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Martins A, Conte M, Goettert MI, Contini V. Attention-deficit/hyperactivity disorder and inflammation: natural product-derived treatments-a review of the last ten years. Inflammopharmacology 2023; 31:2939-2954. [PMID: 37740887 DOI: 10.1007/s10787-023-01339-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 09/09/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVE Attention-deficit hyperactivity disorder (ADHD) is a psychiatric disorder characterized by symptoms of inattention, hyperactivity, and impulsivity. Stimulant medication is the main pharmacological treatment for ADHD. However, the traditional pharmacological treatments may have significant side effects; therefore, non-pharmacological approaches are needed. Thus, there has been growing interest in alternative herbal treatments. The aim of this review was to comprehensively assess the current evidence for plant-based treatment of ADHD in human and animal models, as well as their ability to modulate the inflammatory process. METHODS This study was an integrative review of the current evidence for the plant-based treatment of ADHD. The research involved using literature available on PubMed and Scopus databases. FINDINGS Spontaneously hypersensitive rats treated with baicalin exhibited significant reductions in locomotion, increased spatial learning skills, and increased levels of dopamine in the striatum. Supplementation with Sansonite improved memory and attention capacity. In human studies, Ginkgo biloba significantly improved the symptoms of inattention and reduced memory impairment. In studies conducted using Korean Red ginseng, Klamath, and Crocus sativus L., the patients showed significant improvements in symptoms of inattention and hyperactivity/impulsivity. Furthermore, we demonstrated that the identified plants modulate the inflammatory process through pro-inflammatory and anti-inflammatory cytokines, nitric oxide, Th cells, Toll-like receptor 4, and mitogen-activated protein kinases. CONCLUSION All the studies included in this review focused on plants with demonstrated potential against inflammatory processes, positioning them as promising candidates for ADHD treatment, due to their potential to attenuate or even prevent neuroinflammatory mechanisms.
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Affiliation(s)
- Alexandre Martins
- Graduate Program in Biotechnology, Universidade of Vale do Taquari - Univates, Rua Avelino Talini, 171 - Bairro Universitário, Lajeado, RS, 95914-014, Brazil
| | - Magali Conte
- Center for Biological and Health Sciences, Universidade do Vale do Taquari - Univates, Lajeado, RS, Brazil
| | - Márcia Inês Goettert
- Graduate Program in Biotechnology, Universidade of Vale do Taquari - Univates, Rua Avelino Talini, 171 - Bairro Universitário, Lajeado, RS, 95914-014, Brazil
- Institute of Pharmacy/Pharmaceutical/Medicinal Chemistry, Eberhard-Karls-Universität Tubingen, Tübingen, Germany
| | - Verônica Contini
- Graduate Program in Biotechnology, Universidade of Vale do Taquari - Univates, Rua Avelino Talini, 171 - Bairro Universitário, Lajeado, RS, 95914-014, Brazil.
- Graduate Program in Medical Science, Universidade of Vale do Taquari - Univates, Lajeado, RS, Brazil.
