Objective To explore the abnormality of top-down and bottom-up attention patterns in patients suffering from coronary heart disease(CHD)patients with heart-qi deficiency syndrome based on the theory of"five spirits".Methods From July 2024 to December 2024,30 CHD patients with heart-qi deficiency syndrome were recruited,and 30 subjects without CHD as the control group according to the principle of matching age,sex and years of education.Two groups of subjects were tested with top-down and bottom-up spatial cueing paradigm.Results Compared with the control group,CHD patients with heart-qi deficiency syndrome had longer valid reaction time(vRT)and lower average reaction time difference value(△RT)in top-down test(P＜0.05),and longer vSRT in bottom-up test.Correlation analysis showed that heart-qi deficiency syndrome score was positively correlated with top-down test indexes invalid reaction time(ivRT)(P＜0.05),negatively correlated with △RT(P＜0.01)and valid accurany(vAC)(P＜0.05).It was positively correlated with valid long reaction time(vLRT)(P＜0.01)and invalid long reaction time(ivLRT)(P＜0.01).Generalized linear model analysis showed that non-CHD subjects had shorter vRT(P＜0.01)and larger △ RT(P＜0.05)than CHD patients for top-down test.For bottom-up tests,non-CHD subjects had shorter vSRT than CHD patients(P＜0.05).Conclusion The change of top-down and bottom-up attention patterns in CHD patients with heart-qi deficiency syndrome provides a modern neuropsychological basis for the theory of"heart stores spirits".

Coronary heart disease(CHD)imposes a high disease burden in China and it is still increasing significantly.There is a two-way connection between the heart and the brain,and the premature and rapid decline of cognitive function in patients with CHD has attracted increasing interesting from researchers,but clinical professionals often pay more attention to heart-related symptoms and ignore the impact of cognitive function decline on the quality of life of patients with CHD.This article reviews the current research progresses of cognitive decline in CHD patients from the aspects of manifestation,influencing factors,pathological mechanism and intervention measures.It offers a reference for medical professionals to understand this problem more deeply.

Objective To evaluate the efficacy and safety of Qingre Jiedu recipe in the treatment of bipolar depression.Methods A randomized,double-blind,Chinese medicine and western medicine placebo control design was used in this study.Totally 80 subjects with bipolar depression and fiery internal depression that met the enrollment criteria,were divided into the experimental group(EG,40 cases of western medicine simulation tablets+Chinese medicine formula granules)and the control group(CG,40 cases of western medicine+Chinese medicine placebo)according to a 1∶1 ratio at last,7 cases dropped out after enrollment,EG 36 cases,CG 37 cases.TCM Heat Internal Depression Syndrome(TCMHIDS),Hamilton Depression Scale-24 Item(HAMD-24),Hamilton Anxiety Scale(HAMA),Hypomania Checklist-33(HCL-33),Young Manic Rating Scale(YMRS)and Treatment Emergent Symptom Scale(TESS)scores were assessed at baseline and at the 2nd,4th and 8th week after treatment.Important signs and adverse events were recorded.Blood routine,hepatic and renal function,urine routine and electrocardiogram were performed during the screening period and the 8th week after treatment.For the patients who dropped out of the examination program,the examination item are identical to those at week 8.The primary outcome measure was the change in HAMD score from baseline to 8th week.Secondary outcome evaluation indicators included the changes of TCMHIDS,HAMA,HCL-33 and YMRS scores from baseline to 8th week.Results The scores of the HAMD-24 between EG and CG decreased significantly compared with the baseline at different time-point,and the difference was statistically significant(P＜0.01).However,the scores of the EG on the HAMD-24 decreased more significantly compared with the CG at the 4th and 8th week,and this difference was statistically significant(P＜0.01).The TCMHIDS and HAMD scores between two groups decreased compared with the baseline at different time-point,and this difference was statistically significant(P＜0.01).However,the TCMHIDS and HAMD scores of the EG decreased more significantly ot the 4th and 8th week,compared with the CG,and this difference was statistically significant(P＜0.01).Both YMRS and HCL-33 scores decreased more significantly between two groups at different time-point,compared with the baseline,and this differences was statistically significant,but there was no difference between two groups.Conclusion TCM Qingre Jiedu recipe could effectively relieve depression and anxiety mood of bipolar depression,with more advantages than western medicine.In addition,it showed a certain effect on hypomania or manic-related symptoms of bipolar disorder,No risk of turning to hypomania or manic,better safety and less adverse reactions were observed.

