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ABSTRACT Background Strokes in young individuals often stem from unusual causes. Posterior circulation ischemic stroke caused by vertebral artery insufficiency due to atlantoaxial instability or dislocation is rare. We present a case of posterior circulation ischemic stroke due to an unstable os odontoideum and review the current literature. The clinical features and imaging manifestations are described to promote awareness of etiology, early diagnosis, and assessment. Case Presentation A 24‐year‐old male presented with recurrent right‐sided limb numbness and weakness and cerebellar ataxia due to posterior circulation ischemic stroke. The work‐up revealed thrombosis reformation in the tortuous left vertebral artery. It is noteworthy that the patient developed compression and chronic damage of the vertebral artery secondary to atlantoaxial instability and lateral dislocation due to an os odontoideum. He underwent antiplatelet and anticoagulant therapy, cervical traction, and posterior atlantoaxial screw fixation and fusion with iliac crest autograft. The postoperative course was uneventful. At 6‐month follow‐up, the patient had a solid fusion mass and rigid stability of the atlantoaxial joint without neurologic deficits or ischemic sequelae. Conclusions For unexplained posterior circulation ischemic stroke, it is important to consider unstable os odontoideum as a potential etiology, especially in pediatric and young adult male patients. Atlantoaxial instability and dislocation with os odontoideum, especially when occurring laterally, may cause insufficiency of the vertebral artery and subsequent posterior circulation ischemic strokes. The significance of lateral atlantoaxial dislocation in the genesis of vertebral artery injury and the necessity for specific positional imaging are emphasized.

This paper employs BP Neural Network (BPNN) theory to evaluate innovation and entrepreneurship education in universities. It utilizes students' evaluation indexes as input vectors and determines the number of hidden layer neurons. Experimental results serve as output vectors. The BPNN method proves reasonable and feasible for vocational education course evaluation, exhibiting a 14.96% higher accuracy than traditional genetic algorithms. The paper discusses the model, configuration, characteristics, training process, algorithm enhancement, and limitations of neural networks, followed by an introduction to genetic algorithms. Through analysis of principles, basic operations, and common operators, it establishes a theoretical foundation for subsequent discussions.

Abstract Purpose To identify which non-invasive infection indicators could better predict post-cervical cerclage (CC) infections, and on which days after CC infection indicators should be closely monitored. Methods The retrospective, single-center study included 619 single-pregnancy patients from January 2021 to December 2022. Patients were categorized into infected and uninfected groups based on physicians’ judgments of post-CC infections. Registered information included patient characteristics, cervical insufficiency history, gestational age at CC, surgical method (McDonald/Shirodkar), purpose of CC, mid-pregnancy miscarriage/preterm birth, infection history or risk factors, and infection indices on days 1, 3, 5, and 7 after CC. Propensity score matching (PSM) was applied to reduce patient characteristic bias. Statistical analysis of C-reactive protein (CRP), white blood cell (WBC), neutrophil count (NEU), percentage of neutrophil count (NEU_P), interleukin-6 (IL-6), and procalcitonin (PCT) in the infected group compared with the uninfected group was performed using chi-square tests and t-tests. Receiver operating characteristic (ROC) curves were used to further assess the diagnostic value of CRP, PCT, and CRP-PCT in combination. Results Among the 619 included patients, 206 patients were matched using PSM and subsequently assessed. PCT values on day 1 and day 3 after CC exhibited significant differences between the two groups in two statistical ways (P

