Subject(s)
Cognition Disorders/drug therapy , Cognition/drug effects , Executive Function/drug effects , Ginkgo biloba , Multiple Sclerosis/drug therapy , Phytotherapy , Plant Extracts/therapeutic use , Adult , Cognition Disorders/etiology , Female , Humans , Male , Middle Aged , Multiple Sclerosis/complications , Multiple Sclerosis/psychology , Plant Extracts/pharmacologyABSTRACT
The neurobehavioral sequelae of multiple sclerosis (MS) consistently include fatigue, depression and cognitive dysfunction with slower processing figuring prominently. However, processing speed is often confounded with accuracy and the relative contributions of depressed mood and fatigue in influencing speed of processing are difficult to quantify. Therefore, there were three objectives in this study. First, compare processing speed in MS and healthy controls under conditions in which accuracy is not confounded with speed; second, determine the relationships between information processing speed and cognition; third, determine the contributions of clinical depression and fatigue in mediating these relationships. Forty-eight participants with confirmed MS participated. The findings suggested that slower processing was correlated with higher levels of depressed mood, fatigue, lower verbal fluency, fewer words and digits recalled and poorer recall of visual-spatial information. Depression and physical fatigue had the greatest influence on the association between processing speed and more effortful tasks (e.g., immediate word recall and word list learning). Current findings extend previous work by using a more sensitive measure of processing speed and by quantifying the relative contributions of depression and fatigue in mediating relationships between processing speed and cognition.
Subject(s)
Cognition Disorders/psychology , Depressive Disorder/psychology , Fatigue/psychology , Mental Processes/physiology , Multiple Sclerosis/physiopathology , Multiple Sclerosis/psychology , Adult , Case-Control Studies , Cognition Disorders/complications , Cognition Disorders/physiopathology , Depressive Disorder/complications , Depressive Disorder/physiopathology , Educational Status , Fatigue/complications , Fatigue/physiopathology , Female , Humans , Male , Middle Aged , Neuropsychological Tests , North Carolina , Reaction Time/physiologyABSTRACT
BACKGROUND: Multiple sclerosis (MS) is a chronic demyelinating neurological disease afflicting young and middle-aged adults, resulting in problems with coordination, strength, cognition, affect, and sensation. OBJECTIVE: The objective of this study was to determine whether a ginkgo extract (EGb 761) improved functional performance in individuals with MS. DESIGN: This study used a double-blind, placebo-controlled, parallel group design. The end point was change between baseline (ie, preintervention) and follow-up evaluation following a regimen of four tablets per day at 60 mg per tablet for four weeks. SETTING: The study was conducted in academic and clinical-based settings. PATIENTS/PARTICIPANTS: Twenty-two individuals with MS were randomly assigned to either the treatment or control condition. Groups did not differ with respect to age, IQ, and education. INTERVENTION: Half of the subjects received 240 mg per day of ginkgo special extract (EGb 761), and the other half received placebo. MAIN OUTCOME MEASURE: The main outcome measures assessed depression (Center for Epidemiologic Studies of Depression Scale [CES-D]), anxiety (State-Trait Anxiety Inventory [STAI]), fatigue (Modified Fatigue Impact Scale [MFIS]); symptom severity (Symptom Inventory [SI]) and functional performance (Functional Assessment of Multiple Sclerosis [FAMS]). RESULTS: The ginkgo group had significantly more individuals showing improvement on four or more measures with improvements associated with significantly larger effect sizes on measures of fatigue, symptom severity, and functionality. The ginkgo group also exhibited less fatigue at follow-up compared with the placebo group. CONCLUSIONS: This exploratory pilot study showed that no adverse events or side effects were reported and that ginkgo exerted modest beneficial effects on select functional measures (eg, fatigue) among some individuals with MS.