Objective To characterize working memory performance in patients with chronic fatigue syndrome(CFS)and spleen-deficiency syndrome and to examine its associations with clinical symptoms by Sternberg working memory task(SWMT).Methods 31 CFS patients meeting both CDC-1994 criteria and consensus criteria for spleen-deficiency pattern were recruited from outpatient clinics and universities from September 2022 and June 2025.31 healthy controls were also recruited based on age,sex,and education.All subjects completed the SWMT.Group differences were analyzed.Within the CFS cohort,reaction time(RT)was correlated with scores on the checklist individual strength(CIS),36-item short-form health survey(sf-36),and fatigue scale-14(FS-14).Mediation was examined.Results RT lengthened with increasing memory load in both groups.CFS patients displayed slower RTs than controls in the baseline and 6-digit set(P<0.05).The 3-digit RT difference,though not significant(P>0.05),yielded a medium effect size(r=0.36).Accuracy did not differ between two groups.Among CFS patients,3-digit RT correlated positively with CIS total and the 4 sub-scale scores.6-digit RT correlated with the SF-36 health-transition dimension(r=0.396,P=0.027).CIS and FS-14 scores directly impaired SF-36 social functioning without working-memory mediating.Conclusion CFS patients with spleen-deficiency exhibit slowed processing speed rather than capacity loss.The close link between working-memory slowing and fatigue suggests a distinct neural basis.These results support the traditional concept"the spleen stores Yi"and integrate TCM pattern differentiation with modern cognitive neuroscience in CFS.

Bidirectional communication between the heart and brain has been well documented,and their respective electrophysiological activities are not independent but rather exhibit a measurable degree of coupling.The traditional Chinese medicine(TCM)doctrine of"heart storing the spirit"posits that the heart governs all vital activities and that the heart and brain are functionally interdependent and mutually reinforcing.This paper systematically reviews current methodological approaches for investigating cardio-electroencephalographic coupling,summarizes empirical findings that elucidate human physiological and pathological mechanisms through this coupling framework,and integrates TCM-based perspectives on heart-brain interactions.Finally,prospects for applying emerging cardio-electroencephalographic techniques is outline to advance research on the"heart storing the spirit"theory.

Objective To explore their inter-relationship,cognitive performance and cardio-electroencephalographic coupling in coronary heart disease(CHD)patients with heart-qi deficiency pattern were characterized.Methods Thirty CHD patients who met the diagnostic criteria for heart-qi deficiency were enrolled.Thirty healthy volunteers without heart-qi deficiency or CHD served as controls.Cognitive function was assessed with the repeatable battery for the assessment of neuropsychological status(RBANS).Simultaneous resting-state electrocardiogram and electroencephalogram were recorded,and the strength of heart-brain coupling was quantified by calculating the maximal information coefficient(MIC)between heart-rate variability(HRV)and EEG signals.Results Compared with controls,heart-qi deficiency CHD patients showed lower RBANS total scores and reduced performance in immediate memory,visuospatial/constructional ability,and attention.Significant between-group differences in HRV-EEG MIC values were observed at several channels(P<0.05).In patients,the MIC values for HRV-Beta(channel FC1)and HRV-Delta(channel F2)were positively correlated with RBANS total score(P<0.05).Conclusion CHD patients with heart-qi deficiency exhibit impaired cognition and altered cardio-electroencephalographic coupling.These findings suggest that heart-brain interactions may contribute to the pathophysiological mechanisms underlying cognitive decline in this population.

Objective To build the machine learning classification model for sub-health patients with spleen qi deficiency syndrome and kidney qi deficiency syndrome based on degree centrality characteristics.Methods A total of 80 sub-healthy subjects were included,including 40 subhealth patients with spleen qi de ficiency syndrome and 40 subhealth patients with kidney qi deficiency syndrome were enrolled and underwent resting-state functional magnetic resonance imaging scans.The DPABI software was used to extract the degree centrality characteristics of all subjects,and a random forest model was used for classification.Results Between the sub-health spleen qi deficiency syndrome group and the sub-health kidney qi deficiency syndrome group,after feature selection,10 degree centrality features were finally obtained:The supplementary eye field,posterior cingulate gyrus,MT+area,pre-supramarginal sulcus,ventromedial visual area,secondary visual cortex,supramarginal sulcus,precuneus,ventral supramarginal gyrus complex and dorsolateral prefrontal cortex.Following hyperparameter optimization and leave-one-out cross-validation,a random forest classification model was obtained with an accuracy rate of 0.71.Conclusion The significant changes in the centrality of brain regions such as the supplementary eye field and posterior cingulate gyrus may be key brain regions underlying the neural mechanism differences between subhealth spleen qi deficiency syndrome and kidney qi deficiency syndrome,providing neuroimaging evidence for the cognitive neural basis differences in traditional Chinese medicine theories of"spleen in storing idea"and"kidney storing will".

