Improve cognition of depressive patients through the regulation of basal ganglia connectivity: Combined medication using Shuganjieyu capsule
Improve cognition of depressive patients through the regulation of basal ganglia connectivity: Combined medication using Shuganjieyu capsule
复制标题
通过调节基底神经节连通性改善抑郁症患者的认知：舒肝解郁胶囊联合用药
DOI：
10.1016/j.jpsychires.2020.01.013
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发表时间：
2020-04-01
影响因子：
4.8
通讯作者：
Xu, Yong
中科院分区：
文献类型：
--
作者：
Liu, Sha;Zhao, Wentao;Xu, Yong
舒肝解郁胶囊（舒肝）是贯叶金丝桃（HP）和刺五加（ES）的联合提取物。 HP 和 ES 均已被证明可有效治疗抑郁症和认知障碍。然而，对于轻中度抑郁症（MMD），HP 和 ES 联合治疗的效果和潜在机制尚不清楚。在这里，我们的目的是评估使用 HP 和 ES 的联合药物 Shugan 对认知障碍的治疗效果。研究人员收集了 54 名健康对照者和 55 名接受 8 周舒肝治疗的 MMD 患者的静息态磁共振成像 (MRI) 数据和认知评估。测量了基底神经节种子回路的功能连接（FC）和大脑区域体积变化，并计算了它们与认知评估分数的关系。之后，通过基于文献的通路分析来探讨舒肝、脑区和抑郁症之间的生物学关系。与健康对照相比，MMD 患者的右腹侧尾状核 (vCa) 和左眶额皮质 (OFC) 之间的 FC 显着升高 (P = 0.0025)，但治疗后有所下降 (P < 0.001)。 MMD 中增加的右侧尾状核体积也因疏肝治疗而减少（P=0.017）。重要的是，认知评分与舒肝治疗以及 vCa 和 OFC 之间的 FC 密切相关（r = 0.321，P = 0.02）。此外，我们还发现了多种信号通路，舒肝可能通过这些通路改善MMD患者的认知。我们的结果支持舒肝对 MMD 认知的治疗作用，这可能部分通过 vCa 和 OFC 两个脑区的调节来实现。
Shuganjieyu capsule (Shugan) is a combined extract of Hypericum perforatum (HP) and Eleutherococcus senticosus (ES). Both HP and ES have been proven effective in the treatment of depression and impaired cognition. However, for mild to moderate depression (MMD), the treatment effect and underlying mechanism by combining both HP and ES are largely unknown. Here, we aim to evaluate the therapeutic effects on impaired cognition using Shugan, a combined medication of HP and ES. Resting-state magnetic resonance imaging (MRI) data and cognitive assessment have been collected from 54 healthy controls and 55 MMD patients that have been undergoing 8-week Shugan-treatment. The functional connectivity (FC) and brain region volume Changes of the basal ganglia seeded circuit have been measured, and their relation with the cognitive assessment score was calculated. After that, a literature-based pathway analysis has been conducted to explore the biological relations among Shugan, brain regions, and depression. Compared to healthy controls, MMD patients demonstrated a significantly higher FC (P= 0.0025) between right ventral caudate (vCa) and left orbitofrontal cortex (OFC), which was decreased after the treatment (P < 0.001). A volume of the right caudate, which is increased in MMD, has also been reduced by Shugan treatment (P= 0.017). Importantly, the cognitive scores were strongly correlated with both Shugan treatment and the FC between vCa and OFC (r= 0.321, P= 0.02). Besides, we identified multiple signaling pathways, through which Shugan might improve the cognition of MMD patients. Our results support the therapeutic effects of Shugan on cognition in MMD, which may be realized partly through the regulation within two brain regions, vCa and OFC.