As a physical treatment technique, modified electro-convulsive therapy (MECT) is used to treat mental and certain neurological disorders by causing seizures with short, suitable electrical currents applied to the brain while the patient is under general anesthesia and muscle relaxants. MECT is recognized for its therapeutic efficacy and clinical safety, rendering it one of the most prevalent interventions in psychiatric care. To enhance clinical outcomes and minimize adverse effects, this consensus document delineates the indications, therapeutic parameters, therapeutic procedures, potential adverse effects, and associated management strategies for MECT. These guidelines are informed by the latest clinical research and expert consensus, integrating evidence-based medicine methodologies. The objective is to furnish clinicians with precise operational guidelines and to advance the standardization of MECT practices in clinical settings.

Objective:To investigate altered neurovascular coupling in patients with depression(DEP)using resting-state functional magnetic resonance imaging(MRI)and arterial spin labeling perfusion MRI,as well as its association with depressive symptoms.Methods:Neuropsychological assessment and multimodal MRI scans were performed for 25 DEP patients and 35 healthy controls(HCs).Arterial spin labeling perfusion MRI was used to calculate cerebral blood flow(CBF),and functional MRI was used to calculate regional homogeneity(ReHo).The Pearson correlation coefficient between CBF and ReHo was calculated to obtain neurovascular cou-pling.Results:At the whole-brain level,CBF-ReHo coupling was reduced in DEP patients compared with HCs.At the brain region level,CBF-ReHo coupling was reduced in 26 brain regions in DEP patients,which were mainly located in the visual network,the default network,and the auditory network.The correlation analysis showed that the coupling values of the left suboccipital gyrus,the left angular gyrus,and the left thalamus were negatively correlated with Hamilton Depression Scale score.Conclusion:There is a sig-nificant reduction in neurovascular coupling in DEP patients,which is correlated with the severity of DEP.

Objective : To analyze the distribution characteristics of free water ( FW) and FW-corrected fractional anisotropy (FAt) in the white matter of the brain in patients with anti-N-methyl-D-aspartate receptor ( NMDAR) encephalitis and to explore their correlation with cognitive function． Methods : A total of 38 patients with anti- NMDAR encephalitis and 30 controls were recruited from three hospitals in Hefei．Diffusion tensor imaging data and neuropsychological assessment results were collected．Tract-Based Spatial Statistics was applied to compare group differences in FW and FAt across the whole brain white matter．Correlation analyses were further performed to ex- amine the relationships between FW/ FAt metrics and cognitive function． Results : Compared to the control group， patients with anti-NMDAR encephalitis showed significantly lower scores on the montreal cognitive assessment，im- mediate recall，delayed recall，and the verbal fluency test (all P＜0. 05) ，as well as significantly longer comple- tion times for color naming and word reading tasks in the stroop color word test (all P＜0. 05) ．Diffusion tensor im- aging analysis revealed significantly elevated FW and reduced FAt in widespread white matter regions in the patient group (all P＜0. 000 1) ．Further correlation analysis showed that increased FW was positively associated with the completion time of the color-switching condition in the color digital trail making test (P = 0. 044 ) and with the difference between color-switching and number sequencing conditions ( P = 0. 016 ) ，while negatively correlated with semantic fluency scores (P = 0. 002) ．Additionally，FAt was positively associated with delayed recall perform- ance (P = 0. 012) ，and negatively correlated with the completion times for color naming (P = 0. 018 ) and word reading (P = 0. 046) tasks in the SCWT． Conclusion Patients with anti-NMDAR encephalitis exhibit significantly elevated FW and significantly reduced FAt in white matter tracts，both of which are closely linked to cognitive im- pairment．

