Ginkgo biloba extract EGb761 reduces the development of amphetamine-induced behavioral sensitization: effects on hippocampal type II corticosteroid receptors

Neuroprotective and Antioxidant Effect of Ginkgo biloba Extract Against AD and Other Neurological Disorders

Alzheimer's disease (AD) is the most common progressive human neurodegenerative disorder affecting elderly population worldwide. Hence, prevention of AD has been a priority of AD research worldwide. Based on understanding of disease mechanism, different therapeutic strategies involving synthetic and herbal approaches are being used against AD. Among the herbal extract, Ginkgo biloba extract (GBE) is one of the most investigated herbal remedy for cognitive disorders and Alzheimer's disease (AD). Standardized extract of Ginkgo biloba is a popular dietary supplement taken by the elderly population to improve memory and age-related loss of cognitive function. Nevertheless, its efficacy in the prevention and treatment of dementia remains controversial. Specifically, the added effects of GBE in subjects already receiving "conventional" anti-dementia treatments have been to date very scarcely investigated. This review summarizes recent advancements in our understanding of the potential use of Ginkgo biloba extract in the prevention of AD including its antioxidant property. A better understanding of the mechanisms of action of GBE against AD will be important for designing therapeutic strategies, for basic understanding of the underlying neurodegenerative processes, and for a better understanding of the effectiveness and complexity of this herbal medicine.

Ginkgo biloba: A Cognitive Enhancer?

Ginkgo biloba is an herb often used as an alternative treatment to improve cognitive functions. Like most herbal treatments, the use of ginkgo is poorly regulated by government agencies, on the basis of either its efficacy or its health risks. This article reviews the experimental evidence available regarding efficacy, neurobiological actions, and health risks. Findings obtained in studies of humans often include demonstrations of rather mild cognitive enhancement. Interpretation of these findings is complicated by somewhat inconsistent findings, by experimental designs that do not permit identification of cognitive functions susceptible to the influence of ginkgo, and by the paucity of direct comparisons with other treatments. The number of peer-reviewed reports of studies in nonhuman animals is surprisingly small. In this small set, the findings reveal mild behavioral effects that might be attributable to actions on cognitive functions. However, these experiments in rodents, like those in humans, do not involve the use of designs to assess ginkgo's effects on particular cognitive attributes, and generally do not include direct comparisons with other treatments. Interpretation of the findings is further complicated by evidence, obtained in studies of both humans and rats, showing that a single administration of the treatment enhances performance on cognitive measures.

If ginkgo has effects on cognition, there should be effects evident on biological processes as well. Neurobiological studies have largely examined the effects of chronic ginkgo administration, mirroring the most common design in behavioral studies. However, the addition of findings that single administration of ginkgo may influence behavior directs biological investigations to short-term actions of the treatment. Biological effects of ginkgo include vasodilation, protection of neurons from oxidative stress, and actions mediated by effects via neurotransmitters. Adverse reactions to ginkgo consumption have been observed but are relatively rare.

Collectively, the behavioral literature reviewed cannot be used conclusively to document or to refute the efficacy of ginkgo in improving cognitive functions. At best, the effects seem quite modest. In particular, it is questionable whether effects of ginkgo, if present, are equal to those obtained by administration of acetylcholinesterase inhibitors, hearing an arousing story, or ingesting glucose.

Effects of bilobalide on anxiety, spatial learning, memory and levels of hippocampal glucocorticoid receptors in male Kunming mice

With various constituents in ginkgo biloba extract, the detailed internal mechanism underlying a reduction in anxiety and improvements to learning and memory from GBE is not well understood. The present study investigated whether bilobalide, an important constituent in GBE, could affect anxiety, spatial learning and memory in male mice and whether hippocampal glucocorticoid receptor expression is associated with alteration in these behaviors. Mice were treated orally either with sesame seed oil or one of three dosages of bilobalide (2.5, 5.0 and 10.0 mg/kg) daily until testing. A series of behavioral tests showed that repeated bilobalide treatment decreased levels of anxiety-like behavior and increased locomotor activity in open field and elevated plus maze tests. Treatment with bilobalide also shortened the time taken to find the platform in a Morris water-maze test. Mice exposed to bilobalide showed higher and dose-dependent levels of glucocorticoid receptor expression in the hippocampus. These results suggest that bilobalide reduces anxiety levels and enhances spatial learning and memory, possibly through an increase in hippocampal glucocorticoid receptor expression. This finding sheds light on the mechanisms underlying the effect of ginkgo biloba extract on behavior and also provides an important candidate drug in treatment of anxiety, depression, hypomnesia and amnesia.

