Applications of PRESS‐MRS, MEGA‐PRESS, and pCASL to evaluate treatment effect of Kami Guibi‐tang on amnestic MCI

Abstract

AbstractBackgroundKami Guibi‐tang (KGT) is one of the famous herbal medicines used in Asia to treat amnesia, insomnia, loss of appetite, or depression. Previous studies have suggested that KGT could be beneficial for the cognitive functions of AD patients. Therefore, this study aimed to evaluate the therapeutic effectiveness of a 24‐weeks treatment with KGT granules using measurements of brain metabolite and neurotransmitter levels and CBF using a 3T MRI system.MethodThe institutional review board approved this cross‐sectional prospective study. The participants underwent brain MRIs at baseline and after 24 weeks of medication to obtain structural 3D T1‐weighted (3D T1W) image, single‐voxel proton magnetic resonance spectroscopy (1H‐MRS) with TE=35 ms PRESS for quantifying NAA, Cr, Cho, and glutamate complex (Glx), MEscher‐GArwood (MEGA) Point‐RESolved Spectroscopy (PRESS) for quantifying gamma‐aminobutyric acid (GABA), and pseudo‐continuous arterial spin labeling (pCASL) perfusion images.ResultFor MMSE scores, RM‐ANOVA tests showed significantly difference between the KGT and placebo groups (F = 4.71, p = 0.039), not significantly difference between the before and after treatment conditions (F = 0.870, p = 0.358), and no group x condition interactions. For metabolite values and GABA, the GABA+/Cr values were significantly different between the KGT and placebo groups (F = 5.27, p = 0.029). The Glx/Cr values showed a difference trend between the two groups (F = 4.19, p = 0.050) and the group x condition interactions (F = 4.21, p = 0.050). The difference (Diff [%]) in the Glx/Cr values between the before and after treatment conditions were significantly different between the KGT and placebo groups (p = 0.042).ConclusionThe CBF measure was the sensitive marker to evaluate the treatment effect of KGT on MCI participants. We found that the treatment affected the temporal lobe, including the hippocampus and the fusiform gyrus which are associated with memory. Therefore, further studies should be performed with a relatively larger population and increased dosage.