Objective To investigate the surface electromyography （sEMG） characteristics of drug-induced tremor， and to identify electrophysiological biomarkers for differentiating it from tremor caused by Parkinson disease （PD）. Methods A total of 50 patients with drug-induced tremor and 71 patients with PD were enrolled. The sEMG signals from bilateral radial wrist extensors and flexors，along with accelerometer signals， were recorded under resting and postural conditions.Tremor frequency，amplitude，contraction pattern，and harmonic resonance were analyzed. Results The patients in the drug-induced tremor group exhibited symmetrical bilateral tremor， with a higher proportion of patients with mandibular tremor compared with the PD group（70% vs 42.25%，χ²=9.09，P=0.003）.Compared with the PD group， the drug-induced tremor group had a significantly higher tremor frequency under both resting and postural conditions[（6.43±0.41）Hz/（6.57±0.33）Hz vs （4.68±0.27）Hz，F=620.64，P<0.001]， while there was no significant difference in tremor amplitude. Compared with the PD group， the drug-induced tremor group had a significantly lower proportion of patients with alternating contraction pattern under both resting （χ²=23.20，P<0.001） and postural（χ²=27.52，P<0.001） conditions， as well as a significantly lower proportion of patients with harmonic resonance under both resting（χ²=26.64，P<0.001） and postural（χ²=22.32，P<0.001） conditions. Conclusion Drug-induced tremor has the following electrophysiological features：bilateral symmetry，a higher prevalence rate of mandibular tremor， a higher tremor frequency，and a lower proportion of patients with alternating contraction pattern and harmonic resonance， which can provide objective evidence for differentiating drug-induced tremor from PD in clinical practice.

Objective To compare the differences in non-motor symptoms between the patients with Parkinson disease （PD） carrying LRRK2 G2385R mutation and those without such mutation， and to identify key clinical features. Methods The patients who were consecutively admitted to Xuanwu Hospital， Capital Medical University， from January to November 2025 and were diagnosed with PD were enrolled. According to the results of genetic testing， the patients were divided into carrier group and non-carrier group， and other known pathogenic mutations were excluded. Demographic data and the results of multiple clinical scales were collected， including UPDRS-Ⅲ，NMSS，MMSE，MoCA，HAMA，HAMD， RBDQ-HK， and olfactory questionnaire. Traditional statistical methods and Elastic Net regression were used for comparison between the two groups. Results A total of 292 PD patients were enrolled，among whom there were 27 carriers and 265 non-carriers， and there were no significant differences between the two groups in sex， age of onset， disease duration， and motor symptoms （all P>0.05）. The univariate analysis showed that the carrier group had a significantly lower RBDQ-HK score than the non-carrier group （P<0.05）. The Elastic Net analysis further revealed that RBD symptoms， olfactory function， and overall non-motor symptom burden were negatively correlated with the carrier status， while anxiety score was positively correlated with the carrier status，suggesting a relatively milder burden of non-motor symptoms in carriers. Conclusion There are no significant differences in motor symptoms between LRRK2 G2385R carriers and non-carriers， but LRRK2 G2385R carriers have a distinctive non-motor symptom phenotype， especially milder RBD symptoms.The multivariate analysis suggests that the carrier status may be associated with a lower burden of non-motor symptoms， which may help to deepen the understanding of clinical heterogeneity in genetic subtypes of PD and provide a reference for individualized assessment.

Objective To investigate the feasibility and efficacy of bilateral globus pallidus internus deep brain stimulation （GPi-DBS） as a rescue treatment strategy after failed subthalamic nucleus deep brain stimulation （STN-DBS） in the management of Parkinson disease （PD）. Methods A retrospective analysis was conducted on two patients who had undergone STN-DBS treatment at another hospital for Parkinson’s disease （PD） but showed poor therapeutic response. After evaluation at the Central Hospital affiliated with Shandong First Medical University confirmed that efficacy could not be restored through parameter optimization or medication adjustment， both patients underwent a procedure to retain their original STN-DBS system and implant bilateral GPi-DBS systems. Following the deactivation of the STN-DBS， surgical outcomes were assessed by comparing preoperative and postoperative Unified Parkinson's Disease Rating Scale Part Ⅲ（UPDRS-Ⅲ） scores under conditions of active GPi-DBS， as well as during "on" and "off" medication periods. Results Both patients successfully retained their original STN-DBS systems and underwent uneventful implantation of bilateral GPi-DBS systems， without complications such as bleeding or infection. Six months postoperatively， Patient 1 showed a UPDRS-Ⅲ improvement rate of 61.21% during the "on" medication phase and 68.92% during the "off" medication phase with GPi-DBS activated. Patient 2 demonstrated an improvement rate of 55.81% during the "on" medication phase and 59.34% during the "off" medication phase under GPi-DBS activation. Both patients exhibited significant improvements in dyskinesia， speech， and balance. Conclusion Retaining the original STN system with simultaneous bilateral GPi-DBS reimplantation may be a safe and effective rescue treatment strategy for PD patients who experience a decline in efficacy or severe complications following STN-DBS surgery that cannot be improved by optimizing medication or programming parameters.

