Efficacy of Choto-san on vascular dementia and the protective effect of the hooks and stems of Uncaria sinensis on glutamate-induced neuronal death.

Two different multicenter studies on the efficacy of Choto-san on patients with vascular dementia, one a well-controlled but non-double blind (60 patients), the other a double-blind controlled study (139 patients), were performed. In the well-controlled study, Choto-san was superior in global improvement rating, utility rating and improvement of subjective symptoms, psychiatric symptoms and disturbance in daily living activities. In the double-blind study, with more objective criteria than the well-controlled study, Choto-san was also superior in global improvement rating, utility rating and improvement of subjective symptoms, psychiatric symptoms and disturbance in daily living activities. These results suggest that Choto-san is effective in the treatment of vascular dementia. Uncaria sinensis (OLIV.) HAVIL. (US) is the main medicinal plant composing Choto-san. Glutamate-induced cell death of cultured cerebellar granule cells was protected by the application of water extract of US in a dose-dependent manner, and concentrations of 10(-5) to 10(-4) g/ml had a significant effect compared to exposure to glutamate only. Further, the increase of 45Ca2+ influx into cells by glutamate was also blocked by the water extract in a dose-dependent manner. These results suggest that US has a protective effect on glutamate-induced neuronal death in cultured cerebellar granule cells through the inhibition of Ca2+ influx.