Adjunctive EGb 761 treatment in patients with Parkinson's disease: a case series

Parkinson's disease (PD) is the second most common neurodegenerative disease. It is based on a gradual decrease in the number of dopaminergic neurons in the midbrain. Since various pathological processes, including oxidative stress, neuroinflammation, and impaired neuroplasticity, are involved in PD pathogenesis, there is increasing interest in adjunctive therapies that target multiple pathways. This study aims to provide a preliminary assessment of the effects of adjunctive EGb 761 on motor, cognitive, and molecular markers in patients with Parkinson's disease, to gain insights valuable for the design of future controlled and randomized clinical trials.

The study included 17 patients with Parkinson's disease who received EGb 761 for 1 month in the context of baseline antiparkinsonian therapy. Standard clinical and neurophysiological tests were performed: UPDRS, MMSE, MoCA, FAB, BDI-I, Spielberger-Hanin Anxiety Scale and Hoehn and Yahr scale, motor tempo and sensorimotor response; the following molecular genetic markers were determined: relative average telomere length, relative mtDNA copy number; and biochemical markers: LDH, SOD and CAT activity, as well as AGEs, GSH/GSSG and MDA concentrations were determined.

Statistically significant changes in the relative number of mtDNA copies (decrease), GSH/GSSG (decrease) and MDA (increase), as well as a trend towards telomere elongation were observed.

EGb 761 administration in combination with basic symptomatic therapy is associated with improved cognitive and motor functions, and the molecular findings (a decrease in mtDNA copy number alongside a trend toward telomere elongation) are consistent with, though not proof of, the activation of mitophagy. Our preliminary results provide the basis for designing sufficiently powered, randomized and controlled clinical trials with clearly defined primary and secondary endpoints to assess the efficacy and safety of Ginkgo biloba extract in the adjunctive treatment of Parkinson's disease.