Lu Hui, Dang Mingxi, Chen Kewei, Shang Huajie, Wang Bolong, Zhao Shaokun, Li Xin, Zhang Zhanjun, Zhang Junying, Chen Yaojing
State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China.
Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, China.
Front Pharmacol. 2023 Apr 5;14:1129125. doi: 10.3389/fphar.2023.1129125. eCollection 2023.
Vascular cognitive impairment (VCI) is one of the most common types of dementia. Naoxin'an capsule (NXA), a traditional Chinese medicine compound, has been used to treat VCI for a long time in the clinic. Previous studies proved that the NXA capsules could ameliorate the cerebral mitochondrion deficits of VCI animals. This study aimed to investigate the protectiveness of NXA on human brain structure and function in patients with VCI. In total, 100 VCI patients were enrolled in this 24-week trial and randomly divided into the NXA capsules group ( = 50) and the ginkgo biloba capsules control group ( = 50). Before and after the treatment, cognitive behavior tests and multimodal brain magnetic resonance imaging were analyzed to comprehensively evaluate the effectiveness of NXA treatment on VCI patients after 24 weeks. We found that the NXA group significantly improved overall cognitive ability (Alzheimer's Disease Assessment Scale-Cognitive section, = 0.001; Mini-Mental Status Examination, = 0.003), memory (Rey-Osterrieth Complex Figure test, < 0.001) and executive function (Trail Making Test-A, = 0.024) performance after treatment compared with the control group. For brain function, the degree of centrality in the left middle frontal gyrus, right postcentral gyrus, and left supplementary motor area increased in the NXA group and decreased in the ginkgo biloba group after treatment. The fractional amplitude of low-frequency fluctuation (fALFF) of the left precentral and right superior parietal gyrus increased, and the fALFF of the right parahippocampal and left inferior temporal gyrus decreased in the NXA group after treatment. For brain structure, the gray matter density of the left postcentral gyrus increased in the NXA group after treatment, and the total volume of white matter hyperintensity showed a decreasing trend but was not statistically significant. Furthermore, the improvement effect of NXA on executive function was associated with changes in brain function. These findings suggest that the NXA capsules improved cognitive performance and multiregional brain function, as well as gray matter structure in the postcentral gyrus.
血管性认知障碍（VCI）是最常见的痴呆类型之一。脑心通胶囊（NXA）是一种中药复方制剂，在临床上长期用于治疗VCI。既往研究证明，NXA胶囊可改善VCI动物的脑线粒体缺陷。本研究旨在探讨NXA对VCI患者脑结构和功能的保护作用。本为期24周的试验共纳入100例VCI患者，随机分为NXA胶囊组（n = 50）和银杏叶胶囊对照组（n = 50）。在治疗前后，对认知行为测试和多模态脑磁共振成像进行分析，以全面评估NXA治疗24周后对VCI患者的有效性。我们发现，与对照组相比，NXA组治疗后总体认知能力（阿尔茨海默病评估量表-认知部分，P = 0.001；简易精神状态检查表，P = 0.003）、记忆力（雷-奥斯特里思复杂图形测试，P < 0.001）和执行功能（连线测验-A，P = 0.024）表现显著改善。对于脑功能，治疗后NXA组左侧额中回、右侧中央后回和左侧辅助运动区的中心度增加，而银杏叶组降低。治疗后NXA组左侧中央前回和右侧顶上叶的低频振幅分数（fALFF）增加，右侧海马旁回和左侧颞下回的fALFF降低。对于脑结构，治疗后NXA组左侧中央后回的灰质密度增加，白质高信号总体积呈下降趋势，但差异无统计学意义。此外，NXA对执行功能的改善作用与脑功能变化有关。这些发现表明，NXA胶囊改善了认知表现、多区域脑功能以及中央后回的灰质结构。