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Custódio L, Vizetto‐Duarte C, Cebeci F, Özçelik B, Sharopov F, Gürer ES, Kumar M, Iriti M, Sharifi‐Rad J, Calina D. Natural products of relevance in the management of attention deficit hyperactivity disorder. EFOOD 2023. [DOI: 10.1002/efd2.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Luísa Custódio
- Centre of Marine Sciences, Faculty of Sciences and Technology University of Algarve Faro Portugal
| | - Catarina Vizetto‐Duarte
- School of Material Sciences and Engineering Nanyang Technological University Singapore Singapore
| | - Fatma Cebeci
- Department of Nutrition and Dietetics Bayburt University Bayburt Turkey
| | - Beraat Özçelik
- Department Food Engineering, Faculty of Chemical and Metallurgical Engineering Istanbul Technical University, Maslak Istanbul Turkey
- BIOACTIVE Research & Innovation Food Manufacturing Industry Trade LTD Co., Maslak Istanbul Turkey
| | - Farukh Sharopov
- Department of Pharmaceutical Technology Avicenna Tajik State Medical University Dushanbe Tajikistan
| | - Eda Sönmez Gürer
- Department of Pharmacognosy, Faculty of Pharmacy Sivas Cumhuriyet University Sivas Turkey
| | - Manoj Kumar
- Chemical and Biochemical Processing Division ICAR—Central Institute for Research on Cotton Technology Mumbai India
| | - Marcello Iriti
- Department of Agricultural and Environmental Sciences Università degli Studi di Milano Milan Italy
| | | | - Daniela Calina
- Department of Clinical Pharmacy University of Medicine and Pharmacy of Craiova Craiova Romania
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Abdulghani A, Poghosyan M, Mehren A, Philipsen A, Anderzhanova E. Neuroplasticity to autophagy cross-talk in a therapeutic effect of physical exercises and irisin in ADHD. Front Mol Neurosci 2023; 15:997054. [PMID: 36776770 PMCID: PMC9909442 DOI: 10.3389/fnmol.2022.997054] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/30/2022] [Indexed: 01/28/2023] Open
Abstract
Adaptive neuroplasticity is a pivotal mechanism for healthy brain development and maintenance, as well as its restoration in disease- and age-associated decline. Management of mental disorders such as attention deficit hyperactivity disorder (ADHD) needs interventions stimulating adaptive neuroplasticity, beyond conventional psychopharmacological treatments. Physical exercises are proposed for the management of ADHD, and also depression and aging because of evoked brain neuroplasticity. Recent progress in understanding the mechanisms of muscle-brain cross-talk pinpoints the role of the myokine irisin in the mediation of pro-cognitive and antidepressant activity of physical exercises. In this review, we discuss how irisin, which is released in the periphery as well as derived from brain cells, may interact with the mechanisms of cellular autophagy to provide protein recycling and regulation of brain-derived neurotrophic factor (BDNF) signaling via glia-mediated control of BDNF maturation, and, therefore, support neuroplasticity. We propose that the neuroplasticity associated with physical exercises is mediated in part by irisin-triggered autophagy. Since the recent findings give objectives to consider autophagy-stimulating intervention as a prerequisite for successful therapy of psychiatric disorders, irisin appears as a prototypic molecule that can activate autophagy with therapeutic goals.
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Affiliation(s)
- Alhasan Abdulghani
- C. and O. Vogt Institute for Brain Research, Medical Faculty and University Hospital Düsseldorf, Henrich Heine University, Düsseldorf, Düsseldorf, Germany,*Correspondence: Alhasan Abdulghani,
| | - Mikayel Poghosyan
- Institute for Biology-Neurobiology, Freie University of Berlin, Berlin, Germany
| | - Aylin Mehren
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Elmira Anderzhanova
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
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Chen W, Yao P, Vong CT, Li X, Chen Z, Xiao J, Wang S, Wang Y. Ginseng: A bibliometric analysis of 40-year journey of global clinical trials. J Adv Res 2021; 34:187-197. [PMID: 35024190 PMCID: PMC8655123 DOI: 10.1016/j.jare.2020.07.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Ginseng has a long history of widespread use and remarkable effects as traditional medicine, adjuvant and dietary supplement. The therapeutic value, diverse functionalities and rapid development of ginseng have driven a significant increase in the number of ginseng clinical trials, ranging from its use in various ailments, formulation to safety concerns. Despite the persistent interest in ginseng clinical research, the medical effectiveness of ginseng is inconclusive and there is a lack of bibliometric analysis of the hundreds of ginseng clinical trials. AIM OF REVIEW This review aims to provide an extensive overview of ginseng clinical trials over the past 40 years (1979-2018) in combination with a qualitative and quantitative analysis. The annual clinical trial analysis of time distribution, country and institution network analysis for space cooperation, statistical analysis for various functions, as well as efficiency and effect size were performed for global ginseng clinical trials. Besides, preparation categories, administration routes, and the safety of ginseng clinical trials were also investigated. KEY SCIENTIFIC CONCEPTS OF REVIEW The 40-year journey of ginseng clinical trials has experienced emerging, boom, and stable or transitional stages. The global network of ginseng clinical trials has relevant regional distribution in Asia, North America and Europe. South Korea makes a great contribution to building up large research clusters and strong cooperation links. Universities are the key contributors to ginseng clinical trials. The development of ginseng products could be focused on the clinical trial in diseases with higher effectiveness or effect size, such as sexual function and cognitive & behavior and require rigorous investigations and evidence to evaluate safety. More attention should be paid to different effects from different preparations. We believe this review will provide new insights into the understanding of global ginseng clinical trials and identifies potential future perspectives for research and development of ginseng.