Rigidity is a core motor symptom of Parkinson disease（PD），characterized by uniformly increased resistance during passive muscle stretching. It can be classified into two types：lead-pipe rigidity and cogwheel rigidity. This review systematically summarizes the pathophysiological mechanisms underlying rigidity in PD，including enhanced long-latency stretch reflexes， the combined effects of shortening reaction and stretch-induced inhibition，functional abnormalities in brainstem and cortico-basal ganglia-cerebellar circuit， and alterations in muscle biomechanical properties.This review also summarizes recent advances in objective assessment methods such as electromyography，ultrasound elastography， servo motors， and inertial sensors.Studies indicate that rigidity in PD results from the interaction between abnormal neural regulation and changes in muscle biomechanical properties，with assessment methods evolving from subjective clinical scoring toward multimodal objective quantification.A deeper understanding of the mechanisms and assessment methods of rigidity is crucial for the diagnosis and treatment of PD.

The pathological mechanism of neurogenic orthostatic hypotension （nOH） in Parkinson disease （PD） is shifting from peripheral sympathetic denervation to central network dysfunction. This article explores the core role of locus coeruleus （LC） degeneration and abnormalities in the central autonomic network （CAN） and the somato-cognitive action network （SCAN） in the pathogenesis of nOH. A current research challenge lies in determining whether network hyperconnectivity is physiological compensation or a pathological marker， with a lack of longitudinal multimodal imaging data. Based on the novel understanding of CAN/SCAN impairment， the treatment of PD with nOH is transitioning towards precise neuromodulation paradigms， including SCAN-targeted cortical stimulation， epidural spinal cord stimulation， and closed-loop neuromodulation， which provides new perspectives for individualized management in clinical practice.

Parkinson disease （PD） is a degenerative disease of the nervous system with the main pathological change of nigral-striatal dopaminergic pathway degeneration， mainly manifesting as motor dysfunction. However， in recent years， more and more studies have started to investigate the non-motor symptoms of PD， among which impulse control disorders （ICD）， as one of the most common non-motor symptoms of PD， seriously affects the quality of life of patients. ICD has complex pathogenesis and risk factors， which remain unclear at present. With the development of imaging technology， neuroimaging techniques can help to evaluate the brain structure and function of PD-ICD patients， thereby helping to explore the pathogenesis of ICD and assist in its diagnosis and treatment. Therefore， this article reviews the advances in neuroimaging studies of ICD in PD.

Parkinson disease is a degenerative disorder of the central nervous system characterized by progressive loss of dopaminergic neurons in the midbrain substantia nigra. Pain is one of the most common non-motor symptoms of Parkinson disease， and its pathogenesis remains unclear at present. Structural damage to the substantia nigra may contribute to the development and progression of pain symptoms in such patients. This article reviews the physiological significance of the substantia nigra and summarizes the research advances in its role in mediating the pathogenesis of pain in Parkinson disease.

Parkinson disease （PD） is one of the most common neurodegenerative diseases all over the world， and its prevalence rate is constantly increasing， which brings a huge physical and psychological burden to patients， as well as a heavy care and economic burden to their families. Cognitive impairment， as one of the common non-motor symptoms in PD， has attracted more and more attention in recent years due to the difficulty in early identification， rapid clinical progression， unsatisfactory treatment efficacy， and poor prognosis. At present， the research on PD-associated cognitive impairment is gradually deepening， from pathophysiological mechanism to clinical manifestations and how to achieve early effective diagnosis and treatment， so as to minimize the pain of patients， especially elderly patients and their families. This article discusses the pathogenesis， clinical manifestations， and treatment methods of cognitive impairment in PD at present， in order to better review the current research advances and provide more ideas for future research directions.

