Ginkgo biloba e memória - revisão sistemática

Carmo Filho, Aureo do; Fakoury, Max Kopti; Ferry, Fernando Raphael de Almeida

doi:10.1590/S1809-98232010000100015

Resumos

INTRODUÇÃO: Com o envelhecimento da população, os distúrbios de memória têm-se tornado patologias cada vez mais frequentes. Com exceção de uma minoria dos casos cujas causas são reversíveis, estas doenças possuem prognóstico desanimador, curso inexorável e opções terapêuticas muito limitadas. O medicamento fitoterápico mais frequentemente utilizado para distúrbios de memória é o extrato seco de ginkgo biloba (GB). Suas ações antioxidantes, antiagregantes e vasodilatadoras têm encorajado diversos profissionais a utilizarem-no neste tratamento, porém não há registros convincentes que comprovem a eficácia do uso desta substância para tal fim. OBJETIVOS: Avaliar a eficácia do GB na prevenção e no tratamento de distúrbios de memória. MÉTODOS: Revisão sistemática da literatura dos últimos dez anos dos estudos clínicos duplo-cegos, randomizados, placebo-controlados, publicados na língua inglesa. RESULTADOS E CONCLUSÕES: Embora tenhamos obtido poucos ensaios controlados sobre o tema, não há evidências suficientes para se indicar o uso da droga com a finalidade de tratar e/ou prevenir distúrbios de memória.

Ginkgo Biloba; Transtornos da Memória; Memória; Distúrbios de Memória; Demência

INTRODUCTION: With the aging population, memory disorders have become more frequent diseases. Except for a minority of cases whose causes are reversible, these diseases have a dismal prognosis, inexorable course and very limited therapeutic options. The herbal medicine most often used for memory disorders is the dry extract of ginkgo biloba (GB). Its antioxidant, antiplatelet and vasodilatory actions have encouraged many professionals to use it in this treatment, but there are no convincing records showing the efficacy of this substance for that purpose. OBJECTIVES: To evaluate the effectiveness of GB in the prevention and treatment of memory disorders. METHODS: A systematic review of the literature of the last ten years of clinical double-blind, randomized, placebo-controlled, published in English. RESULTS AND CONCLUSIONS: Although we obtained few controlled trials on the subject, there is insufficient evidence for recommending the drug for the purpose of treating and / or prevention of memory disorders.

Ginkgo Biloba; Memory Disorders; Memory; Dementia

ARTIGO DE REVISÃO REVIEW ARTICLE

Ginkgo biloba e memória - revisão sistemática

Ginkgo biloba and memory systematic review

Aureo do Carmo Filho^I; Max Kopti Fakoury^II; Fernando Raphael de Almeida Ferry^II

^IUnidade de Terapia Intensiva, Hospital Universitário Gaffrée e Guinle. Rio de Janeiro, RJ, Brasil

^IIDepartamento de Medicina Geral, Hospital Universitário Gaffrée e Guinle. Rio de Janeiro, RJ, Brasil

RESUMO

INTRODUÇÃO: Com o envelhecimento da população, os distúrbios de memória têm-se tornado patologias cada vez mais frequentes. Com exceção de uma minoria dos casos cujas causas são reversíveis, estas doenças possuem prognóstico desanimador, curso inexorável e opções terapêuticas muito limitadas. O medicamento fitoterápico mais frequentemente utilizado para distúrbios de memória é o extrato seco de ginkgo biloba (GB). Suas ações antioxidantes, antiagregantes e vasodilatadoras têm encorajado diversos profissionais a utilizarem-no neste tratamento, porém não há registros convincentes que comprovem a eficácia do uso desta substância para tal fim.

OBJETIVOS: Avaliar a eficácia do GB na prevenção e no tratamento de distúrbios de memória.

MÉTODOS: Revisão sistemática da literatura dos últimos dez anos dos estudos clínicos duplo-cegos, randomizados, placebo-controlados, publicados na língua inglesa.

RESULTADOS E CONCLUSÕES: Embora tenhamos obtido poucos ensaios controlados sobre o tema, não há evidências suficientes para se indicar o uso da droga com a finalidade de tratar e/ou prevenir distúrbios de memória.

