Title
Lipid peroxide, phospholipids, glutathione levels and superoxide dismutase activity in rat
brain after ischaemia: effect of ginkgo biloba extract.
Author
Seif El Nasr M; El Fattah AA
Source
Pharmacol Res, 1995 Nov, 32:5, 273-8
Abstract
The influence of ginkgo biloba extract on the lipid peroxide product (malondialdehyde,
MDA), glutathione (GSH) and phospholipids levels as well as superoxide dismutase (SOD,
1.15.1.1) and lactate dehydrogenase (LDH, 1.1.1.27) activities in rat brain after occlusion of
common carotid arteries was investigated. Two experimental models were studied: 60 min
ischaemia without reperfusion and 60 min ischaemia followed by 60 min reperfusion.
Compared to sham-operated animals, ischaemia followed by reperfusion increased cytosolic
LDH activity and mitochondrial lipid peroxide content and decreased the superoxide
dismutase activity and mitochondrial total phospholipids level. Preischaemic administration
of ginkgo biloba extract (150 mg kg-1, p.o.) could normalize the SOD activity of the rat
brain. The extract was also able to reduce the lipid peroxide and phospholipids contents of
the mitochondrial rat brain. These effects could be explained on the basis of the antioxidant
property of ginkgo biloba extract and suggests its beneficial role in the protection against
post-ischaemic injury.

Title
A double blind placebo controlled trial of ginkgo biloba extract in acute cerebral ischaemia.
Author
Garg RK; Nag D; Agrawal A
Source
J Assoc Physicians India, 1995 Nov, 43:11, 760-3
Abstract
A double blind placebo controlled trial was conducted in 55 patients of acute ischaemic
stroke. Twenty one and twenty six patients were randomly allotted in group A and group B
respectively. In group A, the patients received 40 mg Ginkgo biloba extract at 6 hourly
intervals along with routine management. The placebo tablets were dispensed in the tablet
form of same size, shape and colour and were given in the same way. After the patients
were subjected to computerized tomographic (CT) scan to confirm acute ischaemic
infarction, they were assessed on Mathew's scale and reassessed, at 2 weeks and 4 weeks of
drug/placebo administration. Both groups showed significant improvement in Mathew's
scale score after 2 weeks and 4 weeks. The difference in degree of change was negligible (p
> 0.05) in either group. Estimation of relative changes of neurological deficit based on
baseline values also showed negligible (p > 0.05) difference. A trial of Ginkgo biloba extract
within 6 hours of stroke in a larger dose and in larger sample could be beneficial clinically in
patients of cerebral ischaemic infarct, and needs further study. The usefulness of the plant
extract has been demonstrated clinically and experimentally in more than 40 trials of chronic
cerebral ischaemia, done elsewhere. This was not evident in our study as our study group
was different (more than 48 hours after stroke). There appears to be no contraindication or
adverse effect of this medication (Ginkgo biloba) in acute ischaemic stroke.

Title
Traditional Chinese medicine, acupuncture, and other alternative medicines for prostate
cancer: an introduction and the need for more research.
Author
Moyad MA; Hathaway S; Ni HS
Source
Semin Urol Oncol, 1999 May, 17:2, 103-10
Abstract
There are several other alternative medicines apart from vitamins and minerals that the
clinician should be aware of because they have grown in popularity in other fields of
medicine. In time, these therapies should impact the arena of urologic oncology. Traditional
Chinese Medicine, which includes acupuncture, is an area that has received some attention.
The theory behind it can be quite daunting because it is so different from the theory behind
Western Medical Science. In addition, exactly how acupuncture can be applied to a patient
and its potential use in prostate cancer need to be addressed. Other herbal therapies for the
patient experiencing symptoms related to a localized cancer diagnosis also need to be
evaluated. St John's Wort for depression and Kava for anxiety are two examples of herbal
alternatives that some prostate patients are inquiring about. Finally, Ginkgo biloba has
received a great deal of attention in the media for erectile dysfunction, but there is a dearth of
evidence in this area and the information that already exists can be misleading until further
studies are conducted. Also, it is imperative that additional studies be performed in all of the
above subjects as they relate to prostate cancer, but a general survey on alternative medicine
use in urologic diseases is needed first before an adequate review of the most popular
therapies can be published.

