Gingko Biloba Improves Cognitive Function in Subjects Undergoing Electroconvulsive Therapy

by | Apr 10, 2023 | 2022, Botanicals, Brain Health, Cognitive Health, Ginkgo Biloba

Written by Taylor Woosley, Staff Writer. Findings of the double-blind clinical study show that supplementation with gingko biloba resulted in a statistically significant increase in the mean scores of MMSE (p = 0.001) and WMS-III (p = 0.001) compared to the control group. 

gingko biloba - botanicalsElectroconvulsive therapy (ECT) is based on conducting an electrical current through the brain to stimulate it and trigger generalized convulsion activity with therapeutic ends1. It is a well-tolerated and highly effective treatment option for major psychiatric disorders, such as mood disorders and schizophrenia, especially when there is an acute exacerbation of psychotic symptoms or if catatonic symptoms are prominent2. However, there are concerns about long-term side effects such as memory loss3.

Gingko biloba (GB) is associated with several health benefits, including memory and cognitive improvement, due to its antioxidant and anti-inflammatory actions4. GB has been shown to restore impaired mitochondrial function, thereby improving the neuronal energy supply, as well as improving compromised hippocampal neurogenesis and neuroplasticity5. Through GBs reduction in mitochondrial reactive oxygen species production, it increases the energetic metabolism and ATP availability6.

Nazarinasab et al. conducted a double-blind clinical study to investigate the effect of GB on cognitive disorders following electroconvulsive therapy. Inclusion criteria consisted of being between the ages of 16-80, with schizophrenia, schizoaffective, bipolar, or major depressive disorders, which two psychiatrists approved based on DSM-5 criterion. Participants were assessed using the Mini-Mental State Examination (MMSE) and Wechsler Memory Scale Recipe III (WMS-III).

Subjects were randomly assigned to two groups of 40 patients. Participants in the intervention group received a prescription of gingko biloba capsule which started 48 hours before the beginning of shock therapy. Subjects received an average of 2-3 sessions of bilateral ECT per week. The total number of sessions was around 6-12. Subjects took 1 GB capsule per day (a 200 mg capsule) after meals until the end of ECT sessions. The control group received a placebo capsule per day after meals. The MMSE and WMS-III were utilized before ECT, after the fourth sessions, and 72 hours after finishing the ECT course. An independent t-test and Pearson correlation coefficient were used to analyze data.

The average age of subjects was 34.30 ± 9.04 years. The average illness duration was 11.57 ± 5.39 years for all participants. Significant findings of the study are as follows:

  • There was a statistically significant increase in the mean scores of MMSE in the intervention groups (2.85 ±09) compared to the control group (1.27 ± 1.63) (p = 0.001).
  • WMS-III scores increased by 3.11 ±67 after the intervention compared to zero time. Separately, the scores increased in both the intervention (6.95 ± 3.02) and the control (0.27 ± 1.28) group. The average increase in WMS-III score in the intervention group was significantly higher than the control group (p = 0.001).
  • Subjects in the intervention and control group had no significant statistical difference in general memory, spatial-temporal orientation, mental control, and digit repetition scales after 4 sessions of electroshock. However, there were significant differences in the mean scores of logical memory (p = 0.001), visual memory (p = 0.001), and words association (p = 0.001) subscales in the intervention group.

Results of the study show that gingko biloba increased MMSE and WMS-III scores without any side effects. Further research including larger sample sizes are necessary to understand the efficacy of gingko biloba on cognitive function. Study limitations include the small sample size, the loss of patients due to changes in the treatment plan during treatment, and the impossibility of long-term follow-up of patients.

Source: Nazarinasab, Masoumeh, Forouzan Behrouzian, Saeedeh Negahban, Amirali Moghadam Sadegh, and Elham Zeynali. “Investigating the efficacy of Ginkgo biloba on the cognitive function of patients undergoing treatment with electric shock: a double-blind clinical trial.” Journal of Medicine and Life 15, no. 12 (2022): 1540-1547.

© 2022 JOURNAL of MEDICINE and LIFE. VOL: 15 ISSUE: 12 DECEMBER 2022

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Posted April 10, 2023.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

  1. Rojas M, Ariza D, Ortega Á, et al. Electroconvulsive Therapy in Psychiatric Disorders: A Narrative Review Exploring Neuroendocrine-Immune Therapeutic Mechanisms and Clinical Implications. Int J Mol Sci. Jun 22 2022;23(13)doi:10.3390/ijms23136918
  2. Kaliora SC, Zervas IM, Papadimitriou GN. [Electroconvulsive therapy: 80 years of use in psychiatry]. Psychiatriki. Oct-Dec 2018;29(4):291-302. doi:10.22365/jpsych.2018.294.291
  3. Sinclair DJ, Zhao S, Qi F, Nyakyoma K, Kwong JS, Adams CE. Electroconvulsive therapy for treatment-resistant schizophrenia. Cochrane Database Syst Rev. Mar 19 2019;3(3):Cd011847. doi:10.1002/14651858.CD011847.pub2
  4. Barbalho SM, Direito R, Laurindo LF, et al. Ginkgo biloba in the Aging Process: A Narrative Review. Antioxidants (Basel, Switzerland). Mar 9 2022;11(3)doi:10.3390/antiox11030525
  5. Zhan M, Sun L, Liu J, et al. EGb in the Treatment for Patients with VCI: A Systematic Review and Meta-Analysis. Oxid Med Cell Longev. 2021;2021:8787684. doi:10.1155/2021/8787684
  6. Tomino C, Ilari S, Solfrizzi V, et al. Mild Cognitive Impairment and Mild Dementia: The Role of Ginkgo biloba (EGb 761(®)). Pharmaceuticals (Basel, Switzerland). Apr 1 2021;14(4)doi:10.3390/ph14040305