Brahmi

Authors:

Asimul Islam, Lamya Ahmed Al-Keridis, Md. Imtaiyaz Hassan, Mohd Adnan, Nawaf Alshammari, Shahnawaz Ahmad, Sonam Roy, Urooj Fatima

Findings:

This systematic review of 22 clinical trials concluded that Bacopa monnieri (BM) demonstrates therapeutic benefits for brain disorders. BM was found to reduce Nuclear Factor-κB phosphorylation, improve emotional and cognitive functions (including memory, attention, learning), anhedonia, hyperactivity, sleep, depression, impulsivity, and psychiatric problems. Additionally, BM can reduce levels of pro-inflammatory biomarkers and oxidative stress.

Participants:

Systematic review of 22 clinical trials. Participants included children (6-14 years), adults, and elderly individuals. Populations studied were healthy individuals and patients with various conditions including anhedonia, major depression, Alzheimer’s disease, Parkinson’s disease, dementia, hyperactivity, inattention, and self-reported memory impairment.

Dosage:

Dosages of Bacopa monnieri extract in the reviewed clinical trials generally ranged from 160 mg to 640 mg per day. Treatment durations varied from four weeks to one year. Some studies utilized specific standardized extracts such as CDRI 08, BacoMind®, KeenMind®, and Bacognize®.

Study Quality Assessment:

This is a systematic review of 22 clinical trials. The review followed PRISMA guidelines for study selection from COCHRANE, EMBASE, and MEDLINE–PubMed databases, with inclusion criteria limited to human interventional studies. Risk of bias for included trials was assessed using the Cochrane Handbook. Seventeen trials were placebo-controlled. Common biases noted in the included studies were small sample sizes, lack of blinding, and lack of placebo comparison in some instances.

All Effects:

Authors:

Sonam Roy, Urooj Fatima

Findings:

This review summarizes current research on Bacopa monnieri extract (BME), highlighting its pharmacological attributes for neurodegenerative diseases (e.g., Alzheimer's, Parkinson's), anti-cancer effects, and cognitive enhancement. Key bioactive components like bacosides contribute to neuroprotection by reducing oxidative stress, neuroinflammation, and amyloid-β aggregation, and improving memory and learning. The review suggests BME as a promising therapeutic agent for neurological disorders and for exerting cognitive-enhancing effects.

Participants:

The review covers studies conducted on various participants and models: in vitro cell lines (e.g., human neuroblastoma SH-SY5Y, IMR32; human glioblastoma U-87 MG; primary cortical neurons), animal models (e.g., rats, mice, C. elegans, Drosophila), and human clinical trials. Clinical trial participants included healthy adults (various age groups, e.g., 18-60 years, 40-65 years; N ranging from 17 to 76), children and adolescents (N=100, ages 6-14), medical students (N=60), elderly patients, and patients with anhedonia (N=19 treated, N=23 control).

Dosage:

The review reports various dosages from cited studies: Clinical trials: Capsules of 320 mg BME (KeenMind) for 12 weeks; chronic dosages of B. monnieri (KeenMind) for 90 days; 300 mg of Brahmi (Peth Nui et al.); 320 mg and 640 mg doses of Brahmi (CDRI 08) for acute effects; 1 × 160 mg or 2 × 160 mg capsules of Bacopa (CDRI 08) per day for 16 weeks in children; 150 mg Bacopa monnieri extract (Bacognize) twice a day for 6 weeks; 250 mg of Brahmi tablet (b.i.d.) for 3 months; B. monnieri extract (300 mg bid) for 4 weeks in anhedonia patients. Animal studies: e.g., 200 mg/kg ethanolic extract of BM; 100 mg/kg BME; 300 mg/kg BME; 100 mg and 200 mg/kg body weight/day of 70% ethanol extract of BM; 40 mg/kg of mBME; 250 mg/mL Brahmi concentration; 40 and 80 mg/kg BM. In vitro studies: e.g., 100 μg/ml of BME; 100 g/mL extract of BM (PC12 cells); Bacoside A at 50 μM; 10 mg/ml B.monnieri hexane extract.

