Gingko Goes on Trial Again…This Time in London
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Though there is experimental evidence for and against claims that gingko biloba can boost memory (see, e.g., ARF related news story on negative trial in healthy adults), a few positive studies, combined with persistent anecdotal evidence and advertising, have helped boost the coffers of supplement makers, especially in Europe, where gingko is commonly used in attempts to boost memory both in normal aging and in Alzheimer disease. Researchers will now attempt to put gingko to a rigorous scientific test in the earliest stages of AD, according to a news release issued August 19 by the Imperial College London. The project is funded by the Alzheimer's Society, and the London School of Hygiene and Tropical Medicine, along with the Royal London Homeopathic Hospital, will also collaborate in the research.
The researchers, led by James Warner, of Imperial College London and St Mary's Hospital, intend to study 250 patients, aged 55 and over, who are still living in the community and being treated by a general practitioner. Gingko (60 mg, twice daily) will be tested against a placebo in the double-blind trial. Patients will continue to take their conventional medicines for age-associated memory loss.
"We believe gingko may prove more effective if prescribed in a community setting, where patients' symptoms are usually less severe. This trial will help us to find out whether with gingko it's a case of 'the sooner the better' for patients who may benefit from taking it," Warner is quoted as saying in the press release.—Hakon Heimer
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Medical University of Lodz, LZ, Poland
Interesting trial and...a nice try at the same time. Using too low a dose will generate no clear answers on gingko efficacy. In my opinion, the arm of 120 mg of gingko versus 240 mg of gingko versus placebo would be rational advice. So far, both doses have been shown to be either beneficial (e.g., ref 1,2) or of no effect (e.g., ref 3,4). Additionally, the trial should be powered to detect a possible relationship between severity of cognitive decline, dose of gingko, and its efficacy. This should be done, since most of the negative trials are in healthy subjects or in subjects who do not fulfill criteria for dementia.
References:
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. North American EGb Study Group. JAMA. 1997 Oct 22-29;278(16):1327-32. PubMed.
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 Nov;36(6):297-303. PubMed.
van Dongen M, van Rossum E, Kessels A, Sielhorst H, Knipschild P. Ginkgo for elderly people with dementia and age-associated memory impairment: a randomized clinical trial. J Clin Epidemiol. 2003 Apr;56(4):367-76. PubMed.
Solomon PR, Adams F, Silver A, Zimmer J, DeVeaux R. Ginkgo for memory enhancement: a randomized controlled trial. JAMA. 2002 Aug 21;288(7):835-40. PubMed.
Two years ago, my wife, now age 76, was diagnosed as early phase AD. Personal observations caused my concern at least four years ago, and we thus reported this to her internist. There followed multiple consultations with neurologists, psychotherapists, MRIs, etc. The use of ginko was not encouraged, and as a matter of fact, one internist halted its use.
She takes 3/30 mg of ginko biloba each morning and night. Prescriptions include Aricept, 10 mg/p.m. since May 2002, and Namenda, 10 mg twice each day since September 2003.
Her current stage is now diagnosed as early middle AD. Any comments?
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