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The Cognitive-Enhancing Effects of Bacopa monnieri: A Systematic Review of Randomized, Controlled Human Clinical Trials


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Traditional knowledge suggests that Bacopa monnieri enhances cognitive performance. Such traditional beliefs have now been scientifically tested through a handful of randomized, controlled human clinical trials. The current systematic review aimed to examine the scientific evidence as to whether Bacopa can enhance cognitive performance in humans. A systematic review of randomized controlled trials is presented. Multiple databases were systematically searched by multiple authors. Relevant trials were objectively assessed for methodological quality. The subjects studied were adult humans without dementia or significant cognitive impairment. Interventions: B. monnieri, including Bacopa extracts, were administered over long-term supplementation periods. Any validated cognitive test, whether a primary or secondary outcome. Six (6) studies met the final inclusion criteria and were included in review. Trials were all conducted over 12 weeks. Across trials, three different Bacopa extracts were used at dosages of 300-450 mg extract per day. All reviewed trials examined the effects of Bacopa on memory, while other cognitive domains were less well studied. There were no cognitive tests in the areas of auditory perceptual abilities or idea production and only a paucity of research in the domains of reasoning, number facility, and language behavior. Across studies, Bacopa improved performance on 9 of 17 tests in the domain of memory free recall. There was little evidence of enhancement in any other cognitive domains. There is some evidence to suggest that Bacopa improves memory free recall with evidence for enhancement in other cognitive abilities currently lacking perhaps due to inconsistent measures employed by studies across these cognitive domains. Research into the nootropic effects of Bacopa is in its infancy, with research still yet to investigate the effects of Bacopa across all human cognitive abilities. Similarly, future research should examine the nootropic effects of Bacopa at varied dosages and across different extracts.
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Review Article
The Cognitive-Enhancing Effects of Bacopa monnieri:
A Systematic Review of Randomized, Controlled
Human Clinical Trials
Matthew P. Pase, BSc, BA(Hons),
James Kean, BSc(Hons),
Jerome Sarris, MHSc, PhD,
Chris Neale, BSc, MSc,
Andrew B. Scholey, PhD,
and Con Stough, PhD
Objectives: Traditional knowledge suggests that Bacopa monnieri enhances cognitive performance. Such tradi-
tional beliefs have now been scientifically tested through a handful of randomized, controlled human clinical
trials. The current systematic review aimed to examine the scientific evidence as to whether Bacopa can enhance
cognitive performance in humans.
Design: A systematic review of randomized controlled trials is presented. Multiple databases were systemati-
cally searched by multiple authors. Relevant trials were objectively assessed for methodological quality.
Subjects: The subjects studied were adult humans without dementia or significant cognitive impairment.
Interventions: B. monnieri, including Bacopa extracts, were administered over long-term supplementation periods.
Outcome measures: Any validated cognitive test, whether a primary or secondary outcome.
Results: Six (6) studies met the final inclusion criteria and were included in review. Trials were all conducted
over 12 weeks. Across trials, three different Bacopa extracts were used at dosages of 300–450 mg extract per day.
All reviewed trials examined the effects of Bacopa on memory, while other cognitive domains were less well
studied. There were no cognitive tests in the areas of auditory perceptual abilities or idea production and only a
paucity of research in the domains of reasoning, number facility, and language behavior. Across studies, Bacopa
improved performance on 9 of 17 tests in the domain of memory free recall. There was little evidence of
enhancement in any other cognitive domains.
Conclusions: There is some evidence to suggest that Bacopa improves memory free recall with evidence for
enhancement in other cognitive abilities currently lacking perhaps due to inconsistent measures employed by
studies across these cognitive domains. Research into the nootropic effects of Bacopa is in its infancy, with
research still yet to investigate the effects of Bacopa across all human cognitive abilities. Similarly, future research
should examine the nootropic effects of Bacopa at varied dosages and across different extracts.
Bacopa monnieri (L.) Wettst.(syn.Bacopa monniera
Hayata & Matsum), from the family Scrophulariaceae, is a
perennial creeping herb that thrives in damp soils and marshes
throughout the subcontinent. Bacopa has long been renowned
for its medicinal properties. This has been documented in the
sixth-century Ayurvedic text, the Caraka Samhita,wherebyBa-
copa is recommended for the treatment of various mental con-
Of late, Western medicine has shown interest in this
ancient herb as a potential cognitive enhancer.
