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Our previous studies have shown that early exercise intervention after stroke increases neural activity and synaptic plasticity and promotes the recovery of nerve fiber bundle integrity in the brain. However, the effect of exercise on the repair of myelin in the brain and the related mechanism are still unclear. In this study, we randomly divided the rats into three groups. Before and after 28 days of intervention, body weight, nerve function, the infarct size, white matter fiber bundle integrity, and nerve myelin structure and function were observed by measuring body weight, analysis of modified neurological severity score, CatWalk gait analysis, MRI, luxol fast blue staining, immunofluorescence, and transmission electron microscopy. Changes in the expression of proteins in the MEK/ERK pathway were assessed. The results showed that early exercise intervention resulted in neurological recovery, decreased the infarct volume and increased nerve fiber integrity, the myelin coverage area, myelin basic protein (MBP) fluorescence intensity expression, and myelin thickness. Furthermore, the expression level of MBP was significantly increased after early exercise intervention, while the expression levels of p-MEK1/2 and p-ERK1/2 were significantly reduced. In the cell study, MBP expression levels were significantly higher in the oxygen and glucose deprivation and administration group.In summary, early exercise intervention after stroke can promote myelin repair by inhibiting the MEK/ERK signaling pathway.

Background Hyperuricemia (HUA) caused by elevated serum uric acid (SUA) has been shown to be an independent risk factor for the development and progression of chronic kidney disease (CKD). However, there are few cohort studies on the correlation of SUA level with the development and progression of CKD in the elderly of China. Objective To explore the association of baseline SUA level and its changes with the risk of chronic kidney disease (CKD) and estimated glomerular filtration rate (eGFR) in the elderly in longevity areas of China. Methods Based on the Healthy Aging and Biomarkers Cohort Study (HABCS), a sub cohort of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), the older adults who received physical examination and with biomedical indicators in 2012 and 2014 were selected as the study subjects from December 2021 to May 2022. The age, gender, blood pressure, blood lipids, blood glucose and other biomedical indicators were collected at baseline and follow-up period. Cox proportional hazards regression model was used to analyze the association of different SUA levels with the risk of CKD. Spearman rank correlation and generalized linear model analysis were used to analyze the association between baseline SUA level and baseline eGFR level and the linear correlation between changes in SUA level and eGFR changes in the elderly, respectively. Results A total of 981 subjects were included in the study, with the median age of 79 (70, 88) years, the prevalence of HUA of 6.8% (67/981), the cumulative follow-up of 2 029 person-years and the median follow-up of 2.05 years, including 179 new cases of CKD, the cumulative incidence of CKD during the follow-up was 18.2%〔95%CI (15.9%, 20.8%) 〕, and the incidence density was 88.22/1 000 person-years〔95%CI (76.24/1 000 person-years, 101.41/1 000 person-years) 〕. Cox proportional hazards regression analysis with SUA quartile grouping as the independent variable showed that compared with the lowest quartile group of baseline SUA level (Q1), the HR value for the risk of CKD in the highest quartile group of baseline SUA level (Q4) was 2.08〔95%CI (1.27, 3.41), P=0.004〕. Cox proportional hazards regression analysis with SUA level as the independent variable showed that, for every 10 μmol/L increase in baseline SUA level, the risk of CKD in the elderly increased by 4% (P