Objective To explore the neuroimaging mechanisms of sub-health patients with spleen qi deficiency syndrome based on large-scale brain network resting-state functional connectivity.Methods Thirty-seven sub-health patients with spleen qi deficiency syndrome and 37 healthy controls were enrolled.All subjects underwent resting-state functional magnetic resonance imaging(fMRI)scans.Functional connectivity within and between large-scale brain networks was analyzed and compared between the two groups.The correlation between abnormal changes in brain network functional connectivity in the sub-health spleen qi deficiency syndrome group and spleen qi deficiency syndrome scores was also analyzed.Results Compared with the healthy control group,the sub-health spleen deficiency syndrome group showed significantly reduced functional connectivity within and between brain networks,including the visual network,sensorimotor network,dorsal attention network,frontoparietal network,and default mode network(P<0.05,NBS correction,5000 permutations).Among these,the functional connectivity between the sensorimotor network and the frontoparietal network(r=-0.357,P=0.030)and between the dorsal attention network and the frontoparietal network(r=-0.360,P=0.029)showed a significant negative correlation with the spleen qi deficiency syndrome score.Conclusion Abnormal changes in functional connectivity within and between large-scale brain networks in sub-health patients with spleen deficiency syndrome provide further neuroimaging evidence for the cognitive psychological connotation of the"spleen in storing idea"theory.

Objective To explore the neuroimaging mechanisms of cognitive impairment in sub-health patients with spleen qi deficiency syndrome and kidney qi deficiency syndrome using independent component analysis.Methods 40 sub-health patients with spleen qi deficiency syndrome and 40 kidney qi deficiency syndrome were recruited.All subjects underwent repeated neuropsychological testing and resting-state functional magnetic resonance imaging(fMRI)scans.Independent component analysis was used to compare functional connectivity differences between the two groups of subjects in the default mode network(DMN),frontoparietal network(FPN),dorsal attention network(DAN),and executive control network(ECN).The relationship between the differences in functional connectivity and cognitive function in the two groups of patients was also analyzed.Results In sub-health patients with spleen deficiency syndrome,the DMN included six brain regions,including the bilateral superior parietal lobule,left inferior occipital gyrus,and left lingual gyrus.The FPN included four brain regions,including the left superior parietal gyrus and the left caudate nucleus,the DAN included two brain regions,including the right superior temporal gyrus and the left medial frontal gyrus,and the ECN included the left central parietal lobule.The functional connectivity between the spleen qi deficiency syndrome symptom score and the left middle temporal gyrus and right superior temporal gyrus showed a significant positive correlation(r=0.371,P=0.028).In sub-health kidney qi deficiency syndrome patients,the DMN included six brain regions,including the left superior temporal gyrus,left precuneus,and right angular gyrus,the FPN included three brain regions,including the right middle temporal gyrus and right superior temporal gyrus,the DAN included four brain regions,including the right wedge lobe and the left medial frontal superior gyrus,and the ECN included the left central paracentral lobule and the right central posterior gyrus.Among these,the functional connectivity between the left wedge lobe and the left frontal middle gyrus showed a significant positive correlation with the syndrome score of kidney qi deficiency(r=0.404,P=0.016).Conclusion Sub-health patients with spleen qi deficiency syndrome and kidney qi deficiency syndrome exhibit different neuroimaging bases for cognitive impairment,providing neuroimaging evidence to elucidate the differences in the cognitive psychological connotation of the theories of"spleen in storing idea"and"kidney storing will".

Objective To investigate their potential differences in brain functional characteristics from a neuroimaging perspective,functional magnetic resonance imaging(fMRI)was employed.Methods Twenty chronic fatigue syndrome(CFS)patients were recruited and underwent assessments of traditional Chinese medicine(TCM)syndrome patterns,fatigue severity scores,and resting-state fMRI scans.First,correlation analysis was performed between fatigue scores and TCM symptom scores.Symptom clusters significantly associated with fatigue were categorized into spleen deficiency and liver stagnation groups.Principal component analysis(PCA)was then applied to identify the dominant symptom components for each group.These components were subsequently mapped onto whole-brain functional activity to compare the neural signatures between the two syndromes.Finally,the brain functional profiles of spleen deficiency and liver stagnation were compared with publicly available neurotransmitter receptor maps to explore their distinct neurochemical substrates.Results Symptoms correlated with fatigue severity included exhaustion,dizziness,chest tightness,bitter taste in the mouth,epigastric fullness,poor appetite,irritability,lumbar soreness,sallow complexion,dry eyes,and five-center-heat.The brain mapping results revealed that spleen deficiency-related symptoms(poor appetite,sallow complexion,reduced food intake,dizziness)were primarily associated with the left thalamus and left parahippocampal gyrus.Liver stagnation-related symptoms(dry eyes,chest tightness,irritability,bitter taste)were linked to the left parahippocampal gyrus and right middle occipital gyrus(lingual region).The functional brain spectrum of the two syndromes showed significant negative correlations.Moreover,the spleen deficiency spectrum was closely associated with vesicular acetylcholine transporter(VAChT)receptor density.The liver stagnation spectrum correlated with D2 dopamine receptor density.Both spectrums were significantly related to glucose metabolic density but exhibited opposing directional trends.Conclusion CFS patients with spleen deficiency and liver stagnation demonstrate distinct central functional activities and neurochemical substrates,along with opposing brain activity patterns.Clinically,differentiating between these two syndrome patterns is critical for applying targeted TCM interventions.