Objective To investigate the current status of the diagnosis and treatment of insomnia and the clinical use of related drugs in primary medical institutions in Beijing， China through a survey. Methods A questionnaire survey and face-to-face interviews were used to conduct a stratified random sampling survey in primary medical institutions in 16 districts of Beijing. Results The primary medical institutions in Beijing played an important role in the long-term management of insomnia patients， and integrated traditional Chinese and Western medicine therapy is the main treatment paradigm for insomnia. The three most frequently used sedative-hypnotic drugs are estazolam， zolpidem tartrate. At present， there are still several issues in primary medical institutions， including a lack of training on sleep medicine and strict restrictions on the types of sedative-hypnotic drugs. Conclusion Primary medical institutions in Beijing play a significant role in the long-term management of insomnia patients. However， due to a lack of standardized and systematic training on sleep medicine and the limited types and quantities of sedative-hypnotic drugs， there are still difficulties in the standardized diagnosis and treatment of insomnia， as well as the presence of non-standardized use of sedative-hypnotic drugs.

Hypersomnias of central origin are defined as the inability to maintain wakefulness and alertness during the major waking episodes of the day， with the manifestation of irrepressible drowsiness or even unprovoked sleep attacks. This spectrum of disorders mainly includes narcolepsy type 1， narcolepsy type 2， idiopathic hypersomnia， and Kleine-Levin syndrome. Currently， the clinical diagnosis of hypersomnias of central origin mainly depends on subjective medical history， sleepiness scales， and electrophysiological assessments， and these conventional diagnostic methods are easily affected by confounding factors. A reduction in the level of hypocretin-1 in cerebrospinal fluid （CSF） is the gold standard for the diagnosis of narcolepsy type 1， while there is still a lack of specific and Objective laboratory markers for the other subtypes， resulting in the high rates of diagnostic delay and misdiagnosis. As Objective and quantifiable indicators for pathophysiological processes， biomarkers have an important clinical value in the early screening， precise phenotyping， and longitudinal monitoring of hypersomnias of central origin， as well as in the development of targeted therapies for this group of sleep disorders. This article systematically reviews the research advances in biomarkers associated with hypersomnias of central origin from the five dimensions of polysomnography and daytime functional assessment， peripheral serology， cerebrospinal fluid， neuroimaging， and autonomic nervous function， in order to provide a theoretical framework and evidence-based support for constructing a precise diagnosis and treatment system for these disorders.

Objective To investigate the characteristics of executive function impairment in patients with chronic insomnia disorder and its correlation with Objective sleep structure parameters. Methods A total of 92 patients who met the DSM-5 diagnostic criteria for chronic insomnia disorder were enrolled as chronic insomnia disorder group， and 45 healthy controls were enrolled as healthy control group. All subjects underwent assessments for anxiety and depression， overnight polysomnography， and executive function， and the two groups were compared in terms of sleep parameters （including sleep latency， sleep efficiency， total sleep time， sleep stages， and the proportion of each stage） and executive function （Stroop Color-Word Test， digit span test， and trail making test）， as well as the correlation between these parameters. Results Compared with the healthy control group， the chronic insomnia disorder group had significant increases in Stroop Card C completion time， Stroop interference effect， trail making test-B completion time， and trail making test B-A time difference and significant reductions in the score of digit span backward task and the total score of digit span test （P<0.05）. The correlation analysis showed that total sleep time， sleep efficiency， NREM stage 3 duration， and the proportion of NREM stage 3 were negatively correlated with Stroop Card C completion time， Stroop interference effect， trail making test-B completion time， and trail making test B-A time difference and were positively correlated with the score of digit span backward task and the total score of digit span test （P<0.05）. Conversely， NREM stage 1 duration and the proportion of NREM stage 1 were positively correlated with Stroop Card C completion time， Stroop interference effect， trail making test-B completion time， and trail making test B-A time difference and were negatively correlated with the score of digit span backward task （P<0.05）. Conclusion Patients with chronic insomnia disorder exhibit executive function impairment in multiple dimensions including inhibitory control， working memory， and cognitive flexibility， which are associated with the reductions in sleep efficiency and deep sleep.

