Re: Gingko biloba and memory
- From: "trigonometry1972@xxxxxxxxx |" <trigonometry1972@xxxxxxxxx>
- Date: Tue, 25 Nov 2008 01:00:20 -0800 (PST)
On Nov 24, 9:34 pm, schu...@xxxxxxxxxxxxxxx (Richard Schultz) wrote:
http://tinyurl.com/5w4h8p
Why didn't our alternative-health-complementary-medicine friends rush
to bring us this news, which is by now a week old? Feel free to use
this post as a springboard for another rhetorical questions thread.
-----
Richard Schultz schu...@xxxxxxxxxxxxxx
Department of Chemistry, Bar-Ilan University, Ramat-Gan, Israel
Opinions expressed are mine alone, and not those of Bar-Ilan University
-----
"an optimist is a guy/ that has never had/ much experience"
A number of thoughts mostly just those at hand come to mind;-)
Using Ginkgo against properly diagnosed AD seems like a shot in the
dark.
Ginkgo may have some limited merits in those with poor blood flow
in the brain. So perhaps it MIGHT help in multi infarct dementia?
If I was doing such trial, I have a trial with both racemic
and r-lipoic acid at 400 mgs taken 3 times a day with meals.
There is another issue which that even if this research is
correct, it may only apply to that specific ginkgo extraction
method as there are water extractions, ethanol exractions,
and petroleum ether extractions to name a few. I included
below one abstract (plus two others on alpha lipoic acid)
that was apparently positive that used a specific brand
name extraction method. With research the devil is in
the detail.
1: J Neural Transm Suppl. 2007;(72):189-93.
Alpha-lipoic acid as a new treatment option for
Alzheimer's disease--a 48 months
follow-up analysis.
Hager K, Kenklies M, McAfoose J,
Engel J, Münch G.
Department of Medical Rehabilitation and Geriatrics,
Henriettenstiftung,
Hannover, Germany.
Oxidative stress and neuronal energy depletion are
characteristic biochemical hallmarks of Alzheimer's
disease (AD). It is therefore conceivable that
pro-energetic and antioxidant drugs such as
alpha-lipoic acid might delay the onset or
slow down the progression of the disease.
In a previous study, 600mg alpha-lipoic acid was
given daily to nine patients with AD (receiving a
standard treatment with choline-esterase inhibitors)
in an open-label study over an observation period of
12 months. The treatment led to a stabilization of
cognitive functions in the study group, demonstrated
by constant scores in two neuropsychological tests
(the mini mental state exam, MMSE and the Alzheimer's
disease assessment score cognitive subscale, ADAScog).
In this report, we have extended the analysis to
43 patients over an observation period of up to 48
months. In patients with mild dementia (ADAScog < 15),
the disease progressed extremely slowly (ADAScog:
+1.2 points/year, MMSE: -0.6 points/year), in patients
with moderate dementia at approximately twice the rate.
However, the progression appears dramatically lower
than data reported for untreated patients or patients
on choline-esterase inhibitors in the second year of
long-term studies. Despite the fact that this study
was not double-blinded, placebo-controlled and
randomized, our data suggest that treatment with
alpha-lipoic acid might be a successful 'neuroprotective'
therapy option for AD. However, a state-of-the-art
phase II trial is needed urgently.
PMID: 17982894
: Pharmacol Ther. 2007 Jan;113(1):154-64.
Epub 2006 Sep 20.
Lipoic acid as a novel treatment for Alzheimer's
disease and related dementias.
Holmquist L, Stuchbury G, Berbaum K, Muscat S, Young S,
Hager K, Engel J, Münch
G.
Department of Biochemistry and Molecular Biology and
Comparative Genomics Centre,
School of Pharmacy and Molecular Sciences,
James Cook University,
Townsville, Australia.
Alzheimer's disease (AD) is a progressive neurodegenerative
disorder that destroys patient memory and cognition,
communication ability with the social environment and
the ability to carry out daily activities. Despite
extensive research into the pathogenesis of AD, a
neuroprotective treatment - particularly
for the early stages of disease - remains unavailable
for clinical use. In this review, we advance the suggestion
that lipoic acid (LA) may fulfil this therapeutic need.
