Department of Traditional Chinese Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.
Department of Anorectal, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China.
J Tradit Chin Med. 2021 Apr;41(2):316-325.
To investigate the changes of subcortical gray matter volume and cortical thickness, andexplorethe correlations between regional abnormalities of cortical thickness and cognitive impairment and the effect of modified Bushenyisui decoction ( BSYSD) on the cognitive function of multiple sclerosis (MS).
This prospective study was approved by the institutional review board. 92 subjects were recruited, including 46 relapsing-remitting multiple sclerosis (RRMS) patients and 46 healthy controls (HC). Of the 46 patients, 22 patients experienced the treatment of BSYSD for half a year. A conventional three-dimensional T1-weighted sequence were acquired for all participants on a 3.0 tesla magnetic resonance system. Basic information, detailed cognitive scales Montreal Cognitive Assessment (MoCA), symbol digit modalities test (SDMT), immediate memory, delayed recall, and long-term recognition were evaluated. Subcortical gray matter volume and cortical thickness weremeasured by FreeSurfer. The correlations between cortical thickness which MS patients showed reduced with respect to HC and cognitive scales wereanalyzed by Pearson correlation in RRMS patients. The influence of modified BSYSD on MS patients' cognition was analyzed by paired T Test.
MoCA, immediate memory, delayed recall, and long-term delayed recognition in RRMS were significantly decreased than those of HC. Gray matter atrophy measured by FreeSurfer showed mainly in thalamus and hippocampus of RRMS patients. Compared with HC, the cortical thickness of several regions in frontal lobe, parietal lobe, temporal lobe, hippocampal, cingulate gyrus, and fusiform gyrus of RRMS patients were decreased with significant difference. The regions of cortical thickness thinning related to MoCA, immediate memory, delayed recall, and long-term delayed recognition were temporal lobe and fusiform gyrus. Modified BSYSD could improve MoCA, SDMT, immediate memory, delayed recall, and long-term delayed recognition of MS patients, and it could promote the recovery of cognitive function in MS patients.
Gray matter atrophy and cortical thickness thinning were validated in RRMS. Cortical thickness thinning of temporal lobe and fusiform gyrus strongly related to cognitive deficits in RRMS. The modified BSYSD could promote the recovery of cognitive function in MS.
探讨多发性硬化症(MS)患者皮质厚度和皮质下灰质体积的变化,并探讨皮质厚度区域性异常与认知障碍的相关性以及补肾益髓汤(BSYSD)对 MS 认知功能的影响。
本前瞻性研究获得了机构审查委员会的批准。共招募了 92 名受试者,包括 46 名复发缓解型多发性硬化症(RRMS)患者和 46 名健康对照者(HC)。其中 46 名患者接受了 BSYSD 治疗半年。所有参与者均在 3.0T 磁共振系统上采集常规三维 T1 加权序列。通过蒙特利尔认知评估(MoCA)、符号数字模态测试(SDMT)、即刻记忆、延迟回忆和长期识别等详细认知量表评估基本信息。采用 FreeSurfer 测量皮质下灰质体积和皮质厚度。通过 Pearson 相关分析,分析 RRMS 患者皮质厚度与认知量表之间的相关性。采用配对 T 检验分析补肾益髓汤对 MS 患者认知功能的影响。
RRMS 的 MoCA、即刻记忆、延迟回忆和长期延迟识别明显低于 HC。RRMS 患者的脑灰质萎缩主要表现为丘脑和海马。与 HC 相比,RRMS 患者额叶、顶叶、颞叶、海马、扣带回和梭状回等多个区域的皮质厚度变薄,差异有统计学意义。与 MoCA、即刻记忆、延迟回忆和长期延迟识别相关的皮质厚度变薄区域为颞叶和梭状回。补肾益髓汤能改善 MS 患者的 MoCA、SDMT、即刻记忆、延迟回忆和长期延迟识别能力,促进 MS 患者认知功能的恢复。
RRMS 中证实了脑灰质萎缩和皮质厚度变薄。RRMS 患者的颞叶和梭状回皮质厚度变薄与认知障碍密切相关。补肾益髓汤能促进 MS 患者认知功能的恢复。