some progress regarding its therapeutic time-effectiveness. Finally, it is concluded that further verification of the mechanisms, determination of treatment protocols, and expansion of research scale are required for rTMS in the treatment of NB at present. This review aims to provide new clinical ideas for the treatment of NB, with the expectation of exploring more efficient therapeutic methods.
  • Application of Magnetic Resonance Spectroscopy Technique in Neurodegenerative Diseases
    LI Yijie1 ，HAN Yingmei1 ，ZHANG Heng1 ，XU Huiyong1 ，FENG Ze1 ，LI Weiqing1 ，WANG Feng2
    2026, 21(4): 242-245. https://doi.org/10.16780/j.cnki.sjssgncj.20241112
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    Magnetic Resonance Spectroscopy (MRS), as a non-invasive molecular imaging technique, enables the quantitative detection of changes in cerebral metabolites, providing crucial insights into the pathophysiology, early diagnosis, and therapeutic monitoring of neurodegenerative diseases. This review summarizes the applications of MRS in Alzheimer’s disease (AD), Parkinson’s disease (PD), multiple sclerosis (MS), and type 2 diabetes-related cognitive impairment. Studies have shown that MRS can detect early abnormalities in neurotransmitter metabolism in the hippocampus in AD; reveal fluctuations in gamma-aminobutyric acid (GABA) levels and their response to dopamine therapy in PD; identify energy metabolic alterations associated with fatigue severity in MS; and demonstrate associations between prefrontal metabolites and glycemic control in cognitive impairment related to type 2 diabetes. Although currently limited by issues such as low sensitivity and complex signal interpretation, advances in high-field technology, ultra-fast sequences, and multimodal integration suggest broad prospects for MRS in the precise diagnosis and dynamic monitoring of neurodegenerative diseases.