Introduction: Repetitive transcranial magnetic stimulation (rTMS) can improve post stroke motor function. However, there is little research on targets. The purpose of this study is to investigate the effects of rTMS therapy with different targets on post stroke motor function and neural plasticity. Methods: Fifty-four subjects were randomly divided into M1 (Primary motor area) group, SMA (supplementary motor area) group and Sham group, and were given 10 Hz on the affected M1 area, SMA area and sham stimulation rTMS. The primary outcomes included Fugl-Meyer Assessment Upper Extremity Scale (FMA-UE), Fugl-Meyer Assessment Lower Extremity Scale (FMA-LE) and Berg balance scale (BBS). Secondary outcomes: amplitude of low frequency fluctuation (ALFF), regional homogeneity (ReHo) and functional connectivity (FC) were analyzed by functional magnetic resonance imaging (fMRI) to evaluate brain functional activation and functional connectivity changes. Results: The 2-way repeated-measures ANOVA revealed a significant group × time interaction (F = 23.494, p < 0.001; F = 10.801, p < 0.001; F = 17.812, p < 0.001) in the FMA-UE, FMA-LE and BBS scores. Post hoc analysis indicated that 4 weeks of SMA rTMS resulted in an increase in FMA-UE, FMA-LE and BBS scores compared with Sham group (p = 0.006; p = 0.033; p = 0.012), SMA group was significantly increased in BBS compared with M1 group (p = 0.034). Moreover, there were significant effects of time in all 3 groups in the FMA-UE, FMA-LE and BBS scores (p < 0.001). In addition, the increase of ALFF in the supramarginal gyrus on the affected side was correlated with better FMA-UE recovery, the increase of ALFF in the middle temporal gyrus and the middle frontal gyrus on the affected side was positively correlated with the improvement of BBS, and the ALFF in the cerebellum on the healthy side was negatively correlated with the improvement of BBS. There was a positive correlation between FC (SMA – ipsilateral cerebellum) changes and BBS changes in SMA group. Discussion: In conclusion, SMA-rTMS intervention has a better recovery effect on motor dysfunction after stroke than Sham-rTMS. SMA-rTMS led to similar improvement on motor function but significantly greater improvement on balance compared to M1-rTMS, and this may pave a new way for stroke rehabilitation. Clinical trial registration: Registration number: ChiCTR2200060955, https://www.chictr.org.cn/. [ABSTRACT FROM AUTHOR]

Context: Vascular cognitive impairment (VCI) or vascular dementia is widely considered to be the second-most-common cause of dementia after Alzheimer's disease, accounting for 20% of cases. Little is known about the effectiveness of breath qigong for seniors suffering from VCI or dementia.Objectives: For seniors with VCI, the study aimed to compare the benefits of qigong practice, cognitive training, and qigong practice + cognitive training in improving cognitive function, memory, executive function, and daily problem-solving ability.Design: The study was a randomized, controlled pilot study that used a prospective design with repeated measures.Setting: The study took place at the Tianjin Medical University General Hospital (Tianjin, China).Participants: Participants were 93 patients with VCI at a clinic at the hospital.Intervention: The participants were randomly assigned to 1 of 3 groups: (1) qigong practice, an intervention group; (2) cognitive training, a positive control group; or (3) a combination of qigong practice and cognitive training, an intervention group. Participants received the treatments for 3 mo.Outcome Measures: All outcome measures were undertaken at baseline and postintervention. The measures included (1) the Montreal cognitive assessment, (2) the Loewenstein occupational therapy cognitive assessment, and (3) the Barthel activities of daily living index.Results: All 3 groups showed significant improvements in general cognitive function, memory, executive function, and daily problem-solving ability (P < .05).Conclusion: Qigong practice is an easy and convenient exercise performed at no cost and has the potential to improve the cognitive functions of older adults with mild VCI. [ABSTRACT FROM AUTHOR]

Objectives: Tactile stimulation (TS) can promote neurogenesis and motor function recovery in rats with hypoxic-ischaemic brain injury, but the underlying mechanism is not clear. This study aimed to assess the effects of TS on neurological function in rats after cerebral ischaemia and explore the underlying mechanism., Methods: Adult SD rats were randomly divided into a sham operation (SHAM) group, middle cerebral artery occlusion with tactile stimulation (TS-MCAO) group and middle cerebral artery occlusion with sedentary intervention (SED-MCAO) group. Twenty-four hours after MCAO, rats in the TS-MCAO group received TS for 20 min/d 5 d/w for 4 weeks. Cerebral blood flow (CBF), changes in body weight, behavioural scores, the infarct volume, corticospinal tract integrity, and neurochemical changes were measured, and Golgi-Cox staining, transmission electron microscopy and Western blotting were performed., Results: CBF recovery was improved in the TS-MCAO group compared with the SED-MCAO group. Body weight and behavioural scores in the TS-MCAO group significantly changed after 28 days of intervention. After 14 and 28 days of intervention, the infarct volume decreased significantly, the ratios of fractional anisotropy increased and the ratios of apparent diffusion coefficient decreased, the ratios of Nacetylaspartate (NAA)/creatine (Cr) and glutamate (Glu)/ Cr increased. After 28 days of intervention, the complexity and density of dendrites, the number of synapses and the expression of synaptic plasticity-related proteins increased in the peri-infarct cortex., Conclusion: TS can improve motor performance in rats with cerebral ischaemia and the improvement is correlated with synaptic plasticity. This finding would be helpful to provide a rehabilitation program for patients following stroke.

