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疏肝解郁胶囊治疗后中风后抑郁患者静息态功能动力学改善

Improved Resting-State Functional Dynamics in Post-stroke Depressive Patients After Shugan Jieyu Capsule Treatment.

作者信息

Yao Guanqun, Li Jing, Wang Jiaojian, Liu Sha, Li Xinrong, Cao Xiaohua, Chen Huafu, Xu Yong

机构信息

Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.

Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China.

出版信息

Front Neurosci. 2020 Apr 16;14:297. doi: 10.3389/fnins.2020.00297. eCollection 2020.

Abstract

Shugan Jieyu Capsule (SG), a Chinese herbal medicine mainly composed of and , has been used to ameliorate cognitive impairments and emotional problems induced by post-stroke depression (PSD), while the altered brain dynamics underlying the ameliorative effects of SG have remained unclear. Our study focused on investigating the potential neurobiological mechanisms of SG in improving the cognitive function of PSD patients via resting-state functional magnetic resonance imaging (fMRI). Fifteen PSD patients (mean ages: 64.13 ± 6.01 years) were instructed to take 0.72 g of SG twice a day for 8 weeks. PSD patients underwent fMRIs, the 24-item Hamilton Depression Scale (HAMD-24) and the Montreal Cognitive Assessment (MoCA) at baseline and the end of intervention, and these assessments were also performed on twenty-one healthy controls (HC) (mean ages: 60.67 ± 6.95 years). Additionally, the dynamic amplitude of low-frequency fluctuations (dALFF) and functional connectivity (dFC) were determined to reveal changes in dynamic functional patterns. We found that taking SG significantly reduced the depressive symptoms assessed by HAMD-24 and improved cognitive functions assessed by MoCA in PSD patients. Furthermore, at baseline, PSD patients showed decreased dALFF in the right precuneus and increased dFC between the right precuneus and left angular gyrus, compared with HC. After intervention, the dALFF and dFC variances of the abnormal patterns were reversed. Additionally, the dALFF variance in the right precuneus was positively correlated with MoCA scores in PSD patients after SG treatment. Collectively, our results indicate that SG may improve the cognitive function of PSD patients through alteration of brain dynamics. Our findings lay a foundation for the exploration of the neurobiological mechanisms of SG in ameliorating symptoms of PSD patients.

摘要

疏肝解郁胶囊(SG)是一种主要由[具体成分未给出]组成的中药,已被用于改善中风后抑郁(PSD)引起的认知障碍和情绪问题,而SG改善作用背后的大脑动力学变化尚不清楚。我们的研究旨在通过静息态功能磁共振成像(fMRI)研究SG改善PSD患者认知功能的潜在神经生物学机制。15例PSD患者(平均年龄:64.13±6.01岁)被要求每天服用0.72g SG,持续8周。PSD患者在基线和干预结束时接受fMRI检查、24项汉密尔顿抑郁量表(HAMD - 24)和蒙特利尔认知评估(MoCA),同时也对21名健康对照者(HC)(平均年龄:60.67±6.95岁)进行了这些评估。此外,测定低频波动的动态幅度(dALFF)和功能连接(dFC)以揭示动态功能模式的变化。我们发现服用SG可显著降低PSD患者中由HAMD - 24评估的抑郁症状,并改善由MoCA评估的认知功能。此外,在基线时,与HC相比,PSD患者右侧楔前叶的dALFF降低,右侧楔前叶与左侧角回之间的dFC增加。干预后,异常模式的dALFF和dFC变化得以逆转。此外,SG治疗后PSD患者右侧楔前叶的dALFF变化与MoCA评分呈正相关。总体而言,我们的结果表明SG可能通过改变大脑动力学来改善PSD患者的认知功能。我们的研究结果为探索SG改善PSD患者症状的神经生物学机制奠定了基础。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/983b/7177051/b626a737d182/fnins-14-00297-g001.jpg

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