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Pramanik R, Dey A, Chakrabarty AK, Banerjee D, Narwaria A, Sharma S, Rai RK, Katiyar CK, Dubey SK. Diabetes mellitus and Alzheimer's disease: Understanding disease mechanisms, their correlation, and promising dual activity of selected herbs. JOURNAL OF ETHNOPHARMACOLOGY 2024; 333:118402. [PMID: 38821139 DOI: 10.1016/j.jep.2024.118402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 05/12/2024] [Accepted: 05/27/2024] [Indexed: 06/02/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE This review explores the link between Type 2 Diabetes Mellitus (T2DM) and diabetes-induced Alzheimer's disease (AD). It emphasizes the shared pathophysiological links and mechanisms between the two conditions, focusing on reduced insulin levels and receptors, impaired glucose metabolism, insulin resistance, mitochondrial dysfunction, and oxidative damage in AD-affected brains-paralleling aspects of T2DM. The review suggests AD as a "diabetes of the brain," supported by cognitive enhancement through antidiabetic interventions. It focuses on the traditionally used Indian herbs as a means to manage both conditions while addressing developmental challenges. AIM OF THE STUDY This study explores the DM-AD connection, reviewing medicinal herbs with protective potential for both ailments, considering traditional uses and developmental challenges. MATERIALS AND METHODS Studied research, reviews, and ethnobotanical and scientific data from electronic databases and traditional books. RESULTS The study analyzes the pathophysiological links between DM and AD, emphasizing their interconnected factors. Eight Ayurvedic plants with dual protective effects against T2DM and AD are thoroughly reviewed with preclinical/clinical evidence. Historical context, phytoconstituents, and traditional applications are explored. Innovative formulations using these plants are examined. Challenges stemming from phytoconstituents' physicochemical properties are highlighted, prompting novel formulation development, including nanotechnology-based delivery systems. The study uncovers obstacles in formulating treatments for these diseases. CONCLUSION The review showcases the dual potential of chosen medicinal herbs against both diseases, along with their traditional applications, endorsing their use. It addresses formulation obstacles, proposing innovative delivery technologies for herbal therapies, while acknowledging their constraints. The review suggests the need for heightened investment and research in this area.
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Affiliation(s)
- Rima Pramanik
- R&D Healthcare Division, Emami Ltd, 13, BT Road, Belgharia, Kolkata, 700056, India
| | - Anuradha Dey
- R&D Healthcare Division, Emami Ltd, 13, BT Road, Belgharia, Kolkata, 700056, India
| | | | - Dipankar Banerjee
- R&D Healthcare Division, Emami Ltd, 13, BT Road, Belgharia, Kolkata, 700056, India
| | - Avinash Narwaria
- R&D Healthcare Division, Emami Ltd, 13, BT Road, Belgharia, Kolkata, 700056, India
| | - Swapnil Sharma
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, 304022, Rajasthan, India
| | - Rajiva Kumar Rai
- R&D Healthcare Division, Emami Ltd, 13, BT Road, Belgharia, Kolkata, 700056, India
| | - Chandra Kant Katiyar
- R&D Healthcare Division, Emami Ltd, 13, BT Road, Belgharia, Kolkata, 700056, India
| | - Sunil Kumar Dubey
- R&D Healthcare Division, Emami Ltd, 13, BT Road, Belgharia, Kolkata, 700056, India.
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Valotto Neto LJ, Reverete de Araujo M, Moretti Junior RC, Mendes Machado N, Joshi RK, dos Santos Buglio D, Barbalho Lamas C, Direito R, Fornari Laurindo L, Tanaka M, Barbalho SM. Investigating the Neuroprotective and Cognitive-Enhancing Effects of Bacopa monnieri: A Systematic Review Focused on Inflammation, Oxidative Stress, Mitochondrial Dysfunction, and Apoptosis. Antioxidants (Basel) 2024; 13:393. [PMID: 38671841 PMCID: PMC11047749 DOI: 10.3390/antiox13040393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 03/16/2024] [Accepted: 03/22/2024] [Indexed: 04/28/2024] Open
Abstract
The aging of the global population has increased the prevalence of neurodegenerative conditions. Bacopa monnieri (BM), an herb with active compounds, such as bacosides A and B, betulinic acid, loliolide, asiatic acid, and quercetin, demonstrates the potential for brain health. Limited research has been conducted on the therapeutic applications of BM in neurodegenerative conditions. This systematic review aims to project BM's beneficial role in brain disorders. BM has anti-apoptotic and antioxidant actions and can repair damaged neurons, stimulate kinase activity, restore synaptic function, improve nerve transmission, and increase neuroprotection. The included twenty-two clinical trials demonstrated that BM can reduce Nuclear Factor-κB phosphorylation, improve emotional function, cognitive functions, anhedonia, hyperactivity, sleep routine, depression, attention deficit, learning problems, memory retention, impulsivity, and psychiatric problems. Moreover, BM can reduce the levels of pro-inflammatory biomarkers and oxidative stress. Here, we highlight that BM provides notable therapeutic benefits and can serve as a complementary approach for the care of patients with neurodegenerative conditions associated with brain disorders. This review adds to the growing interest in natural products and their potential therapeutic applications by improving our understanding of the mechanisms underlying cognitive function and neurodegeneration and informing the development of new therapeutic strategies for neurodegenerative diseases.
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Affiliation(s)
- Luiz José Valotto Neto
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Marília 17525-902, SP, Brazil; (L.J.V.N.); (M.R.d.A.); (R.C.M.J.); (N.M.M.); (D.d.S.B.)
- Department of Education, Government of Uttarakhand, Nainital 263001, India;
| | - Matheus Reverete de Araujo
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Marília 17525-902, SP, Brazil; (L.J.V.N.); (M.R.d.A.); (R.C.M.J.); (N.M.M.); (D.d.S.B.)
| | - Renato Cesar Moretti Junior
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Marília 17525-902, SP, Brazil; (L.J.V.N.); (M.R.d.A.); (R.C.M.J.); (N.M.M.); (D.d.S.B.)
| | - Nathalia Mendes Machado
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Marília 17525-902, SP, Brazil; (L.J.V.N.); (M.R.d.A.); (R.C.M.J.); (N.M.M.); (D.d.S.B.)
| | - Rakesh Kumar Joshi
- Department of Education, Government of Uttarakhand, Nainital 263001, India;
| | - Daiane dos Santos Buglio
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Marília 17525-902, SP, Brazil; (L.J.V.N.); (M.R.d.A.); (R.C.M.J.); (N.M.M.); (D.d.S.B.)
| | - Caroline Barbalho Lamas
- Department of Gerontology, School of Gerontology, Federal University of São Carlos (UFSCar), São Carlos 13565-905, SP, Brazil;
| | - Rosa Direito
- Laboratory of Systems Integration Pharmacology, Clinical & Regulatory Science, Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy de Farmácia, University of Lisboa, 1649-003 Lisbon, Portugal;
- Faculty of Pharmacy, University of Lisboa, Av. Prof. Gama Pinto, 1649-003 Lisbon, Portugal
| | - Lucas Fornari Laurindo
- Department of Biochemistry and Pharmacology, School of Medicine, Medical School of Marilia (FAMEMA), Marília 17519-030, SP, Brazil;
| | - Masaru Tanaka
- Danube Neuroscience Research Laboratory, HUN-REN-SZTE Neuroscience Research Group, Hungarian Research Network, University of Szeged (HUN-REN-SZTE), Tisza Lajos krt. 113, H-6725 Szeged, Hungary
| | - Sandra Maria Barbalho
- Department of Biochemistry and Pharmacology, School of Medicine, University of Marília (UNIMAR), Marília 17525-902, SP, Brazil; (L.J.V.N.); (M.R.d.A.); (R.C.M.J.); (N.M.M.); (D.d.S.B.)
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, School of Medicine, Universidade de Marília (UNIMAR), Marília 17525-902, SP, Brazil
- Department of Biochemistry and Nutrition, School of Food and Technology of Marília (FATEC), Marília 17500-000, SP, Brazil
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Sivasangari K, Sivamaruthi BS, Chaiyasut C, Rajan KE. Maternal stress-induced changes in adolescent and adult offspring: Neurobehavioural improvement and telomere maintenance. Heliyon 2023; 9:e20385. [PMID: 37767490 PMCID: PMC10520813 DOI: 10.1016/j.heliyon.2023.e20385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 07/22/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023] Open
Abstract
Maternal stress (MS) during gestation is known to increase the risk for the development of behavioural and physiological disorders and advances cellular aging. In this study, we investigated whether the supplementation of standardized Bacopa monnieri extract (CDRI-08/BME) or l-Carnosine (L-C) to the mother exposed to social stress during gestation modify the effect on their offspring's neurobehaviour, antioxidant defence gene expression, telomere length, and telomere biology. To test this, timed pregnant rats were subjected to social stress during the gestational day (GD) 16-18. A subset of stressed pregnant rats received either BME [80 mg/kg in 0.5% gum acacia (per-orally; p.o)] or L-C [1 mg/kg (p.o)] every day from GD-10 to until their pup's attained postnatal day (PND)-23. We observed that MS induced anxiety-like behaviour, altered inter-limb coordination, antioxidant defence genes [Superoxide dismutase (SOD1,2), Catalase (CAT), Glutathione peroxidase-3 (GPX3)], telomerase reverse transcriptase (TERT), shelterin complex subunits (TRF1, RAP1B, POT1) protein level and shorten telomere length. Notably, supplementation of BME/L-C dampens the MS, thus the effect on neurobehaviour, antioxidant defence gene expression, and telomere biology is minimized in their offspring. Together, our results suggest that supplementation of BME/L-C during gestation dampens the MS and reduced oxidative stress-mediated changes in telomere shortening/biology and associated neurobehaviour in offspring born following MS.
