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ORIGINAL RESEARCH article
Front. Neurol.
Sec. Dementia and Neurodegenerative Diseases
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1563056
Efficacy of Ginkgo Biloba as an Adjunct to Donepezil in Amyloid PET-Positive Alzheimer's Patients
Provisionally accepted- 1 Department of Neurology, Soon Chun Hyang University Cheonan Hospital, Cheonan-si, South Chungcheong, Republic of Korea
- 2 Department of Psychiatry, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea
- 3 Hyoja Geriatric Hospital, Yongin-shi, Republic of Korea
Background: Ginkgo biloba is widely used in some regions as an adjunct therapy for Alzheimer's disease (AD). Its potential mechanisms include antioxidative and anti-amyloid properties, yet clinical evidence remains mixed.Objective: We investigated whether combining Ginkgo with donepezil confers additional benefits in amyloid PET-positive AD patients. We also explored changes in the plasma biomarker MDS-Oaβ (Multimer Detection System-Oligomeric Aβ), which reflects the propensity of Aβ monomers to form oligomers. Methods: This retrospective study included newly diagnosed, drug-naïve AD patients who were amyloid PET-positive and had at least 12 months of follow-up. Participants received either donepezil alone (Donepezil-only) or donepezil plus Ginkgo (Donepezil-Ginkgo). Clinical measures included the Korean version of the Mini-Mental State Examination (K-MMSE) and the Sum of Boxes of the Clinical Dementia Rating (CDR-SB). Plasma MDS-Oaβ was assessed at baseline and at 12 months. Results: A total of 101 patients were analyzed (60 Donepezil-only, 41 Donepezil-Ginkgo). Baseline demographics and clinical characteristics were similar. After 12 months, the Donepezil-only group showed minimal change in K-MMSE and a slight decrease in MDS-Oaβ. The Donepezil-Ginkgo group demonstrated a significant improvement in K-MMSE (+2.4) and a larger reduction in MDS-Oaβ (-0.15).No significant between-group difference was observed for CDR-SB. Adverse events were mostly mild 3 and did not lead to discontinuation.The addition of Ginkgo to donepezil may yield superior cognitive outcomes and a greater decrease in plasma MDS-Oaβ compared with donepezil alone in amyloid PET-positive AD patients.Further large-scale, prospective trials are warranted to validate these findings and elucidate Ginkgo's mechanistic role in AD.
Keywords: Alzheimer's disease, Amyloid PET, Donepezil, Ginkgo biloba, MDS-Oaβ * Between-group comparisons were conducted using independent t-tests. K-MMSE, Korean Mini-Mental State Examination, CDR, Clinical Dementia Rating Scale, CDR-SB, Clinical Dementia Rating Scale Sum of Box, MDS-Oaβ, Multimer Detection System-Oligomerized Aβ assay
Received: 19 Jan 2025; Accepted: 26 Feb 2025.
Copyright: © 2025 Yang, Koo and Kwak. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
YongTae Kwak, Hyoja Geriatric Hospital, Yongin-shi, Republic of Korea
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