Neuroprotective effect and possible mechanisms of the extract of ginkgo biloba for spinal cord injury in experimental animal: a meta-analysis and systematic review

Spinal cord injury (SCI) is a major challenge in the medical community because of its difficulty in treatment and poor prognosis. Extract of ginkgo biloba (EGb) has been widely used in the prevention and treatment of age-related neurosensory disease, which is considered to have the effect of neuroprotection. We performed a systematic review to evaluate the neurobiological roles of EGb for treating SCI in rats. Pubmed, Embase, Sinomed and China National knowledge Infrastructure were searched from their inception dates to April 2024, and 30 articles were included. The quality score of the included studies ranged from 4 to 7 out of 10 points, and all of them were randomization. It was shown that after SCI, EGb administration could significantly improve motor function (WMD = 2.09 [1.59, 2.59], p < 0.00001). Subgroup analysis concluded that EGb at the doses of 10-50 mg/kg improved the motor function to the greatest extent. In comparison with the control group, EGb administration could reduce lipid peroxidation and inhibit inflammation (MDA: SMD = -1.43 [-5.05,2.20], p < 0.00001; iNOS: WMD = -22.17 [-35.45, -8.90], p < 0.00001). In addition, this review suggested that EGb can antagonize inflammation, reduce oxidative stress to inhibit the lipid peroxidation and resistance to apoptosis, promote nerve growth and reduce myelin loss on SCI. Preclinical grade suggests that, collectively, EGb may be a promising natural neuroprotective agent on SCI with unique advantages and mechanisms of action. More clinical randomized, blind controlled trials are also needed to confirm the neuroprotective effect of EGb on SCI.