Abstract
We aimed to investigate the long-term therapeutic effects of a compound Chinese medicine, the Bushen capsule, on cognition and brain connectivity in patients with amnestic mild cognitive impairment (aMCI). Thus, sixty aMCI participants were recruited to this 24-month study and were randomly divided into treatment (30 with a Bushen capsule) and placebo (30 with a placebo capsule) groups. Neuropsychological tests with MMSE and episodic memory as the primary outcomes and resting-state functional magnetic resonance imaging (fMRI) were analyzed before and after the treatment over 24 month period. In contrast to the placebo group, the drug group presented improved or stable general cognitive function, memory, language and executive function especially the primary outcomes MMSE and episodic memory with Bushen capsule treatment. FMRI results showed increased connectivity in the right precuneus and the global connectivity indexed with goodness of fit (GOF) of the default mode network (DMN) in the drug group and decreased GOF in the placebo group. More importantly, we found the GOF change was positively correlated with changes in MMSE and memory scores after 24 months in the drug group. Over 24 months, treatment with the compound Chinese medicine Bushen capsule can improve multiple domains of cognition and increase the functional local (right precuneus) and global connectivity within the DMN, which are associated with better performance.
Highlights
Among the investigated treatments are those based on traditional Chinese medicine (TCM), which has sought after for its potential in the prevention and cure of amnesia because of its uniqueness and holistic view of treating diseases[7]
The effect of interactions showed that the general cognitive function (MMSE, P = 0.019), and episodic memory (RAVLT N5, P < 0.001 and RAVLT N1N5, P < 0.001) changed significantly in the drug group along with the treatment time
Findings from our current study showed that the treatment arm, in contrast to the placebo arm, exhibited improved or stable cognitive performances in several cognitive domains, including our primary outcomes in general cognitive function, and memory as well as executive function and language ability
Summary
Among the investigated treatments are those based on traditional Chinese medicine (TCM), which has sought after for its potential in the prevention and cure of amnesia because of its uniqueness and holistic view of treating diseases[7]. The spontaneous fluctuation signals in the resting state brain delineate the human neural functional architecture as multi-networks such as the default mode network (DMN), frontal–parietal network, somatomotor network, and primary visual network[17] Among these networks, DMN is the most reported networks in the AD literatures[18,19]. In the present pilot study, we used a double-blind placebo-controlled design and resting state fMRI to study the long-term effects of TCM on cognitive functions with MMSE and episodic memory as our primary outcomes (due to the reported main effects of the Bushen capsules’ components on improving memory9–13) and connectivity patterns of DMN in amnestic MCI (aMCI) patients undergoing a baseline, following 12 and 24 month visits. The purpose of this study was to evaluate: (a) whether the drug could maintain or improve behavioral performances, in general cognitive function especially MMSE and episodic memory; (b) and whether the drug could improve intrinsic functional connectivity in DMN after treatment
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