Extracts of the leaves of Ginkgo biloba (such as EGb 761 and LI 1370) are widely used for the treatment of dementia and cerebral insufficiency. This review will summarize experimental results concerning the protective effects of EGb 761 and its constituents in different models of cerebral ischemia. Furthermore, we present the supposed mechanisms of action and the current status of clinical trials.For more than 40 years, the extract of the leaves of Ginkgo biloba (EGb 761) has been widely used therapeutically to increase peripheral and cerebral blood flow, as well as for the treatment of cerebral ischemia, brain disorders caused by old age, and of dementia due to neuronal degeneration or to vascular deficiency. In these age-related disorders, EGb 761 should enhance the intellectual capacity of the patients, that is, improve the learning, memory and cognitive faculties. Although it has been shown that organ systems other than the brain, e.g. the lung (1, 2) and the heart (3, 4), could also benefit from the effects of EGb 761, this review will focus only on the effects of Ginkgo biloba extract on the brain function. First, we would like to present the neuroprotective effects of EGb 761 in different in vivo and in vitro models of cerebral ischemia and relate them to the different constituents of EGb 761. Thereafter, we would like to discuss in detail the effects of EGb 761 under normoxic as well as under ischemic conditions of the brain, including the effects of EGb 761 on cerebral blood flow, on cerebral glucose and lipid metabolism, and on the neurotransmitter systems. The last part of this review will summarize the present status of clinical trials on the commercial extracts of Ginkgo biloba (EGb 761 and LI 1370).
The Constituents of Ginkgo Biloba Extract (EGb 761)This extract of Ginkgo biloba is prepared by highly extracting the leaves and removing the constituents ginkgole acid and the biflavones. The purified extract, EGb 761, is standardized to 24 % flavonoids. In addition, it contains approximately 6% terpene 210