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Affiliation(s)
- Karunanithi Sivasangari
- Behavioural Neuroscience Laboratory, Department of Animal Science, Bharathidasan University, Tiruchirappalli, India
| | - Bhagavathi Sundaram Sivamaruthi
- Innovation Center for Holistic Health, Nutraceuticals, and Cosmeceuticals, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
- Office of Research Administration, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Chaiyavat Chaiyasut
- Innovation Center for Holistic Health, Nutraceuticals, and Cosmeceuticals, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Koilmani Emmanuvel Rajan
- Behavioural Neuroscience Laboratory, Department of Animal Science, Bharathidasan University, Tiruchirappalli, India
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Cave AE, Chang DH, Münch GW, Steiner-Lim GZ. A systematic review of the safety and efficacy on cognitive function of herbal and nutritional medicines in older adults with and without subjective cognitive impairment. Syst Rev 2023; 12:143. [PMID: 37592293 PMCID: PMC10433666 DOI: 10.1186/s13643-023-02301-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/28/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Subjective cognitive impairment (SCI) substantially increases dementia risk and is often conceptualised as the preclinical asymptomatic phase of the cognitive decline continuum. Due to the lack of pharmacological interventions available to treat SCI and reduce dementia risk, and the popularity of herbal and nutritional medicines, the primary aim of this review was to investigate the efficacy on cognitive function and safety of herbal and nutritional medicines (relative to a control) for older adults with and without SCI. The secondary aims were to describe the study characteristics and assess the methodological quality of included studies. METHOD Five databases (Cochrane, MEDLINE, CINAHL, PsycInfo, and EMBASE) were searched from database inception with weekly alerts established until review finalisation on 18 September 2022. Articles were eligible if they included the following: study population of older adults with and without SCI, herbal and nutritional medicines as an intervention, evaluated cognitive outcomes and were randomised control trials. RESULTS Data were extracted from 21/7666 eligible full-text articles, and the risk of methodological bias was assessed (with SCI = 9/21; without SCI = 12/21). Most studies (20/21) employed parallel, randomised, placebo-controlled designs and were 12 weeks in length. Herbal supplements were widely used (17/21), namely a form of Ginkgo biloba (8/21) or Bacopa monnieri (6/21). Measures of cognition varied across studies, with 14/21 reporting improvements in at least one domain of cognitive functioning over time, in the intervention group (compared to control). A total of 14/21 studies were deemed as having an overall high methodological risk of bias, 6/21 had some concerns, and only one study (using an SCI population) was assessed as having a low risk of methodological bias. CONCLUSIONS Overall, this review found that there is a low quality of evidence regarding the efficacy of cognitive function and safety of herbal and nutritional medicines for older adults with and without SCI, due to a high risk of bias across studies. Additionally, further work needs to be done in classifying and understanding SCI and selecting appropriate trial primary outcomes before future studies can more accurately determine the efficacy of interventions for this population.
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Affiliation(s)
- Adele E Cave
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Dennis H Chang
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Gerald W Münch
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
- School of Medicine, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Genevieve Z Steiner-Lim
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
- Translational Health Research Institute (THRI), Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
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Basheer A, Agarwal A, Misra B, Gupta A, Srivastava P, Kirubakaran R, Vishnu V. Bacopa monnieri in the treatment of dementia due to Alzheimer's disease: A systematic review of randomised controlled trials. Interact J Med Res 2022; 11:e38542. [PMID: 35612544 PMCID: PMC9379783 DOI: 10.2196/38542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/21/2022] [Accepted: 05/25/2022] [Indexed: 11/14/2022] Open
Abstract
Background Bacopa monnieri, a herb that has been used for many centuries in India, has shown neuroprotective effects in animal and in vitro studies; human studies on patients with Alzheimer disease have been inconclusive. Objective The primary objective of this review was to determine the clinical efficacy and safety of B. monnieri in persons with mild, moderate, or severe dementia, or mild cognitive impairment, due to Alzheimer disease. Methods We searched PubMed, Embase, Cochrane Library, clinical trial registries (World Health Organization, Australia-New Zealand, United States, and South Africa), the metaRegister of Controlled Trials, and CINAHL. We intended to include all randomized and quasi-randomized controlled trials that compared B. monnieri, its extract or active ingredients (at any dosage), with a placebo or a cholinesterase inhibitor among adults with dementia due to Alzheimer disease and in those with mild cognitive impairment due to Alzheimer disease. Results Our comprehensive search yielded 5 eligible studies. A total of 3 studies used B. monnieri in combination with herbal extracts while the remaining 2 used B. monnieri extracts only. Two studies compared B. monnieri with donepezil while the others used a placebo as the control. There was considerable variation in the B. monnieri dose used (ranging between 125 mg to 500 mg twice daily) and heterogeneity in treatment duration, follow-up, and outcomes. The major outcomes were Mini-Mental State Examination scores reported in 3 trials, Cognitive subscale scores of the Alzheimer’s Disease Assessment Scale in 1 study, and a battery of cognitive tests in 2 studies. Using the Cochrane risk-of-bias tool, overall, we judged all 5 studies to be at high risk of bias. While all studies reported a statistically significant difference between B. monnieri and the comparator in at least one outcome, we rated the overall quality of evidence for the Alzheimer’s Disease Assessment Scale-Cognitive Subscale, Postgraduate Institute Memory Scale, Mini-Mental State Examination, and Wechsler Memory Scale to be very low due to downgrading by 2 levels for high risk of bias and 1 more level for impreciseness due to small sample sizes and wide CIs. Conclusions There was no difference between B. monnieri and the placebo or donepezil in the treatment of Alzheimer disease based on very low certainty evidence. No major safety issues were reported in the included trials. Future randomized controlled trials should aim to recruit more participants and report clinically meaningful outcomes. Trial Registration PROSPERO CRD42020169421; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=169421
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Affiliation(s)
- Aneesh Basheer
- DM Wayanad Institute of Medical Sciences (DM WIMS), Wayanad, IN
| | - Ayush Agarwal
- All India Institute of Medical Sciences, New Delhi, RN 704, 7th floor, CN CenterAnsari Nagar, New Delhi, IN
| | - Biswamohan Misra
- All India Institute of Medical Sciences, New Delhi, RN 704, 7th floor, CN CenterAnsari Nagar, New Delhi, IN
| | - Anu Gupta
- All India Institute of Medical Sciences, New Delhi, RN 704, 7th floor, CN CenterAnsari Nagar, New Delhi, IN
| | - Padma Srivastava
- All India Institute of Medical Sciences, New Delhi, RN 704, 7th floor, CN CenterAnsari Nagar, New Delhi, IN
| | | | - Venugopalan Vishnu
- All India Institute of Medical Sciences, New Delhi, RN 704, 7th floor, CN CenterAnsari Nagar, New Delhi, IN
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Efficacy and Safety of Kleeb Bua Daeng Formula in Mild Cognitive Impairment Patients: A Phase I Randomized, Double-Blind, Placebo-Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1148112. [PMID: 35368763 PMCID: PMC8975679 DOI: 10.1155/2022/1148112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/14/2022] [Accepted: 03/01/2022] [Indexed: 11/17/2022]
Abstract
Individuals with mild cognitive impairment (MCI) were at increased risk of conversion to dementia. The Kleeb Bua Daeng (KBD) formula could be the alternative treatment option for MCI through multitarget activities. Lacking of clinical trial information brought about the study in our research. Forty patients with MCI were randomly assigned to receive the KBD capsule or placebo at a dose of 1,000 mg twice a day for three months. Their cognitive functions were monitored by the Montreal Cognitive Assessment (MoCA) and blood chemistry assessment every one month. We found that the KBD-treated group had no significant differences in the MoCA test compared to placebo. Moreover, there was no alteration in biochemical parameters of the liver and renal function was observed which could confirm the safety of this KBD formula.
