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Abstract
Purpose: To evaluate the effectiveness of Kami Guibi-tang (KGT) in the treatment of mild cognitive impairment (MCI) using magnetic resonance imaging (MRI) on brain metabolites, neurotransmitter, and cerebral blood flow (CBF).

Methods: We randomly allocated a total of 30 MCI patients to a KGT (N = 16) or a placebo (N = 14) group and performed MRI scans before and after 24 weeks of treatment. The participants underwent brain magnetic resonance spectroscopy and MRI scans to obtain brain metabolites using Point-RESolved Spectroscopy (PRESS) single-voxel spectroscopy, gamma-aminobutyric acid (GABA) neurotransmitter using Mescher-Garwood PRESS, and CBF using pseudocontinuous arterial spin labeling sequences using a 3.0 Tesla MRI system. We analyzed metabolite and neurotransmitter levels and CBF using repeated-measure analysis of variance to evaluate between-subject group effect, within-subject treatment condition effect, and interaction of group by condition (group x condition).

Results: The GABA+/creatine (Cr) ratio values were not significantly different between the before and after treatment conditions. The glutamate complex/Cr ratio difference before and after treatment was lower in the KGT group than in the placebo group, but was not statistically significant (p = 0.077). The result of region of interest-based CBF measurement showed that CBF values were significantly lower after treatment at Cluster 2 for the KGT group (p = 0.003) and the placebo group (p = 0.011), at hippocampus for the KGT group (p = 0.004) and the placebo group (p = 0.008), and at the fusiform gyrus for the KGT group (p = 0.002). Furthermore, the absolute CBF difference before and after treatment in the fusiform gyrus was significantly lower in the KGT group than in the placebo group (p = 0.024).

Conclusions: Although a KGT treatment of 24 weeks showed some significant impact on the level of CBF, the Korean version of the mini-mental state examination score was not significantly different between before and after treatment conditions, indicating that there was no memory function improvement after treatment in amnestic MCI patients. Therefore, further studies should be performed with a relatively larger population and extending the duration of the KGT treatment.

JACMP논문 Figure 3.

복셀기반 뇌혈류(CBF)의 변화를 가미귀비탕(KGT)군과 위약(Placebo)군 간의 차이(Between-subject, BTS)효과와 치료전후 조건(Within-subject, WIS)을 비교한 결과그림이다. 뇌혈류 값이 KGT를 복용한 군에서 더크게나왔으며(왼쪽) 복용후에 뇌혈류값이 낮아지는 것으로(오른쪽) 나왔다.

Affiliations

Seung-Yeon Cho  1 , Sharonkyuhee Kwon  2 , Hee-Yeon Shin  3 , Ha-Ri Kim  3 , Jeong-Hwa Kim  3 , Soonchan Park  4 , Chang-Woo Ryu  4 , Jung-Mi Park  1 , Richard A E Edden  5 , Geon-Ho Jahng  4
1 Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
2 Department of Biomedical Engineering, Undergraduate School, College of Electronics and Information, Kyung Hee University, Yongin-si, Gyeonggi-do, Republic of Korea.
3 Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
4 Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Republic of Korea.
5 Division of Neuroradiology, Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.