| 1 Objective This study was based on the brain-resting state functional magnetic resonance imaging(rs-f MRI)technique to collect whole brain data of rs-f MRI in patients with or without Parkinson's disease with or without cognitive impairment.Methods To observe the local consistency of cognitive function in patients with Parkinson's disease accompanied by cognitive dysfunction and the influence of KANGZHENG ZHIJING Capsule on Cognitive Domain of Parkinson disease patients with blood stasis and wind act before and after intervention Imaging changes in local consistency,analysis of abnormalities in brain activity of neurons.2 Methods2.1 25 cases of PD patients with PD diagnostic criteria were included.The patients were divided into cognitive group(PD-NC)and mild cognitive impairment group(PD-MCI)according to the MMSE simple scale assessment,and all the involved subjects were collected neuro-functional imaging data.matlab,DPARSF and Spm data collected locally consistent analysis of PD-NC and PD-MCI group of brain activity of neurons were analyzed and compared.2.2 According to the diagnostic criteria of blood stasis and wind movement type PD in 2012,8 cases of blood stasis type and 22 cases of blood stasis type PD-MCI were included in the first part of PD-MCI.They were randomly divided into two groups: the traditional Chinese medicine treatment group(anti-seismic Zhijing capsule combined with routine treatment)and the basic treatment control group(routine treatment group).The safety of the two groups before and after treatment,the score of TCM symptom before and after treatment,and the score of cognitive assessment scale were observed.Changes of single cognitive domain score and neuroimaging in regional consistency.3 Results3.1 The areas in which the Re Ho value increased significantly after PD-MCI and PD-NC analysis included: left cerebellar foot 1 area,right cerebellar foot 2 area,fusiform gyrus(right filiform gyrus,right medial superior frontal gyrus).Lingual gyrus,right superior temporal gyrus,right cortex around the right talar fissure,left middle frontal gyrus,left dorsolateral superior frontal gyrus,right middle occipital gyrus,right cuneate lobe and left posterior cingulate gyrus.There was no obvious decrease of Re Ho in the brain.3.2 In the patients with PD-MCI with blood stasis and wind act,the scores of TCM symptoms in the treatment group decreased significantly after treatment(P<0.01).In the control group,the score of TCM symptom decreased(P<0.05).The scores of TCM symptoms in the two groups were significantly different after treatment(P<0.01).3.3 The scores of comprehensive cognition,attention,visual space,memory and so on in TCM treatment group and western medicine for patients with PD-MCI with blood stasis and wind movement were higher than those before treatment.The executive function was significantly lower than that before treatment.And the Chinese medicine treatment group in the overall cognitive state,executive ability,attention,visual space has a significant effect;There was no significant change in the scores of the two groups before and after treatment.3.4 The Re Ho value of PD-MCI patients with blood stasis and wind act before and after treatment showed that the activated brain areas were bilateral cerebellar feet,left cerebellum 6 areas,prewedge lobe,left middle frontal gyrus.Right superior frontal gyrus,left cingulate gyrus,etc.There was no significant decrease in Re Ho in the brain.4 Conclusion4.1 In the PD-MCI group,the activities of neurons in multiple brain regions were enhanced.The enhanced brain regions included fusiform gyrus,cerebellar peduncle, upper frontal gyrus,middle frontal gyrus,lingual gyrus,superior temporal gyrus,wedge and cingulate gyrus May be related to the loss of dopaminergic degeneration in the substantia nigra compact zone and the compensatory increase of neuronal activity in the cerebellar-cortical ring and limbic system in patients with PD-MCI;4.2 The effect of KANGZHENG ZHIJING capsule on the overall cognitive state,memory,attention,executive ability and visual space in patients with PD-MCI with blood stasis and wind movement was improved,but no significant improvement was found in language function.4.4 The brain areas with increased local consistency after intervention of KANGZHENG ZHIJING capsule in patients with blood-stasis and wind act type of PD-MCI mainly include anterior leaf wedge,cingulate gyrus,superior frontal gyrus,middle frontal gyrus,and bilateral cerebellar feet,suggesting that the earthquake resistance is limited The mechanism of cognitive function improvement of capsules for patients with blood-stasis and wind act type of PD-MCI may be related to the increased activity of cognitive-related brain regions,including cerebellar-cortical loop neurons. |
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