title: Effects of Gingko biloba supplementation in Alzheimer's disease patients receiving cholinesterase inhibitors: data from the ICTUS study.
abstract: Ginkgo biloba (Gb) is currently the most investigated and adopted herbal remedy for cognitive disorders and Alzheimer's disease (AD). Nevertheless, its efficacy in the prevention and treatment of dementia still remains controversial. Specifically, the added effects of Gb in subjects already receiving "conventional" anti-dementia treatments have been to date very scarcely investigated. We evaluated whether the use of Gb is associated with additional cognitive and functional benefit in AD patients already in treatment with cholinesterase inhibitors (ChEIs). Data are from mild to moderate AD patients under ChEI treatment recruited in the Impact of Cholinergic Treatment USe (ICTUS) study. Mixed model analyses were performed to measure six-monthly modifications in the Mini Mental State Examination (MMSE), the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog) subscale score, and the Activities of Daily Living (ADL) scale over a follow-up of 1 year according to the additional Gb supplementation. A total of 828 subjects were considered for the present analyses. Significantly different modifications at the MMSE score over the 12-month follow-up were reported between patients on combined therapy compared to those only taking ChEIs. On the contrary, the modification of the ADAS-Cog score between the two groups did not show statistically significant differences, although similar trends were noticed. No significant modifications of the two adopted outcome measures were observed at the mid-term 6-month evaluation. The modifications over time of the ADL score did not show statistically significant differences between the two groups of interest. Our findings suggest that Gb may provide some added cognitive benefits in AD patients already under ChEIs treatment. The clinical meaningfulness of such effects remains to be confirmed and clarified.
authors.affiliation: Memory Clinic, Department of Neurology and Psychiatry, "Sapienza" University, Rome, Italy; Gérontopôle, Centre Hospitalier Universitaire de Toulouse, France. Electronic address: marco.canevelli@gmail.com.
authors.forename: Marco
authors.initials: M
authors.lastname: Canevelli
authors.affiliation: Gérontopôle, Centre Hospitalier Universitaire de Toulouse, France; Service de Neurologie, CHU Mohammed VI, Faculté de Médecine et de Pharmacie de Marrakech, Morocco.
authors.forename: Nawal
authors.initials: N
authors.lastname: Adali
authors.affiliation: Gérontopôle, Centre Hospitalier Universitaire de Toulouse, France.
authors.forename: Eirini
authors.initials: E
authors.lastname: Kelaiditi
authors.affiliation: Gérontopôle, Centre Hospitalier Universitaire de Toulouse, France; Inserm UMR1027, Toulouse, France; Université de Toulouse III Paul Sabatier, Toulouse, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Cantet
authors.affiliation: Gérontopôle, Centre Hospitalier Universitaire de Toulouse, France.
authors.forename: Pierre-Jean
authors.initials: PJ
authors.lastname: Ousset
authors.affiliation: Gérontopôle, Centre Hospitalier Universitaire de Toulouse, France; Inserm UMR1027, Toulouse, France; Université de Toulouse III Paul Sabatier, Toulouse, France.
authors.forename: Matteo
authors.initials: M
authors.lastname: Cesari
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy*; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000188:drug therapy*; D019587:Dietary Supplements; D004359:Drug Therapy, Combination; D005260:Female; D020441:Ginkgo biloba; D006801:Humans; D008297:Male; D008517:Phytotherapy; D028321:Plant Preparations / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D002800:Cholinesterase Inhibitors; D028321:Plant Preparations
keywords: Alzheimer's disease; Cholinesterase inhibitors; Cognitive impairment; Ginkgo biloba