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Affiliation(s)
- Weijie Chen
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Peifen Yao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Chi Teng Vong
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Xiuzhu Li
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Zhejie Chen
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Jianbo Xiao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Shengpeng Wang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
| | - Yitao Wang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China
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Lee J, Lee SI. Efficacy of Omega-3 and Korean Red Ginseng in Children with Subthreshold ADHD: A Double-Blind, Randomized, Placebo-Controlled Trial. J Atten Disord 2021; 25:1977-1987. [PMID: 32847461 DOI: 10.1177/1087054720951868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose of the present study was to investigate the efficacy of combined omega-3 and Korean red ginseng supplementation on ADHD symptoms and cognitive function in children with subthreshold ADHD. METHOD 120 children from 6 to 12 years with subthreshold ADHD were enrolled in this 12-week, double-blind, randomized, placebocontrolled study. The primary outcome was measured by Attention-Deficit Hyperactivity Disorder Rating Scale (ADHD-RS). Children Behavior Check List (CBCL), and neuropsychological tests assessing attention, memory, and executive function were included as secondary primary outcome measures. RESULTS Significant effects on the scores of ADHDRS, as well as several subscales of CBCL including ADHD and attention problem subscales were revealed. CONCLUSION The combination of omega-3 and Korean red ginseng may have beneficial effects in children with subthreshold ADHD. Increased clinical awareness of ADHD symptoms even at a subthreshold level is needed.
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Affiliation(s)
- Jeewon Lee
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon-Si, Gyeonggi-Do, Republic of Korea
| | - Soyoung Irene Lee
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon-Si, Gyeonggi-Do, Republic of Korea
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Najafi TF, Bahri N, Tohidinik HR, Feyz S, Bloki F, Savarkar S, Jahanfar S. Treatment of cancer-related fatigue with ginseng: A systematic review and meta-analysis. J Herb Med 2021. [DOI: 10.1016/j.hermed.2021.100440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Lopresti AL, Smith SJ, Drummond PD. Modulation of the hypothalamic-pituitary-adrenal (HPA) axis by plants and phytonutrients: a systematic review of human trials. Nutr Neurosci 2021; 25:1704-1730. [PMID: 33650944 DOI: 10.1080/1028415x.2021.1892253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The hypothalamic-pituitary-adrenal (HPA) axis plays a central role in the stress response. Plants, herbs, spices, and plant-based nutrients may influence HPA-axis activity. OBJECTIVE To evaluate randomised controlled, human trials assessing the effects of single plants or phytonutrients on HPA-axis related hormones. METHODS A systematic review of PubMed, Cochrane library, and the Cumulative Index to Nursing and Allied Health Literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria comprised of human, randomised controlled studies with a control intervention examining the effects of a single herb, spice, plant, or extract on pre- and post-changes in blood, saliva, urine, or hair concentrations of cortisol, cortisone, corticotrophin-releasing hormone, or adrenocorticotropic hormone. Databases were searched from inception until October 2020. RESULTS Fifty-two studies were identified examining the effects of ashwagandha, Korean ginseng, St John's Wort, cannabidiol, Rhodiola rosea, curcumin, cherry juice, asparagus, Jiaogulan, Black cohosh, Siberian ginseng, Bacopa monnieri, blueberries, green tea, Caralluma fimbriata, cashew apple juice, melon, American ginseng, Ginkgo biloba, grape juice, grapefruit juice, rosella, hops, mangosteen, holy basil, and pomegranate juice. Due to significant variability in study designs, the effect of phytonutrients on HPA-axis activity in humans was unclear. The most consistent finding was a morning, cortisol-lowering effect from ashwagandha supplementation. CONCLUSION For most phytonutrients, the effects of supplementation on HPA-axis activity in humans is unclear. Before more definitive conclusions about the effects of phytonutrients on the HPA-axis can be made, further research is required.
