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Ginkgo Biloba May Improve Cognitive Function after Acute Ischemic Stroke

by Lewis Chang, PhD 

A randomized trial demonstrated that Ginkgo biloba extract (GBE) supplementation in combination with aspirin improved cognitive function after an ischemic stroke better than aspirin alone.1

Researchers from Nanjing University Medical School (Nanjing, China) conducted a randomized, open-label, single-blind trial.1 They enrolled 348 patients with an onset of acute ischemic stroke within 7 days from five hospitals in Jiangsu Province (Eastern China). Participants were randomly assigned to GBE (450 mg/day) plus aspirin (100 mg/day) or only aspirin (100 mg/day) for 6 months.1 Cognitive functions were assessed at different time points using multiple clinical scales, including the Montreal Cognitive Assessment (MOCA)—a neuropsychological testing evaluating cognitive executive function. Lower MOCA scores indicated impairment in cognitive function.

Compared with aspirin alone, GBE plus aspirin led to a marked delay in the decline in the MOCA scores assessed at 1, 3 and 6 months.1 Similar improvements were seen when other assessment tools were utilized. There was no difference in the incidence of vascular events between the two study groups.

Although the study found statistically significant improvements between groups in terms of changes in clinical scales, there are some important limitations1 that need to be addressed in future trials. First, it is unclear whether changes in the clinical scale used translate into clinical significance. Second, there is no placebo control group in this study; only a comparison group where participants received aspirin. It is unclear if GBE alone would yield clinical benefits.

Why is this Clinically Relevant?

  • Ginkgo biloba is one of the most popular herbal supplements, with a long history of use for memory and blood circulation issues
  • Data from this trial indicate potential cognitive benefits of GBE plus aspirin for patients following an acute ischemic stroke
  • However, clinicians should assess each patient’s health condition and medication use before recommending GBE to patients

Link to article


1. Li S, Zhang X, Fang Q, et al. Ginkgo biloba extract improved cognitive and neurological functions of acute ischaemic stroke: a randomised controlled trial. Stroke Vasc Neurol. 2017;2(4):189-197.

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