| 1.Purpose:Based on resting-state functional magnetic resonance imaging(rs-f MRI)technology,Amplitude of Low Frequency Fluctuation(ALFF)and Functional Connectivity(FC)analysis method and a complete set of cognitive assessment scale were used to systematically study the patients with WD disease and mild cognitive impairment,providing new ideas and theoretical basis for the study of WD disease mild cognitive impairment symptoms,and observing the clinical effect of gandou ningshen decoction on WD-MCI patients with phlegm and blood stasis type.2.Methods:2.1 By testing of Mo CA,CDR,MMSE,and ADL scales on all patients diagnosed with WD,20 people with mild cognitive impairment group(WD-MCI)and 10 people with not mild cognitive impairment group(WD-n MCI)were selected.We collected functional magnetic resonance data and tested cognitive domain scales for two groups of participants,and used MATLAB,DPARSFA,SPM12,and SPSS21.0 software to analyze ALFF values and cognitive domain scales of functional image data Scores were compared for differences.2.2 According to the WD diagnostic criteria of types of phlegm and blood stasis in the "program for diagnosis and treatment of hepatosomiasis in the key specialty collaboration group of the 12 th five-year plan of the state administration of traditional Chinese medicine".WD-MCI patients with types of phlegm and blood stasis will be screened,whose were randomly divided into the observation group(Conventional copper removal treatment + gandou ningshen decoction)and the control group(Conventional copper removal treatment).Functional magnetic resonance imaging(f MRI)data and cognitive domain scale were collected before and after 32 days of treatment.3.Results:3.1 The First Study:(1)Compared with the WD-n MCI group,the WD-MCI group was impaired in attention,memory,frontal function,language,and computing,but there is no difference in orientation,structure,neglect and application.(2)After the test and analysis of the WD-MCI group and the WD-n MCI group,the brain regions with significantly increased ALFF values were: the left parahippocampal gyrus;the areas of the brain that were significantly reduced were the bilateral supplementary motor areas and the left central anterior gyrus.(3)When the left hippocampal gyrus was used as the seed point,the functional connection between the left hippocampal gyrus and bilateral lingual gyrus and the left hippocampal gyrus and the left cortex cerebral cortex area in the WD-MCI group decreased.No significant increase in functional connectivity was found in the brain area.When the left central anterior gyrus was used as the seed point,the left central anterior gyrus and right superior temporal gyrus and the left central anterior gyrus and right lateral temporal gyrus were observed in the WD-MCI group.The intensity of functional connection between them was reduced,and no significant increase in functional connection value was observed in the brain area.3.2 The Second Study:(1)There was no significant difference between the observation group and the control group of WD-MCI patients before the treatment of the eight CNB kit sub-items(P> 0.05);the comparison of the eight sub-items before treatment and after treatment in the observation group was only antegrade memory(immediate Delayed recall)(P =0.013 <0.05)and retrograde memory(P = 0.029 <0.05)were significantly different;in the comparison of the eight sub-items before and after treatment in the control group,only antegrade memory(immediate / delayed recall))(P = 0.013 <0.05),but there was no significant difference in retrograde memory(P = 0.317> 0.05);similarly,there were only statistically significant differences in the antegrade memory(immediate / delayed recall)(P <0.001)and retrograde memory(P = 0.032 <0.05)(P> 0.05).(2)There was no significant imaging difference in ALFF values of observation group and control group before treatment,observation group before treatment and after treatment,control group before treatment and after treatment,observation group and control group after treatment were compared.4.Conclusion:4.1 The First Study:(1)WD-MCI patients were significantly impaired in attention,memory,frontal lobe function,language,and computational cognitive domains,while no significant impairment was observed in orientation,structure and neglect,and application cognitive domains.(2)Compared with WD-n MCI,the brain region with significantly increased ALFF value in WD-MCI patients was the left parahippocampal gyrus,indicating that the corresponding brain region had begun to be damaged,and the increase in ALFF value was a spontaneous functional compensation.The significantly reduced brain areas were the bilateral supplementary motor areas and the left central anterior gyrus,indicating a relatively high risk of potential impairment of the language cognitive domain.(3)The functional connection between the left hippocampal gyrus,bilateral lingual gyrus,and left talar lobes reduced,and the functional connection between the left central anterior gyrus,the right superior temporal gyrus,and the right lateral temporal gyrus decreased,and these brain regions are important components of the default network,visual network and auditory network,indicating that the connection between the brain default network,visual network and auditory network in WD-MCI patients was reduced.4.2 The Second Study:(1)Both Gandou ningshen Decoction and conventional copper expulsion therapy could improve the memory function of patients with phlegm-stasis-associated WD-MCI,but the cognitive domains of attention,frontal lobe function,language and calculation were not improved significantly.(2)The improvement of memory impairment in patients with phlegm-stasis interstitial WD-MCI treated with Gandou ningshen Decoction combined with conventional copper displacing therapy was significantly better than that of conventional copper displacing therapy,which not only improved the anterograde memory of patients,but also improved the retrograde memory of patients.(3)Whether Gandou ningshen Decoction combined with conventional copper drive therapy or conventional copper drive therapy,there was no significant difference in imaging performance in the short term(32 days). |
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