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Affiliation(s)
- Adrian L Lopresti
- Clinical Research Australia, Perth, Australia.,College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
| | - Stephen J Smith
- Clinical Research Australia, Perth, Australia.,College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
| | - Peter D Drummond
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Australia
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Antimania-Like Effect of Panax ginseng Regulating the Glutamatergic Neurotransmission in REM-Sleep Deprivation Rats. BIOMED RESEARCH INTERNATIONAL 2020; 2020:3636874. [PMID: 33123570 PMCID: PMC7586145 DOI: 10.1155/2020/3636874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/29/2020] [Accepted: 09/28/2020] [Indexed: 11/17/2022]
Abstract
Previous studies have shown the therapeutic properties of ginseng and ginsenosides on hyperactive and impulsive behaviors in several psychiatric diseases. Herein, we investigated the effect of Panax ginseng Meyer (PG) on hyperactive/impulsive behaviors in a manic-like animal model, sleep deprivation (SD) rats. Male rats were sleep-deprived for 48 h, and PG (200 mg/kg) was administered for 4 days, from 2 days prior to the start of SD to the end date of SD. The elevated plus maze (EPM) test showed that PG alleviated the increased frequency of entries into and spent time within open arms by SD. In order to investigate the molecular mechanism on this effect of PG, we assessed differentially expressed genes (DEGs) in the prefrontal cortex of PG-treated SD rats using RNA sequencing (RNA-seq) and performed gene-enrichment analysis for DEGs. The gene-enrichment analysis showed that PG most prominently affected the glutamatergic synapse pathway. Among the glutamatergic synapse pathway genes, particularly, PG enhanced the expressions of glutamate transporter Slc1a3 and Slc1a2 reduced in SD rats. Moreover, we found that PG could inhibit the SD-induced phosphorylation of the NR2A subunit of the NMDA receptor. These results suggested that PG might have a therapeutic effect against the manic-like behaviors, regulating the glutamatergic neurotransmission.
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Antonelli M, Donelli D, Firenzuoli F. Ginseng integrative supplementation for seasonal acute upper respiratory infections: A systematic review and meta-analysis. Complement Ther Med 2020; 52:102457. [PMID: 32951718 PMCID: PMC7305750 DOI: 10.1016/j.ctim.2020.102457] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/28/2020] [Accepted: 06/01/2020] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The aim of the review was to assess whether ginseng can be a useful supplementation for seasonal acute upper respiratory infections (SAURIs). METHODS All clinical studies investigating ginseng efficacy for the treatment or prevention of SAURIs were included in the review. Medline, EMBASE, Web of Science, Scopus, Cochrane Library, Google Scholar were systematically screened for relevant articles up to May 26th, 2020. The risk of bias was assessed with the Cochrane tool (RoB 2). RESULTS Nine articles (describing ten trials about P. ginseng or P. quinquefolius) were included in the review. Evidence globally indicated some useful activity of intervention when administered in adjunct to influenza vaccination. The results of our quantitative synthesis suggested a significant effect on SAURIs incidence (RR = 0.69 [95 % C.I. 0.52 to 0.90], p < 0.05), as well as a significant reduction of their duration if only studies with healthy individuals were included in the analysis (MD=-3.11 [95 % C.I.-5.81 to -0.40], p < 0.05). However, the risk of bias was high-to-unclear for most included trials, and publication bias couldn't be excluded. DISCUSSION Limitations of existing evidence don't allow to draw conclusions on the topic. Nevertheless, it is not excluded that ginseng supplementation in adjunct to influenza vaccination and standard care might be useful for SAURIs prevention and management in healthy adult subjects, but further high-quality trials are needed to support this hypothesis. OTHER This research was not funded. The protocol was registered in PROSPERO under the following code: CRD42020156235.
