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Byline: Ching-Hsiang. Lu, Chiao-Wen. Hwang, Nan-Fu. Chen, Wen-Sheng. Liu, Wen-Tung. Wu Background: Ischemic stroke (IS) is a prevalent disease causing a body disability, the third leading cause of death in [...]

Objective: To evaluate the effect of Ginkgo biloba extract (EGB) on the serum levels of cytokines in patients suffering from chronic, age-related neurological disorders (NDs). Materials and Methods: Patients received 9.6 mg of EGB twice daily for 8 weeks. Serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were measured by enzyme-linked immunosorbent assay (ELISA) before and after treatment. Results: The serum level of IL-6 was significantly higher in ND patients as compared to the healthy controls. After these patients underwent 4 and 8 weeks of EGB treatment, their IL-6 levels were shown a statistically significant (P<0.05) decline to near normal values. No significant changes were observed in serum levels of IL-1β and TNF-α after EGB treatment. We also observed an inverse relationship between ND and serum cholesterol levels. Conclusions: EGB may exert its beneficial effects in patients suffering from NDs through down-regulation and suppression of IL-6 secretion. [ABSTRACT FROM AUTHOR]

Background and Objective: Botulinum toxin type A (BtxA) injection and modified constraint-induced movement therapy (mCIMT) are both promising approaches to enhance recovery after stroke. The combined application of these 2 promising modalities has rarely been studied. The aim was to investigate whether combined BtxA and mCIMT would improve spasticity and upper extremity motor function more than BtxA plus conventional rehabilitation in chronic stroke patients with upper extremity spasticity., Methods: In a prospective, randomized controlled, observer-blinded trial with 6-month follow-up, 32 patients (>or=1 year after stroke) with ability to actively extend >10 degrees at metacarpophalangeal and interphalangeal joints and 20 degrees at wrist of the affected upper limb were randomized to receive BtxA + mCIMT (combination group) or BtxA + conventional rehabilitation (control group) for 2 hours/day, 3 days/week for 3 months.The primary outcome assessed spasticity on the Modified Ashworth Scale. Secondary outcomes assessed real-world arm function (Motor Activity Log), laboratory motor activity (Action Research Arm Test), and patients' global satisfaction., Results: A total of 32 stroke patients were recruited, and 29 completed the study. Spasticity significantly improved in all subjects at 4 weeks and 3 months postinjection without between-group differences.The combination group showed significantly greater improvements in elbow, wrist, and finger spasticity (P = .019, P = .019, and P < .001, respectively), affected upper extremity real-world arm function (P < .001) and laboratory motor activity (P < .001) than the control group at 6-month postinjection. Patients reported considerable satisfaction and no serious adverse events occurred., Conclusions: Combining BtxA and mCIMT is an effective and safe intervention for improving spasticity and motor function in chronic stroke patients. The results are promising enough to justify further studies. We recommend future research to address the likely need for including rehabilitation with BtxA to improve function in patients with poststroke spasticity.