Sleep fragmentation， characterized by disrupted nocturnal sleep，is a core manifestation of chronic insomnia and exhibits a close and complex bidirectional relationship with Alzheimer disease （AD）. On the one hand， sleep fragmentation impairs glymphatic system function， reducing the clearance efficiency of toxic metabolites such as amyloid-beta （Aβ） and tau proteins in the brain interstitial fluid， thereby acting as a promoting factor for AD. Concurrently， sleep disturbances directly dysregulate pathogenic protein dynamics，and chronic sleep deprivation exacerbates neuroinflammation and oxidative stress， worsening the AD pathological environment.On the other hand， inherent AD pathological changes further aggravate sleep fragmentation. Damage to brain regions associated with AD leads to circadian rhythm disruption and reduced non-rapid eye movement （NREM） sleep.Additionally，imbalances in neurotransmitters such as orexin and melatonin during AD progression contribute to the disintegration of the sleep-wake cycle. This review aims to explore the mutual interactions between sleep fragmentation and AD， identify current research gaps， and provide new directions for future studies.

Objective To investigate the association between sleep behaviors （including bedtime， sleep quality， and nap duration） and academic performance among college students， as well as the regulatory effect of test anxiety and exercise habit on the association between sleep and academic performance. Methods A questionnaire survey was conducted to collect data. The grade of compulsory courses （with higher grades indicating better academic performance） was used as an ordinal dependent variable. All independent variables were coded by levels： for bedtime during exam and non-exam periods， higher levels indicated later bedtimes； for anxiety during the exam period， higher levels indicated more severe anxiety； for sleep quality during both exam and non-exam periods， higher levels indicated better sleep quality； for nap duration， higher levels indicated longer naps. Exercise habit was treated as a binary variable （yes/no）. Ordinal logistic regression （proportional odds model） was used for multivariable analysis， and OR and 95%CIwere calculated. In addition， sex-stratified models were established to investigate sex differences in the associations between these factors and academic performance. Results A total of 1 221 college students were included， among whom male students accounted for 33.7%. After controlling for confounding factors， bedtime during the exam period was significantly positively associated with the grade of compulsory courses， indicating that later bedtime was associated with a greater likelihood of achieving a higher grade （OR=1.32，95%CI 1.08‒1.62， P=0.007）. Sex was also an independent predictive factor， and the OR of achieving a higher grade in female students was 2.4 times that in male students （OR=2.41， 95%CI 1.90‒3.06， P<0.001）. Sleep quality during the exam period （OR=1.18，95%CI 0.99‒1.42， P=0.070） and exercise habit （OR=1.24， 95%CI 0.99‒1.55， P=0.064） showed marginally significant associations with grade. In contrast， bedtime during the non-exam period， nap duration， anxiety during the exam period， and self-rated sleep quality during the non-exam period showed no statistical significance （all P>0.05）. Sex-stratified analysis showed that among the male students， later bedtime during the exam period was associated with a greater likelihood of achieving a higher grade （OR=1.48， 95%CI 1.05‒2.09， P=0.025）， whereas higher anxiety during the exam period was associated with a lower likelihood （OR=0.79，95%CI 0.63‒0.98， P=0.032）； among the female students， better sleep quality during the exam period was associated with a greater likelihood of achieving a higher grade （OR=1.27， 95%CI 1.02‒1.57， P=0.033）， and bedtime during the exam period showed a positive association with academic performance， but without statistical significance （OR=1.25，95%CI 0.96‒1.62，P=0.091）. Conclusion The association between sleep behaviors and academic performance among college students varies with academic period and sex. Later bedtime during the exam period is associated with better academic performance， but this effect is observed only among male students. In addition， the academic performance of male students is negatively affected by test anxiety， whereas the academic performance of female students is positively associated with subjective sleep quality. Future interventions aimed at improving academic health should consider sex-specific strategies.