Vascular cognitive impairment（VCI） is a group of syndromes ranging from mild cognitive impairment to dementia caused by cerebrovascular disease, due to the lack of sensitivity and specific biomarkers, it is difficult to identify and diagnose early. Abnormal connectivity is observed in brain regions of patients with vascular cognitive disorders, locates mainly in the default mode network（DMN）, and changes in their abnormal functional connectivity correlated with the degree of patients' cognitive impairment. Resting-state functional magnetic resonance imaging(rs-fMRI) is a commonly used method to detect the internal activity of the brain at resting state. The use of various rs-fMRI to study abnormal changes in the DMN in patients with VCI is useful to further investigate the pathogenesis of VCI and provide an objective basis for imaging. This article mainly reviews the application of rs-fMRI in the DMN in patients with VCI, bringing new perspectives for the correct diagnosis and assessment of VCI.

Electroencephalogram (EEG) is a basic physiological signal of human body, which can effectively record the nervous system activities of the brain and contains rich information. The synchronization of EEG signals is not only the key to the exchange of information between different brain regions, but also reflects the neural activity of the brain, which in turn can infer people's cognitive activities. Therefore, studying the phase synchronization of EEG signals after stroke is of great significance for understanding the communication and neuroplasticity of neurons after brain injury. In this paper, the changes of EEG phase synchronization in bilateral, cyclical ankle movements alternately after stroke were studied by Hilbert transform. Ten stroke patients and six healthy adults participated in the test. The results showed that the inter-hemisphere phase synchronization index (inter-PSI) and the global PSI of patients were significantly lower than that of the healthy subjects during the task. The PSI between Cz and the affected sensory cortex associated with lower limb movements was also significantly lower than that in the control group. There was a significant negative correlation between National Institutes of Health Stroke Scale (NIHSS) and cortical synchronization. The above results indicated that PSI under ankle alternating movements may be used as a new biomarker to evaluate the recovery of patients' brain neurons.

Balance problems are the main sequelae of stroke, which increases the risk of falling. The assessment of balance ability can guide doctors to formulate rehabilitation plans, thereby reducing the risk of falls. Studies have reported the role of resting-state EEG during sitting in the motor assessment of the upper extremity and prognosis of stroke patients. However, the above research in the sitting posture lacks specificity in evaluating the balance ability of the lower limbs. Herein, this article investigated whether EEG was different in sitting and standing positions with different difficulty levels and validated the feasibility of EEG in assessing body balance ability. The resting-state EEG signals were collected from 11 stroke patients. The pairwise-derived brain symmetry index (pdBSI) was used to identify the differences in EEG-quantified interhemispheric cortical power asymmetry observable in healthy versus cortical and subcortical stroke patients by calculating the absolute value of the difference in power at each pair of electrodes. Subsequently, we computed the pdBSI over different frequency bands. Balance function was assessed using the BBS (Berg Balance Scale). Stroke survivors showed higher pdBSI (1-25 Hz) values in standing posture compared to sitting (p <0.05) and the pdBSI was significantly negatively correlated with BBS (r = -0.671, p =0.034). Additionally, the pdBSI within beta band was also significantly negatively correlated with BBS (r = -0.711, p=0.017). In conclusion, stroke brain asymmetry in standing posture was significantly more severe and the pdBSIs in 1-25Hz and beta hand were related to balance function. BBS and NIHSS was significantly negatively correlated (r = -0.701, p = 0.024), and NIHSS was significantly correlated with age (r = 0.822, p = 0.004). The present study suggests that stroke can seriously affect the body's balance ability. Compared with the sitting posture, the asymmetry of cortical energy in the standing posture can better assess the patient's balance ability.