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Kean JD, Downey LA, Sarris J, Kaufman J, Zangara A, Stough C. Effects of Bacopa monnieri (CDRI 08®) in a population of males exhibiting inattention and hyperactivity aged 6 to 14 years: A randomized, double-blind, placebo-controlled trial. Phytother Res 2022; 36:996-1012. [PMID: 35041248 DOI: 10.1002/ptr.7372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 12/15/2021] [Accepted: 12/18/2021] [Indexed: 11/06/2022]
Abstract
The current study investigated the efficacy of extract of Bacopa monnieri (BM; CDRI 08®) in reducing levels of inattention and hyperactivity in young children. BM has demonstrated improvements in cognitive outcomes in adults, yet little research is available on its effects in younger populations. A 14-week randomized, double-blind, placebo-controlled clinical trial, with placebo run-in and run-out phases, investigated the effects of BM on behavioural, cognitive, mood, and sleep effects in male children aged 6 to 14 years against placebo. One-hundred and twelve participants were recruited into the trial, with 93 datasets available for analysis. No significant behavioural differences were noted between treatment groups. Cognitive outcomes indicated decreased error-making in children taking CDRI 08® (p = .04) and increased speed of reaction time in those taking placebo (p = .04) at study end. Improvements in cognitive flexibility (p = .01), executive functioning (p = .04), interpersonal problems (p = .02), and sleep routine (p = .04) were noted in those consuming CDRI 08® over placebo. CDRI 08® did not improve behavioural outcomes, but may have cognitive, mood and sleep benefits in children aged 6 to 14 years. Further study is required to support the findings presented here.
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Affiliation(s)
- James D Kean
- Orygen Health, Centre for Youth Mental Health, Parkville, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.,Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Luke A Downey
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Victoria, Australia.,Institute for Breathing and Sleep, Austin Hospital, Melbourne, Victoria, Australia
| | - Jerome Sarris
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.,NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Jordy Kaufman
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Andrea Zangara
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Con Stough
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Victoria, Australia
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Lorca C, Mulet M, Arévalo-Caro C, Sanchez MÁ, Perez A, Perrino M, Bach-Faig A, Aguilar-Martínez A, Vilella E, Gallart-Palau X, Serra A. Plant-derived nootropics and human cognition: A systematic review. Crit Rev Food Sci Nutr 2022; 63:5521-5545. [PMID: 34978226 DOI: 10.1080/10408398.2021.2021137] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Substances with modulatory capabilities on certain aspects of human cognition have been revered as nootropics from the dawn of time. The plant kingdom provides most of the currently available nootropics of natural origin. Here, in this systematic review, we aim to provide state-of-the-art information regarding proven and unproven effects of plant-derived nootropics (PDNs) on human cognition in conditions of health and disease. Six independent searches, one for each neurocognitive domain (NCD), were performed in parallel using three independent scientific library databases: PubMed, Cochrane and Scopus. Only scientific studies and systematic reviews with humans published between January 2000 and November 2021 were reviewed, and 256 papers were included. Ginkgo biloba was the most relevant nootropic regarding perceptual and motor functions. Bacopa monnieri improves language, learning and memory. Withania somnifera (Ashwagandha) modulates anxiety and social-related cognitions. Caffeine enhances attention and executive functions. Together, the results from the compiled studies highlight the nootropic effects and the inconsistencies regarding PDNs that require further research.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2021.2021137.
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Affiliation(s)
- Cristina Lorca
- IMDEA-Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, Madrid, Spain
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida) - Neuroscience Area - University Hospital Arnau de Vilanova (HUAV) - School of Medicine, University of Lleida (UdL), Lleida, Spain
- Proteored - Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - María Mulet
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida) - Neuroscience Area - University Hospital Arnau de Vilanova (HUAV) - School of Medicine, University of Lleida (UdL), Lleida, Spain
| | - Catalina Arévalo-Caro
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida) - Neuroscience Area - University Hospital Arnau de Vilanova (HUAV) - School of Medicine, University of Lleida (UdL), Lleida, Spain
| | - M Ángeles Sanchez
- IMDEA-Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, Madrid, Spain
| | - Ainhoa Perez
- IMDEA-Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, Madrid, Spain
| | - María Perrino
- IMDEA-Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, Madrid, Spain
| | - Anna Bach-Faig
- FoodLab Research Group (2017SGR 83), Faculty of Health Sciences, Open University of Catalonia (UOC), Barcelona, Spain
- Food and Nutrition Area, Barcelona Official College of Pharmacists, Barcelona, Spain
| | - Alicia Aguilar-Martínez
- FoodLab Research Group (2017SGR 83), Faculty of Health Sciences, Open University of Catalonia (UOC), Barcelona, Spain
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata (HUIPM), Institut Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Universitat Rovira i Virgili (URV), Reus, Spain
- Centro de investigación Biomédica en Salud Mental CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Xavier Gallart-Palau
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida) - Neuroscience Area - University Hospital Arnau de Vilanova (HUAV) - School of Medicine, University of Lleida (UdL), Lleida, Spain
- Proteored - Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Hospital Universitari Institut Pere Mata (HUIPM), Institut Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Centro de investigación Biomédica en Salud Mental CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
| | - Aida Serra
- IMDEA-Food Research Institute, +Pec Proteomics, Campus of International Excellence UAM + CSIC, Old Cantoblanco Hospital, Madrid, Spain
- Biomedical Research Institute of Lleida Dr. Pifarré Foundation (IRB Lleida) - Neuroscience Area - University Hospital Arnau de Vilanova (HUAV) - School of Medicine, University of Lleida (UdL), Lleida, Spain
- Proteored - Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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Brioschi Guevara A, Bieler M, Altomare D, Berthier M, Csajka C, Dautricourt S, Démonet JF, Dodich A, Frisoni GB, Miniussi C, Molinuevo JL, Ribaldi F, Scheltens P, Chételat G. Protocols for cognitive enhancement. A user manual for Brain Health Services-part 5 of 6. Alzheimers Res Ther 2021; 13:172. [PMID: 34635149 PMCID: PMC8507160 DOI: 10.1186/s13195-021-00844-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/06/2021] [Indexed: 11/10/2022]
Abstract
Cognitive complaints in the absence of objective cognitive impairment, observed in patients with subjective cognitive decline (SCD), are common in old age. The first step to postpone cognitive decline is to use techniques known to improve cognition, i.e., cognitive enhancement techniques.We aimed to provide clinical recommendations to improve cognitive performance in cognitively unimpaired individuals, by using cognitive, mental, or physical training (CMPT), non-invasive brain stimulations (NIBS), drugs, or nutrients. We made a systematic review of CMPT studies based on the GRADE method rating the strength of evidence.CMPT have clinically relevant effects on cognitive and non-cognitive outcomes. The quality of evidence supporting the improvement of outcomes following a CMPT was high for metamemory; moderate for executive functions, attention, global cognition, and generalization in daily life; and low for objective memory, subjective memory, motivation, mood, and quality of life, as well as a transfer to other cognitive functions. Regarding specific interventions, CMPT based on repeated practice (e.g., video games or mindfulness, but not physical training) improved attention and executive functions significantly, while CMPT based on strategic learning significantly improved objective memory.We found encouraging evidence supporting the potential effect of NIBS in improving memory performance, and reducing the perception of self-perceived memory decline in SCD. Yet, the high heterogeneity of stimulation protocols in the different studies prevent the issuing of clear-cut recommendations for implementation in a clinical setting. No conclusive argument was found to recommend any of the main pharmacological cognitive enhancement drugs ("smart drugs", acetylcholinesterase inhibitors, memantine, antidepressant) or herbal extracts (Panax ginseng, Gingko biloba, and Bacopa monnieri) in people without cognitive impairment.Altogether, this systematic review provides evidence for CMPT to improve cognition, encouraging results for NIBS although more studies are needed, while it does not support the use of drugs or nutrients.
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Affiliation(s)
- Andrea Brioschi Guevara
- Centre Leenaards de la Mémoire, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
| | - Melanie Bieler
- Centre Leenaards de la Mémoire, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Daniele Altomare
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
| | - Marcelo Berthier
- Unit of Cognitive Neurology and Aphasia, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga - IBIMA, Malaga, Spain
| | - Chantal Csajka
- Center for Research and Innovation in clinical Pharmaceutical Sciences, University Hospital and University of Lausanne, Lausanne, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
| | - Sophie Dautricourt
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Jean-François Démonet
- Centre Leenaards de la Mémoire, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Alessandra Dodich
- Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, Italy
| | - Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
| | - Carlo Miniussi
- Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, Italy
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Federica Ribaldi
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
- Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), Saint John of God Clinical Research Centre, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Gael Chételat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
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McPhee GM, Downey LA, Wesnes KA, Stough C. The Neurocognitive Effects of Bacopa monnieri and Cognitive Training on Markers of Brain Microstructure in Healthy Older Adults. Front Aging Neurosci 2021; 13:638109. [PMID: 33692683 PMCID: PMC7937913 DOI: 10.3389/fnagi.2021.638109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 01/28/2021] [Indexed: 11/13/2022] Open
Abstract
Bacopa monnieri (BM) is a herbal supplement that increases signaling molecules implicated in synaptogenesis. Combined with cognitive stimulation, it may be a viable supplement to enhance long-term potentiation (LTP) and improve cognitive health in older adults. This randomized, double-blind, placebo-controlled trial asked 28 healthy adults aged over 55 years to complete cognitive training (CT) 3 hours weekly for 12 weeks. Fifteen consumed a standardized extract of BM and 13 consumed a placebo daily. Cognitive tasks, life-satisfaction, memory complaints and mood were assessed, and bloods analyzed for serum brain-derived neurotrophic factor (BDNF) before and after 12-weeks of the intervention. Diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) in gray (GM) and white matter (WM) were also analyzed. Results demonstrated slower reaction time in an image discrimination task in the BM group and faster reaction time in a spatial working memory task (SWM-O RT) in the placebo group. Mean accuracy was higher in the BM group for these tasks, suggesting a change in the speed accuracy trade-off. Exploratory neuroimaging analysis showed increased WM mean diffusivity (MD) and GM dispersion of neurites (orientation dispersion index, ODI) and decreased WM fractional anisotropy (FA) and GM neurite density (ND) in the BM group. No other outcomes reached statistical significance. An increase in ODI with a decrease in MD and ND in the BM group may indicate an increase in network complexity (through higher dendritic branching) accompanied by dendritic pruning to enhance network efficiency. These neuroimaging outcomes conflict with the behavioral results, which showed poorer reaction time in the BM group. Given the exploratory outcomes and inconsistent findings between the behavioral and neuroimaging data, a larger study is needed to confirm the synaptogenic mechanisms of BM.