Objective To investigate the serum markers for rapid eye movement sleep behavior disorder （RBD） in patients with Parkinson disease （PD） and their predictive value. Methods A total of 132 PD patients who were admitted to Fuxing Hospital， Capital Medical University， from January 2020 to December 2023 were enrolled as subjects， and according to the presence or absence of RBD， they were divided into RBD group with 47 patients and non-RBD group with 85 patients. The two groups were compared in terms of general information and the serum levels of neurofilaments （NFL）， glial fibrillary acidic protein （GFAP）， lipoprotein-associated phospholipase A2 （Lp-PLA2）， neurotrophic factor-3 （NT-3）， and homocysteine （Hcy）.Univariate and multivariate logistic regression analyses were used to investigate independent risk factors for RBD in PD patients， and the receiver operating characteristic （ROC） curve was used to assess their predictive value. Results Compared with the non-RBD group， the RBD group had significantly higher serum levels of NFL， GFAP，Lp-PLA2，and Hcy（P<0.05） and a significantly lower serum level of NT-3（P<0.05）. Serum GFAP （95%CI 0.387‒0.847，P=0.005）， Lp-PLA2（95%CI 0.859‒0.947，P=0.005）， NT-3（95%CI 1.033‒1.180，P=0.003），and Hcy （95%CI 0.259‒0.655，P<0.001） were significant risk factors for RBD in PD patients. The ROC curve analysis showed that GFAP （AUC=0.767），Lp-PLA2 （AUC=0.845）， NT-3 （AUC=0.829）， and Hcy （AUC=0.888） used alone had a good predictive ability， while the combined model of these four indicators had the strongest predictive ability （AUC=0.982）， followed by Lp-PLA2+Hcy （AUC=0.944） and GFAP+Hcy （AUC=0.928）. Conclusion Serum GFAP， Lp-PLA2， NT-3， and Hcy are significant risk factors for RBD in PD patients and have a good predictive value. The combined model of these four indicators has the strongest predictive ability， suggesting that combined measurement of these indicators can be used for early warning of the risk of RBD in PD patients.

Objective Rapid eye movement sleep behavior disorder（RBD） is a common sleep disorder in the elderly， and this study aims to investigate the activity of cerebral cortex based on the changes in electroencephalography （EEG） power spectrum and the difference in approximate entropy during the ictal period of RBD. Methods A total of 35 patients with idiopathic RBD who received video polysomnography monitoring were enrolled as RBD group， and 25 normal volunteers matched for age were enrolled as control group.REM EEG results with fewer artifacts was selected for both groups， and the RBD group had an increase in mandibular electromyographic activity or dream-enacting behaviors. The leads containing artifacts were excluded， and finally O1 （or O2 alternative） leads with relatively little interference were selected. After pretreatment， Fourier transform was performed for EEG data from both groups to calculate the absolute power and relative power ratio of EEG in five different frequency bands， i.e.， δ （0.5-3 Hz）， θ （4-7 Hz）， α （8-13 Hz）， β （14-30 Hz）， and γ （30-35 Hz）. The normal distribution of power values in each frequency band was tested for both groups， and the t-test was used for comparison. Approximate entropy was calculated for EEG in both two groups， and the t-test was used for comparison. Results The θ band was the dominant frequency band of REM EEG in both the control group and the RBD group. Compared with the control group， the RBD group had a significant increase in the absolute power of fast-wave activity on REM α band and significant reductions in δ/α and θ/α relative power ratios. There was a significant difference in EEG ApEn value between the control group and the RBD group （P<0.05）， and the RBD group had a higher ApEn value during REM sleep than the NC group， with a significant difference in EEG ApEn value during the phase of dream-enacting behaviors. Conclusion In the RBD group， there are significant increases in the absolute power and nonlinear approximate entropy of fast-wave activity on REM α band during the ictal period of REM， which reflects the hyperactive functional changes of cerebral cortex during the ictal period of RBD， and the involvement of cerebral cortex in RBD neural pathway disorders is an important supplement to the current theory. Moderate inhibition of cerebral cortex hyperactivity is of great significance for the treatment of RBD.

