<em>Ginkgo biloba</em> extract EGb 761^&reg; alleviates neurosensory symptoms in patients with dementia: a meta-analysis of treatment effects on tinnitus and dizziness in randomized, placebo-controlled trials

Abstract

BackgroundTinnitus and dizziness are frequent in old age and often seen as concomitant symptoms in patients with dementia. In earlier clinical trials, Ginkgo biloba extract EGb 761® was found to alleviate tinnitus and dizziness in elderly patients. Consequently, a meta-analysis was conducted to evaluate the effects of EGb 761® at a daily dose of 240 mg on tinnitus and dizziness associated with dementia.MethodsRandomized, placebo-controlled clinical trials of G. biloba extract EGb 761® identified by a systematic database search were included in a meta-analysis if they met all of the following selection criteria: 1) diagnosis of dementia according to generally accepted criteria, 2) treatment period of at least 20 weeks, 3) outcome measures covering at least two of the three conventional domains of assessment, 4) presence and severity of dizziness and tinnitus were assessed, and 5) assessment was done before and after randomized treatment.ResultsFive trials that met the inclusion criteria were included in the meta-analysis. The risk of bias was judged as low, with Jadad scores of 3 and 5. In all trials, 11-point box scales were used to assess the severity of tinnitus and dizziness. Overall, EGb 761® was superior to placebo, with weighted mean differences for change from baseline, calculated in meta-analyses using random effects models, of −1.06 (95% CI: −1.77, −0.36) for tinnitus (p = 0.003) and −0.77 (95% CI: −1.44, −0.09) for dizziness (p = 0.03).ConclusionOur findings support the notion that EGb 761® is also effective in alleviating concomitant neurosensory symptoms in patients with dementia.

Standardized Ginkgo Biloba Extract in the Treatment of Vertigo and/or Tinnitus: A Review of the Literature

“…Notably, the exact 5 studies evaluated in this review for tinnitus and/or dizziness were previously identified and included in a meta-analysis reported by Spiegel et al (2018). Based on the Jarad scale assessment of methodological quality, the authors judged that the 5 studies included in their meta-analyses had a low bias risk [21]. Overall, they showed that GBE was superior to placebo, with weighted mean differences for [21].…”

“…Based on the Jarad scale assessment of methodological quality, the authors judged that the 5 studies included in their meta-analyses had a low bias risk [21]. Overall, they showed that GBE was superior to placebo, with weighted mean differences for [21]. Interestingly, our review of the literature with regard to the effects of GBE in this indication (up to 1 January 2020) also failed to identify any additional RCTs that had been published in the last six years, i.e., since the RCT was published by Nikolova et al in 2013 [92].…”

Ginkgo biloba Prevents Oxidative Stress-Induced Apoptosis Blocking p53 Activation in Neuroblastoma Cells

“…Most of the studies on the EGb concern its neuroprotective effects, against ageing. Standardized Ginkgo biloba extracts (EGb) have been used for treatment and prevention of different neurological disorders as Alzheimer's disease [15,16], Parkinson's disease [17,18], cerebral vascular deficit, and dementia [27,28].…”

Cytotoxic effect of Ginkgo biloba kernel extract on HCT116 and A2058 cancer cell lines

“…Bioactive constituents extracted from Ginkgo biloba leaves such as flavonoids, their glycosides and terpene lactones, have attracted considerable attention in the therapy of Alzheimer's disease ( Janßen et al., 2010 ; Müller et al., 2019 ; Singh et al., 2019 ; Zeng et al., 2017 ), cognitive disorders ( Beck et al., 2016 ; Guan et al., 2018 ; Luo et al., 2018 ), cardiovascular disease ( Li et al., 2019 ; Nash and Shah, 2015 ; Tian et al., 2017 ; Wu et al., 2019 ) and cancer ( Bai et al., 2015 ; Liu et al., 2017 ; Park et al., 2016 ; Zhao et al., 2013 ). The pharmacology of individual constituents obtained from Ginkgo biloba leaves has been studied in preclinical and clinical trials ( Canter and Ernst, 2007 ; Ji et al., 2020 ; Savaskan et al., 2018 ; Spiegel et al., 2018 ; von Gunten et al., 2016 ). Flavonoids and trilactone terpenes are believed to be responsible for most of the pharmacological properties of Ginkgo biloba leaf extracts, and it has been suggested that synergistic effects might be of importance.…”