Objective To investigate the application value of ultrasound measurement of optic nerve sheath diameter （ONSD） in the assessment of brain death. Methods A total of 124 subjects were enrolled and divided into brain death group with 34 patients， deep coma group with 28 patients， and healthy control group with 62 individuals， and ultrasound measurement of ONSD was performed for all three groups. A Spearman correlation analysis was used to investigate the correlation of brain death with ONSD and baseline characteristics. Univariate and multivariate Logistic regression analyses were used to identify the independent predictive value of ONSD for brain death. The receiver operating characteristic （ROC） curve was plotted to determine the optimal cut-off value of ONSD and evaluate its diagnostic efficacy. Results The Spearman correlation analysis showed a significant positive correlation between brain death and ONSD （r=0.825，P<0.001）. The multivariate Logistic regression analysis confirmed that ONSD was an independent predictive factor for brain death （odds ratio=70.874， P<0.05，Nagelkerke R²=0.739， Hosmer-Lemeshow test P=0.786）.ONSD had an area under the ROC curve （AUC） of 0.939（95%CI 88.3‒99.4） in the brain death group and the deep coma group， with an optimal cut-off value of 6.005 mm， a sensitivity of 97.1%，a specificity of 78.6%， a positive predictive value of 84.6%， and a negative predictive value of 95.7%. Conclusion Ultrasound measurement of ONSD has an important clinical application value in the assessment of brain death.

Objective To investigate the features of lesions on carotid artery ultrasound in Takayasu arteritis （TA） patients with ischemic stroke （IS） as the initial symptom. Methods A retrospective analysis was performed for the clinical data， vascular ultrasound findings， and other imaging data of six TA patients with IS as the initial symptom who were treated in The First Affiliated Hospital of China Medical University from January 2016 to December 2024， and a literature review was also performed to investigate the features of lesions on carotid artery ultrasound. Results Among the six patients， there were two male patients and four female patients， with a median age of 29 years. There were four patients with an increase in erythrocyte sedimentation rate， and magnetic resonance imaging showed three cases of single-region IS and three cases of multi-region IS， with the involvement of the basal ganglia in four patients. Computed tomography angiography showed three patients with Numano type Ⅰ disease and three patients comorbid with middle cerebral artery occlusion. Among the six patients in terms of the changes on carotid artery ultrasound， four patients had significant wall thickening of the proximal common carotid artery （CCA） and intra-luminal thrombosis and occlusion on the stroke-affected side， one patient had wall thickening of the proximal CCA without detectable thrombosis， and one patient had intra-luminal thrombosis and occlusion in the CCA without detectable wall thickening； one patient had thrombotic occlusion of the proximal internal carotid artery （ICA）， one patient had thrombotic occlusion of the distal ICA， and four patients had collateral supply from the external carotid artery to the ICA via reversed flow. The assessment of lesion activity based on carotid ultrasound showed that five patients had active lesions in the CCA on the stroke-affected side， among whom two patients underwent contrast-enhanced ultrasound （CEUS） and were found to have grade Ⅲ enhancement. Carotid artery ultrasound follow-up showed that five patients achieved alleviation of CCA wall thickening， among whom two patients had a reduction from grade Ⅲ enhancement to grade Ⅰ enhancement， while one patient experienced progression from unilateral to bilateral CCA lesions and an increase to grade Ⅲ enhancement on follow-up CEUS. Conclusion TA with IS as the initial symptom mainly occurs during the active phase of the disease and demonstrates characteristic changes on carotid artery ultrasound， and conventional vascular ultrasound and CEUS may help with disease diagnosis， activity assessment， and dynamic follow-up.