Objective To investigate the association of baseline cerebral blood flow （CBF） and cerebral metabolic rate of oxygen （CMRO₂） with sleep structure disorder after thrombolytic therapy in stroke patients， as well as their value in clinical assessment. Methods A total of 145 patients with stroke were enrolled as subjects， and all of them received thrombolytic therapy in our hospital from January 2023 to June 2025. Before thrombolytic therapy， 3.0 T magnetic resonance imaging was used to obtain relative CBF （rCBF） and relative CMRO₂ （rCMRO₂）， and rCBF/rCMRO₂ ratio was calculated. At week 1 after thrombolysis， overnight polysomnography （PSG） was conducted to obtain parameters such as total sleep time， sleep efficiency， the proportion of each NREM stage， and REM sleep duration. According to the presence or absence of sleep structure disorder， the subjects were divided into disorder group and non-disorder group. The Pearson correlation method was used for correlation analysis. A multivariate logistic regression analysis was used to identify the influencing factors for sleep structure disorder in subjects after thrombolytic therapy. The receiver operating characteristic （ROC） curve was plotted to analyze the performance of rCBF/rCMRO₂ ratio in predicting sleep structure disorder in subjects after thrombolytic therapy. Results Compared with the non-disorder group， the disorder group had significantly higher age， infarct volume， NIHSS score on admission， and proportion of patients with infarction in the thalamus （P<0.05）. Compared with the non-disorder group， the disorder group had significantly lower rCBF， rCMRO₂， rCBF/rCMRO₂ ratio， total sleep time， proportion of NREM 3 sleep， proportion of REM sleep， and sleep efficiency （P<0.05） and significantly higher proportion of NREM 1 sleep and sleep arousal index （P<0.05）. The Pearson correlation analysis showed that rCBF， rCMRO₂， and rCBF/rCMRO₂ ratio were positively correlated with total sleep time， proportion of NREM 3 sleep， proportion of REM sleep， and sleep efficiency （P<0.001） and were negatively correlated with the proportion of NREM 1 sleep and sleep arousal index （P<0.001）. The Logistic regression analysis showed that age， infarct volume， infarction location （thalamus）， and NIHSS score on admission were risk factors for sleep structure disorder in stroke patients after thrombolytic therapy （P<0.05）， while rCBF， rCMRO₂， and rCBF/rCMRO₂ ratio were protective factors against sleep structure disorder （P<0.05）. The ROC curve analysis showed that rCBF/rCMRO₂ ratio had an area under the ROC curve of 0.901 （95% CI 0.869-0.938） in predicting sleep structure disorder in stroke patients after thrombolytic therapy， with a sensitivity of 95.50% and a specificity of 82.40%. Conclusion Baseline rCBF， rCMRO₂， and rCBF/rCMRO₂ ratio are closely associated with sleep structure disorder in stroke patients after thrombolytic therapy， among which rCBF/rCMRO₂ ratio has excellent performance in predicting sleep structure disorder and can be used as a sensitive indicator for clinical assessment of high-risk patients.

Objective To investigate the influence of sleep disorders after stroke on the risk of recurrence of cerebrovascular events based on propensity score matching （PSM）. Methods A retrospective analysis was performed for the clinical data of 173 stroke patients who were admitted to our hospital from March 2021 to October 2023， and according to the presence or absence of sleep disorders， they were divided into sleep disorders group with 88 patients and non-sleep disorders group with 85 patients.The two groups of patients were matched by PSM at a ratio of 1∶1 based on the baseline data of sex， age， body mass index（BMI）， and smoking and drinking history， and the recurrence of cerebrovascular events was compared between the two groups before and after matching. The Cox regression model was used to investigate the influence of sleep disorders after stroke on the risk of recurrence of cerebrovascular events after matching. Results A total of 69 cases were successfully matched by PSM. After matching， there were no significant differences between the two groups in sex， age， BMI， drinking history，smoking history， past medical history， stroke type， diastolic blood pressure， systolic blood pressure，National Institutes of Health Stroke Scale score， triglyceride， total cholesterol， low-density lipoprotein cholesterol， high-density lipoprotein cholesterol， fasting blood glucose， glycosylated hemoglobin， C-reactive protein， homocysteine， anxiety， and depression（P>0.05）.Compared with the non-sleep disorders group， the sleep disorders group had a significantly higher incidence rate of transient ischemic attack and a significantly higher overall incidence rate of cerebrovascular events before and after matching （P<0.05）.After matching，the Cox regression model analysis showed that sleep disorders after stroke was an independent risk factor for recurrence of cerebrovascular events（P<0.05）. Conclusion After PSM of the baseline data of stroke patients，sleep disorder after stroke is an independent risk factor for recurrence of cerebrovascular events.