Palavras-chave: Ginkgo Biloba. Transtornos da Memória. Memória. Distúrbios de Memória. Demência.

ABSTRACT

INTRODUCTION: With the aging population, memory disorders have become more frequent diseases. Except for a minority of cases whose causes are reversible, these diseases have a dismal prognosis, inexorable course and very limited therapeutic options. The herbal medicine most often used for memory disorders is the dry extract of ginkgo biloba (GB). Its antioxidant, antiplatelet and vasodilatory actions have encouraged many professionals to use it in this treatment, but there are no convincing records showing the efficacy of this substance for that purpose.

OBJECTIVES: To evaluate the effectiveness of GB in the prevention and treatment of memory disorders.

METHODS: A systematic review of the literature of the last ten years of clinical double-blind, randomized, placebo-controlled, published in English.

RESULTS AND CONCLUSIONS: Although we obtained few controlled trials on the subject, there is insufficient evidence for recommending the drug for the purpose of treating and / or prevention of memory disorders.

Key words: Ginkgo Biloba. Memory Disorders. Memory. Dementia.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Recebido: 02/3/2009

Revisado: 13/6/2009

Aprovado: 06/10/2009

Correspondência / Correspondence Aureo do Carmo Filho Hospital Universitário Gaffrée e Guinle. Unidade de Terapia Intensiva Rua Mariz e Barros, 775 Tijuca 20270-004 - Rio de Janeiro, RJ, Brasil E-mail: aureocf@gmail.com

1. Forlenza OV. Ginkgo biloba e memória: mito ou realidade? Rev Psiq Clín 2003; 30(6): 218-20.
2. DeFeudis FV. Ginkgo biloba extract (EGb 761): pharmacological activities and clinical applications. Elsevier 1991.
3. Kleijnen J, Knipschild P. Ginkgo biloba. Lancet 1992 nov; 340(8828): 1136-9.
4. Luo Y, et al. Inhibition of amyloid-beta aggregation and caspase-3 activation by the Ginkgo biloba extract EGb 761. Proc Natl Acad Sci USA 2002 sep; 99(19): 12197-202.
5. Dartigues JF, et al. Vasodilators and nootropics as predictors of dementia and mortality in the PAQUID cohort. J Am Geriatr Soc 2007 mar; 55(3): 395-9.
6. Gabryelewicz T, Barcikowska M, Jarczewska DL. Alzheimer's disease therapy theory and practice. Wiad Lek. 2005; 58(9-10): 528-35.
7. Frank B, Gupta S. A review of antioxidants and Alzheimer's disease. Ann Clin Psychiatry 2005 dec; 17(4): 269-86.
8. Pan HP. Progress in studies of pharmacological activities and clinical applications of preparations of dried leaf of Ginkgo biloba. Zhongguo Zhong Yao Za Zhi 2005 jan; 30(2): 93-6.
9. Kurz A, Van Baelen B. Ginkgo biloba compared with cholinesterase inhibitors in the treatment of dementia: a review based on meta-analyses by the Cochrane Collaboration. Dement Geriatr Cogn Disord 2004; 18(2): 217-26.
10. Mazza M, et al. Ginkgo biloba and donepezil: a comparison in the treatment of Alzheimer's dementia in a randomized placebo-controlled double-blind study. Eur J Neur 2006 sep; 13(9): 981-5.
11. Solomon PR, et al. Ginkgo for memory enhancement: a randomized controlled trial. JAMA 2002 ago; 288(7): 835-40.
12. Carlson JJ, et al. Safety and efficacy of a Ginkgo biloba-containing dietary supplement on cognitive function, quality of life, and platelet function in healthy, cognitively intact older adults. J Am Diet Assoc 2007 mar; 107(3): 422-32.
13. Van Dongen MC, et al. Ginkgo for elderly people with dementia and age-associated memory impairment: a randomized clinical trial. J Clin Epidemiol 2003 apr; 56(4): 367-76.
14. Van Dongen MC, et al. The efficacy of Ginkgo for elderly people with dementia and agerelated memory impairment: new results of a randomized clinical trial. J Am Geriatr Soc 2000 out; 48(10): 1183-94.
15. Lovera J, et al. Ginkgo biloba for the improvement of cognitive performance in multiple sclerosis: a randomized, placebocontrolled trial. Mult Scler 2007 apr; 13(3): 376-85.
16. Le Bars PL, et al. A placebo-controlled, doubleblind, randomized trial of an extract of Ginkgo biloba for dementia: north american Egb study group. JAMA 1997 out; 278(16): 1327-32.
17. Winther K, et al. Effects of Ginkgo biloba extract on cognitive function and blood pressure in elderly subjects. Curr Ther Res Clin Exp 1998; 59(12): 881-8.
18. Elsabagh S, Hartley DE, File SE. Limited cognitive benefits in stage +2 postmenopausal women after 6 weeks of treatment with Ginkgo biloba. J Psycopharmacol 2005 mar; 19(2): 173-81.
19. Hartley DE, et al. Effects on cognition and mood in postmenopausal women of 1-week treatment with Ginkgo biloba. Pharmacol Biochem Behav 2003 jun; 75(3): 711-20.
20. Elsabagh S, et al. Differential cognitive effects of Ginkgo biloba after acute and chronic treatment in healthy young volunteers. Psychopharmacology (Berl) 2005 may; 179(2): 437-46.
21. Moulton PL, et al. The effect of Ginkgo biloba on memory in healthy male volunteers. Physio Behav 2001 jul; 73(4): 659-65.
22. Maurer K, et al. Clinical efficacy of Ginkgo biloba special extract EGb 761 in dementia of the Alzheimer type. J Psychiat Res 1997 dec; 31(6): 645-55.
23. Chelune G, et al. Assessing reliable neuropsychological change: separating fact from fiction C.E. In: 25th Annual Meeting of the International Neuropsychological Society, 1997, Florida.
24. Schneider C, et al. Spontaneous hyphema caused by Ginkgo biloba extract. J Fr Ophtalmol 2002 sep; 25(7): 731-2.
25. MacVie OP, Harney BA. Vitreous haemorrhage associated with Gingko biloba use in a patient with age related macular disease. Br J Ophthalmol 2005 oct; 89(10): 1378-9.
26. Yagmur E, et al. Bleeding complication under Gingko biloba medication. Am J Hematol 2005 aug; 79(4): 343-4.
27. Fitzpatrick AL, et al. Recruitment of the elderly into pharmacologic prevention trial: the Ginkgo Evaluation of Memory Study experience. Contemp Clin Trials 2006 dec; 27(6): 541-53.

