Gingko Biloba Essay

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Ginko Biloba

Gingko Biloba -- Part I

What are the author's general conclusions (summarized) on the effectiveness of Gingko Biloba as a cognitive enhancer?

According to the author, effects of Gingko on cognition are perplexing because of its dual actions as following. It's seen improving short-term memory but at the same time it impairs digit recall ability. It slows down mental decline in patients with Alzheimer's disease but has lower dose response curve than acetyl cholinesterase inhibitors. Gingko slows mental decline during dementia owing to its action as an anti-oxidant and ability to combat stress. This action is of short-term and isn't seen chronically. Gingko has more scores for improvement seen in patients when compared to acetyl cholinesterase inhibitors like Donepezil but has fewer efficacies than the later. Effects of Gingko are mainly attributable not to its direct action on improving memory but to its indirect action of improving attention and arousal. Moreover, it also improves choice reaction time. Preference of Gingko over placebo to improve cognitive function is also due to the stable state of patient seen in Gingko treated patients which is not seen in ones treated with placebo. To wind up all, though moderate but statistically important improvements of cognitive functions seen with Gingko treatment makes it deserve more extensive research to ascertain its usage. It does improve various aspects of cognitive functions at least in some populations.

2. Briefly summarize the findings regarding ginkgo's cognitive effects in humans.

Effects of Gingko treatment in humans have been studied in patients with impaired functions as well as subjects with normal health and young age. Following results have been obtained from various studies. Effects on subjects with cognitive impairment (patients presenting with dementia, Alzheimer's disease and anxiety):

Patients who were administered Gingko, either in single dose or as chronic treatment, before training, showed improved sensorimotor functions, attention power and motivation functions rather than effects on memory storage ability.

Some studies show that as compared to placebo, chronic treatment of patients presenting with Alzheimer's disease show improved cognitive functions like choice reaction time, attention and short-term memory as compared to subjects treated with placebo. The mean effects of chronic Gingko treatment were comparable with effect of Donepezil which is an Acetyl cholinesterase inhibitor and drug of choice in Alzheimer's disease. Studies report that treatment of Alzheimer's disease patient with Gingko have either slowed down deterioration of brain, improved cognitive function or showed no improvement at all according to cognitive functions assessed in the setup. Moreover, patients with Gingko treatment were more stable than ones on placebo treatment.

Yet another study comprising large and controlled trial of EGb 761 (a form of Gingko) on patients with mild to moderate dementia also showed no improvement of memory with the treatment.

One of the studies concluded that Gingko improves cognitive functions by improving short-term memory rather than long-term memory. This was proved by giving, otherwise healthy subjects with age related memory problems, a rapid recall test of recalling immediately and recently presented list of words or drawings. Patients who were on single dose Gingko treatment showed better results than those on single placebo treatment. Having said that, improving short-term memory is the only mechanism that Gingko uses to make cognitive functions better, is not proven completely.

Gingko study has also shown its usage to treat anxiety disorders in rodents. But, another small placebo controlled study showed that patients had rather impaired digit recall ability as compared to ones treated with placebo.

Considering all the studies, one thing is sure about Gingko, that it does have mild beneficial effects on cognitive functions at least in some population.

In young healthy subjects:

Highest doses improved performance in one of the memory tests called Sternberg short-term memory test. And also improved index of attention according to another study.

3. Briefly summarize the findings regarding ginkgo's cognitive effects in animal models.

Early study showed improvement of learning and memory in young adult mice related to pressing lever to get food. Having said that, this effect of Gingko is due to enhancement of sensorimotor and motivation functions is not sure.

Experiments on old rat showed that Gingko treatment enhanced ability of rat to choose which baited arm of a maze to go for and the rat never visited the arms that he already looked for early in the day.

Treatment of young adult or old rats with Gingko whether in acute or chronic form also improved olfactory distinction of rats between novel and familiar odors.

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Another study showed that administration with Gingko extracts although improved shuttle box learning but had no effect on step up and step down inhibitory avoidance task and swim.

