Journal of the Neurological Sciences
Volume 283, Issue 1 , Pages 224-229 , 15 August 2009

Efficacy and tolerability of Ginkgo biloba extract EGb 761® by type of dementia: Analyses of a randomised controlled trial

  • Oleksandr Napryeyenko

      Affiliations

    • Psychiatry, National Medical University, Kyiv City Clinical Psychoneurological Hospital No. 1, 103 A, Frunze Str., Kyiv 04080, Ukraine
    • ,
  • Grigoriy Sonnik

      Affiliations

    • Psychiatry, Narcology and Medical Psychology Faculty, Poltava Regional Psychoneurological Dispensary, 3, Zygina Str., Poltava 36037, Ukraine
    • ,
  • Igor Tartakovsky

      Affiliations

    • Clinical Research Department, Dr. Willmar Schwabe GmbH & Co. KG, Willmar-Schwabe-Str. 4, 76227 Karlsruhe, Germany
    • Corresponding Author InformationCorresponding author. Fax: +49 721 4005 8545.

References 

  1. Ernst E, Pittler MH. Ginkgo biloba for vascular dementia and Alzheimer's disease: updated systematic review of double-blind, placebo-controlled, randomized trials. Perfusion. 2005;18:388–392
  2. Hoerr R. Behavioural and psychological symptoms in dementia (BPSD): effects of EGb 761®. Pharmacopsychiatry. 2003;36(suppl 1):S56–61
  3. Napryeyenko O, Borzenko I for the GINDEM-NP Study Group. Ginkgo biloba special extract in dementia with neuropsychiatric features. A randomised, placebo-controlled, double-blind clinical trial. Arzneimittelforschung. 2007;56:4–11
  4. Költringer P, Langsteger W, Eber O. Dose-dependent hemorheological effects and microcirculatory modifications following intravenous administration of Ginkgo biloba special extract EGb 761. Clin Hemorheol. 1995;15:649–656
  5. Eckert A, Keil U, Kressmann S, Schindowski K, Leutner S, Leutz S, et al. Effects of EGb 761® Ginkgo biloba extract on mitochondrial function and oxidative stress. Pharmacopsychiatry. 2003;36(suppl 1):S15–23
  6. Sastre J, Lloret A, Borrás C, Pereda J, García-Sala D, Droy-Lefaix MT, et al. Ginkgo biloba extract EGb 761® protects against mitochondrial aging in the brain and in the liver. Cell Mol Biol. 2002;48:685–692
  7. Hoyer S, Lannert H, Nöldner M, Chatterjee SS. Damaged neuronal energy metabolism and behavior are improved by Ginkgo biloba extract (EGb 761). J Neural Transm. 1999;106:1171–1188
  8. Luo Y, Smith JV, Paramasivam V, Burdick A, Curry KJ, Buford JP, et al. Inhibition of amyloid-β aggregation and caspase-3 activation by the Ginkgo biloba extract EGb 761®. Proc Natl Acad Sci U S A. 2002;99:12197–12202
  9. Wu Y, Wu Z, Butko P, Christen Y, Lambert MP, Klein WL, et al. Amyloid-β-induced pathological behaviors are suppressed by Ginkgo biloba extract EGb 761® and ginkgolides in transgenic Caenorhabditis elegans. J Neurosci. 2006;26:13102–13113
  10. Krištofiková Z, Benešová O, Tejkalová H. Changes of high-affinity choline uptake in the hippocampus of old rats after long-term administration of two nootropic drugs (tacrine and Ginkgo biloba extract). Dementia. 1992;3:304–307
  11. Huguet F, Drieu K, Piriou A. Decreased cerebral 5-HT1A receptors during aging: reversal by Ginkgo biloba extract (EGb 761). J Pharm Pharmacol. 1994;46:316–318
  12. Kanowski S, Hoerr R. Ginkgo biloba extract EGb 761® in dementia: intent-to-treat analyses of a 24-week, multi-center, double-blind, placebo-controlled, randomized trial. Pharmacopsychiatry. 2003;36:297–303
  13. Le Bars PL, Katz MM, Berman N, Itil TM, Freedman AM, Schatzberg AF. A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. JAMA. 1997;278:1327–1332
  14. Vermeer SE, Prins ND, den Heijer T, Hofman A, Koudstaal PJ, Breteler MMB. Silent brain infarcts and the risk of dementia and cognitive decline. N Engl J Med. 2003;348:1215–1222
  15. Hofman A, Ott A, Breteler MMB, Bots ML, Slooter AJC, van Harskamp F, et al. Atherosclerosis, apolipoprotein E, and prevalence of dementia and Alzheimer's disease in the Rotterdam Study. Lancet. 1997;349:151–154
  16. Kivipelto M, Helkala EL, Laakso MP, Hänninen T, Hallikainen M, Alhainen K, et al. Midlife vascular risk factors and Alzheimer's disease in later life: longitudinal, population based study. BMJ. 2001;322:1447–1451
  17. Luchsinger JA, Reitz C, Honig LS, Tang MX, Shea S, Mayeux R. Aggregation of vascular risk factors and risk of incident Alzheimer disease. Neurology. 2005;65:545–551