Review and meta-analysis of usage of ginkgo as an adjunct therapy in chronic schizophrenia

This study aimed to review the roles of antioxidants in the pathophysiology of schizophrenia, whether the properties of ginkgo can ameliorate symptoms of this illness, and evaluate available literature to test this assumption. This review is based upon published works on antioxidants and ginkgo. A primary electronic search for meta-analysis on the usage of ginkgo or its derived products in schizophrenia was conducted using Pubmed, Cochrane Library, EMBASE, CINAHL, PsycINFO and AMED. Inclusion criteria were: criteria-based diagnosis of schizophrenia, randomized case assignment, use of ginkgo as an add-on therapy, and assessment using standardized rating scales to measure the state of psychopathology for negative and total symptoms of schizophrenia. Additionally, a detailed review was undertaken to investigate if antioxidants are involved in development of psychotic symptoms in schizophrenia. The six studies that fulfilled the selection criteria were constituted of 466 cases on ginkgo and 362 cases on placebo. They all used the Scale for the Assessment of Negative Symptoms (SANS) to measure negative symptoms, and the Scale for the Assessment of Positive Symptoms (SAPS) or the Brief Psychiatric Rating Scale (BPRS) to measure total symptoms. Difference between ginkgo and control groups from their pre- and post-trial scores and its pooled standard deviation were used to compute standardized mean difference (SMD). Ginkgo as an add-on therapy to antipsychotic medication produced statistically significant moderate improvement (SMD=-0.50) in total and negative symptoms of chronic schizophrenia. Ginkgo as add-on therapy ameliorates the symptoms of chronic schizophrenia. The role of antioxidants in pathogenesis of schizophrenia has also been explored.

Amphetamine withdrawal leads to behavioral sensitization and reduced HPA axis response following amphetamine challenge

Withdrawal from repeated amphetamine (AMPH) administration leads to behavioral sensitization following a drug or a stress challenge and is commonly used to model anhedonia in rats, a core symptom of depression in humans. It is proposed that corticosteroids are involved in the mediation of sensitization and depression. The aim of the present study was to investigate stress and AMPH- induced release of adrenocorticotropic hormone (ACTH) and corticosterone (CORT) during withdrawal from an escalating dosage schedule of AMPH known to produce depression-like effects in rats. Wistar rats were given 3 injections (i.p.) per day over 3 days, escalating from 1 mg/kg to 9 mg/kg and a final injection of 10 mg/kg AMPH or saline on day 4. On day 2 of withdrawal, the animals were tested in the Porsolt swim test. HPA axis activity in response to restraint stress was tested on withdrawal day 14 and in response to AMPH challenge on withdrawal day 30. We found no effect of AMPH withdrawal in the Porsolt swim test and on the ACTH or CORT response following restraint stress. AMPH withdrawn animals expressed behavioral sensitization in terms of locomotion and reduced ACTH and CORT plasma levels following a 1 mg/kg AMPH challenge in comparison to the controls. We conclude that there is no critical involvement of a sensitized HPA axis stress response in the long-term expression of behavioral sensitization.

Effect ofGinkgo bilobaExtract on Plasma Steroid Concentrations in Healthy Volunteers: A Pilot Study

STUDY OBJECTIVE

To determine if a standardized ginkgo supplement significantly alters concentrations of circulating androgenic steroids in humans.

DESIGN

Open-label, fixed-treatment order, crossover study.

SETTING

University general clinical research center.

SUBJECTS

Eleven healthy volunteers (six men, five women).

INTERVENTION

Volunteers received ginkgo biloba 240 mg/day for 14 days.

MEASUREMENTS AND MAIN RESULTS

Plasma concentrations of cortisol, 11-deoxycortisol, 17alpha-hydroxyprogesterone, testosterone, dihydrotestosterone, dehydroepiandrosterone sulfate, sex hormone-binding globulin, androstenedione, and free testosterone, as well as free androgen index and combined concentrations of androsterone sulfate and epiandrosterone sulfate, were analyzed in all subjects before and after their 14-day course of ginkgo biloba. Ginkgo biloba did not significantly alter endogenous steroid levels compared with baseline values (p < 0.05).

CONCLUSION

A 14-day oral administration of a widely used, standardized ginkgo extract at a generally advocated dosage of 240 mg/day did not significantly alter concentrations of major circulating steroids in men and women.