Category:Cognitive circulatory herbs

A cognitive and circulatory herb is a plant medicine used to support cognitive function, cerebral circulation, and the related cognitive-aging indications (mild cognitive impairment, age-associated cognitive decline, post-stroke cognitive recovery). The category overlaps substantially with the adaptogens and with the Ayurvedic medhya rasayana (cognitive-restorative) classification.

The foundational cognitive-circulatory herb in Western use is ginkgo (Ginkgo biloba), the standardised EGb 761 leaf-extract preparation of which has been the subject of more than three hundred controlled clinical trials over the past forty years. The active fraction is composed of flavonoid glycosides (the ginkgo-flavone glycosides, principally quercetin, kaempferol, and isorhamnetin glycosides), terpene lactones (ginkgolides A, B, C, J and bilobalide), and minor proanthocyanidins. The pharmacology combines antiplatelet activity (ginkgolide B is a platelet-activating-factor antagonist), antioxidant action, mild vasodilation of cerebral arterioles, and modulation of the cholinergic and serotonergic neurotransmitter systems. The clinical-trial evidence is mixed: the GEM (Ginkgo Evaluation of Memory) trial in 2008 was negative for the dementia-prevention endpoint over five years in elderly community-dwelling adults, but multiple meta-analyses for established cognitive impairment and dementia show modest benefit comparable to that of the acetylcholinesterase inhibitors. EGb 761 is registered as a medicine in Germany and France for symptomatic treatment of mild-to-moderate dementia.

The Ayurvedic medhya rasayana (cognitive-restorative) class is the parallel Indian tradition. Bacopa (Bacopa monnieri), the principal medhya rasayana, contains the saponin bacosides with substantial controlled-trial evidence for memory consolidation and learning enhancement after eight to twelve weeks of regular use. Gotu kola (Centella asiatica), the second medhya, has historical use for cognitive support and the same modern clinical attention. Ashwagandha (Withania somnifera), described under adaptogens, has cognitive-restorative use as well as its broader stress-resistance indications. Brahmi (the name is shared in Ayurveda between Bacopa monnieri and Centella asiatica, requiring clinical disambiguation) is the umbrella Ayurvedic term.

The TCM cognitive tradition emphasises kidney-essence tonification (the Ayurvedic ojas has a near-equivalent in the TCM jing): reishi (Ganoderma lucidum), gou qi zi (goji, Lycium barbarum), he shou wu (Polygonum multiflorum), and the same Panax ginseng that anchors the adaptogen tradition. The recent Western interest in lion's mane mushroom (Hericium erinaceus, a fungus rather than a plant) for its nerve growth factor-stimulating action has been substantial.

Ginkgo (Ginkgo biloba), bacopa (Bacopa monnieri), gotu kola (Centella asiatica), ashwagandha (Withania somnifera; cross-listed), holy basil (Ocimum tenuiflorum; cross-listed), rosemary (Rosmarinus officinalis), sage (Salvia officinalis), lemon balm (Melissa officinalis; cross-listed), the TCM cognitive tonics dan shen (Salvia miltiorrhiza), goji (Lycium barbarum), he shou wu (Polygonum multiflorum), and the fungal medicines reishi (Ganoderma lucidum) and lion's mane (Hericium erinaceus).

The boundary of this category is "herb whose principal or important indication is cognitive support or cerebral circulation." Herbs whose cognitive-protective action is incidental to a broader adaptogen or nervine indication are cross-listed under adaptogens and nervine herbs. The pharmaceutical cognitive medicines (the cholinesterase inhibitors donepezil, rivastigmine, galantamine; the NMDA-receptor partial antagonist memantine; the recent anti-amyloid monoclonals lecanemab and donanemab) are listed under their primary umbrellas; the herbal interest is in adjunctive and preventive use rather than primary treatment of established dementia.

This category page is an encyclopedia article about its subject. The actual index of herbs belonging to the category is generated automatically by the wiki engine, from category-membership declarations on the individual herb pages, and appears at the foot of the page below the references.