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Affiliation(s)
- Grace M McPhee
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Luke A Downey
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia.,Institute for Breathing and Sleep, Austin Health, Melbourne, VIC, Australia
| | - Keith A Wesnes
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia.,Wesnes Cognition Ltd., Streatley, United Kingdom.,University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Con Stough
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia
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Brimson JM, Brimson S, Prasanth MI, Thitilertdecha P, Malar DS, Tencomnao T. The effectiveness of Bacopa monnieri (Linn.) Wettst. as a nootropic, neuroprotective, or antidepressant supplement: analysis of the available clinical data. Sci Rep 2021; 11:596. [PMID: 33436817 PMCID: PMC7803732 DOI: 10.1038/s41598-020-80045-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 12/14/2020] [Indexed: 02/06/2023] Open
Abstract
Bacopa monnieri (Linn.) Wettst. has been used in traditional medicine as a drug to enhance and improve memory. In this regard, this study aims to provide B. monnieri's efficacy as a neuroprotective drug and as a nootropic against various neurological diseases. Literatures were collected, following Prisma guidelines, from databases, including Scopus, PubMed, Google Scholar, and Science Direct and were scrutinized using a quality scoring system. Means, standard deviations and 'n' numbers were extracted from the metrics and analyzed. Jamovi computer software for Mac was used to carry out the meta-analysis. The selected studies suggested that the plant extracts were able to show some improvements in healthy subjects which were determined in Auditory Verbal Learning Task, digit span-reverse test, inspection time task and working memory, even though it was not significant, as no two studies found statistically significant changes in the same two tests. B. monnieri was able to express modest improvements in subjects with memory loss, wherein only a few of the neuropsychological tests showed statistical significance. B. monnieri in a cocktail with other plant extracts were able to significantly reduce the effects of Alzheimer's disease, and depression which cannot be solely credited as the effect of B. monnieri. Although in one study B. monnieri was able to potentiate the beneficial effects of citalopram; on the whole, currently, there are only limited studies to establish the memory-enhancing and neuroprotective effects of B. monnieri. More studies have to be done in the future by comparing the effect with standard drugs, in order to establish these effects clinically in the plant and corroborate the preclinical data.
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Affiliation(s)
- James M. Brimson
- grid.7922.e0000 0001 0244 7875Age-Related Inflammation and Degeneration Research Unit, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, 10330 Thailand ,grid.7922.e0000 0001 0244 7875Department of Clinical Chemistry, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, 10330 Thailand
| | - Sirikalaya Brimson
- grid.7922.e0000 0001 0244 7875Department of Clinical Microscopy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, 10330 Thailand
| | - Mani Iyer Prasanth
- grid.7922.e0000 0001 0244 7875Age-Related Inflammation and Degeneration Research Unit, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, 10330 Thailand ,grid.7922.e0000 0001 0244 7875Department of Clinical Chemistry, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, 10330 Thailand
| | - Premrutai Thitilertdecha
- grid.10223.320000 0004 1937 0490Siriraj Research Group in Immunobiology and Therapeutic Sciences, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Dicson Sheeja Malar
- grid.7922.e0000 0001 0244 7875Age-Related Inflammation and Degeneration Research Unit, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, 10330 Thailand ,grid.7922.e0000 0001 0244 7875Department of Clinical Chemistry, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, 10330 Thailand
| | - Tewin Tencomnao
- grid.7922.e0000 0001 0244 7875Age-Related Inflammation and Degeneration Research Unit, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, 10330 Thailand ,grid.7922.e0000 0001 0244 7875Department of Clinical Chemistry, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, 10330 Thailand
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Roe AL, Venkataraman A. The Safety and Efficacy of Botanicals with Nootropic Effects. Curr Neuropharmacol 2021; 19:1442-1467. [PMID: 34315377 PMCID: PMC8762178 DOI: 10.2174/1570159x19666210726150432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/23/2021] [Accepted: 07/17/2021] [Indexed: 11/22/2022] Open
Abstract
Recent estimates for the global brain health supplement category, i.e. nootropic market size, will grow to nearly $5.8 billion by 2023. Overall, nearly one-quarter (23%) of adults currently take a supplement to maintain or improve brain health or delay and reverse dementia. Not surprisingly, the use of such supplements increases with age - more than one-third of the oldest generation (ages 74 and older) takes a supplement for brain health. This widespread use is being driven by a strong desire both in the younger and older generations to enhance cognitive performance and achieve healthy aging. The most prevalent botanicals currently dominating the nootropic marketplace include Gingko biloba, American ginseng, and Bacopa monnieri. However, other botanicals that affect stress, focus, attention, and sleep have also been procured by dietary supplement companies developing products for improving both, short and long-term brain health. This review focuses on efficacy data for neuroactive botanicals targeted at improving cognitive function, stress reduction, memory, mood, attention, concentration, focus, and alertness, including Bacopa monnieri, Ginkgo biloba, Holy basil, American ginseng, Gotu kola, Lemon balm, Common and Spanish sages and spearmint. Botanicals are discussed in terms of available clinical efficacy data and current safety profiles. Data gaps are highlighted for both efficacy and safety to bring attention to unmet needs and future research.
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Affiliation(s)
- Amy L. Roe
- Personal Healthcare Division, The Procter & Gamble Company, 8700 Mason-Montgomery Road, Mason, OH, 45040, USA
| | - Arvind Venkataraman
- Personal Healthcare Division, The Procter & Gamble Company, 8700 Mason-Montgomery Road, Mason, OH, 45040, USA
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Abdul Manap AS, Vijayabalan S, Madhavan P, Chia YY, Arya A, Wong EH, Rizwan F, Bindal U, Koshy S. Bacopa monnieri, a Neuroprotective Lead in Alzheimer Disease: A Review on Its Properties, Mechanisms of Action, and Preclinical and Clinical Studies. Drug Target Insights 2019; 13:1177392819866412. [PMID: 31391778 PMCID: PMC6669844 DOI: 10.1177/1177392819866412] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 07/08/2019] [Indexed: 01/24/2023] Open
Abstract
Alzheimer disease is a neurodegenerative disease that is signified by cognitive decline, memory loss, and erratic behavior. Till date, no cure for Alzheimer exists and the current Alzheimer medications have limited effectiveness. However, herbal medicines may slow down the disease’s progression, which may hopefully reduce the number of cases in the years to come. Numerous studies have been done on characterizing the neuroprotective properties from plants belonging to Scrophulariaceae family, particularly Bacopa monnieri and its polyphenolic compounds known as bacosides. This review presents the findings on bacosides in therapeutic plants and their impact on Alzheimer disease pathology. These reports present data on the clinical, cellular activities, phytochemistry, and biological applications that may be used in new drug treatment for Alzheimer disease.