Study Quality Assessment:

This review article cites multiple studies, including clinical trials described as randomized, double-blind, and placebo-controlled, with reported sample sizes (e.g., N=17 to N=100 for various trials). It also references in vitro studies using methods like RT-PCR and immunofluorescence, and in vivo animal studies using tests like the Morris water maze. The review discloses its funding sources (National Medicinal Plants Board, Ministry of AYUSH, Council of Scientific and Industrial Research) and includes a conflict of interest statement declaring no commercial or financial relationships that could be construed as a potential conflict of interest for its authors.

All Effects:

Authors:

Barry Oken, M.D., Carlo Calabrese, N.D., M.P.H., Dale Kraemer, Ph.D., Kerry Bone, F.N.I.M.H., F.N.H.A.A., Michael Leo, Ph.D., William L Gregory, Ph.D.

Findings:

The Bacopa monnieri (BM) group showed slower reaction time (RT) in an image discrimination task (pattern separation) but potentially higher accuracy, suggesting a speed-accuracy trade-off, while the placebo group had faster RT in a spatial working memory task with no change in the BM group. Exploratory, uncorrected neuroimaging analysis suggested BM-related changes in brain microstructure (increased white matter mean diffusivity (MD) and gray matter orientation dispersion index (ODI); decreased white matter fractional anisotropy (FA) and gray matter neurite density (ND)), which conflicted with behavioral results. Most other outcomes, including BDNF and other cognitive tasks, were not statistically significant after corrections.

Participants:

Initially 36 healthy, older (≥55 years, final age range 57–78 years) adults randomized (18 BM, 18 placebo). Final analyzed sample: 15 in BM group, 13 in placebo group (total N=28 for most cognitive outcomes). Participants were right-handed, with no diagnosis of psychiatric, neurological or food metabolism disorder, no history of repeated head injury or substance abuse, non-smokers, consumed <15 standard alcoholic drinks weekly, no hypertension. Excluded if taking cognitive/mood-altering medications/supplements, had implanted electronic/magnetic devices, Mini-Mental State Examination (MMSE) score ≤23, or Beck Depression Inventory-II (BDI-II) score ≥20.

Dosage:

Two capsules of KeenmindTM (CDRI-08) daily. Each capsule contained 160 mg of Bacopa monnieri extract (equivalent to 2.16 g of dried herb). Participants took two capsules (total 320 mg BM extract) each morning with breakfast for 12 weeks.

Study Quality Assessment:

Randomized, double-blind, placebo-controlled trial over 12 weeks. Initial N=36 (final N=28 for most cognitive outcomes: 15 BM, 13 placebo). Standardized extract of Bacopa monnieri (CDRI-08, KeenmindTM) used. Assessments included cognitive tasks (CogTrackTM), questionnaires (CASP-19 for life satisfaction, PRMQ for memory complaints, POMS for mood), serum Brain-Derived Neurotrophic Factor (BDNF), and neuroimaging (3T MRI for Diffusion Tensor Imaging - DTI, and Neurite Orientation Dispersion and Density Imaging - NODDI). Randomization by computerized random number generator by a disinterested third party, stratified by gender. Statistical analysis used ANCOVAs, FSL for imaging with family-wise error (FWE) correction (p < 0.05) for primary analysis and uncorrected exploratory analyses (p < 0.005). Limitations acknowledged: mixed/inconsistent findings between behavioral and neuroimaging data, small sample size, short intervention duration (12 weeks), some cognitive data exclusion reducing sample further, potential baseline group differences, need for a larger study. Funding source (Soho Flordis International, provider of BM extract and placebo) mentioned.

All Effects:

Findings:

Six reviewed trials, all conducted over 12 weeks, found that Bacopa improved performance on 9 of 17 tests in the domain of memory free recall. There was little evidence of enhancement in other cognitive domains, possibly due to inconsistent measures. The review concludes there is some evidence Bacopa improves memory free recall, but evidence for other cognitive enhancements is currently lacking.

Participants:

Adult humans without dementia or significant cognitive impairment.

Dosage:

300-450 mg extract per day, administered over long-term supplementation periods (trials were all conducted over 12 weeks).

Study Quality Assessment:

Systematic review of randomized controlled trials. Relevant trials were objectively assessed for methodological quality. Six studies met inclusion criteria. Limitations noted: research is in its infancy, effects across all human cognitive abilities not yet investigated, future research should examine varied dosages and different extracts, inconsistent measures employed by studies for some cognitive domains.