Ginko Reduces Brain Damage From Stroke
A Comprehensive Cochrane meta-analysis failed to show any quality evidence to support a role for Ginkgo bilboa in the management of acute ischemic stroke.
Ginkgo bilboa is believed to have a neuroprotective effect and is widely used in the management of acute ischemic stroke in China. Websites such as GreenMedInfo have recommended Ginkgo bilboa for the management of acute ischemic stroke patients.
In 2005, researchers published a Cochrane review of available randomised controlled trials and quasi- randomized controlled trials on the use of Ginkgo bilboa for the management of acute ischemic stroke patients (1).
A total of 14 relevant human clinical trials were identified for the meta-analysis. Only 10 of these trials had been completed at the time of the Cochrane meta-analysis. The 10 completed trials involved 792 patients who were followed up for 14 – 35 days after having a stroke. Nine of the completed 10 trials were considered to be of poor quality by the Cochrane reviewers. The single study that was assessed to be of good quality failed to show any improvement in neurological deficits at the end of Gingko treatment.
The Cochrane reviewers concluded that ‘there is insufficient evidence from trials of sufficient methodological quality to support the routine use of Ginkgo bilboa for the management of acute ischemic stroke patients’. They recommended that ‘high quality and large scale randomized trials are needed to evaluate the efficacy of Ginkgo bilbo’.
Since the publication of the Cochrane paper in 2005, a small Iranian clinical trial has been completed (2). This is the study that was referenced on GreenMedInfo to support the use of Ginkgo for stroke patients.
The study enrolled 102 patients with acute ischemic stroke and followed them up for four months. There was a statically significant improvement in stroke symptoms compared to baseline in the Ginkgo bilboa arm of the study versus the placebo arm of the study. However these results would not change the outcome of the Cochrane review considering the fact that 38 out of the 102 patients enrolled in the study were lost of follow-up. Additionally, multivariate analysis adjusted for age and sex did not reveal any improvement in stroke symptoms after four months.
In summary, there is no quality evidence to support a benefit for Ginkgo bilboa in the management of acute ischemic stroke patients.