Pharmacopsychiatry 2003; 36(4): 127-133
DOI: 10.1055/s-2003-41197
Original Paper
© Georg Thieme Verlag Stuttgart · New York

Cognitive Performance, SPECT, and Blood Viscosity in Elderly Non-demented People Using Ginkgo Biloba

R. F. Santos1 , J. C. F. Galduróz1 , A. Barbieri2 , M. L. V. Castiglioni2 , L. Y. Ytaya3 , O. F. A. Bueno1
  • 1Department of Psychobiology, Universidade Federal de São Paulo-Escola Paulista de Medicina
  • 2Imaging Diagnostics/Nuclear Medicine Department, Universidade Federal de São Paulo - Escola Paulista de Medicina
  • 3Nuclear Medicine Service, Hospital Israelita Albert Einstein, Brazil
Further Information

Publication History

Received: 19.12.2001 Revised: 2.9.2002

Accepted: 16.9.2002

Publication Date:
07 August 2003 (online)

The aging process is associated with several cognitive alterations. This study looks at the effects of taking dried extract of Ginkgo biloba, which has been used in several countries in an attempt to minimize these effects. The subjects were 48 men aged 60 - 70 matched between control and experimental groups for educational level. Evaluation was based on a number of neuropsychological tests in an attempt to cover the largest possible number of functions including Single Photon Emission Computer Tomography (SPECT) and measures of blood viscosity. The study was run on a double-blind basis with placebo and Ginkgo biloba groups evaluated over a period of 8 months. After treatment, the experimental group showed a reduction in blood viscosity, improved cerebral perfusion in specific areas and improved global cognitive functioning. The control group showed the opposite - higher blood viscosity, a reduction in cerebral perfusion (in specific areas), and cognitive deterioration in different functions. Although the mechanisms by which Ginkgo biloba may contribute to overall enhancement of the parameters evaluated have not been specified, this plant extract certainly appears to be effective in the treatment of cognitive deficits in older people. Further research into its use is called for on the basis of the results obtained here.