Objective The supine-to-standing transcranial Doppler（TCD） technique is suitable for evaluating cardiovascular autonomic dysfunction， and this study aims to assess its performance in predicting adverse outcomes in diabetic patients with or without orthostatic hypotension （OH）. Methods The patients with type 2 diabetes mellitus who were admitted to Department of Endocrinology and Department of Neurology in The Second Affiliated Hospital of Hainan Medical University from August 2020 to May 2023 were enrolled as subjects. Basic clinical data were collected， and supine-to-standing TCD was performed to monitor and record the changes in blood pressure， heart rate， and cerebral hemodynamics in both supine and standing positions. The patients were followed for 2-4 years to record medication， orthostatic intolerance score， and adverse events. The two-independent-samples t test was used for comparison of normally distributed continuous variables between groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous variables between groups； the chi-square test was used for comparison of categorical variables between groups. The binary logistic regression analysis was used to investigate the association between the results of supine-to-standing TCD and adverse outcomes. Results A total of 118 patients （96 male patients and 22 female patients） were enrolled， among whom there were 28 patients with OH （23.7%） and 90 patients without OH（76.3%）. During follow-up， 19 patients （16.1%） experienced adverse outcomes （including syncope， falls， and death）.TCD showed that impaired “W” wave recovery in cerebral blood flow in the standing position was an independent risk factor for adverse outcomes in diabetic patients （OR=3.536， 95% CI 1.136-11.006， P=0.029）. Conclusion Vascular reflex failure and paradoxical cerebral vasoconstriction may be the mechanisms for impaired cerebral blood flow recovery in the standing position. TCD testing has an important role in detecting cerebrovascular abnormalities and cerebral hemodynamic changes， especially in diabetic patients with OH， and it has good performance in predicting adverse outcomes.

Severe carotid artery stenosis is an independent risk factor for stroke， and carotid endarterectomy （CEA） can effectively prevent ischemic stroke by alleviating such stenosis. However， CEA carries certain risks of adverse events， including perioperative death， ischemic stroke， and hyperperfusion injury， and these adverse events not only compromise perioperative safety but also diminish the efficacy of the procedure in preventing cerebral ischemic events. A multimodal imaging-based comprehensive management mode （i.e.， preoperative assessment with carotid ultrasound， transcranial Doppler （TCD）， and CT angiography， intraoperative monitoring with TCD and cerebral oximetry， and standardized postoperative follow-up with carotid ultrasound and TCD） can significantly reduce perioperative mortality and the incidence rate of stroke and avoid hypoperfusion， hyperperfusion syndrome， and arterial restenosis or occlusion， thereby enhancing the perioperative safety of CEA.

Objective To investigate the severity of white matter lesions （WML） in patients with right-to-left shunt （RLS）-positive migraine. Methods A total of 415 patients with RLS-positive migraine who were consecutively admitted to Department of Neurology， The First Affiliated Hospital of Soochow University， from January 2022 to January 2025 were enrolled， and all these patients met the diagnostic criteria in The International Classification of Headache Disorders， 3 rd edition. RLS was diagnosed based on contrast-enhanced transcranial Doppler and contrast-enhanced transesophageal echocardiography， and the type and grade of RLS were assessed. After a series of statistical analyses was conducted， the factors with P<0.05 in the univariate logistic regression analysis were included in the multivariate binary logistic regression analysis to investigate the risk factors for the onset and severity of WML， with P<0.05 indicating statistical significance. Results The analysis of the baseline data of patients with different grades of WML showed that the grade of WML increased with age in the patients with RLS-positive migraine （P<0.05）. Comparison of multimodal ultrasound findings between the patients with different grades of WML showed that there were significant differences between the patients with different grades of WML in the factors such as large RLS， potential RLS， prolonged PFO tunnel， higher PFO at the right atrial side in resting state and after Valsalva maneuver， higher PFO at the left atrial side after Valsalva maneuver， early appearance of shunt， and longer duration of shunt （P<0.05）. For the establishment of a predictive model， large RLS shunt （P=0.037）， higher PFO at the right atrial side after Valsalva maneuver （P=0.018）， and longer duration of shunt （P<0.001） were independent risk factors for the onset of WML in patients with RLS-positive migraine， and further research showed that prolonged PFO tunnel （P<0.001） was a risk factor for the onset of moderate-to-severe WML in patients with RLS-positive migraine. Conclusion The predictive model established based on the ultrasound factors including large RLS shunt and prolonged PFO tunnel can be used as an imaging method to screen for WML， especially moderate-to-severe WML， which provides a theoretical basis for subsequent treatment.

