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Ginkgo biloba Extract EGb 761 in the Treatment of Patients with Mild Neurocognitive Impairment: A Systematic Review.

  • 2023-03-23
  • Neuropsychiatric disease and treatment 19
    • Jakub Hort
    • Thomas Duning
    • Robert Hoerr

Study Design

Type
Review
Sample size
n = 946
Population
946 patients meeting DSM-5 criteria for mild neurocognitive disorder (mild NCD) from 9 trials
Methods
Systematic review of MEDLINE, PubMed and EMBASE for randomized, placebo-controlled double-blind trials of EGb 761 in mild impairment of cognitive functioning; inclusion of trials with patients meeting retrospectively applied DSM-5 criteria for mild NCD

Background

Many clinical trials testing Ginkgo biloba extract EGb 761 in patients with mild forms of cognitive impairment were conducted before widely accepted terms and diagnostic criteria for such conditions were available. This makes it difficult to compare any results from earlier and more recent trials. The objective of this systematic review was to provide a descriptive overview of clinical trials of EGb 761 in patients who met the diagnostic criteria for mild neurocognitive disorder (mild NCD) according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5).

Methods

MEDLINE, PubMed and EMBASE were searched for randomized, placebo-controlled double-blind trials of EGb 761 in mild impairment of cognitive functioning. All trials involving patients who met retrospectively applied diagnostic criteria for mild NCD were included. Trials of primary prevention of dementia and trials of combinations of medical treatments were excluded.

Results

Among 298 records found in databases and 76 further records related to EGb 761 in references of systematic reviews, 9 reports on clinical trials involving 946 patients met the pre-specified criteria for inclusion. Beneficial effects of EGb 761 were seen in neuropsychological tests (8 of 9 studies), scales for neuropsychiatric symptoms (3 of 3 studies), geriatric rating scales (1 of 2 studies) and global ratings of change (1 of 1 study). Significant effects were found in several domains of cognition (memory, speed of processing, attention and executive functioning). Among the neuropsychiatric symptoms, depression (2 of 3 studies) and anxiety (1 of 1 study) were significantly improved. No differences between EGb 761 treatment and placebo were seen with regard to the rates of adverse events.

Discussion

The included studies demonstrate treatment benefits of Ginkgo biloba extract EGb 761, mainly on cognitive deficits and neuropsychiatric symptoms, in patients with mild NCD. The drug was safe and well tolerated.

Research Insights

  • Ginkgo→Improved Attention Span

    Significant effects were found in several domains of cognition (memory, speed of processing, attention and executive functioning)

    Effect
    Beneficial
    Effect size
    Moderate
  • Ginkgo→Improved Cognitive Function

    Beneficial effects of EGb 761 were seen in neuropsychological tests (8 of 9 studies)

    Effect
    Beneficial
    Effect size
    Moderate
  • Ginkgo→Improved Executive Function

    Significant effects were found in several domains of cognition (memory, speed of processing, attention and executive functioning)

    Effect
    Beneficial
    Effect size
    Moderate
  • Ginkgo→Improved Geriatric Rating

    geriatric rating scales (1 of 2 studies)

    Effect
    Neutral
    Effect size
    Small
  • Ginkgo→Improved Global Rating of Change

    global ratings of change (1 of 1 study)

    Effect
    Beneficial
    Effect size
    Small
  • Ginkgo→Improved Memory Function

    Significant effects were found in several domains of cognition (memory, speed of processing, attention and executive functioning)

    Effect
    Beneficial
    Effect size
    Moderate
  • Ginkgo→Improved Processing Speed

    Significant effects were found in several domains of cognition (memory, speed of processing, attention and executive functioning)

    Effect
    Beneficial
    Effect size
    Moderate
  • Ginkgo→Reduced Anxiety

    Among the neuropsychiatric symptoms, depression (2 of 3 studies) and anxiety (1 of 1 study) were significantly improved

    Effect
    Beneficial
    Effect size
    Moderate
  • Ginkgo→Reduced Depression Symptoms

    Among the neuropsychiatric symptoms, depression (2 of 3 studies) and anxiety (1 of 1 study) were significantly improved

    Effect
    Beneficial
    Effect size
    Moderate
  • Ginkgo→Reduced Neuropsychiatric Symptom

    scales for neuropsychiatric symptoms (3 of 3 studies)

    Effect
    Beneficial
    Effect size
    Moderate

Adverse Events Reported

  • Ginkgo→Overall tolerability

    No differences between EGb 761 treatment and placebo were seen with regard to the rates of adverse events.

    Finding
    No significant difference
    Significant
    No
  • Ginkgo→Overall tolerability

    The drug was safe and well tolerated.

    Finding
    Reported
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