References

  • 1 Akiba S, Kawauchi T, Oka T, Hashizume T, Sato T. Inhibitory effect of the leaf extract of Ginkgo biloba L. on oxidative stress-induced platelet aggregation.  Biochem Mol Biol Int. 1998;  46(6) 243-8
  • 2 Almeida O P. Memory complaints and the diagnosis of dementia.  Arq Neuropsiquiatr. 1998;  56 412-418
  • 3 Andrade V M, Oliveira M GM, Miranda M C, Oliveira A SB, Oliveira E ML, Bueno O FA. Semantic relations and repetition of items enhance the free recall of words by multiple sclerosis patients. (submitted). 
  • 4 Attella M J, Hoffman S W, Stasio M J, Stein D G. Ginkgo biloba extract facilitates recovery from penetrating brain injury in adult male rats.  Exp Neurol. 1989;  105 62-71
  • 5 Bernasconi C, Del Santo A, Marrali F, Laffranchi M, Milani S, Agostoni A. Reference limits for blood viscosity: Influence of sex and age.  Clin Hemorheol. 1991;  11 447-457
  • 6 Bertolucci P HF, Brucki S MD, Campacci S R, Juliano Y. The Mini-Mental State Examination in ann outpatient population: impact of literacy.  Arq Neuropsiquiatr. 1994;  52 1-7
  • 7 Bolanos-Jimenez F, DeCastro R M, Sarhan H, Prudhome N, Drieu K, Fillion G. Stress-induced 5-HT1A receptor desensitization: Protective effects of Ginkgo biloba extract (Dried extract 761).  Fundamental Clin Pharmacol. 1995;  9 169-174
  • 8 Bolla K I, Lindgren K N, Bonaccorsy C, Bleecker M L. Memory complaints in older adults: Fact or Fiction.  Archives of Neurology. 1991;  48 61-64
  • 9 Bridi R, Crossetti F, Steffen V, Henriques A T. Estudo da atividade antioxidante do extrato padronizado de Ginkgo biloba (EGB 761) em hipocampo de ratos. XV Simpósio de Plantas Medicinais do Brasil, Águas de Lindóia - SP. October, 1998
  • 10 Celsis P, Agniel A, Cardebar D, Démonet J F, Ousset P J, Puel M. Age related cognitive decline: a clinical entity? A longitudinal study of cerebral blood flow and memory performance.  J Neurol Neurosurg Psychiatr. 1997;  6 601-608
  • 11 Chung T W, Ho C O. Changes in viscosity of low shear rates and viscoelastic properties of oxidative erythrocyte suspensions.  Clinical Hemorheology & Microcirculation. 1999;  21(2) 99-103
  • 12 Curtis-Prior P, Vere D, Fray P. Therapeutic value of Ginkgo biloba in reducing symptoms of decline in mental function.  J Pharmacy & Pharmacol. 1999;  51 535-41
  • 13 Dumont E, Arbigny P D, Nouvelot A. Protection of polyunsaturated fatty acids against iron-dependent lipid peroxidation by a Ginkgo biloba extrat (Egb 761). Methods Find.  Exp. Clin. Pharmacol.. 1995;  17 83-88
  • 14 Dunlosky J, Hertzog C. Updating knowledge about encoding strategies. A componential analysis of learning about strategy effectiveness from task experience.  Psychology and Aging. 2000;  15 462-474
  • 15 Galduróz J CF, Santos R F, Carlini E A. Os efeitos da idade e sexo sobre a viscosidade sangüínea em voluntários normais.  Temas. 1995;  50 159-166
  • 16 Goldstein S, Reivich M. Cerebral blood flow and metabolism in aging and dementia.  Clin Neuropharmacol. 1991;  14 (Suppl.) S34-44
  • 17 Haase J, Halama P, Hörr R. Efficacy of short-term treatment with intravenously administered Ginkgo biloba special extract EGb 761 in Alzheimer type and vascular dementia.  Zeitschrift für Gerontologie und Geriatrie. 1996;  29 302-309
  • 18 Hofferberth B. The efficacy of EGB-761 in patients with senile dementia of the Alzheimer-type. A double-blind, placebo-controlled study on different levels of investigation.  Human Psychopharmacology: Clinical and Experimental. 1994;  9 215-222
  • 19 Hoffman S W, Stein D G. Extract of Ginkgo biloba (dried extract 761) improves behavioral performance and reduces histopathology after cortical contusion in the rat.  Restorative Neurol Neurosci. 1997;  11 1-12
  • 20 Holgers K M, Axelsson A, Pringle I. Ginkgo biloba extract for the treatment of tinnitus.  Audiology. 1994;  33 85-92
  • 21 Hopfenmuller W. Evidence for a therapeutic effect of Ginkgo biloba special extract. Meta-analysis of 11 clinical studies in patientswith cerebrovascular insufficiency in old age.  Arzneimittel-Forsch/Drug Res. 1994;  44 1005-1013
  • 22 Howard D V, Fry A F, Brune C M. Aging and memory for new associations: Direct versus indirect measures.  Journal of Experimental Psychology: Learning, Memory, and Cognition. 1991;  17 779-792
  • 23 Jenkins L, Myerson J, Joerding J A, Hale S. Converging evidence that visuospatial cognition is more age-sensitive than verbal cognition.  Psychology and Aging. 2000;  15 157-175
  • 24 Kanowski S, Herrmann W M, Stephan K, Wierich W, Hörr R. Proof of efficacy of the Ginkgo biloba special extract EGb 761 in outpatients suffering from mild to moderate primary degenerative dementia of the Alzheimer type or multi-infarct dementia.  Pharmacopsychiatry. 1996;  29 47-56
  • 25 Kleijnen J, Knipschild P. Ginkgo biloba for cerebral insufficiency.  Brit J Clin Pharmacol. 1992;  34 352-358
  • 26 Klein I, Paradis A -L, Poline J B, Kosslyn S M, Bihan D L. Transient activity in the human calcarine cortex during visual-mental imagery: an event-related fMRI study.  Journal of Cognitive Neuroscience. 2000;  12 S15-23