Datas de Publicação

Publicação nesta coleção
23 Out 2014
Data do Fascículo
Abr 2010

Histórico

Aceito
06 Out 2009
Revisado
13 Jun 2009
Recebido
02 Mar 2009

This work is licensed under a Creative Commons Attribution 4.0 International License.

[1] 1. Forlenza OV. Ginkgo biloba e memória: mito ou realidade? Rev Psiq Clín 2003; 30(6): 218-20.

[2] 2. DeFeudis FV. Ginkgo biloba extract (EGb 761): pharmacological activities and clinical applications. Elsevier 1991.

[3] 3. Kleijnen J, Knipschild P. Ginkgo biloba. Lancet 1992 nov; 340(8828): 1136-9.

[4] 4. Luo Y, et al. Inhibition of amyloid-beta aggregation and caspase-3 activation by the Ginkgo biloba extract EGb 761. Proc Natl Acad Sci USA 2002 sep; 99(19): 12197-202.

[5] 5. Dartigues JF, et al. Vasodilators and nootropics as predictors of dementia and mortality in the PAQUID cohort. J Am Geriatr Soc 2007 mar; 55(3): 395-9.

[6] 6. Gabryelewicz T, Barcikowska M, Jarczewska DL. Alzheimer's disease therapy theory and practice. Wiad Lek. 2005; 58(9-10): 528-35.

[7] 7. Frank B, Gupta S. A review of antioxidants and Alzheimer's disease. Ann Clin Psychiatry 2005 dec; 17(4): 269-86.

[8] 8. Pan HP. Progress in studies of pharmacological activities and clinical applications of preparations of dried leaf of Ginkgo biloba. Zhongguo Zhong Yao Za Zhi 2005 jan; 30(2): 93-6.

