Brain protective effect of ginkgo biloba extract on patients with meningioma resection

Abstract

Objective To investigate the effects of ginkgo biloba extract on the early postoperative cognitive function and the serum neuron specific enolase (NSE), S100β, tumor necrosis factor-α (TNF-α), interleukin (IL)-6, superoxide dismutase (SOD) and malondialdehyde (MDA) in patients with meningioma resection. Methods 60 patients with meningioma scheduled for elective intracranial tumor resection were enrolled and randomly divided into two groups (n=30 each): ginkgo biloba extract group (group G) and control group (group C). Ginkgo biloba extract was infused intravenously 30 min before anesthesia induction in group G, while group C received the equal volume of normal saline. Venous blood sample were taken at three time points: 30 min before induction (T1), extubation (T2) and 24 h after operation (T3) for determination of serum concentration of NSE, S100β, TNF-α, IL-6, SOD and MDA. Cognitive function was evaluated at 1 d before and 3 d after surgery using Mini-mental State Examination (MMSE), Wechsler Adult Intelligence Scale (WAIS) and Wechsler Memory Scale (WMS). Results Compared with T1, the concentration of NSE, S100β, TNF-α, IL-6 and MDA in serum were significantly increased at T2 and T3 in the two groups, while SOD was decreased (P<0.05). Compared with group C, the concentration of NSE, S100β, TNF-α, IL-6 and MDA were significantly decreased at T2 and T3 in group G, while SOD was increased (P<0.05). Compared with 1 d before surgery, the scores of MMSE, digit accumulation, digit breadth (forward), vocabulary association and digit symbol replacement were significantly decreased and tracing connection time was significantly increased on the 3rd day after surgery in the two groups. The scores of digital breadth (reverse) and visual regeneration were significantly decreased in group C (P<0.05). Compared with group C, the scores of digit accumulation, digit breadth (forward and reverse) and visual regeneration were significantly increased on the 3rd day after surgery in group G (P<0.05). The incidence of postoperative cognitive dysfunction (POCD) at 3 d after surgery in group G was significantly lower than group C (P<0.05). Conclusions The pretreatment of ginkgo biloba extract can decrease the incidence of early POCD in patients with meningioma resection, and its mechanism may be related to the reduction of inflammatory reaction and antioxidation. Key words: Plant extracts; Ginkgo biloba; Meningioma; Neurosurgical procedures; Cognition