Brain Imaging Study Of Cognitive Function In Post-stroke Depressive Patients

Objective:1.Stroke with basal ganglia damage(SBG)is a neurological disorder accompanying with cognitive impairment.The neurobiological mechanism of cognitive impairment in SBG-patients remains unclear.The present study aimed to explore the underlying neurobiological mechanisms of SBG-patients using functional magnetic resonance imaging(fMRI).2.Shugan Jieyu Capsule,a Chinese herbal medicine mainly composed of acanthopanax and hypericum perforatum,has been used to ameliorate cognitive impairment and emotional problems induced by post-stroke depression(PSD),while the brain imaging mechanism underlying the ameliorative effects of Shugan Jieyu Capsule remain unclear.The present study aimed to explore the underlying neurobiological mechanisms of Shugan Jieyu Capsule in ameliorating cognitive function of PSD patients using amplitude of low frequency fluctuation(ALFF).On the basis of ALFF analyses,we further used dALFF and dFC methods to explore the dynamics mechanism of Shugan Jieyu Capsule in ameliorating cognitive function of PSD patients.Methods:1.The alterations of functional connectivity including voxel-mirrored homotopic connectivity(VMHC)and degree centrality(DC)were examined between 14 SBG-patients and 21 healthy controls(HC).Moreover,the subjects’cognitive functions characterized by the Wechsler Memory Scale(WMS)and the Wechsler Adult Intelligence Scale(WAIS)were also performed.2.fMRI and cognitive assessment for 15 PSD patients underwent treatment for 8 weeks and 21 age-and gender-matched HC were acquired,and ALFF was used to reveal the changes of brain functional patterns.Based on the ALFF analyses,we used dALFF and dFC methods to explore the dynamics mechanism of Shugan Jieyu Capsule in ameliorating cognitive function of PSD patients.Results:1.SBG patients showed significantly lower Memory Quotient(MQ)and Full-scale intelligence quotient(FIQ)scores compared to HC.SBG patients also exhibited significantly decreased VMHC values in the bilateral hippocampus,precuneus,angular gyrus,anterior central gyrus,middle temporal cortex,middle occipital cortex,supramarginal gyrus,inferior frontal gyrus and decreased DC values in the right supramarginal gyrus,angular gyrus and right postcentral gyrus.Moreover,the VMHC values in the supramarginal gyrus were marginally correlated with FIQ scores and the DC values in the right angular gyrus were marginally correlated with MQ scores.2.We found that administrating Shugan Jieyu Capsule can significantly reduce the depressive symptom assessed with Hamilton Depression Scale(HAMD-24)and improve the cognitive functions assessed with Montreal Cognitive Assessment(MoCA).ALFF analyses revealed significant decreased ALFF of altered left insula in PSD patients after Shugan Jieyu Capsule treatment,and the change of ALFF in altered left insula was correlated with the change of MoCA scores.dALFF and dFC analyses revealed significant increased dALFF in altered right precuneus and decreased dFC between right precuneus and left angular gyrus in PSD patients after Shugan Jieyu Capsule treatment,and the changed patterns in PSD patients after Shugan Jieyu Capsule treatment were consistent with that compared to HC.Moreover,the dALFF variance in the right precuneus was positively correlated with MoCA scores in PSD patients after treatment.Conclusion:1.For SBG patients,local abnormalities and defects in interhemispheric interaction in the default mode network(DMN)and frontoparietal network(FPN)may be the critical characteristics in the potential neurophysiological mechanism of cognitive decline.2.Shugan Jieyu Capsule may improve post-stroke depression patients’cognitive function through altered brain functional patterns.Our study provides ideas and insights for understanding the neurobiological mechanism of Shugan Jieyu Capsule in improving cognitive function of PSD patients from different perspectives.