  • 27 Krieglstein J, Beck T, Seibert A. Influence of an extract of Ginkgo biloba on cerebral blood flow and metabolism.  Life Sci. 1986;  39 2327-2334
  • 28 LeBars P L, Katz M M, Berman N, Itil T M, Freedman A M, Schatzberg A F. A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia.  JAMA. 1997;  278 1327-1332
  • 29 Lezak M D. Neuropsychological Assessment. 3rd Edition New York; Oxford University Press 1995
  • 30 Maitra I, Marcocci L, Droy-Lefaix M T, Packer L. Peroxyl radical scavenging activity of Ginkgo biloba dried extract EGb 761.  Biochem Pharmacol. 1995;  49 1649-1655
  • 31 Maurer K, Ihl R, Dierks T, Frolich L. Clinical efficacy of Ginkgo biloba special extract (dried extract 761) in dementia of the Alzheimer type.  Phytomedicine. 1998;  5 417-424
  • 32 Meyer B. A multicenter. randomized. double-blind drug versus placebo study of Ginkgo biloba extract in the treatment of tinnitus.  Presse Medicale. 1986;  15 1562-1564
  • 33 Meyer J S, Terayama Y, Takashima S. Cerebral circulation in the elderly.  Cerebral Vascular and Brain Metabolism Reviews. 1993;  5 122-146
  • 34 Mizumoto N. Regulação do fluxo sangüíneo cerebral. In: Stávale, M.C Bases da Terapia Intensiva Neurológica. Livraria Editora Santos 1996
  • 35 Moulton P L, Boyko L N, Fitzpatrick J L, Petros T V. The effect of Ginkgo biloba on memory in healthy male volunteers.  Physiology & Behavior. 2001;  73 659-665
  • 36 Murdock BB J r. The serial position effect of free recall.  Journal of Experimental Psychology. 1962;  64 482-488
  • 37 Nathan P J, Ricketts E, Wesnes K, Mrazek L, Greville W, Stough C. The acute nootropic effects of Ginkgo biloba in healthy older human subjects: A preliminary investigation.  Human Psychopharmacology: Clinical and Experimental. 2002;  17 45-49
  • 38 Oken B S, Storzbach D M, Kaye J A. The efficacy of Ginkgo biloba on cognitive function in Alzheimer disease.  Arch Neurol. 1998;  55 1409-1415
  • 39 Otten L J, Henson R NA, Rugg M D. Depth of processing effects on neural correlates of memory encoding.  Brain. 2001;  124 399-412
  • 40 Oyama Y, Chikahisa L, Ueha T, Kanemaru K, Noda K. Ginkgo biloba extract protects brain neurons against oxidative stress induced by hydrogen peroxide.  Brain Res. 1996;  712 349-352
  • 41 Polich J, Gloria R. Cognitive effects of a Ginkgo biloba/vinpocetine compound in normal adults: Systematic assessment of perception, attention and memory.  Human Psychopharmacology: Clinical and Experimental. 2001;  16 409-416
  • 42 Portney L G. Watkins, Foundations of Clinical Research: Applications to Practice. Norwik; Appleton and Lange 1993
  • 43 Rainho O (Ed.). Manual da Bateria CEPA de Aptidões Específicas. Rio de Janeiro; CEPA - Centro Editor de Psicologia Aplicada 1992
  • 44 Ritch R. Potential role for Ginkgo biloba extract in the treatment of glaucoma.  Med Hypotheses. 2000;  54 221-35
  • 45 Smith E E, Jonides J. Storage and executive processes in the frontal lobes.  Science. 1999;  283 1657-1661
  • 46 Smith P F, Maclennan K, Darlington C L. The neuroprotective properties of the Ginkgo biloba leaf: a review of the possible relationship to platelet-activating factor (PAF).  J Ethnopharmacol. 1996;  50 131-9
  • 47 Soholm B. Clinical improvement of memory and other cognitive functions by Ginkgo biloba: Review of relevant literature.  Advances in Therapy. 1998;  15 54-65
  • 48 Spreen O, Strauss E A. Compendium of Neuropsychological Tests. New York; Oxford University Press 1991
  • 49 Stein D G. Brain damage and recovery.  Progr Brain Res. 1994;  100 203-11
  • 50 Stuss D T, Benson D F. The frontal lobes and control of cognition and memory. In: Perecman, E. (ed.) The Frontal Lobe Revisited New York; The IRBN Press 1987
  • 51 Tadano T, Nakagawasai O, Tan-no K, Morikawa Y, Takahashi N, Kisara K. Effects of Ginkgo biloba extract on impairment of learning induced by cerebral ischemia in mice.  American Journal of Chinese Medicine. 1998;  26 127-32
  • 52 Timerbaeva S L, Suslina Z A, Bodareva E A, Fedin P A, Korepina O S, Pervosvanskii B E. Tanakan in the treatment of primary manifestations of insufficiency of brain blood supply.  Zh Nevrol Psikhiatr Im S S Korsakova;. 2000;  100(8) 24-8
  • 53 van Dongen M CJM, van Rossum E, Kessels A GH, Sielhorst H JG, Knipschild P G. The efficacy of ginkgo for elderly people with dementia and age-associated memory impairment: New results of a randomized clinical trial.  Journal of the American Geriatrics Society. 2000;  48 1183-1194
  • 54 White H L, Scates P W, Cooper B R. Extracts of Ginkgo biloba leaves inhibit monoamine oxidase.  Life Sciences. 1996;  58 1315-1321
  • 55 Zhang W R, Hayashi H Sasaki C, Sakai K, Warita H, Wang J M, Shiro Y, Uchida M, Abe K. protective effect of Ginkgo extract on rat brain with transient middle cerebral artery occlusion.  Neurol Res. 2000;  22 517-21

Dr. Ruth Ferreira Santos

R. Napoleão de Barros, 925

São Paulo - SP - CEP: 04024-002

Brazil

Email: ruthfs@uol.com.br

Email: ruth@psicobio.epm.br