Objective To analyze the whole-brain structural-functional coupling imaging characteristics of patients with cerebral small vessel disease(CSVD)based on multiparametric functional and structural MRI,and to explore their correlation with cognitive function.Methods A prospective,consecutive study enrolled 60 CSVD patients from the Department of Neurology,the Second Affiliated Hospital of Anhui Medical University,between May 2021 and December 2023,and 47 controls matched for age,sex,education level,and handedness recruited from the community during the same period.Baseline data,including demographic information(age,sex,education),cognitive function,and imaging data,were collected for both groups.All participants underwent standardized neuropsychological assessments in a quiet environment.Emotional function was assessed using the patient health questionnaire-9(PHQ-9).Global cognitive function was screened using the Montreal cognitive assessment scale(MoCA)and Alzheimer's disease 8-item questionnaire(AD-8).Executive function was evaluated using the trail making test-B(TMT-B),the TMT time difference(TMT-B time minus TMT-A time),and the verbal fluency test(VFT).Attention and processing speed were assessed using TMT-A and the digit span test(DS).Memory function was evaluated using the Chinese auditory verbal learning test(AVLT),including learning,immediate recall,and delayed recall.Multimodal brain functional and structural MRI images were acquired for all participants.Fractional amplitude of low-frequency fluctuations(fALFF)and gray matter volume(GMV)were calculated using the DPABI software.A structure-function coupling index was computed by integrating the fALFF and GMV values of corresponding voxels.Structural-function coupling changes in CSVD patients and controls were assessed,and the correlations between fALFF,GMV,fALFF/GMV and cognitive function were explored.Results(1)Compared to the control group,CSVD patients showed significant lower scores in MoCA score(21.5[20.0,24.0]vs.24.3[23.0,26.0],Z=-4.094),higher PHQ-9 score(5.4±5.0vs.2.1±2.2,t=4.150),less VFT(15.5±3.8 vs.17.2±4.3,t=-3.258),increased TMT-B time([164.4±72.7]s vs.[123.6±45.7]s,t=3.307),TMT-A time([83.8±34.3]s vs.[62.9±22.7]s,t=3.704),and less DS forward span(6.3[5.0,8.0]vs.7.4[6.0,8.0],Z=-3.679),DS backward span(3.7±1.2 vs.4.5±1.4,t=-3.119),AVLT-learning(7.0±1.8 vs.8.7±1.9,t=-4.523),A VLT-immediate recall(7.2[6.0,9.0]vs.9.6[7.2,11.8],Z=-4.105),AVLT-delayed recall(6.9±3.1 vs.9.6±3.0,t=-4.310;all P＜0.01).No significant differences were observed in age,education,sex,AD-8 score,or TMT time difference(all P＞0.05).(2)CSVD patients showed decreased fALFF values in the right anterior cingulate gyrus(1.00±0.06 vs.1.07±0.06,t=-4.66)and increased fALFF values in the left superior parietal lobule(1.14±0.07 vs.1.07±0.07,t=5.68)and the right postcentral gyrus(1.08±0.05 vs.1.01±0.05,t=5.22;both P＜0.01).CSVD patients had increased GMV in the bilateral caudate nucleus(right:[0.27±0.06]mm3 vs.[0.21±0.04]mm3,t=6.12,left:[0.27±0.05]mm3 vs.[0.22±0.04]mm3,t=6.67;both P＜0.01)but decreased fALFF/GMV in the bilateral caudate nucleus(left:6.27±0.97 vs.7.75±1.70,t=-7.33;right:3.12±0.97 vs.4.18±0.95,t=-5.96)and the right globus pallidus(14.11±4.14 vs.19.99±4.03,t=-6.36;all P＜0.01).(3)Right anterior cingulate gyrus fALFF positively correlated with DS backward scores(R=0.348,P=0.013).Left superior parietal lobule fALFF negatively correlated with PHQ-9 scores(R=-0.308,P=0.029)and TMT time difference(R=-0.360,P=0.012).Right postcentral gyrus fALFF negatively correlated with TMT-A time(R=-0.419,P=0.003).Right caudate nucleus GMV positively correlated with TMT time difference(R=0.293,P=0.042),while left caudate nucleus GMV negatively correlated with AD-8 score(R=-0.284,P=0.043).fALFF/GMV in the right caudate nucleus(R=0.288,P=0.046)and right globus pallidus(R=0.290,P=0.045)positively correlated with VFT.After multiple comparison corrections,only the negative correlation between right postcentral gyrus fALFF and TMT-A time remained significant(P(alse discovery rate adjusted=0.024).Conclusions CSVD patients exhibit significant structure-function decoupling values in bilateral caudate nucleus and right globus pallidus are reduced,and this reduction is associated with a decline in verbal fluency.The results of this study still need to be further validated in larger sample size studies.