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Affiliation(s)
- Aimi Syamima Abdul Manap
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Shantini Vijayabalan
- School of Pharmacy, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Yoke Yin Chia
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Aditya Arya
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Eng Hwa Wong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Farzana Rizwan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Umesh Bindal
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Shajan Koshy
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
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Cave AE, Chang DH, Münch GW, Steiner GZ. Efficacy of Cognition Support Formula® on cognitive function in older adults with subjective cognitive impairment: a protocol for a 26-week, randomised, double-blind, placebo-controlled trial. Trials 2019; 20:345. [PMID: 31182153 PMCID: PMC6558749 DOI: 10.1186/s13063-019-3431-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 05/13/2019] [Indexed: 11/25/2022] Open
Abstract
Background Due to an ageing population in Australia there has been an increase in the number of older adults with subjective cognitive impairment (SCI), a self-reported decline in cognitive function associated with an increased risk of mild cognitive impairment and dementia. There is no current, recommended treatment for SCI; therefore, the effectiveness of a supplement approved by the Therapeutic Goods Association that has the potential to enhance cognitive function in an at-risk cohort should be tested. The primary aim of this proposed research is to determine the efficacy of 6 months of treatment with BioCeuticals Cognition Support Formula® (containing Bacopa monniera (brahmi), Ginkgo biloba, Panax ginseng and alpha-lipoic acid) on cognition in older adults with SCI (utilising the CogState® one card learning and identification tests as co-primary outcome measures of visual short-term memory and attention; mean speed (ms), accuracy (%), and total number of hits, misses, and anticipations) compared with placebo. The secondary aims are to assess an improvement in other cognitive domains (executive functioning, processing speed, and working memory), evaluate safety, adverse effects, and determine efficacy on mood, fatigue, and neurocognition. It is expected that improvements across the study timepoints in the co-primary outcomes in the active treatment group (compared with placebo) will be evident. Method One-hundred and twenty participants will be recruited for the randomised, double-blind, placebo-controlled study. Participants will be randomly assigned to one of the treatment groups (active or placebo) at a 1:1 ratio, and will be required to complete a series of cognitive (using CogState®), mood (using the Depression, Anxiety, Stress Scale (DASS-42) and Short Health Anxiety Inventory (SHAI)), and fatigue (using the Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-F)) tasks at baseline (0 months), the midpoint (3 months), and the endpoint (6 months). These tasks will be evaluated between timepoints (baseline vs. midpoint, midpoint vs. endpoint, and baseline vs. endpoint). Neurocognition will be measured by electroencephalography at baseline and at the endpoint in half of the participants. Adverse effects will be documented over the 6-month trial period. Discussion This is the first study to test the efficacy of Cognition Support Formula® on cognition in older adults with SCI. As people with SCI have an increased risk of dementia, and there are limited treatments options for this population, it is important to assess a supplement that has the potential to enhance cognitive function. Trial registration Universal Trial Number (UTN), U1111–1196-9548. Australian New Zealand Clinical Trials Registry, ACTRN12617000945325. Registered on 30 June 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3431-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adele E Cave
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Dennis H Chang
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Gerald W Münch
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.,School of Medicine, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Genevieve Z Steiner
- NICM Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia. .,Translational Health Research Institute (THRI), Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
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Kean JD, Downey LA, Stough C. Systematic Overview of Bacopa monnieri (L.) Wettst. Dominant Poly-Herbal Formulas in Children and Adolescents. MEDICINES (BASEL, SWITZERLAND) 2017; 4:medicines4040086. [PMID: 29165401 PMCID: PMC5750610 DOI: 10.3390/medicines4040086] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 11/16/2017] [Accepted: 11/18/2017] [Indexed: 01/07/2023]
Abstract
Background: The Ayurvedic medicinal system employs a holistic approach to health, utilising the synergistic properties of organic resources. Research into the Ayurvedic herb Bacopa monnieri (L.) Wettst. (B.monnieri) has reported improvements in cognitive outcomes in child and adult populations. The aim of current review is to systematically assess and critically summarize clinical trials investigating B.monnieri-dominant poly-herbal formulas and their effects on the cognition, memory, learning, and behaviour in children and adolescents. Methods: Key word searches were performed using PubMed, Scopus, Cochrane Library, DHARA, and CINAHL for publications meeting inclusion criteria up to November 2017. There were no restrictions in study design. Effect sizes were calculated for all significant findings to allow for direct comparisons, and each study was evaluated on design quality. Cognitive and behavioural outcomes were grouped into validated constructs for cross-study comparison. Results: Nine trials met inclusion criteria. Five studies reported sufficient data for effect size analysis with most improvements reported in behavioural outcomes. True cognitive abilities and behavioural constructs were reviewed in six studies, with visual perception, impulsivity, and attention demonstrating the greatest improvements. The veracity of the evidence for the formulations reviewed is weakened by inconsistent statistical design and under-reporting of safety and tolerability data (44%). Conclusions: The current review extends research supporting B.monnieri as a cognitive enhancer and provides modest evidence for the use of B.monnieri in poly-herbal preparations for improving cognitive and behavioural outcomes in child and adolescent populations. Greater emphasis on statistical vigour and the reporting of tolerability data are essential for future trials to adequately document poly-herbal treatment efficacy.
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Affiliation(s)
- James D Kean
- Centre for Human Psychopharmacology, Swinburne University, Melbourne 3122, Australia.
| | - Luke A Downey
- Centre for Human Psychopharmacology, Swinburne University, Melbourne 3122, Australia.
- Institute for Breathing and Sleep, Austin Hospital, Melbourne 3084, Australia.
| | - Con Stough
- Centre for Human Psychopharmacology, Swinburne University, Melbourne 3122, Australia.
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Kean JD, Downey LA, Stough C. A systematic review of the Ayurvedic medicinal herb Bacopa monnieri in child and adolescent populations. Complement Ther Med 2016; 29:56-62. [DOI: 10.1016/j.ctim.2016.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 07/14/2016] [Accepted: 09/02/2016] [Indexed: 11/27/2022] Open
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Cognitive training and Bacopa monnieri: Evidence for a combined intervention to alleviate age associated cognitive decline. Med Hypotheses 2016; 95:71-76. [PMID: 27692172 DOI: 10.1016/j.mehy.2016.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 09/03/2016] [Indexed: 12/11/2022]
Abstract
As the elderly population grows the impact of age associated cognitive decline as well as neurodegenerative diseases such as Alzheimer's disease and dementia will increase. Ageing is associated with consistent impairments in cognitive processes (e.g., processing speed, memory, executive function and learning) important for work, well-being, life satisfaction and overall participation in society. Recently, there has been increased effort to conduct research examining methods to improve cognitive function in older citizens. Cognitive training has been shown to improve performance in some cognitive domains; including memory, processing speed, executive function and attention in older adults. These cognitive changes are thought to be related to improvements in brain connectivity and neural circuitry. Bacopa monnieri has also been shown to improve specific domains of cognition, sensitive to age associated cognitive decline (particularly processing speed and memory). These Bacopa monnieri dependent improvements may be due to the increase in specific neuro-molecular mechanisms implicated in the enhancement of neural connections in the brain (i.e. synaptogenesis). In particular, a number of animal studies have shown Bacopa monnieri consumption upregulates calcium dependent kinases in the synapse and post-synaptic cell, crucial for strengthening and growing connections between neurons. These effects have been shown to occur in areas important for cognitive processes, such as the hippocampus. As Bacopa monnieri has shown neuro-molecular mechanisms that encourage synaptogenesis, while cognitive training enhances brain connectivity, Bacopa monnieri supplementation could theoretically enhance and strengthen synaptic changes acquired through cognitive training. Therefore, the current paper hypothesises that the combination of these two interventions could improve cognitive outcomes, over and above the effects of administrating these interventions independently, as an effective treatment to ameliorate age associated cognitive decline.
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Preethi J, Singh HK, Rajan KE. Possible Involvement of Standardized Bacopa monniera Extract (CDRI-08) in Epigenetic Regulation of reelin and Brain-Derived Neurotrophic Factor to Enhance Memory. Front Pharmacol 2016; 7:166. [PMID: 27445807 PMCID: PMC4921742 DOI: 10.3389/fphar.2016.00166] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Accepted: 06/02/2016] [Indexed: 11/17/2022] Open
Abstract
Bacopa monniera extract (CDRI-08; BME) has been known to improve learning and memory, and understanding the molecular mechanisms may help to know its specificity. We investigated whether the BME treatment alters the methylation status of reelin and brain-derived neurotropic factor (BDNF) to enhance the memory through the interaction of N-methyl-D-aspartate receptor (NMDAR) with synaptic proteins. Rat pups were subjected to novel object recognition test following daily oral administration of BME (80 mg/kg) in 0.5% gum acacia (per-orally, p.o.; PND 15–29)/three doses of 5-azacytidine (5-azaC; 3.2 mg/kg) in 0.9% saline (intraperitoneally, i.p.) on PND-30. After the behavioral test, methylation status of reelin, BDNF and activation of NMDAR, and its interactions with synaptic proteins were tested. Rat pups treated with BME/5-azaC showed higher discrimination towards novel objects than with old objects during testing. Further, we observed an elevated level of unmethylated DNA in reelin and BDNF promoter region. Up-regulated reelin along with the splice variant of apolipoprotein E receptor 2 (ApoER 2, ex 19) form a cluster and activate NMDAR through disabled adopter protein-1 (DAB1) to enhance BDNF. Observed results suggest that BME regulate reelin epigenetically, which might enhance NMDAR interactions with synaptic proteins and induction of BDNF. These changes may be linked with improved novel object recognition memory.
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Affiliation(s)
- Jayakumar Preethi
- Behavioral Neuroscience Laboratory, Department of Animal Science, School of Life Sciences, Bharathidasan University Tiruchirappalli, India
| | - Hemant K Singh
- Laboratories for CNS Disorder, Learning and Memory, Division of Pharmacology, Central Drug Research Institute Lucknow, India
| | - Koilmani E Rajan
- Behavioral Neuroscience Laboratory, Department of Animal Science, School of Life Sciences, Bharathidasan University Tiruchirappalli, India
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Molecular and Functional Characterization of Bacopa monniera: A Retrospective Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:945217. [PMID: 26413131 PMCID: PMC4564644 DOI: 10.1155/2015/945217] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 03/24/2015] [Accepted: 04/09/2015] [Indexed: 12/21/2022]
Abstract
Over the last 50 years, laboratories around the world analyzed the pharmacological effect of Bacopa monniera extract in different dimensions, especially as a nerve tonic and memory enhancer. Studies in animal model evidenced that Bacopa treatment can attenuate dementia and enhances memory. Further, they demonstrate that Bacopa primarily either acts via antioxidant mechanism (i.e., neuroprotection) or alters different neurotransmitters (serotonin (5-hydroxytryptamine, 5-HT), dopamine (DA), acetylcholine (ACh), γ-aminobutyric acid (GABA)) to execute the pharmacological effect. Among them, 5-HT has been shown to fine tune the neural plasticity, which is a substrate for memory formation. This review focuses on the studies which trace the effect of Bacopa treatment on serotonergic system and 5-HT mediated key molecular changes that are associated with memory formation.