Abstract Background The tumor immune microenvironment can influence the prognosis and treatment response to immunotherapy. We aimed to develop a non-invasive radiomic signature in high-grade glioma (HGG) to predict the absolute density of tumor-associated macrophages (TAMs), the preponderant immune cells in the microenvironment of HGG. We also aimed to evaluate the association between the signature, and tumor immune phenotype as well as response to immunotherapy. Methods In this retrospective setting, total of 379 patients with HGG from three independent cohorts were included to construct a radiomic model named Radiomics Immunological Biomarker (RIB) for predicting the absolute density of M2-like TAM using the mRMR feature ranking method and LASSO classifier. Among them, 145 patients from the TCGA microarray cohort were randomly allocated into a training set (N=101) and an internal validation set (N=44), while the immune-phenotype cohort (N=203) and the immunotherapy-treated cohort (N=31, patients from a prospective clinical trial treated with DC vaccine) recruited from Huashan Hospital were used as two external validation sets. The immunotherapy-treated cohort was also used to evaluate the relationship between RIB and immunotherapy response. Radiogenomic analysis was performed to find functional annotations using RNA sequencing data from TAM cells. Results An 11-feature radiomic model for M2-like TAM was developed and validated in four datasets of HGG patients (area under the curve = 0.849, 0.719, 0.674, and 0.671) using MRI images of post contrast enhanced T1-weighted (T1CE). Patients with high RIB scores had a strong inflammatory response. Four hub-genes (SLC7A7, RNASE6, HLA-DRB1 and CD300A) expressed by TAM were identified to be closely related to the RIB, providing important evidence for biological interpretation. Only individuals with a high RIB score were shown to have survival benefits from DC vaccine [DC vaccine vs. Placebo: median progression-free survival (mPFS), 10.0 mos vs. 4.5 mos, HR=0.17, P=0.0056, 95%CI=0.041-0.68; median overall survival (mOS), 15.0 mos vs. 7.0 mos, HR=0.17, P =0.0076, 95%CI=0.04-0.68]. Multivariate analyses also confirmed that treatment by DC vaccine was an independent factor for improved survival in the high RIB score group. However, in the low RIB score group, DC vaccine was not associated with improved survival. Furthermore, a radiomic nomogram based on the RIB score and clinical factors could efficiently predict the 1-, 2-, and 3-year survival rates, as confirmed by ROC curve analysis (AUC for 1-, 2- and 3-year survival: 0.705, 0.729 and 0.684, respectively). Conclusions The radiomic model could allow for non-invasive assessment of the absolute density of TAM from MRI images in HGG patients. Of note, our RIB model is the first immunological radiomic model confirmed to have the ability to predict survival benefits from DC vaccine in gliomas, thereby providing a novel tool to inform treatment decisions and monitor patient treatment course by radiomics.

Abstract Introduction Proton pump inhibitor (PPI) abuse poses an overwhelming threat to the allocation of medical resources and places a heavy burden on global medical expenses. In this study, we put forward our prospective prescription review system and evaluated the effects of this system on clinical outcomes, rational medication use and costs related to PPIs. Methods A retrospective cohort study was conducted in which the included patients were divided into a preintervention group (2019.10–2020.09) and a postintervention group (2020.10–2021.09). To reduce the bias of patients’ baseline characteristics, the propensity score matching (PSM) method was employed. The primary endpoints were the incidence of stress ulcers (SUs), the improvement and cure rates of gastrointestinal haemorrhage, the defined daily dose (DDD), the drug utilization index (DUI) and the DDD/100 patient-days. The secondary endpoints included the types of unreasonable medication orders for PPIs, the PPI utilization rate and PPI costs. Results A total of 53,870 patients were included to evaluate the secondary endpoints, and 46,922 patients were paired by PSM and assessed to evaluate the primary endpoints. The number of PPIs used and PPI costs were significantly lower in the postintervention group than in the preintervention group (P

PurposeRight obstetric brachial plexus injuries (OBPI) often lead to left-handedness before limb function is restored post-surgery. A pertinent question arises about promoting a transition from left to right-handedness. We hypothesized that, with the decrease in neuroplasticity, handedness switching is not only difficult, but also reduces handedness-speech lateralization, impaired motor adaptability, and compromised language proficiency.MethodsWe retrospectively analyzed clinical data from January 1996 to January 2012 at our hospital. Participants were divided into intervention or control groups based on handedness switching. We compared handedness and computed lateral quotient (LQ) and lateralization index (LI) for handedness-speech center. Additionally, we assessed dominant hand’s writing speed, language function, and IQ. Associations between absolute LI and LQ values, writing speed, language scores, and IQ were examined.ResultsNineteen extended Erb’s palsy participants were enrolled, eight in the intervention group, and 11 in the control. No right-handed individuals were found in either cohort. The intervention group had significantly lower LQ and LI values, and fewer achieved normal writing speed. Yet, no notable disparities in language scores or IQ emerged. Notably, we established correlations between motor finesse, handedness degree, and handedness-speech lateralization.ConclusionFor right extended Erb’s palsy, shifting handedness is nearly unfeasible, and such an endeavor could trigger a reduction in handedness-speech lateralization magnitude and diminished motor finesse.

