Herbs and formulas for cognitive performance

Herbs and formulas for cognitive performance

By Andrew Gaeddert

There is a sharp increase in diagnosed cases of dementia. Alzheimer’s disease and other forms of dementia affect about ten percent of people 65 and older. Among those in their mid-80s and older, up to half have a significant degree of cognitive impairment. Millions of younger Americans suffer from less obvious mental impairments, including mild memory loss and diminished alertness as well as related conditions such as ADD/ ADHD, depression and chronic anxiety.

Neurologists now believe that most mental impairments are caused by lifelong exposure to toxic agents, including pollution, tobacco, and to naturally occurring molecules that damage brain tissue and impair circulation to the brain.

Current research clearly shows that some foods, herbs and nutritional supplements can improve mental performance and help prevent long-term damage. A diet rich in fresh fruits and vegetables provides antioxidant protection essential for cognitive function and overall enhanced longevity.

In terms of traditional Chinese medicine (TCM), there are several categories of herbs, which may help people with poor cognitive performance: Tonics, phlegm reducing, blood regulating, calming and liver supportive. The brain is described as an extension of the marrow, and herbs that nourish kidney function are thought to nourish the brain. The spleen promotes the upward circulation of Qi to the brain and converts food to nutrients.

Weak stomach/spleen function can lead to the accumulation of phlegm, which is said to obstruct the acupuncture channels, thus leading to disordered thinking. Liver regeneration can be accomplished by using herbs and nutritional supplements that improve liver functioning, calming agents that are used to clear heat, sedate wind, settle the upward rising of Qi and yang, and blood-regulating herbs that help to improve microcirculation, treat headache, and may help to restore memory.

One of the more interesting ingredients is cordyceps (dong chong xia cao). Traditionally used as a food, this ingredient is used to treat kidney yang and Jing (essence) deficiency characterized by tinnitus, forgetfulness, and poor memory.

It is also said to tonify the lung, and resolve phlegm. Cordyceps has been shown to stimulate adrenal gland function, improve sleep quality1 and treat cardiovascular disease, which is implicated in dementia. Animal, human, and in vitro studies confirm that cordyceps enhances aerobic capacity and cellular energy stores, reduces myocardial oxygen consumption, lowers cholesterol levels, normalizes immune function2, 3 and reduces oxidative damage to cells lining the arterial walls. An additional benefit of cordyceps is it increases adenosine triphosphate (ATP) levels thus repairing the liver. In 22 patients with liver cirrhosis, patients taking 6-9 grams of a cordyceps preparation per day for three months had dramatically improved symptoms, including the disappearance of cirrhotic cells in 15 patients.4, 5

Salvia miltiorrhiza (dan shen) regulates blood circulation, treats insomnia, has hepatoprotective and central nervous system suppressant effects. Salvia is widely used in TCM in combination with other herbs to treat heart and vascular disorders such as atherosclerosis or blood clotting abnormalities. The ability of salvia to “thin” the blood and reduce blood clotting is well documented. Laboratory experiments and small human trials suggest that salvia may provide cardiovascular benefits. Vascular dementia is a degenerative cerebrovascular disease that leads to a progressive decline in memory and cognitive functioning. It occurs when the blood supply carrying oxygen and nutrients to the brain is interrupted by a blocked or diseased vascular system. Vascular dementia generally affects people between the ages of 60 and 75, and affects more men than women. It is the second most common form of dementia in the United States and Europe, ranking behind Alzheimer’s disease. Some research suggests that the most common type of vascular dementia, multi-infarct dementia (MID) may actually cause or exacerbate Alzheimer’s disease.

MID is caused by a series of small strokes, or “mini-strokes,” that often go unnoticed and cause damage to the cortex of the brain—the area associated with learning, memory, and language. These mini-strokes are sometimes referred to as transient ischemic attacks (TIAs), which result in only temporary, partial blockages of blood supply and brief impairments in consciousness or sight. Over time, however, the damage caused to brain tissue interferes with basic cognitive functions and disrupts everyday functioning.

Multi-infarct dementia causes loss of functioning to specific areas of the brain, impairing some neurological and mental functions and not others. When vascular dementia occurs with other types of dementia, such as Alzheimer’s disease, it is know n as “mixed dementia”. (helpguide.org) Because salvia can inhibit platelet aggregation, its use should be monitored carefully in clients with bleeding disorders, or when taking anticoagulant drugs. As a precaution formulas containing saliva should be halted before surgical procedures.