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Ramasamy S, Chin SP, Sukumaran SD, Buckle MJC, Kiew LV, Chung LY. In Silico and In Vitro Analysis of Bacoside A Aglycones and Its Derivatives as the Constituents Responsible for the Cognitive Effects of Bacopa monnieri. PLoS One 2015; 10:e0126565. [PMID: 25965066 PMCID: PMC4428790 DOI: 10.1371/journal.pone.0126565] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 04/03/2015] [Indexed: 12/20/2022] Open
Abstract
Bacopa monnieri has been used in Ayurvedic medicine to improve memory and cognition. The active constituent responsible for its pharmacological effects is bacoside A, a mixture of dammarane-type triterpenoid saponins containing sugar chains linked to a steroid aglycone skeleton. Triterpenoid saponins have been reported to be transformed in vivo to metabolites that give better biological activity and pharmacokinetic characteristics. Thus, the activities of the parent compounds (bacosides), aglycones (jujubogenin and pseudojujubogenin) and their derivatives (ebelin lactone and bacogenin A1) were compared using a combination of in silico and in vitro screening methods. The compounds were docked into 5-HT1A, 5-HT2A, D1, D2, M1 receptors and acetylcholinesterase (AChE) using AutoDock and their central nervous system (CNS) drug-like properties were determined using Discovery Studio molecular properties and ADMET descriptors. The compounds were screened in vitro using radioligand receptor binding and AChE inhibition assays. In silico studies showed that the parent bacosides were not able to dock into the chosen CNS targets and had poor molecular properties as a CNS drug. In contrast, the aglycones and their derivatives showed better binding affinity and good CNS drug-like properties, were well absorbed through the intestines and had good blood brain barrier (BBB) penetration. Among the compounds tested in vitro, ebelin lactone showed binding affinity towards M1 (Ki = 0.45 μM) and 5-HT2A (4.21 μM) receptors. Bacoside A and bacopaside X (9.06 μM) showed binding affinity towards the D1 receptor. None of the compounds showed any inhibitory activity against AChE. Since the stimulation of M1 and 5-HT2A receptors has been implicated in memory and cognition and ebelin lactone was shown to have the strongest binding energy, highest BBB penetration and binding affinity towards M1 and 5-HT2A receptors, we suggest that B. monnieri constituents may be transformed in vivo to the active form before exerting their pharmacological activity.
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Affiliation(s)
- Seetha Ramasamy
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sek Peng Chin
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sri Devi Sukumaran
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Lik Voon Kiew
- Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Lip Yong Chung
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Center for Natural Products and Drug Research (CENAR), University of Malaya, Kuala Lumpur, Malaysia
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Jansen RLM, Brogan B, Whitworth AJ, Okello EJ. Effects of five Ayurvedic herbs on locomotor behaviour in a Drosophila melanogaster Parkinson's disease model. Phytother Res 2014; 28:1789-95. [PMID: 25091506 PMCID: PMC4310928 DOI: 10.1002/ptr.5199] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 06/09/2014] [Accepted: 06/23/2014] [Indexed: 12/24/2022]
Abstract
Current conventional treatments for Parkinson's disease (PD) are aimed at symptom management, as there is currently no known cure or treatment that can slow down its progression. Ayurveda, the ancient medical system of India, uses a combination of herbs to combat the disease. Herbs commonly used for this purpose are Zandopa (containing Mucuna pruriens), Withania somnifera, Centella asiatica, Sida cordifolia and Bacopa monnieri. In this study, these herbs were tested for their potential ability to improve climbing ability of a fruit fly (Drosophila melanogaster) PD model based on loss of function of phosphatase and tensin-induced putative kinase 1 (PINK1). Fruit flies were cultured on food containing individual herbs or herbal formulations, a combination of all five herbs, levodopa (positive control) or no treatment (negative control). Tests were performed in both PINK1 mutant flies and healthy wild-type (WT) flies. A significant improvement in climbing ability was observed in flies treated with B. monnieri compared with untreated PINK1 mutant flies. However, a significant decrease in climbing ability was observed in WT flies for the same herb. Centella asiatica also significantly decreased climbing ability in WT flies. No significant effects were observed with any of the other herbs in either PINK1 or WT flies compared with untreated flies.
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Affiliation(s)
- R. L. M. Jansen
- School of Agriculture, Food and Rural Development, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - B. Brogan
- School of Biology, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
| | - A. J. Whitworth
- Department of Biomedical Science, University of Sheffield, Western Bank, Sheffield S10 2TN, UK
| | - E. J. Okello
- School of Agriculture, Food and Rural Development, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK
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Ramasamy S, Kiew LV, Chung LY. Inhibition of human cytochrome P450 enzymes by Bacopa monnieri standardized extract and constituents. Molecules 2014; 19:2588-601. [PMID: 24566323 PMCID: PMC6271976 DOI: 10.3390/molecules19022588] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 02/19/2014] [Accepted: 02/19/2014] [Indexed: 11/16/2022] Open
Abstract
Bacopa monnieri and the constituents of this plant, especially bacosides, possess various neuropharmacological properties. Like drugs, some herbal extracts and the constituents of their extracts alter cytochrome P450 (CYP) enzymes, causing potential herb-drug interactions. The effects of Bacopa monnieri standardized extract and the bacosides from the extract on five major CYP isoforms in vitro were analyzed using a luminescent CYP recombinant human enzyme assay. B. monnieri extract exhibited non-competitive inhibition of CYP2C19 (IC50/Ki = 23.67/9.5 µg/mL), CYP2C9 (36.49/12.5 µg/mL), CYP1A2 (52.20/25.1 µg/mL); competitive inhibition of CYP3A4 (83.95/14.5 µg/mL) and weak inhibition of CYP2D6 (IC50 = 2061.50 µg/mL). However, the bacosides showed negligible inhibition of the same isoforms. B. monnieri, which is orally administered, has a higher concentration in the gut than the liver; therefore, this herb could exhibit stronger inhibition of intestinal CYPs than hepatic CYPs. At an estimated gut concentration of 600 µg/mL (based on a daily dosage of 300 mg/day), B. monnieri reduced the catalytic activities of CYP3A4, CYP2C9 and CYP2C19 to less than 10% compared to the total activity (without inhibitor = 100%). These findings suggest that B. monnieri extract could contribute to herb-drug interactions when orally co-administered with drugs metabolized by CYP1A2, CYP3A4, CYP2C9 and CYP2C19.
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Affiliation(s)
- Seetha Ramasamy
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Lik Voon Kiew
- Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
| | - Lip Yong Chung
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.
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Kongkeaw C, Dilokthornsakul P, Thanarangsarit P, Limpeanchob N, Norman Scholfield C. Meta-analysis of randomized controlled trials on cognitive effects of Bacopa monnieri extract. JOURNAL OF ETHNOPHARMACOLOGY 2013; 151:528-535. [PMID: 24252493 DOI: 10.1016/j.jep.2013.11.008] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Revised: 11/01/2013] [Accepted: 11/06/2013] [Indexed: 06/02/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Bacopa monnieri has a long history in Ayurvedic medicine for neurological and behavioral defects. To assess its efficacy in improving cognitive function. MATERIALS AND METHODS MEDLINE, EMBASE, CINAHL, AMED, Cochrane Central of clinical trial, WHO registry, Thai Medical Index, Index Medicus Siriraj library and www.clinicaltrial.gov were searched from the inception date of each database to June 2013 using scientific and common synonyms of Bacopa monnieri, cognitive performance or memory. The reference lists of retrieved articles were also reviewed. Randomized, placebo controlled human intervention trials on chronic ≥ 12 weeks dosing of standardized extracts of Bacopa monnieri without any co-medication were included in this study. The methodological quality of studies was assessed using Cochrane's risk of bias assessment and Jadad's quality scales. The weighted mean difference and 95% confidence interval (95% CI) were performed using the random-effects model of the Dersimonian-Laird method. RESULTS Nine studies met the inclusion criteria using 518 subjects. Overall quality of all included trials was low risk of bias and quality of reported information was high. Meta-analysis of 437 eligible subjects showed improved cognition by shortened Trail B test (-17.9 ms; 95% CI -24.6 to -11.2; p<0.001) and decreased choice reaction time (10.6 ms; 95% CI -12.1 to -9.2; p<0.001). CONCLUSION This meta-analysis suggests that Bacopa monnieri has the potential to improve cognition, particularly speed of attention but only a large well designed 'head-to-head' trial against an existing medication will provide definitive data on its efficacy on healthy or dementia patients using a standardized preparation.