Gingko is also reported to enhance passive avoidance learning in aged mice. This effect was mainly due to increased latency to return to the shock compartment, that is, it was more like post-shock freezing than memory.

When Dose-Response curve of Gingko was compared with Acetyl cholinesterase inhibitors Tacrine and Galanthamine and nootropic agent Piracetam, the effect of Gingko on optimum dose was less than 50% of effect shown by treatment with Acetylcholine esterase inhibitors and about same as that of Piracetam administration.

4. Briefly summarize the findings regarding the biological actions associated with ginkgo.

Effects of Gingko on cardiovascular system include vasodilatation and ultimate low blood pressure. It also serves as antagonist to Platelet Activating Factor and hence blocks platelet aggregation, thrombin activity and fibrinolysis. For its effect on central nervous system, Gingko treatment may end up with development of occlusive or hemorrhagic strokes.

Gingko extracts have been found to block activity of superoxide dismutase and monoamine oxidase, two enzymes responsible for generation of free radicals which turn on vicious circle of damage. Due to this anti-oxidant property, these extract scavenge free radicals that might cause neuronal damage and hence delay age related deterioration.

These extracts also prevent cells from oxidative stress such as apoptosis.

Gingko extracts improve tissue response to ischemic injury by reducing production of Arachidonic acid, which serves as major mediator in these processes.

Treatment of patients with degenerative diseases like Alzheimer's, in which major defect lies in acetylcholine producing neurons, Gingko has shown to improve the production of this neurotransmitter by enhancing transport system efficacy.

Gingko consumption leads to increased utilization of glucose by brain's vital areas like frontal and parietal lobes, cerebellum and nucleus accumbens. This leads to better performances as shown by the subjects.

It also supports actions of stress neurotransmitter like serotonin, and by acting on serotonin receptors, it reduces anxiety and helps combating stress conditions of fright or flight.

Extracts of Gingko have been found to enhance nor epinephrine neurotransmitter system and hence has helped in reducing symptoms of depression and so has also controlled mood.

Complications of gingko treatment include subdural hematoma and GIT problems like nausea, increased salivation, decreased appetite and vomiting. CNS complications include headache, dizziness, and tinnitus associated with skin rash. Large doses have been found to cause orthostatic hypotension (postural hypotension).

5. Having read the article, elaborate on your opinions about the effectiveness of ginkgo. Would you choose to use it? Why or why not?

Having studied many researches done on effects of Gingko on human health and animal function, I can't deny the fact that it does have beneficial effects and does cause improvement of mental health like learning, memory and behavior. However, so far it goes for me, I would have preferred Gingko treatment only if had I suffered from any dangerous disease like Alzheimer's, given that I had tried all other possible treatments.

Moreover, I would have never tried this drug just to, frantically, increase my mental abilities when I would be in normal condition of health.

My comment is not baseless and has reasons like I wouldn't prefer such a drug for myself whose efficacy and effectiveness is still subject to doubts and researches, and the fact it doesn't produce same effects in all populations, it would be quite risky to 'try' such drug.

And had I been in old age, I would have withdrawn from this drug after using it once, owing to its side-effects like headache, nausea, vomiting, tinnitus, skin rash and much more that would make my life more bothersome.

Gingko Biloba -- Part II

6. What are the authors' conclusions about the effectiveness of each of the following a) phosphatidylserine, b) choline, c) piracetam, d) vinpoctine, acetyl-l-carnitine, and antioxidants?

a. Phosphatidylserine: Generally, PS is believed to be effective for improving memory related problems associated with age in conditions like dementia and observations have resulted in belief that PS is effective to improve learning, word recall, concentration and mood. However, the author concludes that all these observations are valid only when considering limited number of subjects with no diagnosed dementia and don't show consistency among various populations and different methods of tests used. Though statistically important, the effectiveness is found to be modest. Further study is warranted to rule out the reason for this inconsistency that isn't it because.....

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