Objective There are currently limited studies on the hemodynamics of posterior cerebral artery （PCA） compensation in patients with severe stenosis or occlusion of the internal carotid artery （ICA）， and this study aims to investigate the application value of transcranial Doppler （TCD） in assessing PCA compensation after severe stenosis or occlusion of the unilateral extracranial ICA. Methods A retrospective analysis was performed for 107 patients who were hospitalized in Encephalopathy Center， Guangdong Provincial Hospital of Traditional Chinese Medicine， from January 2022 to February 2025 and met the diagnostic criteria for severe stenosis or occlusion of the unilateral extracranial ICA， and all patients underwent both digital subtraction angiography （DSA） and TCD. The patients were divided into groups based on PCA compensation on DSA， and TCD quantitative parameters were analyzed. The receiver operating characteristic （ROC） curve was plotted to investigate the value of TCD in assessing graded compensation of the PCA. Results Among the 107 patients， there were 75 patients （70.1%） in the compensation group and 32 patients （29.9%） in the non-compensation group. The optimal cut-off value of TCD in assessing PCA compensation was a mean velocity of ≥65 cm/s at the PCA P1 segment， with an area under the ROC curve（AUC） of 0.869（95% CI 0.785‒0.953）， a sensitivity of 78.7%， a specificity of 84.4%， and a Youden index of 0.630. Compared with the non-compensation group， the compensation group had significant increases in peak systolic velocity， end-diastolic velocity， and mean velocity （P<0.01） and a significant reduction in pulsatility index （P<0.05）. As for the graded compensation of the PCA， the patients with posterior communicating artery （PCoA） compensation alone accounted for 57.3% （43/75）， those with leptomeningeal collateral compensation of the PCA alone accounted for 16.0%（12/75）， and those with both patterns of compensation accounted for 36.7% （20/75）.An end-diastolic velocity of ≥48 cm/s at the PCA P1 segment was the optimal cut-off value for assessing PCoA compensation， with an AUC of 0.813 （95%CI 0.726‒0.900）， a sensitivity of 76.2%， a specificity of 79.5%， and a Youden index of 0.557； a mean velocity of ≥60 cm/s at the PCA P2 segment was the optimal cut-off value for assessing leptomeningeal collateral compensation of the PCA， with an AUC of 0.824 （95%CI 0.723‒0.925）， a sensitivity of 71.5%， a specificity of 90.7%， and a Youden index of 0.625. Conclusion This study conducts a hemodynamic stratification analysis on compensation patterns of the PCA in patients with severe stenosis or occlusion of the unilateral extracranial ICA. Quantitative blood flow indicators at the PCA-P1 and PCA-P2 segments are highly consistent with DSA in assessing PCA compensation and can reliably evaluate the compensation status of the PCoA and the leptomeningeal collaterals.

Case-based teaching is a teaching model that integrates theoretical knowledge with clinical practice， and it is widely used in medical education and plays an important role in standardized residency training. Taking preoperative vascular ultrasound evaluation for carotid endarterectomy （CEA） as an example， this article explores the application of the case-based teaching method in cultivating clinical thinking ability among trainees receiving standardized residency training for ultrasound. Through an analysis of typical cases， trainees engage in the whole process of clinical practice under the guidance of instructors， from medical history collection and imaging interpretation to identification of key intraoperative issues. The teaching process emphasizes the characteristics of vascular ultrasound， such as the combination of vascular structure and hemodynamics， integrated cerebrovascular and cervical assessment， and precise evaluation of collateral circulation. The case-based teaching method not only deepens the understanding of diseases among trainees， but also fosters their ability to think independently and solve clinical problems， facilitating the transition from theory to practice and ensuring precise diagnosis and treatment. This article summarizes the implementation steps and effectiveness of the case-based teaching method， in order to provide a reference for ultrasound residency training.

Artificial intelligence （AI） technologies， especially machine learning algorithms， have achieved remarkable advances in medical image analysis in recent years. As a noninvasive， real-time， and cost-effective imaging modality， vascular ultrasound is one of the most active areas for the application of AI technologies in medicine. This article reviews the latest research advances in the application of AI in vascular ultrasound image recognition， automatic segmentation， diagnostic assistance， and risk prediction in 2021—2025， covering the aspects of transcranial Doppler， carotid artery， abdominal aortic aneurysms， aortic dissection， peripheral artery disease， arteriovenous fistula， venous thrombosis， and the inferior vena cava. This article highlights the key technological innovations， clinical value， and research challenges of AI within these areas.