Ginkgo biloba (yin guo ye) extract (GBE), acts as an antioxidant preventing lipid peroxidation of neural tissue under experimental conditions.6, 7 It also has a relaxing effect on blood vessel walls, inhibits platelet activating factor, improves microcirculation, and stimulates neurotransmitters.8 GBE has been shown to increase cerebral circulation and to protect cells from free radical damage. In Germany, GBE is approved for the symptomatic treatment of dementia syndromes including primary degenerative dementia, vascular dementia, and dementia with memory deficits, poor concentration, depression, vertigo, tinnitus, and headache. Although not all trials show benefit, in a yearlong study of more than 300 subjects with dementia, who received 120mg of GBE, stabilized or improved cognitive performance.9 A meta-analysis by Birks et al., included 33 double blind random controlled trials of patients with diagnosis of dementia or non-dementia—cognitive decline; at twelve to twenty-four weeks, GBE improved cognition compared with a placebo. In addition to senior subjects, in a study with twenty volunteers who were administered 120mg, 240mg, or 360mg of GBE or a placebo, a series of computerized tests were conducted to assess speed, attention and memory. There was a dose dependent improvement in speed and attention in both the 240mg and 360mg groups.

In traditional Chinese medicine, dan shen has been used to prevent and treat heart conditions and strokes. Results from animal and human studies support these uses of dan shen to some extent because dan shen is known to decrease the blood’s ability to clot in at least two ways. First, it limits the stickiness of blood components known as platelets. It also decreases the production of fibrin— threads of protein that trap blood cells to form clots. Both these effects help to improve blood circulation. In addition, chemicals in dan shen may relax and w iden blood vessels, especially those around the heart. In animal studies, chemicals in dan shen may also have protected the inner linings of arteries from damage.10

According to TCM, ginseng (ren shen) helps convert food to energy and treats fatigue, poor appetite, malaise, and improves cognition. It is commonly used alone or with other herbs to treat insomnia, worry, disturbed sleep, and forgetfulness. Ginseng binds to the nicotinic acid receptor; a receptor for which reduced stimulation is associated with cognitive decline. It has been reported that constituents of ginseng, ginsenosides Rb1 and Rg1 both improve learning and memory. In addition, they stimulate synaptosomal choline intake, stimulate acetylcholine release, alter 5-HTP concentrations in the brain, increase expression of choline acetyltransferase and nerve growth factor messenger RNA, and stimulate synapse formation. Long-term administration of ginsenoside from American ginseng (xi yang shen) exerts a protective effect against scopolamine-induced learning deficits. PGO, a constituent of Panax ginseng (ren shen) significantly enhanced memory performance in scopolamine–induced memory deficit rats.11 In a recent double blind placebo-controlled trial with more than 250 subjects over a fourteen-week period, demonstrated that a ginseng formula produces significant improvement in cognition and memory.12

It is estimated over 100,000 people have been treated with Huperzine A in China where it is used as a treatment for Alzheimer’s disease (AD), as well as other kinds of dementia. In addition to being safer than current drugs used to treat AD, it appears more effective in a number of areas. Huperzine A is a compound that can be manufactured in the lab or extracted from club moss extract (Huperzia serrata; qian ceng ta) which has been traditionally used to treat fever and inflammation. Research carried out at the Shanghai Institute of Materia Medica, Huperzine A improved memory significantly better than tacrine or the drug E2020.13

Fifty patients with AD were administered 200mcg Huperzine A BID for 8 weeks. Twenty-nine out of fifty patients showed improvements in memory, cognitive, and behavioral functions on the basis of the Wechsler memory scale, Hasegawa dementia scale, and other internationally accepted standards.14

Huperzine A may reduce injury to cells from strokes, epilepsy, and other disorders. It is being clinically used for treatment of myasthenia gravis in China. It is also being studied in Israel for its ability to be used prophylactically against nerve gas poisoning.

Vinpocetine is derived from the periwinkle plant. It has been used for more than 20 years as a treatment of cerebrovascular disorders. Laboratory experiments indicate that it dilates blood vessels, improves circulation to the brain, improves oxygen utilization, increases glucose metabolism in the brain, and inhibits platelet aggregation. Vinpocetine has been shown to alter properties of the blood to improve blood flow through the brain. It also improves energy available to the brain by inhibiting phosphodiesterase thus preserving ATP, the source of cell energy.

In a study of 203 patients with mild to moderate dementia at the University of Surrey, in England, vinpocetine was administered at doses of 10mg TID or 20mg TID for sixteen weeks. There was a significant cognitive improvement when compared with a placebo. In another double blind trial, vinpocetine produced significant improvement to elderly patients with chronic cerebral dysfunction at dosages of 10mg TID for 30 days, followed by 5mg TID for 60 days.

Cogni-Spark (Alpha GPC), a nutrient that occurs naturally in the body; it is found in breast milk. Cogni-Spark has been studied for its effects at improving neurological functions. It provides choline for the nerve cells of the brain and protects the brain cell wall. Preliminary research indicates that it may improve growth hormone release and enhances pituitary functioning. In laboratory experiments, it has demonstrated anti-aging effects such as preventing the loss of neurotransmitter receptors. Cogni-Spark is a precursor of acetylcholine (A Ch) and aids in the synthesis of phosphatidyl choline (PC) in the nerves and cell membranes. It elevates levels of choline, thus improving liver metabolism and the transport and utilization of fats.