Objective To investigate the risk factors for abnormal cardiac function in patients with hepatolenticular degeneration （also known as Wilson disease ，WD） using cardiac magnetic resonance imaging （CMR）， and to identify indicators with a value for early diagnosis. Methods Patients diagnosed with WD were randomly selected to undergo CMR examination， and based on CMR findings， they were divided into abnormal group and normal group. A univariate analysis was used to obtain potential risk factors， then a multivariate logistic regression analysis was performed for variables with a significant difference， and finally the receiver operating characteristic （ROC） curve analysis was performed for the independent risk factors identified. Results A total of 42 WD patients were enrolled， with 21 in the abnormal CMR group and 21 in the normal CMR group. Compared with the normal CMR group， the abnormal CMR group had a significantly higher age and significantly higher levels of total bilirubin， serum copper， and peak 24-hour urinary copper during treatment. The multivariate Logistic regression analysis showed that white blood cell count （WBC） （OR=2.927， 95%CI 1.127‒7.839， P=0.028）， serum copper（OR=3.822， 95%CI 1.108‒13.178， P=0.034）， and type Ⅳ collagen （OR=1.097， 95%CI 1.011‒1.191，P=0.027） were independent risk factors for CMR abnormalities in WD patients. The ROC curve analysis showed that among the above three indicators used alone， serum copper had the highest diagnostic value with an area under the ROC curve （AUC） of 0.713， followed by WBC（AUC=0.651） and type Ⅳ collagen （AUC=0.644）， and the combination of these three indicators had significantly higher diagnostic efficacy （AUC=0.869）. Conclusion Serum copper is the single indicator with the highest diagnostic efficacy for CMR abnormalities in WD patients， but the combination of serum copper， WBC， and type Ⅳ collagen has a significantly better diagnostic value in identifying abnormal cardiac function in WD patients.

Objective To quantitatively analyze the volumetric characteristics of each subregion of the basal ganglia in patients with hepatolenticular degeneration （also known as Wilson disease ，WD） using brain magnetic resonance imaging （MRI） and brain segmentation technology， to explore the specific imaging findings of choreiform symptoms， and to assess the clinical value of caudate nucleus atrophy as an imaging indicator for this symptom. Methods A retrospective analysis was performed for 40 WD patients with choreiform symptoms and 40 patients without choreiform symptoms from June 2023 to June 2025， and clinical indicators were compared between the two groups. In addition， the two groups were compared in terms of the volume of the basal ganglia after estimated total intracranial volume （eTIV） correction， and the correlation between the volume of differential brain regions and the chorea subscale score of Unified Wilson's Disease Rating Scale （UWDRS） was explored. Results There were no significant differences in baseline data between the two groups. UWDRS scores showed that the choreiform group had a higher neurological function score （P=0.005）， a significantly higher chorea subscale score （P<0.01）， and a lower hepatic function score （P<0.01）. The choreiform group had a significantly smaller caudate nucleus volume than the non-choreiform group （P<0.001）， suggesting severe subregional atrophy， and in contrast， the choreiform group had a significant increase in thalamus volume （P=0.002）. Caudate nucleus volume ratio was significantly negatively correlated with chorea subscale score in the choreiform group （P<0.001）. Conclusion Caudate nucleus atrophy is a specific imaging finding of choreiform symptoms in WD patients， and a quantitative analysis of caudate nucleus volume is expected to become an objective imaging indicator for assessing the severity of choreiform symptoms and monitoring disease progression in WD.

Objective To investigate the cranial magnetic resonance imaging （MRI） features of patients with hepatolenticular degeneration （also known as Wilson disease，WD） and epilepsy， and to identify the neuroimaging risk factors for seizures in WD patients. Methods A total of 69 WD patients with epilepsy who were hospitalized in Affiliated Hospital of Neurology Institute， Anhui University of Chinese Medicine， from January 2018 to November 2025 were enrolled as study group， while 80 WD patients without seizures， matched for sex and age， during the same period of time were randomly selected as control group. Cranial MRI findings were compared between the two groups. Results There were 69 WD patients （43 male patients and 26 female patients） in the study group， with a mean age of （29.46±8.58） years at the time of attending the hospital， and all these patients had abnormal electroencephalogram （EEG） findings. There were no significant differences between the two groups in age of onset，disease duration， WD subtype， and serum copper. Cranial MRI showed that the putamen was the most common site of brain injury （47 patients， 68.1%）， followed by the frontal lobe （40 patients，58.0%） and the parietal lobe （31 patients，44.9%）， and there was a significantly higher probability of epilepsy in patients with abnormal lesions in the frontal， temporal， or parietal lobes （P<0.05）. Conclusion While the putamen is the most common site of brain injury in WD patients with epilepsy， frontal or temporal lobe injuries are neuroimaging risk factors for seizures in such patients.