Objective To apply bedside ultrasound for real-time monitoring of intracranial conditions in patients with severe traumatic brain injury experiencing acute encephalocele during large craniotomy， and to investigate the clinical value of intraoperative bedside ultrasound in the diagnosis and prognostic evaluation of acute encephalocele. Methods A retrospective analysis was performed for 32 adult patients with severe traumatic brain injury， and according to whether intraoperative ultrasound was performed， they were divided into ultrasound group with 17 patients and CT group with 15 patients. The two groups were compared in terms of time of operation， accuracy， mortality rate， and postoperative Glasgow Outcome Scale （GOS） score. The chi-square test was used for comparison of categorical data between groups， and the independent samples t-test was used for comparison of continuous data between groups. Results Both ultrasound and CT could provide an accurate basis for diagnosis， with no significant difference in diagnostic accuracy； however， compared with the CT group， the ultrasound group had significantly shorter time of operation and diagnostic time. Based on GOS score and grading results at 6 months after surgery， the patients undergoing ultrasound examination had a significantly better prognosis than those undergoing CT examination. Conclusion Intraoperative ultrasound for patients with severe traumatic brain injury enables rapid and accurate identification of etiology， facilitates dynamic intracranial monitoring， and shortens the time for rescue， showing an important clinical significance in improving prognosis and reducing mortality rate. Therefore， it holds promise for clinical application.

Objective We sought to investigate the clinical characteristics and echocardiographic changes of cryptogenic perforator infarction（PI） patient with patent foramen ovale（PFO）. Methods From Jan 2015 to Dec 2023， patients diagnosed with cryptogenic stroke were retrospectively included in our study. All patients received transthoracic echocardiography（TTE） and transcranial Doppler（TCD）.PFO was diagnosed by the bubble test of TCD. Comparisons of clinical features and TTE findings were performed firstly in PI patients， between PFO and non-PFO， and then in patients with PFO， between PI and cortical infarction（CI）. Results A total of 251 patients were retrospectively analyzed. PFO was detected in 104 patients，of those，40.4%（42/104） had pure PI（PFO-PI） and 59.6%（62/104） had CI（PFO-CI）. In patients without PFO，30.6%（45/147） had pure PI（non-PFO-PI）.Compared with non-PFO-PI， PFO-PI associated with a higher proportion of vertebrobasilar circulation infarctions（VCI）（47.6% vs 17.8%， P=0.003）， lower mean value of left ventricle end-diastolic diameters（LVEDd）（47.3 mm vs 49.8 mm， P=0.037） and lower peak E-wave velocity（62.6 cm/s vs 70.8 cm/s，P=0.015）.In PFO patients， PFO-PI was detected with a lower mean value of aorta root diameters（32.5 mm，P=0.011） and lower mean value of LVEDd（47.3 mm，P=0.045） than PFO-CI（34.5 mm and 49.4 mm， respectively）. Conclusion Higher proportion of VCI was found in PFO-PI. Lower LVEDd， lower Em and without aortic root dilatation were three echocardiographic features associated with PFO-PI in cryogenic PI patients.

Objective To investigate the potential pathogenic genes of ischemic stroke（IS） based on transcriptomics/bioinformatics analyses and validation， and to perfect the molecular pathogenesis of IS. Methods The peripheral whole blood gene expression microarray dataset GSE58294 for human IS was downloaded from GEO database， and R software was used to analyze the differentially expressed genes（DEGs）. The STRING program in R software was used to construct a protein-protein interaction（PPI） network and identify Hub genes. Three high-confidence machine learning algorithms（LASSO， SVM-RFE， and RF） and eQTL Mendelian randomization were used to obtain the core feature genes of IS， and box plots of differentially expressed genes， the receiver operating characteristic curve analysis， and single-gene Mendelian randomization further validated their association with IS. Finally， gene ontology （GO）/Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analyses， Gene Set Enrichment Analysis （GSEA）， and immune infiltration analysis （CIBERSORT） were performed for the core features genes of IS to explore the molecular mechanism of their association with IS. Results A total of 183 DEGs were identified by the differential expression analysis of the IS dataset， and Mendelian randomization and machine learning algorithms finally obtained and verified one key IS pathogenic gene RPL22L1. The GO/KEGG analysis showed that this gene was mainly involved in ribosomal and cytoplasmic translation， the GSEA analysis showed that it was most closely associated with AMP metabolism， cell motility， and fat metabolism， and the CIBERSORT analysis showed that RPL22L1 expression significantly inhibited infantile CD4⁺ T cell infiltration. Conclusion RPL22L1 IS a key pathogenic gene for IS， and it may promote the onset of IS by influencing cytoplasmic translation， AMP metabolism， and cellular immunity， which provides a new direction for the clinical diagnosis and treatment of IS.

