Li Zhaoying, Liu Shanyu, Shen Yuling, Zhao Huan, Chen Zhenwei, Tan Rui, Li Zhuoling, Quan Ling, Yang Dongdong, Shi Min
Department of Neurology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China.
Front Neurosci. 2025 Mar 12;19:1555365. doi: 10.3389/fnins.2025.1555365. eCollection 2025.
Abnormalities in brain activity patterns during episodic memory tasks have been inconsistently reported in amnestic mild cognitive impairment (aMCI) patients using functional magnetic resonance imaging (fMRI). This study applied traditional Chinese medicine (TCM) syndrome differentiation to categorize aMCI patients into distinct subgroups, aiming to clarify the neural mechanisms underlying their cognitive profiles.
Participants included aMCI patients categorized into the turbid phlegm clouding the orifices (PCO) or spleen-kidney deficiency (SKD) syndrome subgroups, alongside cognitively normal controls (NC) matched for age and gender. Neuropsychological assessments were performed, and fMRI scans were acquired during an episodic memory task involving the recognition of new and old vocabulary. Brain activity across different stages of episodic memory was analyzed using SPM12 and DPABI 7.0 software.
A total of 57 aMCI patients (34 with SKD and 23 with PCO) and 54 healthy controls were involved in the final task-based fMRI analysis. Compared with the NC group, the PCO group exhibited increased brain activation during both encoding and retrieval phases, primarily involving the prefrontal cortex and occipital lobe. Compared with the SKD group, the PCO group demonstrated the elevated activation in the right central sulcus and right insula during the encoding phase. Correlation analysis indicated a specific association between PCO symptom scores and insula activation. No statistically significant differences were found between the SKD and NC groups.
Distinct patterns of fMRI brain activity found in aMCI patients with PCO and SKD syndromes during episodic memory tasks suggest differing neural mechanisms that may contribute to the clinical heterogeneity of aMCI.
使用功能磁共振成像（fMRI）对遗忘型轻度认知障碍（aMCI）患者进行情景记忆任务时，大脑活动模式异常的报道并不一致。本研究运用中医综合征分化将aMCI患者分为不同亚组，旨在阐明其认知特征背后的神经机制。
参与者包括分为痰浊蒙蔽清窍（PCO）或脾肾亏虚（SKD）综合征亚组的aMCI患者，以及年龄和性别匹配的认知正常对照组（NC）。进行了神经心理学评估，并在涉及识别新旧词汇的情景记忆任务期间进行了fMRI扫描。使用SPM12和DPABI 7.0软件分析情景记忆不同阶段的大脑活动。
共有57例aMCI患者（34例SKD患者和23例PCO患者）和54例健康对照参与了最终基于任务的fMRI分析。与NC组相比，PCO组在编码和检索阶段均表现出大脑激活增加，主要涉及前额叶皮质和枕叶。与SKD组相比，PCO组在编码阶段右侧中央沟和右侧脑岛的激活升高。相关性分析表明PCO症状评分与脑岛激活之间存在特定关联。SKD组和NC组之间未发现统计学上的显著差异。
在情景记忆任务期间，PCO和SKD综合征的aMCI患者中发现的fMRI大脑活动模式不同，表明可能导致aMCI临床异质性的不同神经机制。