[9] 9. Kurz A, Van Baelen B. Ginkgo biloba compared with cholinesterase inhibitors in the treatment of dementia: a review based on meta-analyses by the Cochrane Collaboration. Dement Geriatr Cogn Disord 2004; 18(2): 217-26.

[10] 10. Mazza M, et al. Ginkgo biloba and donepezil: a comparison in the treatment of Alzheimer's dementia in a randomized placebo-controlled double-blind study. Eur J Neur 2006 sep; 13(9): 981-5.

[11] 11. Solomon PR, et al. Ginkgo for memory enhancement: a randomized controlled trial. JAMA 2002 ago; 288(7): 835-40.

[12] 12. Carlson JJ, et al. Safety and efficacy of a Ginkgo biloba-containing dietary supplement on cognitive function, quality of life, and platelet function in healthy, cognitively intact older adults. J Am Diet Assoc 2007 mar; 107(3): 422-32.

[13] 13. Van Dongen MC, et al. Ginkgo for elderly people with dementia and age-associated memory impairment: a randomized clinical trial. J Clin Epidemiol 2003 apr; 56(4): 367-76.

[14] 14. Van Dongen MC, et al. The efficacy of Ginkgo for elderly people with dementia and agerelated memory impairment: new results of a randomized clinical trial. J Am Geriatr Soc 2000 out; 48(10): 1183-94.

[15] 15. Lovera J, et al. Ginkgo biloba for the improvement of cognitive performance in multiple sclerosis: a randomized, placebocontrolled trial. Mult Scler 2007 apr; 13(3): 376-85.

[16] 16. Le Bars PL, et al. A placebo-controlled, doubleblind, randomized trial of an extract of Ginkgo biloba for dementia: north american Egb study group. JAMA 1997 out; 278(16): 1327-32.

[17] 17. Winther K, et al. Effects of Ginkgo biloba extract on cognitive function and blood pressure in elderly subjects. Curr Ther Res Clin Exp 1998; 59(12): 881-8.

[18] 18. Elsabagh S, Hartley DE, File SE. Limited cognitive benefits in stage +2 postmenopausal women after 6 weeks of treatment with Ginkgo biloba. J Psycopharmacol 2005 mar; 19(2): 173-81.

[19] 19. Hartley DE, et al. Effects on cognition and mood in postmenopausal women of 1-week treatment with Ginkgo biloba. Pharmacol Biochem Behav 2003 jun; 75(3): 711-20.

[20] 20. Elsabagh S, et al. Differential cognitive effects of Ginkgo biloba after acute and chronic treatment in healthy young volunteers. Psychopharmacology (Berl) 2005 may; 179(2): 437-46.

[21] 21. Moulton PL, et al. The effect of Ginkgo biloba on memory in healthy male volunteers. Physio Behav 2001 jul; 73(4): 659-65.

[22] 22. Maurer K, et al. Clinical efficacy of Ginkgo biloba special extract EGb 761 in dementia of the Alzheimer type. J Psychiat Res 1997 dec; 31(6): 645-55.

[23] 23. Chelune G, et al. Assessing reliable neuropsychological change: separating fact from fiction C.E. In: 25th Annual Meeting of the International Neuropsychological Society, 1997, Florida.

[24] 24. Schneider C, et al. Spontaneous hyphema caused by Ginkgo biloba extract. J Fr Ophtalmol 2002 sep; 25(7): 731-2.

[25] 25. MacVie OP, Harney BA. Vitreous haemorrhage associated with Gingko biloba use in a patient with age related macular disease. Br J Ophthalmol 2005 oct; 89(10): 1378-9.

[26] 26. Yagmur E, et al. Bleeding complication under Gingko biloba medication. Am J Hematol 2005 aug; 79(4): 343-4.

[27] 27. Fitzpatrick AL, et al. Recruitment of the elderly into pharmacologic prevention trial: the Ginkgo Evaluation of Memory Study experience. Contemp Clin Trials 2006 dec; 27(6): 541-53.

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Ginkgo biloba e memória - revisão sistemática

Ginkgo biloba and memory - systematic review

Resumos

Datas de Publicação

Histórico