Objective To investigate the association between excessive daytime sleepiness （EDS） and other non-motor symptoms （NMS） in patients with Parkinson disease （PD） using a graphical LASSO （GLASSO） network analysis， as well as the potential role of the sleepiness-olfaction-emotion axis in the onset of EDS. Methods A total of 500 PD patients who attended Xuanwu Hospital， Capital Medical University， from February 2023 to February 2024 were enrolled， and according to the Epworth Sleepiness Scale （ESS） score， they were divided into EDS group （ESS score ≥10） and non-EDS group （ESS score<10）. General clinical data were collected from all patients， and NMSS， HAMA， HAMD， PDSS， RBDQ-HK， MoCA， MMSE， and QOD-F scales were used to assess NMS. A graphical LASSO analysis was used to construct the NMS network in PD， and centrality indices were calculated to investigate the core role of EDS in the NMS network. Results The incidence rate of EDS was 7.12% in this study population. Compared with the non-EDS group， the EDS group had significantly higher HAMA， HAMD， NMSS， PDSS， and RBDQ-HK scores （P<0.05）. The network analysis showed that NMSS had the highest centrality （strength=0.906） in the non-EDS group， serving as the core node of the NMS network. However， in the EDS group， there was a significant increase in the centrality of olfactory function （strength=0.930）， replacing NMSS as the core of the network， and there was also an increase in the influence of RBDQ-HK （strength=0.318）. Conclusion EDS is closely associated with multiple NMS in PD patients， and the state of somnolence may alter the structure of the NMS network. Further studies can be conducted to investigate the role of the sleepiness-olfaction-emotion axis in the development of EDS.

Objective To investigate the changes in the serum levels of visinin-like protein 1 （VILIP-1） and fibrinogen-like protein 2（FGL2） and their correlation with the degree of neurological deficits and prognosis in patients with acute cerebral hemorrhage. Methods A total of 121 patients with acute cerebral hemorrhage who received treatment in our hospital were enrolled as observation group， and 121 individuals who underwent physical examination during the same period of time were enrolled as control group. The serum levels of VILIP-1 and FGL2 were measured， and their correlation with the degree of neurological deficits was analyzed； a logistic regression analysis was used to investigate the influencing factors for poor prognosis in patients with acute cerebral hemorrhage；the value of the serum levels of VILIP-1 and FGL2 in predicting the prognosis of patients with acute cerebral hemorrhage was analyzed. Results The observation group had significantly higher serum levels of VILIP-1 and FGL2 than the control group（P<0.05），and the serum levels of VILIP-1 and FGL2 were positively correlated with the neurological function of patients（P<0.05）.Compared with the good prognosis group， the poor prognosis group had significantly higher proportion of patients with hyperglycemia， serum levels of VILIP-1 and FGL2， and NHISS score （P<0.05）. Serum VILIP-1 and FGL2 were independent risk factors for poor prognosis in patients with acute cerebral hemorrhage （P<0.05），and the combination of serum VILIP-1 and FGL2 had a higher predictive value than each indicator alone （P<0.05）. Conclusion There are increases in the serum levels of VILIP-1 and FGL2 in patients with acute cerebral hemorrhage， which are positively correlated with neurological function and are risk factors for poor prognosis in patients with acute cerebral hemorrhage， and the combination of the two indicators has a higher predictive value for the prognosis of patients with acute cerebral hemorrhage.

Objective There are complex pathophysiological changes in each component of cerebral tissue after cerebral ischemia-reperfusion injury，and routine neuroprotective strategies fail to exert an effective therapeutic effect in clinical practice. However， the proposal of neurovascular unit（NVU） provides a new conceptual framework for a more comprehensive understanding of the pathophysiological process for interactions between each component of cerebral tissue after cerebral ischemia-reperfusion injury， laying a theoretical foundation for investigating new targets for clinical treatment. Methods A novel NVU in vitro model was established in Transwell co-culture plate using the neurons， astrocytes， and brain microvascular endothelial cells （BMECs） derived from the cortex of Sprague-Dawley rats， and MTT assay was used to measure cell viability in the modified and classical NVU models after OGD/R injury for 1 hour. Results An in vitro NVU model with the three-layer structure of neurons， astrocytes， and BMECs from the top to the bottom was successfully established using Transwell co-culture plate. After OGD/R injury for 1 hour， the neurons in the modified in vitro NVU model showed a significantly higher viability than those in the classical NVU model （P<0.05）， while there were no significant differences in the viability of astrocytes and BMECs between the two models （P>0.05）. Conclusion The modified in vitro NVU model is more suitable for the research on ischemic cerebrovascular disease.

