{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T12:00:07Z","timestamp":1792929607464,"version":"4.5.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T00:00:00Z","timestamp":1775779200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Tourette syndrome (TS) is a common pediatric neurodevelopmental disorder. Changma Xifeng tablet (CMXF), a traditional Chinese medicinal formulation, is widely used clinically for TS but its mechanisms remain unclear. This study aimed to evaluate CMXF\u2019s efficacy and explore its action mechanisms via a TS murine model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The chemical constituents of CMXF were analyzed and identified by UPLC-Q-TOF-MS\/MS. Sixty male BALB\/c mice were divided into 6 groups (CON, MOD, HAL, CMXF-L\/M\/H). TS models were induced by IDPN injection. Behavioral assessments, ELISA (neurotransmitters\/inflammatory cytokines), HE staining (striatal pathology), RT-qPCR\/WB (DRD1\/DRD2\/COMT\/MAO-B), and UHPLC-Q-TOF LC-MS (serum metabolomics) were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of twenty-one components, including gallic acid, gastrodin, catechin, sibiricose A3, paeoniflorin, parishin B, and tenuifoliside B, were identified in CMXF. From week 4 to week 8, the HAL group and CMXF-H group showed significantly improved behavioral performance compared with the MOD group (\n                      <jats:italic>F<\/jats:italic>\n                      &amp;gt; 1,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), presenting a dose-dependent trend. ELISA results revealed that CMXF-H significantly increased the levels of 5-HT in serum and striatum (\n                      <jats:italic>F<\/jats:italic>\n                      &amp;gt; 1,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), while decreasing the levels of DA, HVA, NE, IL-1\u03b2, and IL-6 in serum (\n                      <jats:italic>F<\/jats:italic>\n                      &amp;gt; 1,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). RT-qPCR and WB results indicated that CMXF regulated the mRNA and protein, inhibiting DRD1\/DRD2 expressions and inducing COMT\/MAO-B expressions. Serum metabolomics analysis identified 398 differentially expressed metabolites, which were mainly involved in lipid metabolism and organic acid metabolism pathways.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>CMXF exerts anti-TS effects by regulating neurotransmitters, inflammatory cytokines, DA signaling, and serum metabolites, providing novel insights into its mechanisms and potential targeted therapy for TS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1773753","type":"journal-article","created":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T06:02:30Z","timestamp":1775800950000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Mechanisms of Changma Xifeng tablet in alleviating Tourette syndrome via modulation of neurotransmitters, inflammatory responses, and metabolic pathways"],"prefix":"10.3389","volume":"17","author":[{"given":"Yuanyang","family":"Shao","sequence":"first","affiliation":[{"name":"Department of Chinese Medicine, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-E","family":"Guo","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Beijing Fengtai Hospital of Chinese Medicine (Beijing Fengtais Hospital of Nanyuan District)","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Chinese Medicine, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Bian","sequence":"additional","affiliation":[{"name":"Department of Chinese Medicine, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Chinese Medicine, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingyan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Chinese Medicine, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengjuan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Chinese Medicine, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Chinese Medicine, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunsheng","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Chinese Medicine, The First Affiliated Hospital of Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbr.2023.114606","article-title":"Tourette syndrome and obsessive-compulsive disorder: a comprehensive review of structural alterations and neurological mechanisms","volume":"453","author":"Shitova","year":"2023","journal-title":"Behav Brain Res"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.13703\/j.0255-2930.20230615-0002","article-title":"Patterns of acupoint selection in acupuncture treatment for pediatric Changma 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