Abstract Colorectal cancer (CRC) is among the most prominent causes of cancer-associated mortality in the world, with chemoresistance representing one of the leading causes of treatment failure. However, the mechanisms governing such chemoresistance remain incompletely understood. In this study, the role of DYRK2 as a mediator of CRC cell drug resistance and the associated molecular mechanisms were assessed by evaluating human tumor tissue samples, CRC cell lines, and animal model systems. Initial analyses of The Cancer Genome Atlas database and clinical tissue microarrays revealed significant DYRK2 downregulation in CRC in a manner correlated with poor prognosis. We further generated LoVo CRC cells that were resistant to the chemotherapeutic drug 5-FU, and found that such chemoresistance was associated with the downregulation of DYRK2 and a more aggressive mesenchymal phenotype. When DYRK2 was overexpressed in these cells, their proliferative, migratory, and invasive activities were reduced and they were more prone to apoptotic death. DYRK2 overexpression was also associated with enhanced chemosensitivity and the inhibition of epithelial–mesenchymal transition (EMT) induction in these LoVo 5-FUR cells. Co-immunoprecipitation assays revealed that DYRK2 bound to Twist and promoted its proteasomal degradation. In vivo studies further confirmed that the overexpression of DYRK2 inhibited human CRC xenograft tumor growth with concomitant Twist downregulation. Overall, these results thus highlight DYRK2 as a promising therapeutic target in CRC worthy of further investigation.

Iron dysregulation may attenuate cognitive performance in patients with CADASIL. However, the underlying pathophysiological mechanisms remain incompletely understood. Whether white matter microstructural changes mediate these processes is largely unclear. In the present study, 30 cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) patients were confirmed via genetic analysis and 30 sex- and age-matched healthy controls underwent multimodal MRI examinations and neuropsychological assessments. Quantitative susceptibility mapping and peak width of skeletonized mean diffusivity (PSMD) were analyzed. Mediation effect analysis was performed to explore the interrelationship between iron deposition, white matter microstructural changes and cognitive deficits in CADASIL. Cognitive deterioration was most affected in memory and executive function, followed by attention and working memory in CADASIL. Excessive iron in the temporal-precuneus pathway and deep gray matter specific to CADASIL were identified. Mediation analysis further revealed that PSMD mediated the relationship between iron concentration and cognitive profile in CADASIL. The present findings provide a new perspective on iron deposition in the corticosubcortical circuit and its contribution to disease-related selective cognitive decline, in which iron concentration may affect cognition by white matter microstructural changes in CADASIL.

Abstract Background To assess heart rate variability (HRV) among patients with arteriosclerotic cerebral small vessel disease (CSVD) by comparing with control subjects, and to determine whether HRV parameters were related to structural alterations in brain regions involved in autonomic regulation among CSVD patients. Methods We consecutively recruited subjects aged between 50 and 80 years who visited the Stroke Prevention Clinic of our hospital and have completed brain magnetic resonance imaging examination from September 1, 2018 to August 31, 2019. Polysomnography and synchronous analyses of HRV were then performed in all participants. Multivariable binary logistic regression was used to identify the relationship between HRV parameters and CSVD. Participants were invited to further undergo three-dimensional brain volume scan, and the voxel based morphometry (VBM) analysis was used to identify gray matter atrophy. Results Among 109 participants enrolled in this study, 63 were assigned to the arteriosclerotic CSVD group and 46 to the control group. Lower standard deviation of normal-to-normal intervals (SDNN, OR = 0.943, 95% CI 0.903 to 0.985, P = 0.009) and higher ratio of low to high frequency power (LF/HF, OR = 4.372, 95% CI 1.033 to 18.508, P = 0.045) during the sleep period were associated with CSVD, independent of traditional cerebrovascular risk factors and sleep disordered breathing. A number of 24 CSVD patients and 21 controls further underwent three-dimensional brain volume scan and VBM analysis. Based on VBM results, SDNN during the awake time (β = 0.544, 95% CI 0.211 to 0.877, P = 0.001) and the sleep period (β = 0.532, 95% CI 0.202 to 0.862, P = 0.001) were both positively related with gray matter volume within the right inferior frontal gyrus only among CSVD patients. Conclusions Decreased nocturnal HRV is associated with arteriosclerotic CSVD independent of traditional cerebrovascular risk factors and sleep disordered breathing. The structural atrophy of some brain regions associated with cardiac autonomic regulation sheds light on the potential relationship. Trial registration Trial registration number: ChiCTR1800017902 . Date of registration: 20 Aug 2018.