Objective To analyze the whole-brain structural-functional coupling imaging characteristics of patients with cerebral small vessel disease(CSVD)based on multiparametric functional and structural MRI,and to explore their correlation with cognitive function.Methods A prospective,consecutive study enrolled 60 CSVD patients from the Department of Neurology,the Second Affiliated Hospital of Anhui Medical University,between May 2021 and December 2023,and 47 controls matched for age,sex,education level,and handedness recruited from the community during the same period.Baseline data,including demographic information(age,sex,education),cognitive function,and imaging data,were collected for both groups.All participants underwent standardized neuropsychological assessments in a quiet environment.Emotional function was assessed using the patient health questionnaire-9(PHQ-9).Global cognitive function was screened using the Montreal cognitive assessment scale(MoCA)and Alzheimer's disease 8-item questionnaire(AD-8).Executive function was evaluated using the trail making test-B(TMT-B),the TMT time difference(TMT-B time minus TMT-A time),and the verbal fluency test(VFT).Attention and processing speed were assessed using TMT-A and the digit span test(DS).Memory function was evaluated using the Chinese auditory verbal learning test(AVLT),including learning,immediate recall,and delayed recall.Multimodal brain functional and structural MRI images were acquired for all participants.Fractional amplitude of low-frequency fluctuations(fALFF)and gray matter volume(GMV)were calculated using the DPABI software.A structure-function coupling index was computed by integrating the fALFF and GMV values of corresponding voxels.Structural-function coupling changes in CSVD patients and controls were assessed,and the correlations between fALFF,GMV,fALFF/GMV and cognitive function were explored.Results(1)Compared to the control group,CSVD patients showed significant lower scores in MoCA score(21.5[20.0,24.0]vs.24.3[23.0,26.0],Z=-4.094),higher PHQ-9 score(5.4±5.0vs.2.1±2.2,t=4.150),less VFT(15.5±3.8 vs.17.2±4.3,t=-3.258),increased TMT-B time([164.4±72.7]s vs.[123.6±45.7]s,t=3.307),TMT-A time([83.8±34.3]s vs.[62.9±22.7]s,t=3.704),and less DS forward span(6.3[5.0,8.0]vs.7.4[6.0,8.0],Z=-3.679),DS backward span(3.7±1.2 vs.4.5±1.4,t=-3.119),AVLT-learning(7.0±1.8 vs.8.7±1.9,t=-4.523),A VLT-immediate recall(7.2[6.0,9.0]vs.9.6[7.2,11.8],Z=-4.105),AVLT-delayed recall(6.9±3.1 vs.9.6±3.0,t=-4.310;all P＜0.01).No significant differences were observed in age,education,sex,AD-8 score,or TMT time difference(all P＞0.05).(2)CSVD patients showed decreased fALFF values in the right anterior cingulate gyrus(1.00±0.06 vs.1.07±0.06,t=-4.66)and increased fALFF values in the left superior parietal lobule(1.14±0.07 vs.1.07±0.07,t=5.68)and the right postcentral gyrus(1.08±0.05 vs.1.01±0.05,t=5.22;both P＜0.01).CSVD patients had increased GMV in the bilateral caudate nucleus(right:[0.27±0.06]mm3 vs.[0.21±0.04]mm3,t=6.12,left:[0.27±0.05]mm3 vs.[0.22±0.04]mm3,t=6.67;both P＜0.01)but decreased fALFF/GMV in the bilateral caudate nucleus(left:6.27±0.97 vs.7.75±1.70,t=-7.33;right:3.12±0.97 vs.4.18±0.95,t=-5.96)and the right globus pallidus(14.11±4.14 vs.19.99±4.03,t=-6.36;all P＜0.01).(3)Right anterior cingulate gyrus fALFF positively correlated with DS backward scores(R=0.348,P=0.013).Left superior parietal lobule fALFF negatively correlated with PHQ-9 scores(R=-0.308,P=0.029)and TMT time difference(R=-0.360,P=0.012).Right postcentral gyrus fALFF negatively correlated with TMT-A time(R=-0.419,P=0.003).Right caudate nucleus GMV positively correlated with TMT time difference(R=0.293,P=0.042),while left caudate nucleus GMV negatively correlated with AD-8 score(R=-0.284,P=0.043).fALFF/GMV in the right caudate nucleus(R=0.288,P=0.046)and right globus pallidus(R=0.290,P=0.045)positively correlated with VFT.After multiple comparison corrections,only the negative correlation between right postcentral gyrus fALFF and TMT-A time remained significant(P(alse discovery rate adjusted=0.024).Conclusions CSVD patients exhibit significant structure-function decoupling values in bilateral caudate nucleus and right globus pallidus are reduced,and this reduction is associated with a decline in verbal fluency.The results of this study still need to be further validated in larger sample size studies.