A naturally occurring precursor of an essential cofactor for
mitochondrial enzymes, including pyruvate dehydrogenase
(PDH) and alpha-ketoglutarate dehydrogenase (KGDH), LA
has been shown to have a variety of properties which can
interfere with pathogenic principles of AD. For example, LA
increases acetylcholine (ACh) production by activation of
choline acetyltransferase and increases glucose uptake,
thus supplying more acetyl-CoA for the production of ACh.
LA chelates redox-active transition metals, thus
inhibiting the formation of hydroxyl radicals and
also scavenges reactive oxygen species (ROS), thereby
increasing the levels of reduced glutathione. Via the same
mechanisms, downregulation redox-sensitive inflammatory
processes is also achieved. Furthermore, LA can scavenge
lipid peroxidation products such as hydroxynonenal and
acrolein. The reduced form of LA, dihydrolipoic acid (DHLA),
is the active compound responsible for most of these
beneficial effects. R-alpha-LA can be applied instead of
DHLA, as it is reduced by mitochondrial lipoamide
dehydrogenase, a part of the PDH complex. In this review,
the properties of LA are explored with particular
emphasis on how this agent, particularly the R-alpha-enantiomer,
may be effective to treat AD and related
dementias.
PMID: 16989905 [
1: Eur J Neurol. 2006 Sep;13(9):981-5.
Comment in:
Eur J Neurol. 2007 Sep;14(9):e11; author reply e12.
Eur J Neurol. 2007 Sep;14(9):e9; author reply e10.
Ginkgo biloba and donepezil: a comparison in the
treatment of Alzheimer's dementia in a randomized
placebo-controlled double-blind study.
Mazza M, Capuano A, Bria P, Mazza S.
Department of Psychiatry,
Catholic University of Sacred Heart,
Rome, Italy.
mariannamazza@xxxxxxxxxxx
The Ginkgo biloba special extract EGb 761 seems to
produce neuroprotective effects in neurodegenerative
diseases of multifactorial origin. There is still
debate about the efficacy of
Ginkgo biloba special extract EGb 761
compared with second-generation cholinesterase inhibitors
in the treatment of mild to moderate Alzheimer's dementia.
Our aim is to assess the efficacy of the Ginkgo biloba
special extract E.S. in patients with dementia of the
Alzheimer type in slowing down the disease's degenerative
progression and the patients' cognitive impairment compared
with donepezil and placebo. The trial was designed as a
24-week randomized, placebo-controlled, double-blind study.
Patients aged 50-80 years, suffering from mild to moderate
dementia, were allocated into one of the three treatments:
Ginkgo biloba (160 mg daily dose), donepezil (5 mg daily dose),
or placebo group. The degree of severity of dementia was
assessed by the Syndrom Kurz test and the Mini-Mental State
Examination. Clinical Global Impression score was recorded
to assess the change in the patients' conditions and the
therapeutic efficacy of tested medications. Our results
confirm the clinical efficacy of Ginkgo biloba E.S.
(Flavogin) in the dementia of the Alzheimer type, comparable
with donepezil clinical efficacy. There are few published
trials that have directly compared a cholinesterase inhibitor
with Ginkgo for dementia. This study
directly compares a cholinesterase inhibitor with
Ginkgo biloba for dementia of the Alzheimer type and
could be a valid contribution in this debate. Our study
suggests that there is no evidence of relevant differences
in the efficacy of EGb 761 and donepezil in the treatment of
mild to moderate Alzheimer's dementia, so
the use of both substances can be justified.
In addition, this study contributes to establish the efficacy
and tolerability of the Ginkgo biloba special extract
E.S. in the dementia of the Alzheimer type with special
respect to moderately
severe stages.
PMID: 16930364
"A dead optimist is one who got what he deserved;
A dead pessimist is one who got what he expected."
Trig
.
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