Nineteen trials have been completed using Cogni-Spark. It improved the recall and attention in a group of young males compared against a control group. In middle-aged patients, it benefited reaction time, improved energy generation, and electrical coordination within the brain. It has also been studied in subjects with moderate or severe brain damage exhibiting signs of dementia. Cogni-Spark improved mood and cognitive processing.

In a trial of 2044 patients suffering from recent stroke or TIA, Cogni-Spark was administered 1000mg IM for 28 days followed by 400mg TID, for five months. Using a variety of mental tests, 71 percent of the patients saw benefits in cognitive recovery. In an 817 patient study with seniors affected by dementia, 79.2 percent of patients received a clinical response to Cogni-Spark.

Cogni-Spark has been compared with other brain nutrients such as Acetyl L carnitine and CDP choline and has performed better in clinical trials in the areas of mental focus, recall, verbal fluency and enhancement of mental performance. It is a complex extraction derived from soy lecithin. Eating soy products will not provide an equivalent effect.

DISCUSSION

One of the key challenges in modern herbal practice is to make sure clients are taking an adequate dosage of active compounds. Ginseng and salvia (dan shen) can be administered traditional formulas.15

Shen-Gem (gui pi tang) is an example of a traditional formula containing ginseng, thought to improve memory. It is used to treat heart blood deficiency. Shen Ling (shen ling, bai zhu san) containing codonopsis is used to treat spleen deficiency and dampness, and has been used by the author to treat ADD.

Ginkgo, cordyceps, Cogni-Spark, huperzine A, and vinpocetine are  specially manufactured to assure the presence and levels of active ingredients in order to obtain the desired results. As GBE is often used long-term, it has been formulated with salvia, tonics and additional circulatory enhancing herbs in Flavonex. It is suitable for middle-aged and senior patients who have poor circulatory memory deficiencies, and may treat depression in these populations.

Huperzine A and vinpocetine are combined in Vinpurazine. Vinpurazine is best used to improve focus in elderly patients. Response time can be up to 3 months for clients diagnosed with dementia.

Cordyceps PS and CordySeng utilize a purified extract of cordyceps that has been validated by the Institute of Materia Medica; cordyceps formulas are typically u s e d to treat middle-aged and elderly patients who have a weak constitution. Cogni-Spark is used for clients of all ages. In clinical practice, the author recommends the above mentioned herbs with EPAQ krill oil as well as antioxidant rich fruits and vegetables.

REFERENCES

  1. Zhong Cao Yao. Chinese Herbology, 1998;785:788
  2. Halpern, Georges M. Cordyceps: China’s Healing Mushroom. Avery Publishing Group. Garden City Park, NY. 1999.
  3. Winston, David. Maimes, Steven. Adaptogens: herbs for strength, stamina, and stress relief. Healing Arts Press. Rochester, VT. 2007. p150.
  4. Halpern, Georges M. Cordyceps: China’s Healing Mushroom. Avery Publishing Group. Garden City Park, NY. 1999. p42.
  5. Bensky, Dan, Clavey, Steven, Stoger, Erich., with Gamble, Andrew. Chinese Herbal Medicine: Materia Media, 3rd ed. Eastland Press. 2004. p770.
  6. Koc, R., Akdemir, H., Kurtsoy, A., et al. Lipid peroxidation in experimental spinal cord injury: Comparison of treatment with Ginkgo biloba, TRH and methylprednisone. Res Exp Med (Berlin) 195(2):117-123, 1995.
  7. Dorman, D., Cote, L., Buck, W. Effects of an extract of Ginkgo biloba on bromethalin-induced cerebral lipid peroxidation and edema in rats. Am J Vet Res 1992. 53(1):138-142.
  8. Yoshikawa, T., Naito, Y., Kondo, M. Ginkgo biloba leaf extract: review of biological actions and clinical applications. Antioxid Redox Signal. 1999. 1(4):469-480.
  9. Yoshikawa, T., Naito, Y., Kondo, M. Ginkgo biloba leaf extract: review of biological actions and clinical applications. Antioxid Redox Signal. 1999. 1(4):469-480.
  10. helpguide.org/ above is wikepedia.org
  11. Wang Y, Jang R, Li G, Chen Y, Luo H, Gao Y, Gao Q. Structural and enhanced memory activity studies of extracts from Panax ginseng root. Food Chemistry. 2010. 119(3)969-973.
  12. Wesnes, K.A., Ward, T., McGinty, A., Petrini, O. The memory enhancing effects of Ginkgo biloba / Panax ginseng combination in healthy middle-aged volunteers. Psychopharmacology (Berlin). 2000. 152(4):353-361.
  13. Neuroreport. 1996, Dec 20. 8(1):97–101.
  14. Chung Kuo Yao Li hsueh pao 1995, Sept. 16(5):391–395.
  15. Most Chinese herbs require heat or steam treatment prior to use.

REV 2022

Back to blog