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Abstract
Objective: To determine whether Ginkgo biloba extract (ginkgo) improves cognitive function in persons with multiple sclerosis (MS).
Methods: Persons with MS from the Seattle and Portland VA clinics and adjacent communities who scored 1 SD or more below the mean on one of 4 neuropsychological tests (Stroop Test, California Verbal Learning Test II [CVLT-II], Controlled Oral Word Association Test [COWAT], and Paced Auditory Serial Addition Task [PASAT]) were randomly assigned to receive either one 120-mg tablet of ginkgo (EGb-761; Willmar Schwabe GmbH & Co, Germany) or one placebo tablet twice a day for 12 weeks. As the primary outcome, we compared the performance of the 2 groups on the 4 tests at exit after adjusting for baseline performance.
Results: Fifty-nine subjects received placebo and 61 received ginkgo; 1 participant receiving placebo and 3 receiving ginkgo were lost to follow-up. Two serious adverse events (AEs) (myocardial infarction and severe depression) believed to be unrelated to the treatment occurred in the ginkgo group; otherwise, there were no significant differences in AEs. The differences (ginkgo − placebo) at exit in the z scores for the cognitive tests were as follows: PASAT −0.2 (95% confidence interval [CI] −0.5 to 0.1); Stroop Test −0.5 (95% CI −0.9 to −0.1); COWAT 0.0 (95% CI −0.2 to 0.3); and CVLT-II 0.0 (95% CI −0.3 to 0.3); none was statistically significant.
Conclusions: Treatment with ginkgo 120 mg twice a day did not improve cognitive performance in persons with MS.
Classification of evidence: This study provides Class I evidence that treatment with ginkgo 120 mg twice a day for 12 weeks does not improve cognitive performance in people with MS.
GLOSSARY
- AD=
- Alzheimer disease;
- AE=
- adverse event;
- BDI-II=
- Beck Depression Inventory II;
- CI=
- cognitive impairment;
- COWAT=
- Controlled Word Association Test;
- CVLT-II=
- California Verbal Learning Test II;
- EDSS=
- Expanded Disability Status Scale;
- MFIS=
- Modified Fatigue Impact Scale;
- MS=
- multiple sclerosis;
- MSNSQ=
- Multiple Sclerosis Neuropsychological Screening Questionnaire;
- PAF=
- platelet-activating factor;
- PASAT=
- Paced Auditory Serial Addition Test;
- PDQ=
- Perceived Deficits Questionnaire
Footnotes
Study funding: Supported by the Department of Veterans Affair, Office of Research and Development, Rehabilitation Research and Development. The contents of this manuscript do not represent the views of the Department of Veterans Affairs or the US government.
Supplemental data at www.neurology.org
- Received November 30, 2011.
- Accepted May 1, 2012.
- Copyright © 2012 by AAN Enterprises, Inc.
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