Thursday, 18 October 2018

Ginkgo biloba extract EGb 761® alleviates neurosensory symptoms in patients with dementia: a meta-analysis of treatment effects on tinnitus and dizziness in randomized, placebo-controlled trials.

Clin Interv Aging. 2018 Jun 13;13:1121-1127. doi: 10.2147/CIA.S157877. eCollection 2018. Spiegel R1, Kalla R2, Mantokoudis G3, Maire R4, Mueller H5, Hoerr R5, Ihl R6. Author information 1 Division of Internal Medicine, Basel University Hospital, University of Basel, Basel, Switzerland. 2 Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland. 3 Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, Bern, Switzerland. 4 Lausanne University Hospital, Lausanne, Switzerland. 5 Clinical Research Department, Dr Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany. 6 Department of Psychiatry, University of Duesseldorf, Alexian Research Center Krefeld, Krefeld, Germany. Abstract Background: Tinnitus and dizziness are frequent in old age and often seen as concomitant symptoms in patients with dementia. In earlier clinical trials, Ginkgo biloba extract EGb 761® was found to alleviate tinnitus and dizziness in elderly patients. Consequently, a meta-analysis was conducted to evaluate the effects of EGb 761® at a daily dose of 240 mg on tinnitus and dizziness associated with dementia. Methods: Randomized, placebo-controlled clinical trials of G. biloba extract EGb 761® identified by a systematic database search were included in a meta-analysis if they met all of the following selection criteria: 1) diagnosis of dementia according to generally accepted criteria, 2) treatment period of at least 20 weeks, 3) outcome measures covering at least two of the three conventional domains of assessment, 4) presence and severity of dizziness and tinnitus were assessed, and 5) assessment was done before and after randomized treatment. Results: Five trials that met the inclusion criteria were included in the meta-analysis. The risk of bias was judged as low, with Jadad scores of 3 and 5. In all trials, 11-point box scales were used to assess the severity of tinnitus and dizziness. Overall, EGb 761® was superior to placebo, with weighted mean differences for change from baseline, calculated in meta-analyses using random effects models, of -1.06 (95% CI: -1.77, -0.36) for tinnitus (p = 0.003) and -0.77 (95% CI: -1.44, -0.09) for dizziness (p = 0.03). Conclusion: Our findings support the notion that EGb 761® is also effective in alleviating concomitant neurosensory symptoms in patients with dementia. KEYWORDS: gait; hearing; inner ear; neurodegenerative disorders; review; unsteadiness PMID: 29942120 PMCID: PMC6005330 DOI: 10.2147/CIA.S157877 [Indexed for MEDLINE] Free PMC Article