EGb 761 is a standardized extract of dried leaves of Ginkgo biloba containing 24% ginkgo-
flavonol glycosides, 6%
terpene lactones such as
ginkgolides A, B, C, J and
bilobalide. Its broad spectrum of pharmacological activities allows it to be in adequacy to the numerous pathological requirements--hemodynamic, hemorheological, metabolic--which occur in cerebral,
retinal, cochleovestibular, cardiac or peripheral
ischemia. Moreover,
EGb 761 has direct effects against
necrosis and apoptosis of neurons and improves neural plasticity as evidenced in vestibular compensation. At the molecular and the cellular levels, some evidence obtained with animal models indicates that
EGb 761 can interact as a
free radical-scavenger and a inhibitor of lipid peroxidation with all, or nearly all
reactive oxygen species; maintains
ATP content by a protection of mitochondrial respiration and preservation of oxidative phosphorylations; exerts arterial and venous vasoregulator effects involving the release of endothelial factors and the catecholaminergic system. Moreover,
EGb 761 regulates ionic balance in damaged cells and exerts a specific and potent
Platelet-activating factor antagonist activity. Numerous well-controlled clinical studies, realized in Europe and in USA, have revealed that
EGb 761 is an effective
therapy for a wide variety of disturbances of cerebral function, ranging from cerebral impairment of ischemic vascular origins (i.e.
multi infarct dementia), early
cognitive decline to mild-to-moderate cases of the more severe types of senile
dementias (including
Alzheimer's disease) or mixed origins (i.e. psychoorganic origin). Improvement of signs and symptoms have been demonstrated for cognitive functions, particularly for
memory loss, attention, alertness, vigilance, arousal and mental fluidity. Some clinical studies have showed that
EGb 761 treatment may improve the capacity of geriatric patients to cope with the stressful demands of daily life. The explanation is a dual stress-alleviating action of
EGb 761: its facilitates behavioral adaptation to stress and may decrease the excess of
cortisol release to stress. Moreover,
EGb 761 shows a specific
neuroprotective effects to hippocampic cells. Regarding the visual system, experimental studies have shown that
EGb 761 can inhibit or reduce the functional
retinal impairments resulting from
ischemia-reperfusion, photo-degeneration, diabetic or proliferative retinopathy. Clinical studies have revealed that
EGb 761 may be useful in treating visual activity impairments and damages to the visual field associated with chronic
cerebrovascular insufficiency, senile
macular degeneration and diabete mellitus. Regarding the vestibular and auditory systems, experimental and clinical studies have shown the efficacy of
EGb 761 in treating
hypoacusis,
tinnitus,
vertigo,
dizziness and other symptoms of vestibulocochlear disorders. At least, adequatly controlled studies in patients with
peripheral arterial occlusive disease have provided good evidence for therapeutic efficacy in
intermittent claudication. The future of
EGb 761 is undoubtedly in the promise in slowing the progression of
Alzheimer's disease. Indeed, two recent american clinical studies have shown the efficacy and safety of
EGb 761 in patients with mild to severe
Alzheimer's disease and
multi-infarct dementia. In clinical terms, progression of symptoms was delayed by approximately 6 months. Actually new clinical studies are undertaken in USA and Europe. At the dawn of the third millenium (the Sixth for Ginkgo biloba) we propose a state of art about it.