Objective: To investigate the mechanism of aerobic exercise in the relief of vascular cognitive impairment (VCI)., Materials and Methods: Latency of Water Maze test was measured at sham, 2VO, 2VO+EX groups. miR-503 and BDNF mRNA levels were detected by quantitative real-time PCR. Protein levels of NF-κB and BDNF were detected by Western blot. Hippocampal neuron cell apoptosis was detected by flow cytometry. Luciferase reporter assay was conducted to investigate the effect of miR-503 on BDNF., Results: Latency of Water Maze test in 2VO group was longer than Sham group, while exercise shortened the latency. The expressions of NF-κB and miR-503 in 2VO group were higher than Sham group, while exercise downregulated the expressions. BDNF level in 2VO group were downregulated than Sham group, while exercise upregulated the levels. We also found NF-κB, miR-503 levels were upregulated and BDNF level was downregulated in OGD-treated hippocampal neuron cells. In addition, OGD increased the expression of NF-κB and miR-503, and the expression of miR-503 was downregulated when treated with NF-κB inhibitor (PDTC). Moreover, we confirmed BDNF was a direct target of miR-503. OGD decreased the expression of BDNF, while miR-503 inhibitor reversed this effect. And we proved OGD induced cell apoptosis via NF-κB/miR-503/BDNF. Finally, in rats injected with miR-503 inhibitor, latency of Water Maze test was shortened, miR-503 expression was downregulated, and BDNF level was upregulated. While in rats injected with miR-503 mimic, the results were the opposite., Conclusion: Aerobic exercise relieved VCI via NF-κB/miR-503/BDNF pathway., Competing Interests: None.

Objective: To locate and trace endogenous endothelial progenitor cells (EPCs) in rabbits subjected to myocardial ischaemia and/or physiological ischaemia training., Methods: Rabbits were randomly divided into 4 groups: a myocardial ischaemia group (subjected to myocardial ischaemia only); a physiological ischaemia training group (subjected to physiological ischaemia training only); a physiological ischaemia training-myocardial ischaemia group (subjected to both myocardial ischaemia and physiological ischaemia training); and a sham-operated group. Myocardial ischaemia was induced experimentally by a 2-min ischaemia, followed by a 1-h reperfusion. Physiological ischaemia training involved a 4-min isometric contraction elicited by electrical stimulation (biphase square wave, 40 Hz, 1 ms), which generated a contraction force at 40% of the maximal isometric contraction force. Myocardial ischaemia I and/or physiological ischaemia training were performed twice a day, 5 days a week for 4 weeks. Capillary densities and EPC levels in both blood and the ischaemic heart region were then measured. EPCs were traced by double-labelling with super paramagnetic iron oxide and chloromethyl-benzamidodialkylcarbocyanine., Results: EPC levels in the blood and the ischaemic heart region both improved significantly in the physiological ischaemia training-myocardial ischaemia group (mean 0.046% (standard deviation (SD) 0.007), 0.013% (SD 0.005)) and group myocardial ischaemia (mean 0.038% (SD 0.016), 0.008% (SD 0.004)). For the physiological ischaemia training group, moderately raised EPCs were found in the blood (0.026 ± 0.010%), but not in the heart. Capillary density increased in the physiological ischaemia training-myocardial ischaemia and myocardial ischaemia groups. The dual-labelled EPCs were confirmed in the ischaemic heart region. Pearson's analysis demonstrated that there is a positive correlation between EPC levels in the blood and the heart region (p < 0.05), and between circulating EPCs and the capillary (p < 0.05) for the physiological ischaemia training-myocardial ischaemia group., Conclusion: Physiological ischaemia training can effectively improve endogenous EPCs. Their homing process from the circulating blood to the ischaemic myocardium was clearly traced in this study on rabbits. This homing process is of great importance for remote neovascularization.