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Affiliation(s)
- Chuenjid Kongkeaw
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand; Center of Pharmaceutical Outcomes Research, Faculty of Pharmaceutical Sciences, Naresuan University, Thailand; Center of Excellence for Environmental Health & Toxicology, Naresuan University, Thailand.
| | - Piyameth Dilokthornsakul
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand; Center of Pharmaceutical Outcomes Research, Faculty of Pharmaceutical Sciences, Naresuan University, Thailand; Center for Pharmacoepidemiology and Pharmacoeconomic Research, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA
| | - Phurit Thanarangsarit
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand
| | - Nanteetip Limpeanchob
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand
| | - C Norman Scholfield
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand; Center of Excellence for Environmental Health & Toxicology, Naresuan University, Thailand
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Benson S, Downey LA, Stough C, Wetherell M, Zangara A, Scholey A. An acute, double-blind, placebo-controlled cross-over study of 320 mg and 640 mg doses of Bacopa monnieri (CDRI 08) on multitasking stress reactivity and mood. Phytother Res 2013; 28:551-9. [PMID: 23788517 DOI: 10.1002/ptr.5029] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 05/15/2013] [Accepted: 05/24/2013] [Indexed: 11/11/2022]
Abstract
Little research exists in humans concerning the anxiolytic, antidepressant, sedative, and adaptogenic actions the traditional Ayurvedic medicine Bacopa monnieri (BM) possesses in addition to its documented cognitive-enhancing effects. Preclinical work has identified a number of acute anxiolytic, nootropic, and adaptogenic effects of BM that may also co-occur in humans. The current double-blind, placebo-controlled cross-over study assessed the acute effects of a specific extract of BM (KeenMind® - CDRI 08) in normal healthy participants during completion of a multitasking framework (MTF). Seventeen healthy volunteers completed the MTF, at baseline, then 1 h and 2 h after consuming a placebo, 320 mg BM and 640 mg of BM. Treatments were separated by a 7-day washout with order determined by Latin Square. Outcome measures included cognitive outcomes from the MTF, with mood and salivary cortisol measured before and after each completion of the MTF. Change from baseline scores indicated positive cognitive effects, notably at both 1 h post and 2 h post BM consumption on the Letter Search and Stroop tasks, suggesting an earlier nootropic effect of BM than previously investigated. There were also some positive mood effects and reduction in cortisol levels, pointing to a physiological mechanism for stress reduction associated with BM consumption. It was concluded that acute BM supplementation produced some adaptogenic and nootropic effects that need to be replicated in a larger sample and in isolation from stressful cognitive tests in order to quantify the magnitude of these effects. The study was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12612000834853).
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Affiliation(s)
- Sarah Benson
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
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Brahmi for the better? New findings challenging cognition and anti-anxiety effects of Brahmi (Bacopa monniera) in healthy adults. Psychopharmacology (Berl) 2013; 227:299-306. [PMID: 23354535 DOI: 10.1007/s00213-013-2978-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 12/17/2012] [Indexed: 10/27/2022]
Abstract
RATIONALE A number of studies have indicated positive effects of long-term administration (3 months) of Bacopa monniera (Brahmi) on various cognitive functions especially memory and anxiety. However, inconsistent results in literature may be linked to various methodological issues. OBJECTIVE The present study aimed to test the chronic effects (12 weeks) of 450 mg of a B. monniera (Brahmi) extract on learning and memory, information processing and anxiety in healthy adult Indian population. METHODS The study design was a randomised, double-blind, placebo-controlled parallel design. Participants comprised of 72 healthy urban adults, both men and women, in the age range of 35-60 years who were educated and English speaking with basic knowledge of computers from Bangalore. The outcome measures included verbal learning and memory, inspection time, attention and interference. State and trait anxiety were additional outcome variables. RESULTS In the present study, there were no significant differences between the two groups on any of the cognitive measures. However, there was a trend for lower state anxiety in the B. monniera (Brahmi) group as compared to placebo group. CONCLUSIONS The current study attempted to determine the chronic effects of single daily dose of 450 mg of Brahmi extract on cognitive performance and anxiety in healthy adults. The results of the current study are not in agreement with findings of some of the earlier studies which have found improvement both on cognitive parameters and a reduction of anxiety scores.
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Neale C, Camfield D, Reay J, Stough C, Scholey A. Cognitive effects of two nutraceuticals Ginseng and Bacopa benchmarked against modafinil: a review and comparison of effect sizes. Br J Clin Pharmacol 2013; 75:728-37. [PMID: 23043278 PMCID: PMC3575939 DOI: 10.1111/bcp.12002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 09/28/2012] [Indexed: 11/29/2022] Open
Abstract
Over recent years there has been increasing research into both pharmaceutical and nutraceutical cognition enhancers. Here we aimed to calculate the effect sizes of positive cognitive effect of the pharmaceutical modafinil in order to benchmark the effect of two widely used nutraceuticals Ginseng and Bacopa (which have consistent acute and chronic cognitive effects, respectively). A search strategy was implemented to capture clinical studies into the neurocognitive effects of modafinil, Ginseng and Bacopa. Studies undertaken on healthy human subjects using a double-blind, placebo-controlled design were included. For each study where appropriate data were included, effect sizes (Cohen's d) were calculated for measures showing significant positive and negative effects of treatment over placebo. The highest effect sizes for cognitive outcomes were 0.77 for modafinil (visuospatial memory accuracy), 0.86 for Ginseng (simple reaction time) and 0.95 for Bacopa (delayed word recall). These data confirm that neurocognitive enhancement from well characterized nutraceuticals can produce cognition enhancing effects of similar magnitude to those from pharmaceutical interventions. Future research should compare these effects directly in clinical trials.
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Affiliation(s)
- Chris Neale
- Centre for Human Psychopharmacology, Swinburne UniversityMelbourne, Vic., 3122, Australia
| | - David Camfield
- Centre for Human Psychopharmacology, Swinburne UniversityMelbourne, Vic., 3122, Australia
| | - Jonathon Reay
- School of Life Sciences, Northumbria UniversityNewcastle upon Tyne, NE1 8ST, UK
| | - Con Stough
- Centre for Human Psychopharmacology, Swinburne UniversityMelbourne, Vic., 3122, Australia
| | - Andrew Scholey
- Centre for Human Psychopharmacology, Swinburne UniversityMelbourne, Vic., 3122, Australia
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Downey LA, Kean J, Nemeh F, Lau A, Poll A, Gregory R, Murray M, Rourke J, Patak B, Pase MP, Zangara A, Lomas J, Scholey A, Stough C. An Acute, Double-Blind, Placebo-Controlled Crossover Study of 320 mg and 640 mg Doses of a Special Extract of Bacopa monnieri
(CDRI 08) on Sustained Cognitive Performance. Phytother Res 2012; 27:1407-13. [DOI: 10.1002/ptr.4864] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 09/20/2012] [Accepted: 09/27/2012] [Indexed: 11/07/2022]
Affiliation(s)
- Luke A. Downey
- Centre for Human Psychopharmacology; Swinburne University of Technology; Melbourne Australia
| | - James Kean
- Centre for Human Psychopharmacology; Swinburne University of Technology; Melbourne Australia
| | - Fiona Nemeh
- Centre for Human Psychopharmacology; Swinburne University of Technology; Melbourne Australia
| | - Angela Lau
- Centre for Human Psychopharmacology; Swinburne University of Technology; Melbourne Australia
| | - Alex Poll
- Centre for Human Psychopharmacology; Swinburne University of Technology; Melbourne Australia
| | - Rebecca Gregory
- Centre for Human Psychopharmacology; Swinburne University of Technology; Melbourne Australia
| | - Margaret Murray
- Centre for Human Psychopharmacology; Swinburne University of Technology; Melbourne Australia
| | - Johanna Rourke
- Centre for Human Psychopharmacology; Swinburne University of Technology; Melbourne Australia
| | - Brigit Patak
- Centre for Human Psychopharmacology; Swinburne University of Technology; Melbourne Australia
| | - Matthew P. Pase
- Centre for Human Psychopharmacology; Swinburne University of Technology; Melbourne Australia
| | - Andrea Zangara
- Centre for Human Psychopharmacology; Swinburne University of Technology; Melbourne Australia
- Soho Flordis International; Sydney Australia
| | - Justine Lomas
- Centre for Human Psychopharmacology; Swinburne University of Technology; Melbourne Australia
| | - Andrew Scholey
- Centre for Human Psychopharmacology; Swinburne University of Technology; Melbourne Australia
| | - Con Stough
- Centre for Human Psychopharmacology; Swinburne University of Technology; Melbourne Australia
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Peth-Nui T, Wattanathorn J, Muchimapura S, Tong-Un T, Piyavhatkul N, Rangseekajee P, Ingkaninan K, Vittaya-areekul S. Effects of 12-Week Bacopa monnieri Consumption on Attention, Cognitive Processing, Working Memory, and Functions of Both Cholinergic and Monoaminergic Systems in Healthy Elderly Volunteers. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2012; 2012:606424. [PMID: 23320031 PMCID: PMC3537209 DOI: 10.1155/2012/606424] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 09/20/2012] [Accepted: 11/25/2012] [Indexed: 11/23/2022]
Abstract
At present, the scientific evidence concerning the effect of Bacopa monnieri on brain activity together with working memory is less available. Therefore, we aimed to determine the effect of B. monnieri on attention, cognitive processing, working memory, and cholinergic and monoaminergic functions in healthy elderly. A randomized double-blind placebo-controlled design was utilized. Sixty healthy elderly subjects (mean age 62.62 years; SD 6.46), consisting of 23 males and 37 females, received either a standardized extract of B. monnieri (300 and 600 mg) or placebo once daily for 12 weeks. The cholinergic and monoaminergic systems functions were determined using AChE and MAO activities. Working memory was assessed using percent accuracy and reaction time of various memory tests as indices, whereas attention and cognitive processing were assessed using latencies and amplitude of N100 and P300 components of event-related potential. All assessments were performed before treatment, every four weeks throughout study period, and at four weeks after the cessation of intervention. B. monnieri-treated group showed improved working memory together with a decrease in both N100 and P300 latencies. The suppression of plasma AChE activity was also observed. These results suggest that B. monnieri can improve attention, cognitive processing, and working memory partly via the suppression of AChE activity.