Iron catalyzed coupling of β-amino alcohols with allylic alcohols for the synthesis of 3,4-dihydro-2H-pyrrole derivatives has been developed. Mechanistic studies suggest that the reaction involves iron catalyzed dehydrogenative coupling and C–C bond cleavage processes.

Wireless power transfer (WPT) is an effective way to prolong the lifetime of the energy-constraint networks. In this paper, we investigate a wireless powered cooperative non-orthogonal multiple access (WP-CNOMA) system, consisting of a power beacon (PB), an information transmitter (S), multiple relays (R) and two information receiving devices with near device D1 and far device D2. We assume both S and R are energy-constraint and there is no direct link between S and D2. With the help of PB, S and R can harvest energy from it to restart the communication for WP-CNOMA network. For such a system, low-complexity but effective relay and antenna selection schemes are applied. To characterize the performance, outage probabilities and average throughput are derived for linear and non-linear energy harvesting (EH) models, respectively. Moreover, to maximize the average throughput, invoking the unimodal feature for average throughput with respect to the EH time, we find the optimal EH time via Golden section search method. Simulation results validate the accuracy of analytical results, and reveal the performance gain for our system over the benchmark schemes. Also, it can be seen that the non-linear EH model shows different outage behaviors from the linear one. On the other hand, considering the practical application and to improve the performance, the optimization for a simple WP-CNOMA system with single-antenna PB and single relay is also investigated, in which we aim to maximize the minimum throughput by jointly optimizing EH time and power allocation. A low-complexity analytical method is developed to find the max-min rate. Numerical results show that through optimization, the system performance can be improved significantly.

The survival of motor neurons (MNs) is the key to recovery of the motor function after brachial plexus root avulsion (BPRA). (-)-epigallocatechin-3-gallate (EGCG) exerts neuroprotective roles in neurons under different pathological conditions. However, the role of EGCG in regulating motor neurons under BPRA remains to be unclear. In the present study, we investigated the functional role of EGCG both in vitro and in vivo . In an in vitro study, we observed that EGCG obviously increased the cell survival rate of MNs and FIG4 protein levels compared with the vehicle control, with a peak level observed at 50 µM; EGCG can also upregulate FIG4 to reduce the cell death of MNs and increase the neurite outgrowth under oxidative stress; moreover, EGCG can upregulate FIG4 to promote the functional recovery and the survival of MNs in the ventral horn in mice after BPRA. These combined results may lay the foundation for EGCG to be a novel strategy for the treatment of BPRA.

Objectives: To investigate how PM2.5 exposure affects the microstructure, metabolites or functions of the visual system. Methods: C57BL/6J mice were randomly assigned to groups exposed to the filtered air (the control group) or the concentrated ambient PM2.5 (the PM2.5 group). Visual evoked potentials (VEP), electroretinograms (ERG), diffusion tensor imaging (DTI), proton magnetic resonance spectroscopy (1H-MRS) and resting-state functional MRI (rsfMRI) were performed. Parameters were obtained and compared between the two groups, including latencies and amplitudes of the P1 wave, N1 wave and P2 wave from VEP, latencies and amplitudes of the a wave and b wave from ERG, fractional anisotropy (FA), mean diffusion (MD), axial diffusivity (AD) and radial diffusivity (RD) from DTI, visual cortex (VC) metabolites from 1H-MRS, and regional homogeneity (ReHo) from rsfMRI. Results: Compared with the values of the control group, the PM2.5 group showed a prolonged N1 latency (43.11 ± 7.94 ms vs. 38.75 ± 4.60 ms) and lowered P1 amplitude (5.62 ± 4.38 μV vs. 8.56 ± 5.92 μV) on VEP (all p

Consciousness is a mental characteristic of the human mind, whose exact neural features remain unclear. We aimed to identify the critical nodes within the brain's global functional network that support consciousness. To that end, we collected a large fMRI resting state dataset with subjects in at least one of the following three consciousness states: preserved (including the healthy awake state, and patients with a brain injury history (BI) that is fully conscious), reduced (including the N1-sleep state, and minimally conscious state), and lost (including the N3-sleep state, anesthesia, and unresponsive wakefulness state). We also included a unique dataset of subjects in rapid eye movement sleep state (REM-sleep) to test for the presence of consciousness with minimum movements and sensory input. To identify critical nodes, i.e., hubs, within the brain's global functional network, we used a graph-theoretical measure of degree centrality conjoined with ROI-based functional connectivity. Using these methods, we identified various higher-order sensory and motor regions including the supplementary motor area, bilateral supramarginal gyrus (part of inferior parietal lobule), supragenual/dorsal anterior cingulate cortex, and left middle temporal gyrus, that could be important hubs whose degree centrality was significantly reduced when consciousness was reduced or absent. Additionally, we identified a sensorimotor circuit, in which the functional connectivity among these regions was significantly correlated with levels of consciousness across the different groups, and remained present in the REM-sleep group. Taken together, we demonstrated that regions forming a higher-order sensorimotor integration circuit are involved in supporting consciousness within the brain's global functional network. That offers novel and more mechanism-guided treatment targets for disorders of consciousness.