As a physical treatment technique, modified electro-convulsive therapy (MECT) is used to treat mental and certain neurological disorders by causing seizures with short, suitable electrical currents applied to the brain while the patient is under general anesthesia and muscle relaxants. MECT is recognized for its therapeutic efficacy and clinical safety, rendering it one of the most prevalent interventions in psychiatric care. To enhance clinical outcomes and minimize adverse effects, this consensus document delineates the indications, therapeutic parameters, therapeutic procedures, potential adverse effects, and associated management strategies for MECT. These guidelines are informed by the latest clinical research and expert consensus, integrating evidence-based medicine methodologies. The objective is to furnish clinicians with precise operational guidelines and to advance the standardization of MECT practices in clinical settings.

Neuromyelitis optica spectrum disorders (NMOSD) are a group of autoimmune-mediated demyelinating diseases of the central nervous system. A growing number of studies have identified asymptomatic lesions on imaging in patients with NMOSD, including asymptomatic optic neuropathy, asymptomatic spinal lesions, and asymptomatic brain lesions, even in the absence of clinical symptoms. The characteristics of asymptomatic lesions of NMOSD, influencing factors, relationship with relapse and disability progression, and management strategies were reviewed in this article.

Objective:To explore whether sleep quality suffers in patients with mild Alzheimer's disease(AD)and mild cognitive impairment(MCI), and to further investigate the correlation between sleep disorders and cognitive function in these patients.Methods:In this study, 30 mild AD patients, 39 MCI patients and 43 demographically matched healthy controls were enrolled.Sleep quality was assessed by the Pittsburgh sleep quality index(PSQI), and cognitive function was assessed by the mini-mental state examination(MMSE), the Montreal cognitive assessment(MoCA)and a set of neuropsychological scales.The correlation of sleep quality with cognitive function was analyzed for the three groups.Results:Differences were significant in sleep time score[0.0(1.0), 1.0(2.0) vs.1.0(1.0), F=8.18, P=0.02]and daytime function score[1.0(1.0), 1.0(1.0) vs.0.0(1.0), F=8.73, P=0.01]between mild AD, MCI and health control groups.Spearman correlation analysis suggested that scores of sleep disorders were negatively correlated with DSB( r=-0.43, P=0.02)and scores of daytime function were positively correlated with ADL( r=0.39, P=0.03)in patients with mild AD.In addition, scores of sleep quality were negatively correlated with the DSB score( r=-0.40, P=0.01), scores of sleep disorders were positively correlated with ADL( r=0.45, P<0.01), scores of daytime function were negatively correlated with DSF( r=-0.42, P=0.01), DSB( r=-0.62, P<0.01)and VFT-S( r=-0.33, P=0.04), and the total PSQI score was negatively correlated with DSF( r=-0.45, P=0.01)and DSB( r=-0.44, P=0.01)in the MCI group. Conclusions:Patients with mild AD and MCI have longer sleep time and impaired daytime function than healthy people, and sleep quality is correlated with memory, attention and daily living ability in patients with mild AD and MCI.

Spinal cord infarction is a rare type of central nervous system ischemic disease. Previous studies have mainly been based on a small number of clinical case reports and retrospective analyses. Its causes are diverse, mainly including vasogenic, systemic and iatrogenic diseases. Spinal cord infarction is mostly acute onset, and its clinical manifestation depends on the infarct location and infarct size, and is usually diagnosed based on combined MRI and other examinations. At present, there is no unified treatment plan for spinal cord infarction, and the mortality and disability are relatively higher. This article reviews the clinical characteristics of spinal cord infarction, and provides help for clinical decision making.

Objective To investigate the abnormality of cerebral laterality of the three attentional networks (alerting, orienting, executive control) in patients with bipolar depression disorder. Methods Patients with bipolar depression disorder (n=28) and healthy controls (n=40) were selected. Lateralized Attention Network Test (LANT) was used to explore the efficiency of the networks in bilateral cerebral hemisphere. Results In the response time (RT), there was a significant interaction between groups and hemispheres in orienting network (F=4.67, P=0.03). The result of post hoc test indicated that the RT in the orienting function was significantly longer in the left hemisphere than in the right in control group (t=-4.47, P＜0.05). There was no significant difference in the orienting network between the left and right hemisphere in patients with the depressive bipolar disorder. Conclusion Attention is impaired in patients with depressive bipolar disorder in which the disappearance of left hemisphere advantage of orienting network is the main manifestation of attention impairments.