Zhang YQ. Herbal medicine for mild cognitive impairment: Neuroimaging perspectives. World J Clin Cases 2026; 14(16): 118410 [DOI: 10.12998/wjcc.v14.i16.118410]
Corresponding Author of This Article
Yu-Qi Zhang, Researcher, Department of Geriatrics, Harbin Traditional Chinese Medicine Hospital, No. 270A Jianguo Street, Daoli District, Harbin 150010, Heilongjiang Province, China. zhangyu-qi@outlook.com
Research Domain of This Article
Neuroimaging
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Herbal medicine for mild cognitive impairment: Neuroimaging perspectives
Yu-Qi Zhang
Yu-Qi Zhang, Department of Geriatrics, Harbin Traditional Chinese Medicine Hospital, Harbin 150010, Heilongjiang Province, China
Author contributions: Zhang YQ contributed to conceptualization, literature search, data curation, writing-original draft preparation, writing-review & editing, and final approval of the version to be published.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Corresponding author: Yu-Qi Zhang, Researcher, Department of Geriatrics, Harbin Traditional Chinese Medicine Hospital, No. 270A Jianguo Street, Daoli District, Harbin 150010, Heilongjiang Province, China. zhangyu-qi@outlook.com
Received: January 4, 2026 Revised: January 30, 2026 Accepted: April 20, 2026 Published online: June 6, 2026 Processing time: 142 Days and 1 Hours
Abstract
Mild cognitive impairment (MCI) represents a critical preclinical stage of dementia, with 10%-15% annual progression to Alzheimer’s disease. Although conventional pharmacotherapies provide limited symptomatic relief, herbal medicines have attracted increasing interest because of their pleiotropic mechanisms, which may target neuroinflammation, cholinergic dysfunction, cerebral hypometabolism, and gut microbiota imbalance. Contemporary neuroimaging evidence, derived from preclinical animal models and a limited number of human studies, suggests that standardized herbal interventions may be associated with hippocampal volume preservation, modulation of default mode network connectivity, alternations in cerebral glucose metabolism, and changes in white matter integrity. Nevertheless, substantial challenges remain in clinical translation, including insufficient phytochemical standardization, heterogeneity in neuroimaging protocols, and a lack of robust predictive models. Future research should prioritize mechanistic studies that elucidate causal relationships between bioactive herbal compounds and neuroimaging biomarkers, while also exploring potential synergy with lifestyle interventions. This integrated approach may ultimately facilitate the development of evidence-based, disease-modifying strategies for the management of MCI.
Core Tip: Mild cognitive impairment (MCI) is a critical and potentially reversible stage preceding dementia, yet current pharmacological options offer limited benefit. This review highlights herbal medicines as multi-target interventions acting on neuroinflammation, cholinergic dysfunction, cerebral metabolism, and the gut-brain axis. Importantly, converging evidence from multimodal neuroimaging, including structural magnetic resonance imaging, functional magnetic resonance imaging, positron emission tomography, and diffusion tensor imaging, demonstrates measurable brain structural, functional, and metabolic benefits of standardized herbal interventions. Integrating neuroimaging biomarkers with phytochemical standardization and artificial intelligence may accelerate precision, disease-modifying strategies for MCI.