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Affiliation(s)
- Michele Antonelli
- Terme di Monticelli, Parma, Italy; Research and Innovation Center in Phytotherapy and Integrated Medicine (CERFIT), Careggi University Hospital, Florence, Italy; Institute of Public Health, University of Parma, Parma, Italy.
| | - Davide Donelli
- Terme di Monticelli, Parma, Italy; Research and Innovation Center in Phytotherapy and Integrated Medicine (CERFIT), Careggi University Hospital, Florence, Italy; AUSL-IRCCS Reggio Emilia, Italy
| | - Fabio Firenzuoli
- Research and Innovation Center in Phytotherapy and Integrated Medicine (CERFIT), Careggi University Hospital, Florence, Italy
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Rosi E, Grazioli S, Villa FM, Mauri M, Gazzola E, Pozzi M, Molteni M, Nobile M. Use of Non-Pharmacological Supplementations in Children and Adolescents with Attention Deficit/Hyperactivity Disorder: A Critical Review. Nutrients 2020; 12:nu12061573. [PMID: 32481502 PMCID: PMC7352506 DOI: 10.3390/nu12061573] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 12/31/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children and adolescents, with environmental and biological causal influences. Pharmacological medication is the first choice in ADHD treatment; recently, many studies have concentrated on dietary supplementation approaches to address nutritional deficiencies, to which part of non-responses to medications have been imputed. This review aims to evaluate the efficacy of non-pharmacological supplementations in children or adolescents with ADHD. We reviewed 42 randomized controlled trials comprised of the following supplementation categories: polyunsaturated fatty acids (PUFAs), peptides and amino acids derivatives, single micronutrients, micronutrients mix, plant extracts and herbal supplementations, and probiotics. The reviewed studies applied heterogeneous methodologies, thus making it arduous to depict a systematic overview. No clear effect on single cognitive, affective, or behavioral domain was found for any supplementation category. Studies on PUFAs and micronutrients found symptomatology improvements. Peptides and amino acids derivatives, plant extracts, herbal supplementation, and probiotics represent innovative research fields and preliminary results may be promising. In conclusion, such findings, if confirmed through future research, should represent evidence for the efficacy of dietary supplementation as a support to standard pharmacological and psychological therapies in children and adolescents with ADHD.
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Affiliation(s)
- Eleonora Rosi
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, 23842 Bosisio Parini, Italy; (E.R.); (F.M.V.); (M.M.); (M.M.); (M.N.)
| | - Silvia Grazioli
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, 23842 Bosisio Parini, Italy; (E.R.); (F.M.V.); (M.M.); (M.M.); (M.N.)
- Correspondence:
| | - Filippo Maria Villa
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, 23842 Bosisio Parini, Italy; (E.R.); (F.M.V.); (M.M.); (M.M.); (M.N.)
| | - Maddalena Mauri
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, 23842 Bosisio Parini, Italy; (E.R.); (F.M.V.); (M.M.); (M.M.); (M.N.)
- PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milan, Italy
| | - Erica Gazzola
- Department of Psychology, University of Milano Bicocca, 20126 Milan, Italy;
| | - Marco Pozzi
- Scientific Institute, IRCCS Eugenio Medea, 23842 Bosisio Parini, Italy;
| | - Massimo Molteni
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, 23842 Bosisio Parini, Italy; (E.R.); (F.M.V.); (M.M.); (M.M.); (M.N.)
| | - Maria Nobile
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, 23842 Bosisio Parini, Italy; (E.R.); (F.M.V.); (M.M.); (M.M.); (M.N.)