  18. Snowdon DA, Greiner LH, Mortimer JA, Riley KP, Greiner PA, Markesbery WR. Brain infarction and the clinical expression of Alzheimer disease. The Nun Study. JAMA. 1997;277:814–815
  19. Neuropathology Group of the Medical Research Council Cognitive Function and Ageing Study. Pathological correlates of late-onset dementia in a multicentre, community-based population in England and Wales. Lancet. 2001;357:169–175
  20. Langa KM, Foster NL, Larson EB. Mixed dementia. Emerging concepts and therapeutic implications. JAMA. 2004;292:2901–2908
  21. Korczyn AD. Mixed dementia — the most common cause of dementia. Ann N Y Acad Sci. 2002;977:129–134
  22. Förstl H. Alzheimer-plus. Int Psychogeriatr. 2003;15:7–8
  23. International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). Good Clinical Practice: Consolidated Guideline. Geneva: ICH; 1996.
  24. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984;34:939–944
  25. Román GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH, et al. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology. 1993;43:250–260
  26. Mahoney R, Johnston K, Katona C, Maxmin K, Livingston G. The TE4D-Cog: a new test for detecting early dementia in English-speaking populations. Int J Geriatr Psychiatry. 2005;20:1172–1179
  27. Ihl R, Biesenbach A, Brieber S, Grass-Kapanke B, Salamon T. A head-to-head comparison of the sensitivity of two screening tests for dementia. Mini-Mental-State-Examination (MMSE) and the Test for the Early Detection of Dementia with Discrimination from Depression (TE4D). Psychogeriatria Polska. 2005;2:263–271
  28. Kim YS, Nibbelink DW, Overall JE. Factor structure and scoring of the SKT test battery. J Clin Psychol. 1993;49:61–71
  29. Ihl R, Grass-Kapanke B, Jänner M, Weyer G. Neuropsychometric tests in cross sectional and longitudinal studies — a regression analysis of ADAS-Cog, SKT and MMSE. Pharmacopsychiatry. 1999;32:248–254
  30. Sunderland T, Hill JL, Mellow AM, Lawlor BA, Gundersheimer J, Newhouse PA, et al. Clock drawing in Alzheimer's disease. A novel measure of dementia severity. J Am Geriatr Soc. 1989;37:725–729
  31. Cummings JL. The neuropsychiatric inventory: assessing psychopathology in dementia patients. Neurology. 1997;48(suppl 6):S10–16
  32. Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56–62
  33. Bråne G, Gottfries CG, Winblad B. The GBS scale: validity, reliability and application in anti-dementia drug trials. Dement Geriatr Cogn Disord. 2001;12:1–14
  34. Rosen WG. Verbal fluency in aging and dementia. J Clin Neuropsychol. 1980;2:135–146
  35. Weitbrecht WU, Jansen W. Primär degenerative Demenz: Therapie mit Ginkgo-biloba-Extrakt. Placebokontrollierte Doppelblind- und Vergleichsstudie. [Ginkgo biloba extract in the treatment of primary degenerative dementia. Placebo-controlled, double-blind and comparative study.]. Fortschr Med. 1986;104:199–202
  36. 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. Hum Psychopharmacol. 1994;9:215–222
  37. Maurer K, Ihl R, Dierks T, Frölich L. Clinical efficacy of Ginkgo biloba special extract EGb 761® in dementia of the Alzheimer type. J Psychiat Res. 1997;31:645–655
  38. Schneider LS, DeKosky ST, Farlow MR, Tariot PN, Hoerr R, Kieser M. A randomized, double-blind, placebo-controlled trial of two doses of Ginkgo biloba extract in dementia of the Alzheimer's type. Curr Alzheimer Res. 2005;2:541–551
  39. Mancini M, Agozzino B, Bompani R. Effetti clinico-terapeutici dell'estratto di Ginkgo biloba (EGb) in confronto a placebo, nel trattamento di pazienti affetti da demenza psicorganica senile su base arteriosclerotica. [Clinical and therapeutic effects of Ginkgo biloba extract (EGb) versus placebo in the treatment of psycho-organic senile dementia of arteriosclerotic origin.]. Gazz Med Ital — Arch Sci Med. 1993;152:69–80
  40. Lyketsos CG, Lopez O, Jones B, Fitzpatrick AL, Breitner J, DeKosky ST. Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment. Results from the Cardiovascular Health Study. JAMA. 2002;288:1475–1483
  41. Schneider LS, Olin JT, Lyness SA, Chui HC. Eligibility of Alzheimer's disease clinic patients for clinical trials. J Am Geriatr Soc. 1997;45:923–928

PII: S0022-510X(09)00442-0

doi: 10.1016/j.jns.2009.02.353

Journal of the Neurological Sciences
Volume 283, Issue 1 , Pages 224-229 , 15 August 2009

Article Tools

* Image Usage & Resolution