Shuganjieyu capsule (Shugan) is a combined extract of Hypericum perforatum (HP) and Eleutherococcus senticosus (ES). Both HP and ES have been proven effective in the treatment of depression and impaired cognition. However, for mild to moderate depression (MMD), the treatment effect and underlying mechanism by combining both HP and ES are largely unknown. Here, we aim to evaluate the therapeutic effects on impaired cognition using Shugan, a combined medication of HP and ES. Resting-state magnetic resonance imaging (MRI) data and cognitive assessment have been collected from 54 healthy controls and 55 MMD patients that have been undergoing 8-week Shugan-treatment. The functional connectivity (FC) and brain region volume changes of the basal ganglia seeded circuit have been measured, and their relation with the cognitive assessment score was calculated. After that, a literature-based pathway analysis has been conducted to explore the biological relations among Shugan, brain regions, and depression. Compared to healthy controls, MMD patients demonstrated a significantly higher FC (P= 0.0025) between right ventral caudate (vCa) and left orbitofrontal cortex (OFC), which was decreased after the treatment (P < 0.001). A volume of the right caudate, which is increased in MMD, has also been reduced by Shugan treatment (P= 0.017). Importantly, the cognitive scores were strongly correlated with both Shugan treatment and the FC between vCa and OFC (r= 0.321, P= 0.02). Besides, we identified multiple signaling pathways, through which Shugan might improve the cognition of MMD patients. Our results support the therapeutic effects of Shugan on cognition in MMD, which may be realized partly through the regulation within two brain regions, vCa and OFC.

中文翻译：

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通过调节基底神经节的连通性来提高抑郁症患者的认知度：使用舒肝解郁胶囊联合用药。

疏肝解郁胶囊（Shugan）是贯叶连翘（HP）和刺五加肠球菌（ES）的联合提取物。事实证明，HP和ES均可有效治疗抑郁症和认知障碍。然而，对于轻度至中度抑郁症（MMD），通过结合使用HP和ES的治疗效果和潜在机制尚不清楚。在这里，我们旨在评估使用舒肝（HP和ES的联合药物）对认知受损的治疗效果。静息态磁共振成像（MRI）数据和认知评估已从54名健康对照者和55名接受8周舒肝治疗的MMD患者中收集。测量了基底神经节种子电路的功能连通性（FC）和大脑区域的体积变化，并计算它们与认知评估得分的关系。之后，进行了基于文献的途径分析，以探讨疏肝，脑区和抑郁症之间的生物学关系。与健康对照组相比，MMD患者的右腹尾状核（vCa）和左眶额皮质（OFC）之间的FC明显更高（P = 0.0025），治疗后有所降低（P <0.001）。舒肝治疗也降低了MMD中增加的右尾状核的体积（P = 0.017）。重要的是，认知评分与舒肝治疗以及vCa和OFC之间的FC密切相关（r = 0.321，P = 0.02）。此外，我们确定了多种信号通路，舒肝可能通过这些通路改善MMD患者的认知。