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Lee J, Lee A, Kim JH, Shin YM, Kim SJ, Cho WD, Lee SI. Effect of Omega-3 and Korean Red Ginseng on Children with Attention Deficit Hyperactivity Disorder: An Open-Label Pilot Study. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2020; 18:75-80. [PMID: 31958908 PMCID: PMC7006981 DOI: 10.9758/cpn.2020.18.1.75] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/21/2019] [Accepted: 04/24/2019] [Indexed: 11/29/2022]
Abstract
Objective The purpose of the present study was to evaluate the efficacy of omega-3 and Korean red ginseng on improving attention deficit hyperactivity disorder (ADHD) symptoms and cognitive function in children with ADHD. Methods A total of 40 children aged 6 to 12 years diagnosed with ADHD participated in this open-label trial. Participants received daily supplements containing 500 mg of omega-3 (eicosapentaenoic acid, 294 mg; docosahexaenoic acid, 206 mg) and 3 mg of Korean red ginseng extract (combination of ginsenoside Rg1, Rb1, and Rg3) for 12 weeks. No psychotropic drug was allowed during the study period. ADHD symptoms were assessed using the ADHD Rating Scale (ADHD-RS) and Clinical Global Impression-Severity (CGI-S) scale. Neuropsychological tests on sustained attention, short-term memory, and executive function were also assessed. Results After 12 weeks, participants showed significant improvements on ADHD-RS (31.12 ± 8.82 at baseline, 24.15 ± 11.45 at endpoint; p < 0.001) and CGI-S (3.38 ± 1.18 at baseline, 2.94 ± 1.00 at endpoint; p < 0.001). On the Continuous Performance Test, commission errors significantly decreased, while reaction time significantly increased. Immediate recall and delayed recall on both Auditory Verbal Learning Test and Complex Figure Test showed significant improvements. Scores of Color–Word Task from Stroop Color–Word Test also showed significant improvements after the treatment. The supplement was well tolerated. Conclusion The results of this pilot study suggest that the combination of omega-3 and Korean red ginseng may improve ADHD symptoms and cognitive function including attention, memory, and executive function in children with ADHD. Future randomized placebo-controlled trials with a larger sample is warranted.
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Affiliation(s)
- Jeewon Lee
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Areum Lee
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Ji-Hoon Kim
- Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yun Mi Shin
- Department of Psychiatry and Behavioral Sciences, Ajou University Hospital, Suwon, Korea
| | - Seong-Ju Kim
- Department of Psychiatry and Behavioral Sciences, Ajou University Hospital, Suwon, Korea
| | - Woo Dong Cho
- Department of Psychiatry and Behavioral Sciences, Ajou University Hospital, Suwon, Korea
| | - Soyoung Irene Lee
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
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Sung WS, Kang HR, Jung CY, Park SS, Lee SH, Kim EJ. Efficacy of Korean red ginseng (Panax ginseng) for middle-aged and moderate level of chronic fatigue patients: A randomized, double-blind, placebo-controlled trial. Complement Ther Med 2019; 48:102246. [PMID: 31987248 DOI: 10.1016/j.ctim.2019.102246] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 10/12/2019] [Accepted: 11/15/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Chronic fatigue (CF) is unexplained fatigue lasting more than 6 months. Korean red ginseng (KRG) is known to have higher anti-fatigue substance than white ginseng. However, its efficacy and safety for CF is unknown. The purpose of this study was to investigate the effect of KRG on CF by various measurements and objective indicators. DESIGN A randomized, double-blind, clinical trial was conducted on 50 patients with CF. INTERVENTION Participants were allocated to KRG or placebo group (1:1 ratio) and visited hospital every 2 weeks during taking 3 g KRG or placebo for 6 weeks and followed up 4 weeks after the treatment. MAIN OUTCOME MEASURES The primary outcome measurement was fatigue VAS. Secondary outcome measurements included FSS, CFSQ, SRI, scales of various fields (Depression: BDI; Sleep: ISI; Quality of life: EQ-5D 5 L), biochemical test (Antioxidants: d-ROMs, TBARS, BAP, and SOD; Cortisol concentration: salivary cortisol), blinding assessment, and adverse events. RESULTS The fatigue VAS declined significantly in each group, but there were no significant differences between the groups. The 2 groups also had no significant differences in the secondary outcome measurements and there were no adverse events. Sub-group analysis indicated that patients with initial fatigue VAS below 80 mm and older than 50 years had significantly greater reductions in the fatigue VAS if they used KRG rather than placebo. CONCLUSIONS By our study, KRG did not show absolute anti-fatigue effect but provided the objective evidence of fatigue-related measurement and the therapeutic potential for middle-aged individuals with moderate fatigue.
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Affiliation(s)
- Won-Suk Sung
- Department of Acupuncture & Moxibustion, Dongguk University Bundang Oriental Hospital, Gyeonggi-do, South Korea
| | - Ha-Ra Kang
- Department of Korean Medicine, Dongguk University Graduate School, Gyeonggi-do, South Korea
| | - Chan-Yung Jung
- Institute of Oriental Medicine, College of Korean Medicine, Dongguk University, South Korea
| | - Seong-Sik Park
- Department of Sasang Constitutional Medicine, College of Oriental Medicine, Dongguk University, South Korea
| | | | - Eun-Jung Kim
- Department of Acupuncture & Moxibustion, Dongguk University Bundang Oriental Hospital, Gyeonggi-do, South Korea.
