title: Ginkgo biloba extract: mechanisms and clinical indications.
abstract: OBJECTIVE
  Ginkgo biloba may have a role in treating impairments in memory, cognitive speed, activities of daily living (ADL), edema, inflammation, and free-radical toxicity associated with traumatic brain injury (TBI), Alzheimer's dementia, stroke, vasoocclusive disorders, and aging. The purpose of this review is to provide a synthesis of the mechanisms of action, clinical indications, and safety of Ginkgo biloba extract.
  
  
  METHODS
  Empirical studies, reviews, chapters, and conference proceedings were identified in the following databases: Medline, the Research Council for Complementary Medicine based on the British Library database, and Psychlnfo. Ginkgo biloba, EGb 761, Tanakan, Tebonin, Rokan, and LI 1370 were the principal index terms.
  
  
  METHODS
  Controlled clinical studies with both positive and negative findings are included, in addition to animals studies illustrating mechanisms of activity.
  
  
  RESULTS
  Ginkgo has shown activity centrally and peripherally, affecting electrochemical, physiologic, neurologic, and vascular systems in animals and humans with few adverse side effects or drug interactions. Ginkgo shows promise in patients with dementia, normal aging, and cerebrovascular-related disorders. Clinical indications include memory, information processing, and ADL.
  
  
  CONCLUSIONS
  Ginkgo shows promise in treating some of the neurologic sequelae associated with Alzheimer's disease, TBI, stroke, normal aging, edema, tinnitus, and macular degeneration. Mechanisms of action may include antioxidant, neurotransmitter/receptor modulatory, and antiplatelet activating factor properties. While safe, caution is advised when recommending ginkgo to patients taking anticoagulants. Future studies should examine dose effects, component activity, mechanisms, and clinical applications.
authors.affiliation: Department of Research, Center for Research in Complementary and Alternative Medicine, Kessler Medical Rehabilitation Research and Education Corporation, West Orange, NJ 07052, USA.
authors.forename: B J
authors.initials: BJ
authors.lastname: Diamond
authors.forename: S C
authors.initials: SC
authors.lastname: Shiflett
authors.forename: N
authors.initials: N
authors.lastname: Feiwel
authors.forename: R J
authors.initials: RJ
authors.lastname: Matheis
authors.forename: O
authors.initials: O
authors.lastname: Noskin
authors.forename: J A
authors.initials: JA
authors.lastname: Richards
authors.forename: N E
authors.initials: NE
authors.lastname: Schoenberger
mesh_terms: D000818:Animals; D002986:Clinical Trials as Topic; D005419:Flavonoids / Q000009:adverse effects / Q000627:therapeutic use*; D020441:Ginkgo biloba; D006801:Humans; D010936:Plant Extracts; D012046:Rehabilitation; D016896:Treatment Outcome; D000096983:Ginkgo Extract
chemical_list: D005419:Flavonoids; D010936:Plant Extracts; C063170:Ginkgo biloba extract; D000096983:Ginkgo Extract