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OBJECTIVE:To investigate the changes of subcorti-cal gray matter volume and cortical thickness,and-explorethe correlations between regional abnor-malities of cortical thickness and cognitive impair-ment and the effect of modified Bushenyisui decoc-tion(补肾益髓汤,BSYSD)on the cognitive function of multiple sclerosis(MS).METHODS:This prospective study was approved by the institutional review board.92 subjects were recruited,including 46 relapsing-remitting multiple sclerosis(RRMS)patients and 46 healthy controls(HC).Of the 46 patients,22 patients experienced the treatment of BSYSD for half a year.A conven-tional three-dimensional T1-weighted sequence were acquired for all participants on a 3.0 tesla magnetic resonance system.Basic information,de-tailed cognitive scales Montreal Cognitive Assess-ment(MoCA),symbol digit modalities test(SDMT),immediate memory,delayed recall,and long-term recognition were evaluated.Subcortical gray mat-ter volume and cortical thickness weremeasured by FreeSurfer.The correlations between cortical thick-ness which MS patients showed reduced with re-spect to HC and cognitive scales wereanalyzed by Pearson correlation in RRMS patients.The influence of modified BSYSD on MS patients'cognition was analyzed by paired T Test.RESULTS:MoCA,immediate memory,delayed re-call,and long-term delayed recognition in RRMS were significantly decreased than those of HC.Gray matter atrophy measured by FreeSurfer showed mainly in thalamus and hippocampus of RRMS pa-tients.Compared with HC,the cortical thickness of several regions in frontal lobe,parietal lobe,tempo-ral lobe,hippocampal,cingulate gyrus,and fusi-form gyrus of RRMS patients were decreased with significant difference.The regions of cortical thick-ness thinning related to MoCA,immediate memo-ry,delayed recall,and long-term delayed recogni-tion were temporal lobe and fusiform gyrus.Modi-fied BSYSD could improve MoCA,SDMT,immediate memory,delayed recall,and long-term delayed rec-ognition of MS patients,and it could promote the recovery of cognitive function in MS patients.CONCLUSIONS:Gray matter atrophy and cortical thickness thinning were validated in RRMS.Cortical thickness thinning of temporal lobe and fusiform gyrus strongly related to cognitive deficits in RRMS.The modified BSYSD could promote the recovery of cognitive function in MS.