Neuroinflammation is a common pathological feature of neurodegenerative diseases （NDs）. Microglia （MG）， a resident macrophage in the brain with a unique developmental origin， is the core driver of neuroinflammation. It can participate in the occurrence and development of NDs through different polarization states and play a key role in regulating neurogenesis and synapse shaping and maintaining homeostasis. MG can be divided into M1 pro-inflammatory phenotype and M2 anti-inflammatory phenotype according to its function. The inflammatory mediators released by the M1 phenotype can lead to nerve degeneration and myelin sheath damage， while the activation of the M2 phenotype is required to inhibit the inflammatory response and promote tissue repair. With the advantages of multi-pathway， multi-target， and bidirectional regulation， traditional Chinese medicine can regulate the polarization balance of MG and has dual effects on NDs such as Alzheimer's disease， Parkinson's disease， and multiple sclerosis. The active components of traditional Chinese medicine and its compound can inhibit the activation of MG by regulating phosphatidylinositol-3-kinases/protein kinase B（PI3K/Akt）， NOD-like receptor thermal protein domain associated protein 3（NLRP3）， signal transducer and activator of transcription factor1（STAT1）， nuclear transcription factor kappa B（NF-κB）， and other pathways， promote the polarization of M1 phenotype to M2 phenotype， reduce the expression of interleukin（IL）-6， tumor necrosis factor-α（TNF-α）， and other pro-inflammatory factors， and increase the secretion of IL-10， arginase-1（Arg-1）， and other anti-inflammatory factors. It can also reduce β-amyloid deposition and tau protein expression in Alzheimer's disease， alleviate dopaminergic neuronal damage in Parkinson's disease， and relieve demyelination， inflammatory cell infiltration， and related clinical symptoms of multiple sclerosis. The bidirectional regulation of the M1/M2 polarization balance of MG by traditional Chinese medicine is a potential strategy for the treatment of NDs. This paper focused on the targets of the regulation of MG polarization balance by traditional Chinese medicine monomer and its compound in the treatment of NDs， so as to further study and summarize the existing research results and provide ideas and basis for the future treatment of NDs.

Objective:To explore the feasibility of staging Wilson's disease (WD) based on imaging indexes, and evaluate the clinical characteristic differences of WD patients at different stages.Methods:Sixty WD patients (40 with cerebral type and 20 with hepatic type) hospitalized in Department of Neurology, First Affiliated Hospital of Sun Yat-sen University from July 2015 to June 2022 and 20 age- and gender-matched normal controls were selected. All subjects accepted susceptibility-weighted imaging (SWI), diffusion tensor imaging (DTI), magnetic resonance spectroscopy (MRS); 7 regions of interest were selected: globus pallidus, caudate nucleus, putamen, thalamus, cerebellum, midbrain and pons; their fractional anisotropy (FA), corrected phase (CP), N-acetylaspartate/creatine (NAA/Cr) values were measured. According to DTI, SWI and MRS results, WD patients were divided into group of metal deposition stage (decreased CP, normal FA and NAA/Cr), group of fiber damage stage (abnormal FA, normal NAA/Cr), and group of neuron necrosis stage (decreased NAA/Cr); the clinical data (modified Young scale scores, Child-Pugh grading of liver function, serum copper content, and urinary copper content) and imaging indexes (FA, CP, and NAA/Cr) among the 3 groups and control group were compared. Results:Among the 60 patients, 19 patients were at metal deposition stage (including 18 with liver type and 1 with brain type), 28 patients at fiber injury stage (including 2 with liver type and 26 with brain type), and 13 patients at neuron necrosis stage (all brain type). (1) Compared with group of metal deposition stage and fiber damage stage, group of neuron necrosis stage had significantly decreased urinary copper content ( P<0.05). The modified Young scale scores in groups of metal deposition stage, fiber injury stage and neuronal necrosis stage increased successively; Child-Pugh grading in group of metal deposition stage was higher than that in groups of fiber injury stage and neuronal necrosis stage. (2) Compared with groups of metal deposition stage and neuron necrosis stage, CP values in the globus pallidus and substantia nigra in group of fiber injury stage group were significantly decreased ( P<0.05). Compared with groups of metal deposition stage and fiber injury stage, the FA value in the putamen and NAA/Cr value in the pallidum, thalamus and caudate nucleus in group of neuron necrosis stage were significantly decreased ( P<0.05). Conclusion:Disease stages of WD patients can be divided by imaging methods; neurological symptoms gradually worsen following progressed WD.