Yang YoungSoon, Koo Min-Seong, Kwak Yong Tae
Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Republic of Korea.
Department of Psychiatry, Catholic Kwandong University College of Medicine, Incheon, Republic of Korea.
Front Neurol. 2025 Mar 11;16:1563056. doi: 10.3389/fneur.2025.1563056. eCollection 2025.
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.
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.
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.
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 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.
在某些地区被广泛用作阿尔茨海默病（AD）的辅助治疗方法。其潜在机制包括抗氧化和抗淀粉样蛋白特性，但临床证据仍存在分歧。
我们研究了银杏叶与多奈哌齐联合使用是否能给淀粉样蛋白PET阳性的AD患者带来额外益处。我们还探讨了血浆生物标志物MDS-Oaβ（多聚体检测系统-寡聚Aβ）的变化，该标志物反映了Aβ单体形成寡聚体的倾向。
这项回顾性研究纳入了新诊断的、未接受过药物治疗的淀粉样蛋白PET阳性且至少随访12个月的AD患者。参与者分别接受单独使用多奈哌齐（仅多奈哌齐组）或多奈哌齐加银杏叶（多奈哌齐-银杏叶组）治疗。临床测量指标包括韩国版简易精神状态检查表（K-MMSE）和临床痴呆评定量表方框总和（CDR-SB）。在基线和12个月时评估血浆MDS-Oaβ。
共分析了101例患者（60例仅多奈哌齐组，41例多奈哌齐-银杏叶组）。基线人口统计学和临床特征相似。12个月后，仅多奈哌齐组K-MMSE变化极小，MDS-Oaβ略有下降。多奈哌齐-银杏叶组K-MMSE有显著改善（提高2.4分），MDS-Oaβ下降幅度更大（下降0.15）。CDR-SB在两组之间未观察到显著差异。不良事件大多为轻度，未导致停药。
在淀粉样蛋白PET阳性的AD患者中，与单独使用多奈哌齐相比，多奈哌齐加银杏叶可能产生更好的认知结果，血浆MDS-Oaβ下降幅度更大。需要进一步进行大规模前瞻性试验来验证这些发现，并阐明银杏叶在AD中的作用机制。
