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Comparative effects of Bacopa monnieri and Ginkgo biloba on cognitive functions: A systematic review and network
Pailada Tiemtad1, Kornkanok Ingkaninan1, Prapapan Temkitthawon2
1Department of Pharmaceutical Chemistry and Pharmacognosy, Faculty of Pharmaceutical Sciences, and Center of Excellence for Innovation in Chemistry, Naresuan University, Phitsanulok, Thailand.
Background:
Growing cognitive health interest fuels 8.3% market growth. Bacopa monnieri Wettst. (Brahmi) and Ginkgo biloba L. (Ginkgo) are among the most studied natural nootropics, but their effects have not been directly compared. This study aimed to evaluate and compare their efficacy in healthy adults using a network meta-analysis.
Methods:
We searched PubMed, EMBASE, Cochrane CENTRAL, and EBSCO Open Dissertations in November 2024. Randomized controlled trials (RCTs) on healthy adults receiving Brahmi or Ginkgo extracts and reported cognitive outcomes were included. Risk of bias was assessed using the Cochrane Risk of Bias version 2. Cognitive outcomes were analyzed using standardized mean differences (SMDs) with 95% confidence intervals (CI) under a random-effects model. Interventions were ranked using the surface under the cumulative ranking curve (SUCRA).
Results:
Twenty-nine RCTs (n = 2107) were included. High-dose Brahmi (≥600 mg/day) significantly improved working memory compared to low-dose Brahmi (300 to <600 mg/day), high-dose Ginkgo (≥240 mg/day), low-dose Ginkgo (60 to <240 mg/day), and placebo, with SMDs (95% CI) of 1.84 (1.05-2.64), 1.94 (1.10-2.77), 2.04 (1.24-2.84), and 2.03 (1.28-2.78), respectively. A SUCRA of 100% further supports the strong efficacy of high-dose Brahmi. It also demonstrated significantly greater benefits for short-term memory. For delayed memory, low-dose Brahmi outperformed both low-dose Ginkgo and placebo. No significant differences were observed in sustained attention, selective attention, or processing speed.
Conclusion:
Brahmi, particularly in high-dose formulations, shows promise as a cognitive enhancer compared to Ginkgo in healthy adults. However, the lack of direct comparisons may limit the strength of this evidence.
Other:
The authors are grateful for financial support from The Royal Golden Jubilee Ph.D. Program (RGJ-Ph.D. Program), Thailand Research Fund (TRF) (N41A670299). This study is registered with PROSPERO (CRD420251034900).
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