Ginkgo Biloba Extract Is Comparable With Donepezil in Improving Functional Recovery in Alzheimer’s Disease: Results From a Multilevel Characterized Study Based on Clinical Features and Resting-State Functional Magnetic Resonance Imaging

Zheng, Yu; Xie, Yi; Qi, Ming; Zhang, Ling; Wang, Wei; Zhang, Wanrong; Sha, Liju; Wu, Jiawen; Li, Wanting; Wu, Ting

doi:10.3389/fphar.2021.721216

Cited by 11 publications

(12 citation statements)

References 48 publications

(53 reference statements)

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“…The brain regions with significantly increased ReHo values involved widespread frontal lobe regions. Another study ( Zheng et al, 2021 ) has found that patients with Ginkgo biloba extract showed significantly decreased ALFF in the left parahippocampal gyrus, FFG.l, right gyrus rectus, and right superior frontal gyrus, while an increase in ALFF in the right middle temporal gyrus. Such brain activity change patterns are not consistent with our results.…”

Section: Discussionmentioning

confidence: 99%

Intrinsic Brain Activity Alterations in Patients With Mild Cognitive Impairment-to-Normal Reversion: A Resting-State Functional Magnetic Resonance Imaging Study From Voxel to Whole-Brain Level

Wang

et al. 2022

Front. Aging Neurosci.

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Mild cognitive impairment (MCI) reversion refers to patients with MCI who revert from MCI to a normal cognitive state. Exploring the underlying neuromechanism of MCI reverters may contribute to providing new insights into the pathogenesis of Alzheimer’s disease and developing therapeutic interventions. Information on patients with MCI and healthy controls (HCs) was collected from the Alzheimer’s Disease Neuroimaging Initiative database. We redefined MCI reverters as patients with MCI whose logical memory scores changed from MCI to normal levels using the logical memory criteria. We explored intrinsic brain activity alterations in MCI reverters from voxel, regional, and whole-brain levels by comparing resting-state functional magnetic resonance imaging metrics of the amplitude of low-frequency of fluctuation (ALFF), the fractional amplitude of low-frequency fluctuation (fALFF), percent amplitude of fluctuation (PerAF), regional homogeneity (ReHo), and degree centrality (DC) between MCI reverters and HCs. Finally, partial correlation analyses were conducted between cognitive scale scores and resting-state functional magnetic resonance imaging metrics of brain regions, revealing significant group differences. Thirty-two patients with MCI from the Alzheimer’s Disease Neuroimaging Initiative database were identified as reverters. Thirty-seven age-, sex-, and education-matched healthy individuals were also enrolled. At the voxel level, compared with the HCs, MCI reverters had increased ALFF, fALFF, and PerAF in the frontal gyrus (including the bilateral orbital inferior frontal gyrus and left middle frontal gyrus), increased PerAF in the left fusiform gyrus, and decreased ALFF and fALFF in the right inferior cerebellum. Regarding regional and whole-brain levels, MCI reverters showed increased ReHo in the left fusiform gyrus and right median cingulate and paracingulate gyri; increased DC in the left inferior temporal gyrus and left medial superior frontal; decreased DC in the right inferior cerebellum and bilateral insular gyrus relative to HCs. Furthermore, significant correlations were found between cognitive performance and neuroimaging changes. These findings suggest that MCI reverters show significant intrinsic brain activity changes compared with HCs, potentially related to the cognitive reversion of patients with MCI. These results enhance our understanding of the underlying neuromechanism of MCI reverters and may contribute to further exploration of Alzheimer’s disease.

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Section: Discussionmentioning

confidence: 99%

Intrinsic Brain Activity Alterations in Patients With Mild Cognitive Impairment-to-Normal Reversion: A Resting-State Functional Magnetic Resonance Imaging Study From Voxel to Whole-Brain Level

Wang

et al. 2022

Front. Aging Neurosci.

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“…Previous studies on nootropics revealed nootropics to have minimal, if any, effects on the prevention of cognitive decline. Most studies were either examined over a relatively short follow-up time or conducted with a limited number of subjects, and many of them focused on nootropic monotherapy rather than concomitant use with ChEI [ 6 , 9 , 10 , 17 , 23 , 24 , 25 ]. This study aimed to compare the nootropics and ChEI combination with ChEI monotherapy in an attempt to validate the effectiveness of nootropics in association with ChEI.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Nootropics in Combination with Cholinesterase Inhibitors on Cognitive Function in Mild-to-Moderate Dementia: A Study Using Real-World Data

