TOPLINE:

Ginkgo biloba, a plant extract used in traditional medicine, has shown benefit in previous studies when used with antidementia medication. However, a new study showed G biloba monotherapy was associated with improved cognition, improved daily functioning, and reduced plasma amyloid beta (Aβ) levels in patients with mild cognitive impairment (MCI) compared with standard cognitive enhancers. Additionally, there was no conversion to Alzheimer’s disease (AD) dementia in any of the Ginkgo-treated patients.

METHODOLOGY:

• The retrospective cohort study was conducted in South Korea and included patients with amyloid PET-positive MCI, 42 of whom received G biloba (240 mg/d orally) and 22 who received standard cognitive enhancers, including choline precursors and omega-3 fatty acid supplements. Neither group received adjunctive antidementia medications; all were followed for 12 months.
• Data were obtained from the Soonchunhyang Dementia Registry. Measures included the Korean version of the Mini-Mental State Examination (K-MMSE) for global cognitive function, the Clinical Dementia Rating-Sum of Boxes (CDR-SB) for multidomain cognitive and functional abilities, and the Korean Instrumental Activities of Daily Living (K-IADL), with a higher score showing greater impairment.
• Plasma Multimer Detection System-Oligomeric Aβ (MDS-OAβ) levels were assessed at baseline and at 12 months to evaluate Aβ “oligomerization tendency,” or the propensity of the proteins to aggregate into small clusters.
• Responders were defined as those with no decline in K-MMSE scores and no increase in CDR-SB scores over 12 months. Conversion to AD was defined as a K-IADL score increase from < 0.4 at baseline to ≥ 0.4 at 12 months.

TAKEAWAY:

• The G biloba group achieved a higher responder rate at 12 months than the control group (100% vs 59%, respectively; P < .001), with no conversion to AD (0% vs 14%; P = .04).
• The Gingko-treated group also showed a significant improvement in K-MMSE scores from baseline (28.4-28.8; within-group P = .008), whereas the control group showed a decline in scores (28.5-27.7; within-group P = .008). Significant between-group differences were also observed (P < .001).
• K-IADL total scores improved significantly in the G biloba group (3.4-2.5; P = .001) but worsened in the control group (3.0-3.5; P = .01), with significant between-group differences (P < .001).
• Finally, plasma MDS-OAβ levels were significantly decreased in the Gingko group (0.88-0.80 ng/mL; P < .001) but showed a nonsignificant increase in the control group (0.89-0.91 ng/mL). Adverse events were mild and transient in both groups.

IN PRACTICE:

“This study provides preliminary but compelling evidence that Ginkgo biloba monotherapy may offer clinical and biological benefits in amyloid PET-positive MCI,” the investigators of the study wrote.

“By stabilizing cognitive performance and reducing amyloid oligomerization in plasma, Ginkgo may represent a cost-effective and accessible option for early-stage intervention in the Alzheimer’s continuum,” they added.

SOURCE:

The study was led by YoungSoon Yang, Soonchunhyang University Cheonan Hospital in Cheonan-si, Republic of Korea. It was published online on August 15 in the Frontiers in Neurology.

LIMITATIONS:

The retrospective and nonrandomized nature of this study limited causal inference, while the sample size did not provide sufficient power to detect subtler subgroup effects or rare adverse events. There was also a possibility of residual confounding, and adherence to assigned treatments was not objectively measured. Additionally, the MDS-OAβ biomarker used in this study is not yet globally standardized, and the study did not assess other potential biomarkers such as plasma p-tau or neurofilament light chain.

DISCLOSURES:

The investigators reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.