To determine the filling body’s width along the gob-side remained roadway which is underneath the gob, the authors analyzed the interaction mechanism between the roof and the supporting body along the remained roadway, based on the elastic thin plate theory of the stope roof. The stress state and mechanical response of the filling body along the remained roadway were studied. Specifically, firstly, the supporting pressure of the coal pillar which is on one side of the gob-side remained roadway was deduced. Also, an equation that is used to calculate the width of the balance area in the stress limit state was acquired. Then, an equation that is used to calculate the roof cutting force on one side of the supporting body was obtained. By using FLAC3D, the authors investigated the displacement field and stress field response laws of rock masses around the roadway with different filling body’s widths. The results show that with the filling body’s width increasing, the supporting ability of the filling body increases. Meanwhile, the rock mass displacement around the roadway and the filling body deformation decrease. The better the filling body’s supporting effect is, the higher the roof cutting force will be. When the filling body’s width is larger than 3.0 m, its internal bearing ability becomes stable and the filling body’s deformation became non-apparent. Finally, analysis shows that the filling body’s width should be 2.5 m. Furthermore, the authors conducted field tests in the supply roadway 1204, using high-water materials and acquired expected outcomes. Keywords: Gob-side entry retaining, High-water materials, Numerical simulation, Support along the roadway

Abstract Previous studies have demonstrated that altered states of consciousness are related to changes in resting state activity in the default-mode network (DMN). Anatomically, the DMN can be divided into anterior and posterior regions. The anterior DMN includes the perigenual anterior cingulate cortex and other medial prefrontal cortical regions, whereas the posterior DMN includes regions such as the posterior cingulate cortex (PCC) and the temporal parietal junction (TPJ). Although differential roles have been attributed to the anterior and posterior DMN regions, their exact contributions to consciousness levels remain unclear. To investigate the specific role of the posterior DMN in consciousness levels, we investigated 20 healthy controls (7 females, mean age = 33.6 years old) and 20 traumatic brain injury (TBI) patients (5 females, mean age = 43 years old) whose brain lesions were mainly restricted to the bilateral frontal cortex but retained a well-preserved posterior DMN (e.g., the PCC and the TPJ) and who exhibited varying levels of consciousness. We investigated the intra- and cross-functional connectivity strengths (FCSs) between the right/left PCC and the right/left TPJ and their correlation with consciousness levels. Significant reductions in both the intra- and cross-hemispheric FCSs were observed in patients compared with controls. A significant correlation with consciousness levels was observed only for the cross-hemispheric PCC-TPJ FCS but not for the intra-hemispheric PCC-TPJ FCS. Taken together, our results show that the cross-hemispheric posterior DMN is related to consciousness levels in a specific group of patients without posterior structural lesions. We therefore propose that the PCC may be central in maintaining consciousness through its cross-hemispheric FC with the TPJ.