Kang

Lee

Kwon

et al. 2022

JCM

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The clinical benefits of nootropics in the treatment of cognitive decline has been either limited or controversial. This study aimed to observe the effectiveness of cholinesterase inhibitor (ChEI) and nootropics combination in the treatment of cognitive impairment in dementia. Data were based on electronic medical records in a university health system. Patients with mild-to-moderate dementia and no history of prior cognitive enhancer use were included (n = 583). The subjects were categorized into the ChEI only group and the ChEI and nootropics combination group. The primary outcome measure was the change in cognitive function, as assessed by the mini-mental state examination (MMSE) from baseline to 300–400 days after the first ChEI prescription. Subsequent analyses were conducted in consideration of the dementia type, medical adherence, and type of nootropics. The changes in MMSE scores from baseline to endpoint were not significantly different between the two groups. In Alzheimer’s dementia, the combination group showed significantly less deterioration in MMSE language subscale scores compared to the ChEI only group (F = 6.86, p = 0.009), and the difference was consistent in the highly adherent subjects (F = 10.16, p = 0.002). The choline alfoscerate and the ginkgo biloba extract subgroups in Alzheimer’s dementia showed more significant improvements in the MMSE language subscale scores compared to the other nootropics subgroup (F = 7.04, p = 0.001). The present study showed that the effectiveness of ChEI and nootropics combination on cognition may appear differently according to the dementia type. This emphasizes the need for well-controlled studies to generalize the effectiveness of nootropics across various clinical settings.

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“…In addition, the PerAF approach indicates the ratio of frequency-domain in blood oxygen level-dependent signal in the resting-state to average signal strength for a specific period. Following the pre-processing, the PerAF method was computed ( 30 ).…”

Section: Methodsmentioning

confidence: 99%

“…Some covariates, such as age, gender, and education level, were regressed. For the preliminary comparison results of the average PerAF values between the two groups, the multiple-comparison correction based on the Gaussian random field theory (GRF, two-tailed, cluster-wise p < 0.05, voxel-wise p < 0.001) was further conducted ( 30 ). Previous studies reported that, compared with the Bonferroni correction and false discovery rate (FDR), GRF could reduce the false-positive rate and improve statistical power by utilizing the spatial information of fMRI data ( 31 ).…”

Section: Methodsmentioning

confidence: 99%

Altered Intrinsic Brain Activity in Patients With Late-Life Depression: A Resting-State Functional MRI Study

et al. 2022

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ObjectivesTo investigate the altered intrinsic brain activity (IBA) in patients suffering from late-life depression (LLD) using a percent amplitude of fluctuation (PerAF) method.MethodsIn total, fifty patients with LLD and 40 non-depressed controls (NCs) were recruited for the present research. Participants underwent the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) test and resting-state functional MRI (rs-fMRI) scans. The RBANS test consists of 12 sub-tests that contribute to a total score and index scores across the following five domains: immediate memory, visuospatial/constructional, language, attention, and delayed memory. The PerAF method was used for data analysis to detect changes in neural activity in the relevant brain regions. A receiver operating characteristic (ROC) curve was conducted to evaluate the ability of the RBANS test and proposed the PerAF method in distinguishing the two groups. The relationships between altered IBA and neuropsychologic deficits were determined by the Pearson correlation analysis.ResultsA significant difference existed in RBANS total score, immediate memory, visuospatial/constructional, language, attention, and delayed memory between groups (P < 0.05). Compared with the NCs group, the LLD group demonstrated decreased PerAF differences in the bilateral superior frontal gyrus, orbital part (Frontal_Sup_Orb), and bilateral anterior cingulate cortex (ACC). The PerAF method and RBANS test exhibited an excellent discriminatory power with the area under curve (AUC) values in distinguishing the two groups. In addition, the attention score of the RBANS test positively correlated with the PerAF values of the bilateral Frontal_Sup_Orb and bilateral ACC.ConclusionThe changes of PerAF in the bilateral Frontal_Sup_Orb and bilateral ACC are related to an increased risk of developing LLD. Moreover, the PerAF method could be used as an underlying sensitivity biomarker to identify the psychiatric disorder.

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Ginkgo Biloba Extract Is Comparable With Donepezil in Improving Functional Recovery in Alzheimer’s Disease: Results From a Multilevel Characterized Study Based on Clinical Features and Resting-State Functional Magnetic Resonance Imaging

Cited by 11 publications

References 48 publications

Intrinsic Brain Activity Alterations in Patients With Mild Cognitive Impairment-to-Normal Reversion: A Resting-State Functional Magnetic Resonance Imaging Study From Voxel to Whole-Brain Level

Intrinsic Brain Activity Alterations in Patients With Mild Cognitive Impairment-to-Normal Reversion: A Resting-State Functional Magnetic Resonance Imaging Study From Voxel to Whole-Brain Level

Effectiveness of Nootropics in Combination with Cholinesterase Inhibitors on Cognitive Function in Mild-to-Moderate Dementia: A Study Using Real-World Data

Altered Intrinsic Brain Activity in Patients With Late-Life Depression: A Resting-State Functional MRI Study

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