Neurosyphilis （NS） is a group of diseases with a series of nervous system symptoms when Treponema pallidum infects the central nervous system， with an unknown pathogenesis and significant heterogeneity in clinical manifestations. It is called the “universal imitator”， leading to a high misdiagnosis rate in clinical practice. Cognitive impairment is one of the most common clinical manifestations of NS， but delayed diagnosis may cause irreversible neuronal damage. Therefore， early identification of NS with the main manifestation of mild cognitive impairment is of great importance for achieving a good prognosis of patients. This article reports a case of NS with the main manifestation of mild cognitive impairment and reviews its clinical features， in order to improve the understanding of this disease among clinicians.

This article reports a case of autoimmune glial fibrillary acidic protein astrocytopathy （GFAP-A） with the initial symptoms of intermittent headache for 1 year and slow response for 6 months. Head magnetic resonance combined with artificial intelligence brain segmentation software was used to measure the volume of each brain region， and the results showed that brain atrophy involved multiple functional areas of the brain， with a volume of brain parenchymal area lower than the normal reference level. Magnetic resonance images taken 60 days apart showed significant progression of hippocampal atrophy. Head magnetic resonance combined with artificial intelligence brain segmentation software can provide precise segmentation and quantitative measurement of brain regions， and the results show progressive aggravation of the reduction in brain volume in GFAP-A.

Disorders of consciousness（DoC） refer to the state of loss of consciousness caused by various severe brain injuries， and there is still a lack of widely recognized effective treatment methods for DoC at present. As a promising neuromodulation technique， vagus nerve stimulation（VNS） has shown significant potential in promoting the recovery of consciousness through various mechanisms such as the modulation of key neural network activities. This review systematically elaborates on the potential mechanism of VNS in the treatment of DoC and comprehensively evaluate the evidence for its clinical efficacy. At first， this article introduces the technical principles of VNS and the clinical classification of DoC， and then it delves into the mechanisms by which VNS promotes the recovery of consciousness， including modulation of neural networks， activation of the ascending reticular activating system， regulation of neurotransmitter balance， suppression of inflammatory responses， and enhancement of neuroplasticity.Finally， it systematically reviews existing clinical studies， including those on invasive VNS and transcutaneous auricular vagus nerve stimulation （taVNS）， and discusses the limitations of current research and the directions for future development. This review shows that VNS， especially noninvasive taVNS， is expected to become a new therapeutic strategy for DoC， although large-scale randomized controlled trials are needed to validate its clinical efficacy.

Through a systematic review of the articles on the association between mitochondrial function and sleep disorders in recent years， this article discusses the central role and pathological mechanisms of mitochondrial dysfunction in the pathogenesis and development of various sleep disorders. Mitochondrial dysfunction participates in the pathological processes of sleep disorders through various mechanisms： intermittent hypoxia in obstructive sleep apnea leads to excessive production of reactive oxygen species （ROS）， oxidative stress， and mitochondrial damage， thereby affecting energy metabolism and neurological function； abnormalities in dopamine synthesis and iron metabolism in restless legs syndrome/periodic limb movement disorder are closely associated with insufficient mitochondrial ATP production； sleep disturbances associated with neurodegenerative diseases （e.g.， Alzheimer disease） often involve significant mitochondrial functional defects and form a vicious cycle with circadian rhythm disruption； the core mechanisms of persistent fatigue and sleep disturbances in chronic fatigue syndrome involve inadequate mitochondrial ATP generation， the increase in oxidative stress， and imbalance in neurotransmitters； mitochondria help maintain the stability of circadian rhythm through energy supply， ROS regulation， and metabolic pathways，and mitochondrial dysfunction can disrupt the biological clock； sleep deprivation itself can impair mitochondrial function，leading to abnormal energy metabolism， oxidative stress， DNA damage， and neuroinflammation；neuroinflammation and mitochondrial dysfunction form a bidirectional vicious cycle in neurodegenerative sleep disorders.Mitochondrial dysfunction involves the key pathological links such as impaired energy metabolism， oxidative stress，neuroinflammation， and circadian rhythm dysregulation in the development and progression of various sleep disorders.Targeted protection of mitochondrial function and alleviation of oxidative stress and neuroinflammation are expected to become new strategies for improving various sleep disorders and delaying disease progression.