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Scientists have found new evidence that the herbal supplement ginkgo biloba may help ease some mental disabilities associated with multiple sclerosis. This ScienCentral News video has more.
Stepping Into Thin Air
When Ellen Bramble was 49 she stepped off a flight of stairs into thin air. She tumbled down, her laundry flying "every which way" and her limbs relaxed, as if she didn't even know she was falling.
"I just kind of rolled and bounced on the concrete stairs…and I didn't get hurt, just a couple of bruises," says Bramble, a photographer from Portland, Oregon.
This was the first of three falls that later led doctors to diagnose Bramble with multiple sclerosis (MS). MS is a disease in which the body's own white blood cells attack and erode the protective insulation around nerve fibers in the brain, spinal cord, and optical nerves, causing patients' bodies to go numb and lose track of what they're doing.
Ellen Bramble
As her disease progressed, Bramble, who is now 59, learned to deal with her physical limitations. But what's been most frustrating is that she's often felt lost in a "fog."
Bramble has "cognitive dysfunction," a symptom shared by half of America's 400,000 multiple sclerosis patients, which makes it difficult for her to think clearly and to do simple things many people take for granted — remembering words, reading, keeping track of her daily chores, or even knowing where she's going when she pulls out of her driveway.
New Hope
There is no treatment for cognitive dysfunction, but recently things have gotten a bit better for Bramble. She joined a pilot study at Oregon Health and Science University. The study's goal was to determine if the ancient Chinese herbal medicine, ginkgo biloba, could help multiple sclerosis patients with cognitive dysfunction concentrate better and think more clearly. The results are consistent with a handful of similar studies, leaving the researchers hopeful that they may finally find a treatment for cognitive dysfunction, but nevertheless convinced that more research is still needed.
"The major difference that we found was that in one of the usual cognitive tests that's used to evaluate patients with multiple sclerosis, the patients that were taking ginkgo performed about 13 percent better than the patients who were taking placebo," says one of the study's lead neurologists Jesus Lovera.
Lovera and his colleagues told attendees at the 2005 meeting of the American Academy of Neurology that they first gave 39 multiple sclerosis patients diagnosed with cognitive dysfunction, four separate tests to establish their baseline cognitive skills. Then the participants were divided into two groups. For a period of twelve weeks they took a mystery pill, either a dose of ginkgo biloba or a sugar pill.
"I didn't know whether I was on the ginkgo or the placebo at all," says Bramble. The researchers didn't know either.
Stroop Color Word Test
The volunteers repeated the initial four cognitive tests at the end of the twelve weeks. No one improved significantly on three of the tests. But on a forth test, called the "Stroop Color Word Test," participants showed clear improvement. The Stroop test is a version of several childhood games and known for measuring a person's ability to concentrate on two things at once – something people like Bramble struggle to do. For example, participants are asked to read these words, "blue, green, red, yellow," but say "red, yellow, blue, green," the colors in which the words are printed. "You have to be able to pay attention to two things at the same time," says Lovera, "The word of the color and the ink in which it is printed and be able to suppress one of them."
The study's coauthor, OHSU neurologist Dennis Bourdette believes participants taking ginkgo may have performed better because the ginkgo helped diseased nerve cells in their brains work better. "In multiple sclerosis, white blood cells are releasing toxic substances which cause nerve dysfunction. Ginkgo biloba contains antioxidants which can neutralize the effects of some of these toxic substances and help the brain to function better," says Bourdette.
Consistent But Not Conclusive
Though this study's results are consistent with some similar studies, which have shown an average cognitive improvement of 10 to 20 percent after starting a ginkgo regime, it is not conclusive. Numerous studies have tested ginkgo's ability to improve memory and alertness as well as to ease the symptoms of Alzheimer's disease, MS and other cognitive disabilities. But many of the studies have design flaws.
"The evidence is weak supporting the case that ginkgo enhances any cognitive function," says psychologist Paul Gold from the University of Illinois at Urbana-Champaign, who has contributed to various reviews of the affect of ginkgo biloba on cognition.
Unlike Lovera's study, earlier studies have tested regular ginkgo users without first establishing their cognitive abilities prior to using ginkgo. Others were not "case-controlled" studies in which some people received ginkgo and others received placebo.
Lovera's research team agrees they need to repeat their study in a larger group of people to confirm if ginkgo biloba is helpful for multiple sclerosis patients with cognitive impairment. "If we do that," says Bourdette, "It will be the first treatment available for patients with multiple sclerosis and cognitive difficulties."
Bramble is already convinced. Now that she takes gingko regularly, "My life has changed from hopelessness to hope," she says.
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