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Affiliation(s)
- Tatimah Peth-Nui
- Neuroscience Program, Department of Physiology and Graduate School, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
- Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Jintanaporn Wattanathorn
- Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
- Integrative Complimentary Alternative Medicine Research and Development Group, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Supaporn Muchimapura
- Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
- Integrative Complimentary Alternative Medicine Research and Development Group, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Terdthai Tong-Un
- Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
- Integrative Complimentary Alternative Medicine Research and Development Group, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Nawanant Piyavhatkul
- Integrative Complimentary Alternative Medicine Research and Development Group, Khon Kaen University, Khon Kaen 40002, Thailand
- Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Poonsri Rangseekajee
- Integrative Complimentary Alternative Medicine Research and Development Group, Khon Kaen University, Khon Kaen 40002, Thailand
- Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Kornkanok Ingkaninan
- Department of Pharmaceutical Chemistry and Pharmacognosy, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand
| | - Sakchai Vittaya-areekul
- Department of Pharmaceutical Chemistry and Pharmacognosy, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok 65000, Thailand
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Bathala LR, Rao CV, Manjunath S, Vinuta S, Vemulapalli R. Efficacy of Ocimum sanctum for relieving stress: a preclinical study. J Contemp Dent Pract 2012; 13:782-786. [PMID: 23404003 DOI: 10.5005/jp-journals-10024-1229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED HISTORY AND OBJECTIVE: The aim of this study was to study the anxiolytic effects of Ocimum sanctum stress-induced anxiety. MATERIALS AND METHODS The study was carried out using male albino rats (200 ± 50 gm), male albino mice (25 ± 100) the effect of O. sanctum evaluated for anxiety and depression using forced swim test FST and rotarod test. RESULTS Restraint stress (3 hours/day for six consecutive days) induced a significant reduction. It was significantly decreases the mobility period during stress. The standard deviation values are 14.4 and 9.26 and is statistically significant (p = 0.001). In rotarod test, (a) increased latency and (b) decreased ambulation and rearing were also reversed by O. sanctum. A significant increase in immobility period was observed in FST and TST after restraint stress. O. sanctum and C. sinensis significantly reduced the immobility times of rats in FST and TST. CONCLUSION Ocimum sanctum possess significant antistress activity but the magnitude and efficacy for relieving stress is less, when compare to standard anxiolytic agent, i.e. Alprazolam.
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Affiliation(s)
- Lakshmana Rao Bathala
- Department of Prosthodontics, Rama Dental College, Hospital and Research Centre, Kanpur, Uttar Pradesh, India.
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Pase MP, Kean J, Sarris J, Neale C, Scholey AB, Stough C. The cognitive-enhancing effects of Bacopa monnieri: a systematic review of randomized, controlled human clinical trials. J Altern Complement Med 2012; 18:647-52. [PMID: 22747190 DOI: 10.1089/acm.2011.0367] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Traditional knowledge suggests that Bacopa monnieri enhances cognitive performance. Such traditional beliefs have now been scientifically tested through a handful of randomized, controlled human clinical trials. The current systematic review aimed to examine the scientific evidence as to whether Bacopa can enhance cognitive performance in humans. DESIGN A systematic review of randomized controlled trials is presented. Multiple databases were systematically searched by multiple authors. Relevant trials were objectively assessed for methodological quality. SUBJECTS The subjects studied were adult humans without dementia or significant cognitive impairment. INTERVENTIONS B. monnieri, including Bacopa extracts, were administered over long-term supplementation periods. OUTCOME MEASURES Any validated cognitive test, whether a primary or secondary outcome. RESULTS Six (6) studies met the final inclusion criteria and were included in review. Trials were all conducted over 12 weeks. Across trials, three different Bacopa extracts were used at dosages of 300-450 mg extract per day. All reviewed trials examined the effects of Bacopa on memory, while other cognitive domains were less well studied. There were no cognitive tests in the areas of auditory perceptual abilities or idea production and only a paucity of research in the domains of reasoning, number facility, and language behavior. Across studies, Bacopa improved performance on 9 of 17 tests in the domain of memory free recall. There was little evidence of enhancement in any other cognitive domains. CONCLUSIONS There is some evidence to suggest that Bacopa improves memory free recall with evidence for enhancement in other cognitive abilities currently lacking perhaps due to inconsistent measures employed by studies across these cognitive domains. Research into the nootropic effects of Bacopa is in its infancy, with research still yet to investigate the effects of Bacopa across all human cognitive abilities. Similarly, future research should examine the nootropic effects of Bacopa at varied dosages and across different extracts.
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Affiliation(s)
- Matthew P Pase
- Centre for Human Psychopharmacology, Faculty of Life and Social Sciences, Swinburne University of Technology, Hawthorn, Australia.
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Saxena RC, Singh R, Kumar P, Negi MPS, Saxena VS, Geetharani P, Allan JJ, Venkateshwarlu K. Efficacy of an Extract of Ocimum tenuiflorum (OciBest) in the Management of General Stress: A Double-Blind, Placebo-Controlled Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2011; 2012:894509. [PMID: 21977056 PMCID: PMC3185238 DOI: 10.1155/2012/894509] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2011] [Accepted: 07/12/2011] [Indexed: 11/30/2022]
Abstract
A randomized, double-blind, placebo-controlled study was conducted to evaluate the efficacy of OciBest, an extract of Ocimum tenuiflorum Linn. in symptomatic control of general stress. The participants received either placebo (n = 79) or OciBest (n = 71; 1200 mg of actives per day) for six weeks. The severity of stress-related symptoms was self-evaluated by patients at weeks 0, 2, 4 and 6 of the trial period using a symptom rating scale. After six weeks of intervention, scores of symptoms such as forgetfulness, sexual problems of recent origin, frequent feeling of exhaustion, and frequent sleep problems of recent origin decreased significantly (P ≤ 0.05) in OciBest group as compared with placebo group. Also, the total symptom scores of OciBest group revealed significant reduction (P ≤ 0.05) as compared to placebo group. The overall improvement in OciBest group was found to be 1.6 times or 39% more in the control of general stress symptoms with respect to placebo. No adverse events were reported during the study. The findings revealed that OciBest was found to be effective and well tolerated by all the patients over the six weeks of study period.
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Affiliation(s)
- Ram Chandra Saxena
- Clinical Pharmacology, OP Chaudhry Hospital and Research Centre, Lucknow 226 015, India
| | - Rakesh Singh
- General Medicine and Cardiology, Lucknow 226 001, India
| | - Parveen Kumar
- General Medicine, Bhatnagar Nursing Home, Lucknow 226 012, India
| | | | | | - Periasamy Geetharani
- Research and Development Centre, Natural Remedies, Karnataka, Bangalore 560 100, India
| | - Joseph Joshua Allan
- Research and Development Centre, Natural Remedies, Karnataka, Bangalore 560 100, India
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Jesky R, Hailong C. Are Herbal Compounds the Next Frontier for Alleviating Learning and Memory Impairments? An Integrative Look at Memory, Dementia and the Promising Therapeutics of Traditional Chinese Medicines. Phytother Res 2011; 25:1105-18. [DOI: 10.1002/ptr.3388] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2010] [Revised: 11/18/2010] [Accepted: 11/22/2010] [Indexed: 12/28/2022]
Affiliation(s)
- Robert Jesky
- Department of General Surgery-Integrated Traditional Chinese and Western Medicine; 1st Affiliated Hospital of Dalian Medical University; No. 222, Zhongshan Road, Xigang District Dalian China
| | - Chen Hailong
- Department of General Surgery-Integrated Traditional Chinese and Western Medicine; 1st Affiliated Hospital of Dalian Medical University; No. 222, Zhongshan Road, Xigang District Dalian China
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Abascal K, Yarnell E. Bacopa for the Brain: A Smart Addition to Western Medicine. ACTA ACUST UNITED AC 2011. [DOI: 10.1089/act.2011.17106] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Kathy Abascal
- The Botanical Medicine Academy in Vashon, Washington
| | - Eric Yarnell
- Northwest Naturopathic Urology, in Seattle, Washington, and is a faculty member at Bastyr University in Kenmore, Washington
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