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Motaharifard MS, Effatpanah M, karimi M, Akhondzadeh S, Rahimi H, Yasrebi SA, Nejatbakhsh F. Effect of sweet almond syrup versus methylphenidate in children with ADHD: A randomized triple-blind clinical trial. Complement Ther Clin Pract 2019; 36:170-175. [DOI: 10.1016/j.ctcp.2019.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 06/21/2019] [Accepted: 07/19/2019] [Indexed: 11/28/2022]
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Natural Compounds for the Management of Parkinson's Disease and Attention-Deficit/Hyperactivity Disorder. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4067597. [PMID: 30596091 PMCID: PMC6282143 DOI: 10.1155/2018/4067597] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/31/2018] [Accepted: 11/11/2018] [Indexed: 11/18/2022]
Abstract
Parkinson's disease (PD) is the second most common neurodegenerative disorder with an unknown aetiology. The pathogenic mechanisms include oxidative stress, mitochondrial dysfunction, protein dysfunction, inflammation, autophagy, apoptosis, and abnormal deposition of α-synuclein. Currently, the existing pharmacological treatments for PD cannot improve fundamentally the degenerative process of dopaminergic neurons and have numerous side effects. On the other hand, attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder of childhood and is characterised by hyperactivity, impulsivity, and inattention. The aetiology of ADHD remains unknown, although it has been suggested that its pathophysiology involves abnormalities in several brain regions, disturbances of the catecholaminergic pathway, and oxidative stress. Psychostimulants and nonpsychostimulants are the drugs prescribed for the treatment of ADHD; however, they have been associated with increased risk of substance use and have several side effects. Today, there are very few tools available to prevent or to counteract the progression of such neurological disorders. Thus, therapeutic approaches with high efficiency and fewer side effects are needed. This review presents a brief overview of the two neurological disorders and their current treatments, followed by a discussion of the natural compounds which have been studied as therapeutic agents and the mechanisms underlying the beneficial effects, in particular, the decrease in oxidative stress.
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Complementary and Alternative Medicine use in Pediatric Attention-Deficit Hyperactivity Disorder (ADHD): Reviewing the Safety and Efficacy of Herbal Medicines. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2016. [DOI: 10.1007/s40474-016-0074-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Natural Product-Derived Treatments for Attention-Deficit/Hyperactivity Disorder: Safety, Efficacy, and Therapeutic Potential of Combination Therapy. Neural Plast 2016; 2016:1320423. [PMID: 26966583 PMCID: PMC4757677 DOI: 10.1155/2016/1320423] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 12/30/2015] [Accepted: 01/10/2016] [Indexed: 01/27/2023] Open
Abstract
Typical treatment plans for attention-deficit/hyperactivity disorder (ADHD) utilize nonpharmacological (behavioral/psychosocial) and/or pharmacological interventions. Limited accessibility to behavioral therapies and concerns over adverse effects of pharmacological treatments prompted research for alternative ADHD therapies such as natural product-derived treatments and nutritional supplements. In this study, we reviewed the herbal preparations and nutritional supplements evaluated in clinical studies as potential ADHD treatments and discussed their performance with regard to safety and efficacy in clinical trials. We also discussed some evidence suggesting that adjunct treatment of these agents (with another botanical agent or pharmacological ADHD treatments) may be a promising approach to treat ADHD. The analysis indicated mixed findings with regard to efficacy of natural product-derived ADHD interventions. Nevertheless, these treatments were considered as a “safer” approach than conventional ADHD medications. More comprehensive and appropriately controlled clinical studies are required to fully ascertain efficacy and safety of natural product-derived ADHD treatments. Studies that replicate encouraging findings on the efficacy of combining botanical agents and nutritional supplements with other natural product-derived therapies and widely used ADHD medications are also warranted. In conclusion, the risk-benefit balance of natural product-derived ADHD treatments should be carefully monitored when used as standalone treatment or when combined with other conventional ADHD treatments.
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