Title
The pharmacology of extinction.
Author
Huxtable RJ
Source
J Ethnopharmacol, 1992 Aug, 37:1, 1-11
Abstract
It is impossible to predict what compounds of pharmacological interest may be present in an
unexamined species. The extinction of such species may result, therefore, in the loss of
therapeutically significant compounds. The fact that science will never know what has been
lost does not lessen the significance of the loss. A number of species are discussed to
exemplify the potential loss. Ginkgo biloba is an ancient plant, apparently saved from a
natural extinction by human intervention. From this tree, the ginkgolides have been isolated.
These are potent inhibitors of platelet activating factor and hold promise in the treatment of
cerebral ischemia and brain edema. Two species, the tree Taxus brevifolia and the leech
Hirudo medicinalis, are threatened as a result of human activity. Both have recently yielded
complex compounds of therapeutic importance. The antitumor agent, taxol, is obtained from
T. brevifolia and the thrombin inhibitor, hirudin, is found in H. medicinalis. Catharanthus
roseus, Source of the anticancer agents vincristine and vinblastine, although not threatened,
derives from a largely unexamined but severely stressed ecosystem of some 5000 plant
species. In other examples, ethnobotanical knowledge of certain plants may be lost while the
species survive, as exemplified by the suppression of the Aztec ethnobotany of
Mesoamerica by the invading Spanish. Finally, the fallacy of the 'snail darter syndrome',
where species may be viewed as too insignificant to worry about, is exposed by
consideration of the pharmacological activities of a sea hare (a shell-less marine mollusc)
and various leeches.

Title
Antagonistic effects of extract from leaves of ginkgo biloba on glutamate neurotoxicity.
Author
Zhu L; Wu J; Liao H; Gao J; Zhao XN; Zhang ZX
Source
Chung Kuo Yao Li Hsueh Pao, 1997 Jul, 18:4, 344-7
Abstract
AIM: To determine whether the extract of leaves of Ginkgo biloba L (EGb) and several
active constituents of EGb have protective effects against glutamate (Glu)-induced neuronal
damage. METHODS: Microscopy and image analysis of nucleus areas in the arcuate nuclei
(AN) of mice were made. The neuronal viability in primary cultures from mouse cerebral
cortex was assessed using MTT [3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium
bromide] staining and the intracellular free calcium concentration ([Ca2+]i) of single neuron
was measured using Fura-2. RESULTS: EGb (2.5 mg.L-1) and its constituent ginkgolide B
(Gin B, 2 mg.L-1) protected the neuronal viability against Glu-induced injury, and prevented
the Glu-induced elevation in [Ca2+]i. EGb (3-10 mg.kg-1) attenuated the decrease of
nucleus areas in arcuate nuclei induced by Glu (1 g.kg-1, s.c.). CONCLUSION: EGb and
Gin B prevent neurons from Glu neurotoxicity through reduction of the rise in [Ca2+]i.

Title
Assessing the risks and benefits of herbal medicine: an overview of scientific evidence.
Author
Barrett B; Kiefer D; Rabago D
Source
Altern Ther Health Med, 1999 Jul, 5:4, 40-9
Abstract
The use of herbal medicine is widespread and growing, with as many as 3 in 10 Americans
using botanical remedies in a given year. Because many herbal medicines have significant
pharmacological activity, and thus potential adverse effects and drug interactions, healthcare
professionals must be familiar with this therapeutic modality. This article summarizes the
history and current use of plant-based medicine and highlights the evidence of the risks and
benefits associated with 6 plants: echinacea, garlic, ginger, ginkgo, St John's wort, and
valerian. Therapies outside the medical mainstream tend to suffer from a dearth of research
and critical evaluation. Critics and supporters alike note the conceptual and practical
difficulties in studying many complementary and alternative therapies such as acupuncture,
homeopathy, and meditation. Herbal medicine, however, lends itself well to standard
evaluation methods. This article summarizes and evaluates evidence from randomized
controlled trials and meta-analyses. We present the results of meta-analyses and subsequent
randomized controlled trials for garlic and St John's wort; a comprehensive critical review
and subsequent randomized controlled trials for ginkgo; and summaries of all identified
randomized controlled trials for echinacea, ginger, and valerian.

Title
Herbal remedies in psychiatric practice.
Author
Wong AH; Smith M; Boon HS
Source
Arch Gen Psychiatry, 1998 Nov, 55:11, 1033-44
Abstract
Patients' use of alternative and complementary health services has created a need for
physicians to become informed about the current literature regarding these treatments.
Herbal remedies may be encountered in psychiatric practice when they are used to treat
psychiatric symptoms; produce changes in mood, thinking, or behavior as a side effect; or
interact with psychiatric medications. English-language articles and translated Abstracts or
articles (where available) found on MEDLINE and Sources from the
alternative/complementary health field were reviewed. Each herb was assessed for its safety,
side effects, drug interactions, and efficacy in treating target symptoms or diagnoses. A
synopsis of the information available for each herb is presented. In many cases the quantity
and quality of data were insufficient to make definitive conclusions about efficacy or safety.
However, there was good evidence for the efficacy of St John's wort for the treatment of
depression and for ginkgo in the treatment of memory impairment caused by dementia.
More research is required for most of the herbs reviewed, but the information published to
date is still of clinical interest in diagnosing, counseling, and treating patients who may be
taking botanical remedies.

