According to a recent study, the popular herbal
extract ginkgo biloba may help the brain recover after a stroke.
The supplement, available in health food shops or pharmacies all over the
world, is used in China to aid memory and fight depression.
In a trial of 330 stroke patients over six months in China, ginkgo biloba
was linked with better cognitive skill scores on tests.
However, experts say the evidence for ginkgo is too weak to recommend it.
Those behind the study – published in the online journal Stroke & Vascular Neurology – admit
that larger, longer and more robust trials are needed.
The small study was carried out by Nanjing University Medical School, with patients from five Chinese hospitals.
All 330 participants began the trial within a week of having an ischemic
stroke. The average age of the patients was 64.
Roughly half of them were given 450mg of ginkgo biloba daily, in addition to
100mg of aspirin, while the remainder were given only the aspirin.
During a stroke, the blood supplying vital parts of the brain is
interrupted, often leading to impaired memory and a decline in organizational
and reasoning skills among stroke survivors.
Researchers wanted to see if combining ginkgo biloba with aspirin might help
lessen or halt the cognitive decline.
Previous experimental studies in animals have suggested that
ginkgo biloba protects against the nerve cell death associated with blood clots
in the brain, possibly by increasing blood flow in the cerebral arteries.
All the participants took a
neuropsychological test (Montreal Cognitive Assessment) at the start of the
trial, and then 12, 30, 90 and 180 days later, to check for any cognitive
impairment.
The results showed that those taking
the combination of aspirin and ginkgo biloba had higher scores for cognitive
skills, including memory and reasoning, than those who weren’t.
Speech problems and muscle strength
also improved more rapidly, with indications of improved functional capacity 12
and 30 days after the start of treatment. However, both the clinicians and the
patients knew which treatment they had been assigned to, which may have skewed
the results, and the monitoring period was not very long.
Ginkgo biloba is one of the oldest
living tree species.
According to researchers, the
extract used in the study contained more protective, and fewer harmful,
chemicals than the extract typically used in previous studies.
Few side-effects were reported
during the trial.
The participants were subsequently
monitored for nearly two years, with little difference in the vascular health
of the two groups: 16 people in the combined treatment group, and 20 in the
aspirin group had further problems, including recurrent stroke and aneurysm.
However, longer term studies looking
at stroke severity are necessary, before any more definitive conclusions can be
reached.
According to a pilot study by Imperial College London, infusing stem cells into the brain may help boost recovery after a stroke.
Scientists believe the cells encourage new blood vessels to grow in damaged areas of the brain.
They found most patients were able to walk and look after themselves independently by the end of the trial, despite having suffered severe strokes.
Larger studies are needed to evaluate whether this could be used more widely.
In this early trial – designed primarily to look at the safety of this approach – researchers harvested stem cells from the bone marrow of five people who had recently had a stroke.
Infusing stem cells into the brain may help boost recovery after a stroke
They isolated particular types of stem cells – known as CD34+. These have the ability to stimulate the growth of new blood vessels.
They were infused directly into damaged sections of the brain, via the major artery that supplies this area.
Scientists monitored the patients for six months, charting their ability to carry out everyday activities independently.
Four of the five patients had suffered particularly severe strokes – resulting in the loss of speech and marked paralysis down one side of the body.
This type of stroke usually has a high fatality and disability rate.
However, researchers found three of the four patients were able to walk and look after themselves independently at the end of the six-month period.
With some help, all five were mobile and could take part in everyday tasks.
Though other stem cell treatment has shown promise as stroke therapy before.
Scientists hope getting to patients early will improve chances of success.
The study is published in Stem Cell Translational Medicine.
A new study has found that women have a poorer quality of life after a stroke than men.
The US research, published in Neurology, assessed the mental and physical health of 1,370 patients three months and a year after a stroke.
Women had more depression and anxiety, pain and discomfort, and more restricted mobility.
The study also says more people survive a stroke now than 10 years ago because of improved treatment and prevention.
The researchers at Wake Forest Baptist Medical Center, North Carolina, looked at patients who had had a stroke or transient ischaemic attack (TIA), also known as a mini-stroke.
Quality of life is calculated using a formula that assesses mobility, self-care, everyday activities, depression/anxiety and pain.
Women have a poorer quality of life after a stroke than men
At three months, women were more likely than men to report problems with mobility, pain and discomfort, anxiety and depression, but the difference was greatest in those aged over 75.
After a year, women still had lower quality-of-life scores overall than men but the difference between them was smaller.
Prof. Cheryl Bushnell, who led the study, said: “We found that women had a worse quality of life than men up to 12 months following a stroke.”
She said mood, ability to move about, and having pain or discomfort may contribute to the poorer quality of life for women.
Prof. Cheryl Bushnell suggested that women may have less muscle mass than men before their strokes, making it harder to recover.
She added: “As more people survive strokes, physicians and other healthcare providers should pay attention to quality-of-life issues and work to develop better interventions, even gender-specific screening tools, to improve these patients’ lives.”
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