Induced pluripotent stem cells (iPS cells) are promising cell source for stem cell replacement strategy applied to brain injury caused by traumatic brain injury (TBI) or stroke. Neural stem cell (NSCs) derived from iPS cells could aid the reconstruction of brain tissue and the restoration of brain function. However, tracing the fate of iPS cells in the host brain is still a challenge. In our study, iPS cells were derived from skin fibroblasts using the four classic factors Oct4, Sox2, Myc, and Klf4. These iPS cells were then induced to differentiate into NSCs, which were incubated with superparamagnetic iron oxides (SPIOs) in vitro. Next, 30 TBI rat models were prepared and divided into three groups ( n = 10). One week after brain injury, group A&B rats received implantation of NSCs (labeled with SPIOs), while group C rats received implantation of non-labeled NSCs. After cell implantation, all rats underwent T2*-weighted magnetic resonance imaging (MRI) scan at day 1, and 1 week to 4 weeks, to track the distribution of NSCs in rats’ brains. One month after cell implantation, manganese-enhanced MRI (ME-MRI) scan was performed for all rats. In group B, diltiazem was infused during the ME-MRI scan period. We found that (1) iPS cells were successfully derived from skin fibroblasts using the four classic factors Oct4, Sox2, Myc, and Klf4, expressing typical antigens including SSEA4, Oct4, Sox2, and Nanog; (2) iPS cells were induced to differentiate into NSCs, which could express Nestin and differentiate into neural cells and glial cells; (3) NSCs were incubated with SPIOs overnight, and Prussian blue staining showed intracellular particles; (4) after cell implantation, T2*-weighted MRI scan showed these implanted NSCs could migrate to the injury area in chronological order; (5) the subsequent ME-MRI scan detected NSCs function, which could be blocked by diltiazem. In conclusion, using an in vivo MRI tracking technique to trace the fate of iPS cells-induced NSCs in host brain is feasible.

Objective. To determine whether and how longitudinal acupuncture modulates the impaired default mode network (DMN) in chronic migraine (CM) patients without aura. Methods. Resting-state functional magnetic resonance imaging (fMRI) data from 14 CM patients treated with longitudinal pre- and postacupuncture treatment (PPAT) and data of 18 age- and gender-matched healthy controls (HCs) were analyzed using independent component analysis (ICA) and seed-based correlation analysis (SCA) to investigate connectivity within the DMN. Correlation analyses were performed to identify associations between changes in functional connectivity (FC) and in clinical pain based on PPAT observations. The monthly mean visual analog scale (VAS) scores, monthly mean headache attacks, monthly headache days, monthly amount of acute headache medications, and immediate VAS scores were assessed for evaluation of pain. Results. The decreased FC within the DMN found in the left superior prefrontal gyrus (L_SPFG) and left precuneus (L_PRECUN) of CM patients was returned to the healthy control level after acupuncture treatments. Furthermore, the diminished pairwise FC strengths in some regions of interest (ROIs) within the DMN were also increased, mainly distributed between the right temporal lobe (R_TPL) and left anterior cingulate cortex, between the R_TPL and bilateral superior medial gyrus, and between the R_TPL and right precuneus. Increased z-scores within the DMN (L_SPFG and L_PRECUN) were associated with reduced immediate VAS scores, and increases in z-scores of the L_PRECUN were negatively correlated with reductions in the monthly amount of acute headache medications. However, no association existed between the increased DMN connectivity and reduced monthly mean VAS scores, monthly mean headache attacks, and monthly headache days. Conclusion. Altered DMN connectivity and its normalization postacupuncture can be employed to monitor CM and its modulating effects. The DMN is useful for understanding the therapeutic mechanisms of acupuncture in CM.

Background: Cerebral microbleeds (CMBs) are considered to be risk factors for cognitive dysfunction. The specific pathology and clinical manifestations of CMBs are different based on their locations. We investigated the association between CMBs at different locations and cognitive dysfunction and explored the potential underlying pathways in a rural Han Chinese population. Methods: We used baseline data from 562 community-dwelling adults (55–65 years old) in the Taizhou Imaging Study between 2013 and 2015. All individuals underwent multimodal brain magnetic resonance imaging (MRI) and 444 subjects completed neuropsychological tests: the Mini-Mental Status Examination and the Montreal Cognitive Assessment. Multinomial logistic regression was used to estimate the association between CMBs and cognitive dysfunction. The volume of brain regions and white matter microstructure were analyzed using Freesurfer and tract-based spatial statistics, respectively. Results: CMBs were detected in 104 individuals (18.5%) in our study. Multinomial logistic regression found deep/mixed CMBs were associated with global cognitive dysfunction (OR 3.52; 95% CI 1.21 to 10.26), whereas lobar CMBs (OR 1.76; 95% CI 0.56 to 5.53) were not. Quantification of multimodal brain MRI showed that deep/mixed CMBs were accompanied by decreased thalamic volume and loss of fractional anisotropy of bilateral anterior thalamic radiations. Conclusion: Deep/mixed CMBs were associated with cognitive dysfunction in this Chinese cross-sectional study. Disruption of thalamocortical connectivity might be a potential pathway underlying this relationship. Keywords: Cerebral microbleeds, Cognitive impairment, Multimodal imaging