Title
Ginkgo biloba extract protects brain neurons against oxidative stress induced by hydrogen
peroxide.
Author
Oyama Y; Chikahisa L; Ueha T; Kanemaru K; Noda K
Source
Brain Res, 1996 Mar, 712:2, 349-52
Abstract
Effect of Ginkgo biloba extract was examined on dissociated rat cerebellar neurons
suffering from oxidative stress induced by hydrogen peroxide using a flow cytometer and
ethidium bromide. Hydrogen peroxide at a concentration of 3 mM increased the number of
neurons stained with ethidium (presumably dead neurons) in a time-dependent manner.
Pretreatment of neurons with G. biloba extract (10 micrograms/ml) greatly delayed a
time-dependent increase in number of dead neurons during exposure to hydrogen peroxide.
It was true, but less effective, in the case of treatment with G. biloba extract immediately or
60 min after start of oxidative stress. Results implicate G. biloba extract as a potential agent
in protecting the neurons suffering from oxidative stress induced by hydrogen peroxide.

Title
Medicinal plants and Alzheimer's disease: Integrating ethnobotanical and contemporary
scientific evidence.
Author
Perry EK; Pickering AT; Wang WW; Houghton P; Perry NS
Source
J Altern Complement Med, 1998 Win, 4:4, 419-28
Abstract
The use of complementary medicines such as plant extracts in dementia therapy, varies
according to the different cultural traditions. In orthodox Western medicine, contrasting with
that in China and the Far East for example, pharmacological properties of traditional
cognitive or memory enhancing plants have not been widely investigated in the context of
current models of Alzheimer's disease. An exception is Ginkgo biloba in which the
ginkgolides have antioxidant, neuroprotective, and cholinergic activities relevant to
Alzheimer's disease mechanisms. The therapeutic efficacy of Ginkgo biloba extracts in
Alzheimer's disease in placebo-controlled clinical trials is reportedly similar to currently
prescribed drugs such as tacrine or donepezil and, importantly, undesirable side effects of
Ginkgo biloba are minimal. Old European reference books (eg, medical herbals) document
a variety of other plants such as Salvia officinalis (sage) and Melissa officinalis (balm) with
memory improving properties, and cholinergic activities have recently been identified in
extracts of these plants. Precedents for modern discovery of clinically relevant
pharmacological activities in plants with long-established medicinal use include, for
example, the interaction of alkaloid opioids in Papaver somniferum (Opium poppy) with
endogenous opiate receptors in the brain. With recent major advances in understanding the
neurobiology of Alzheimer's disease, and as yet limited efficacy of so-called rationally
designed therapies, it may be timely to re-explore historical archives for new directions in
drug development. This article considers not only the value of an integrative traditional and
modern scientific approach to developing new treatments for dementia, but also in the
understanding of disease mechanisms. Long before the current biologically based
hypothesis of cholinergic derangement in Alzheimer's disease emerged, plants now known
to contain cholinergic antagonists were recorded for their amnesic and dementia-inducing
properties.

Title
Decreased cerebral 5-HT1A receptors during ageing: reversal by Ginkgo biloba extract
(EGb 761).
Author
Huguet F; Drieu K; Piriou A
Source
J Pharm Pharmacol, 1994 Apr, 46:4, 316-8
Abstract
Investigation of [3H]8-hydroxy-2(di-n-propylamino)tetralin binding to 5-HT1A receptors in
cerebral cortex membranes of Wistar rats showed that the maximal number of binding sites
(Bmax) was reduced significantly (22%) in aged (24-month-old) as compared with young
(4-month-old) animals. Chronic treatment with Ginkgo biloba extract did not alter binding
in young rats but increased binding density significantly (33%) in aged rats. These results
confirm previously described age-related 5-hydroxytryptaminergic alterations. Together
with data in the literature, they also suggest a restorative effect in aged rats, associated with
decreased receptor density resulting from the protective action of Ginkgo biloba extract
treatment on neuronal membrane.