| Objective:To explore the neuroimaging features of amnestic mild cognitive impairment(aMCI)patients with liver qi stagnation syndrome by performing resting state functional magnetic resonance functional connection analysis on the participant;Intervention of smoothing liver qi was conducted to explore the efficacy of the treatment,during which progress the mechanism of long-term negative emotions affecting the occurrence of aMCI was discussed.Methods:1.Screening aMCI patients with liver qi stagnation syndrome by using neuropsychological scale,mainly Montreal Cognitive Assessment Scale(MoCA),Mini-Mental State Examination Scale(MMSE),Daily Living Ability Scale(ADL),Symptom Score Scale of Liver Qi Stagnation(LQS),Global Deterioration Scale(GDS),Wechsler Adult Memory Scale(WMS),etc.2.Choosing left and right hippocampus?anterior cingulate cortex(ACC)?middlel cingulate cortex(MCC)posterior cingulate cortex(PCC)and medial prefrontal cortex as the seeds respectively and performing voxel-based whole brain function connectivity between normal group and aMCI liver qi stagnation syndrome patients.3.Case-control study was used to examine the difference in functional connectivity between the normal population and patients with aMCI of LQS.Signals from the differential brain region was extracted and correlated with the liver qi stagnation symptom score scale and other neuropsychological scale score.4.Patients with aMCI of LQS were divided into treatment group and non-treatment group according to age,gender and education level.Shugan method was given to treatment group for 12 weeks and the other was keep out of drugs treatment.Cognitive function scales and voxel-based whole brain function connection analysis were evaluated before as well as after the intervention among three groups including the normal control group.Finally the intervention effects of Shugan method on aMCI of LQS was observed and the role of long-term negative emotion on cognitive dysfunction was explored.Results:1.In terms of neuropsychological scale scores,Statistics on overall cognitive function,visual spatial function,attention,abstraction,and delayed recall ability all show significant decline except naming domain(P< 0.05),which indicted the recruitment of aMCI of LQS has basically met the requirements.2.Compared with the normal control,the functional connection(FC)between the left hippocampus and the right lingual\ right calcarine was decreased in the aMCI of LQS group(P=0.05,fwe clusters correction).No enhanced FC information of all seeds with the other brain was observed.3.Correlation analysis results: FC value extracted from differential brain regions was significantly negative correlation with the scores of LQS(r<0,P<0.05),meanwhile a significant positive correlation with directional cognition was found(r >0,P<0.05).4.Drug intervention: After 12 weeks of intervention with Shugan method,compared to the stage of pre-treatment,liver qi stagnation(GY)symptom score,visual space/execution ability,attention,abstract ability,delayed recall and overall cognitive function of aMCI of LQS were improved(P<0.05),meanwhile the non-treatment group also improved in GY symptom scores,visual space/execution ability(P< 0.05).5.According to one-way analysis of variance before and after three groups.It was found that compared with the normal control group,attention function ?delayed recall and overall cognitive function of both of the treatment group and non-treatment group were improved after 12 weeks.And improvement of overall cognitive function in the treatment group was significantly better than that in the non-treatment group,and the difference was statistically significant(P<0.05).6.According to the voxel wise based function connection analysis,no significant difference of the change before and after intervention among three groups were observed.However,the deterioration of cognitive function in two aMCI groups was stopped.And FC between the left ight posterior anterior gyrus and Frontal_Sup_L\Frontal_Mid_L\ Frontal_Sup_Medial_L;FC between the left MPFC and Angular_L;FC between the right MPFC and Frontal_Mid_L\Frontal_Sup_L \Frontal_Sup_Medial_L\Supp_Motor_Area_L showed decrease trends.(P=0.05,fwe clusters correction)Conclusion:1.Both the function of semantic information processing based on hippocampus and lingual and attention-motivation control based on hippocampus and calcarine declined may be the neuroimaging features of brain dysfunction in patients with liver qi stagnation of aMCI.2.Pathogenesis of long-term negative emotional interventing in mild cognitive impairment may be the inhibition function based on the medial prefrontal cortex-posterior cingulate cortex-lingual of the default network(DMN)was disturbed.Improvement of spatial memory ability of hippocampus and active inhibition function of DMN may be part of the mechanism of preventing the cognitive decline in patients with liver qi stagnation aMCI by Shugan method. |
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