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To examine prefrontal hemodynamic changes in patients with post-stroke anxiety (PSA), both at rest and during cognitive task engagement, with the aim of elucidating the underlying neural mechanisms of PSA and identifying potential neural correlates for clinical application. Fifty patients with PSA and 45 post-stroke patients without anxiety symptoms were recruited. PSA was diagnosed using the Hamilton Anxiety Rating Scale (HAMA ≥ 7), and comorbid depression was screened using the 17-item Hamilton Depression Rating Scale (HAMD-17 ≥ 8). Patients with significant cognitive impairment were excluded. Functional near-infrared spectroscopy (fNIRS) was used to measure resting-state functional connectivity in the frontopolar cortex (FPC) and dorsolateral prefrontal cortex (DLPFC), as well as task-evoked activation during the verbal fluency task (VFT). Demographic and clinical characteristics showed no significant differences between groups except for stroke type. Between-group comparisons were conducted to identify PSA-related differences in prefrontal network characteristics. Subgroup analyses were performed to explore the influence of comorbid depression on neural alterations. There were no significant differences between the PSA and non-PSA groups in demographic or clinical characteristics, including age, sex, and disease duration ( > 0.05). Compared to the non-PSA group, patients with PSA exhibited significantly reduced activation in the bilateral FPC during the VFT ( < 0.05). Within the PSA group, those with comorbid depression showed further reductions in activation in the bilateral FPC and the left DLPFC ( < 0.05). No significant differences in resting-state functional connectivity were observed between groups ( > 0.05). Reduced activation in the bilateral FPC may represent a key neural substrate associated with post-stroke anxiety. In addition, altered activation patterns in the bilateral FPC and left DLPFC may reflect neural correlates related to depressive symptoms in patients with PSA, providing candidate targets for future mechanistic and clinical studies.

Background Schools are high incidence places for public health emergencies. Good health literacy helps students cope with public health emergencies. Overall, the health literacy of young students is relatively low. Health education can promote health literacy, but the health education related to public health emergencies for Chinese junior middle school students needs to be improved. To design and implement health education courses related to public health emergencies for junior middle school students and examine the impact on their health literacy, emotions, and coping styles. Methods From March to December 2022, 724 students in Grade 7 and Grade 8 of two junior middle schools in Changzhou were randomly divided into a course group (n = 359) and a control group (n = 365). The course group received an age-appropriate health education course that addressed public health emergencies; there were 12 classes, one per week. The control group received general health education. One week before and after the courses, the two groups of students were assessed with the Adolescent Health Literacy Evaluation Scale under Public Health Emergencies (AHLES-PHE), the Depression Self-Rating Scale for Children (DSRSC), the Generalized Anxiety Disorder 7-item scale (GAD-7), and the Simplified Coping Style Questionnaire (SCSQ). Results After the courses were completed, the scores of AHLES-PHE [156.0 (45.0,180.0) vs. 165.0 (54.0,180.0), P  < 0. 05] in the course group increased significantly. The positive rate of DSRSC [81 (22.6%) vs. 57 (15.9%), P  < 0.05] and GAD-7 [45 (12.5%) vs. 29 (8.1), P  < 0.05]in the course group were significantly lower than those before courses. There was no significant difference in the above indices before and after courses in the control group ( P  > 0.05). Conclusion This suggests that the health education courses related to public health emergencies designed in this study has an effect on improving health literacy, depression and anxiety in junior middle school students.