Studies conducted on animals were among the first to
investigate the cognitive- enhancing effects of Bacopa.
an alcoholic extract (40 mg/kg orally for 3 days), Singh and
Dhawan showed that Bacopa improved learning in a shock-
motivated brightness discrimination task and attenuated
memory deficits induced by the administration of various
Preclinical work suggests that Bacopa’s mech-
anisms of action on the central nervous system are varied
and include antioxidant activity (across various Bacopa ex-
b-amyloid scavenging properties (Bacopa ethanol
extract: 40 or 160 mg/kg orally),
protection against b-
amyloid-induced cell death (Bacopa ethanol extract adminis-
tered to cultured neurons),
modulation of frontocortical and
hippocampal acetylcholine levels (5–10 mg/kg Bacopa extract
administered to animal models of Alzheimer disease),
Centre for Human Psychopharmacology, Faculty of Life and Social Sciences, Swinburne University of Technology, Hawthorn, Australia.
Department of Psychiatry, Faculty of Medicine, The University of Melbourne, Melbourne, Australia.
Volume 18, Number 7, 2012, pp. 1–6
ªMary Ann Liebert, Inc.
DOI: 10.1089/acm.2011.0367
modulation of cholinergic neuron densities (Bacopa ethanol
extract: 20–80 mg/kg orally ).
Such effects of Bacopa have
been attributed to the saponins contained within Bacopa,
most notably that of bacoside A.
Of late, there have been a large number of studies ex-
ploring the cognitive-enhancing effects of Bacopa in humans.
Although a previous review has provided an excellent
general overview of Bacopa’s reputed health benefits,
to the
authors’ knowledge, no study has systematically reviewed
the cognitive-enhancing effects of Bacopa in humans. Fur-
thermore, since the review by Russo and Borrelli,
key trials in the area have surfaced. Consequently, this re-
view aimed to qualitatively examine the cognitive-enhanc-
ing effects of Bacopa in humans. A qualitative systematic
review of relevant trials was performed to explore the long-
term effects of Bacopa extracts on any validated cognitive
Database searching
The electronic databases SCOPUS, PubMed, and the
Cochrane Library were searched until April 2011 by com-
bining the following key words and truncations: cognit* or
memory or neuropsycholog* or neurocognit* or executive
function* with bacopa or brahmi or bacoside* or water
hyssop. Searching was limited to randomized controlled
trials conducted in adult humans. Forward searchers were
performed on all trials meeting the inclusion criteria using
Trial selection
Located trials were considered appropriate for review if
they used Bacopa as a monotherapy, examined the effects of
Bacopa on valid cognitive outcomes, used a randomized and
controlled design, and had adequate methodologic quality as
defined by a score of at least 5 on the augmented Jadad scale.
To limit heterogeneity at the study level, trials were only
considered appropriate for review if they were conducted in
adult samples without cognitive impairment and if they
administered Bacopa daily over a long-term supplementation
period, defined as 4 or more weeks. Articles of all languages
were considered appropriate for review.
Quality rating
Each trial was analyzed for methodologic quality using a
purpose-designed modified Jadad scale
as first developed
in Sarris and Byrne.
Using the modified Jadad scale, studies
were objectively assessed for quality and given 1 point when
each of the following criteria was satisfied: (1) Was the study
described as randomized? (2) Was the randomization pro-
tocol detailed and appropriate? (3) Was the study described
as double-blind? (4) Was the blinding process detailed and
appropriate? (5) Did the study have a control group? (6) Was
the control detailed and appropriate? (7) Were there ade-
quate exclusion criteria? (8) Was the intervention used at a
therapeutic dose? (9) Was there a description of withdrawals
and dropouts? and (10) Were the data clearly and adequately
reported? Using this scale, each trial was given a score be-
tween 0 and 10, with higher scores reflecting superior
methodologic quality.
Any valid test of cognitive performance was considered ap-
propriate for review, whether a primary or secondary outcome.
Cognitive tests were grouped into true cognitive abilities, as
guided by the extensive factor analytic work by Carroll.
cognitive abilities include the following: (1) reasoning, which
includes general, quantitative, syllogistic, and verbal reasoning
as well as induction; (2) language behavior, which includes
vocabulary, spelling ability, phonetic coding, and verbal com-
prehension; (3) memory, which includes associative memory,
free recall, visual memory, and memory span; (4) visual per-
ception, which includes figural relations, closure speed, and
perceptual speed; (5) auditory perception, which includes pitch
discrimination; (6) number facility, which includes the ability to
compute basic numerical operations; (7) mental speed, which
includes processing speedand simple reaction time; and (8) idea
production, which includes abilities in producing words, ideas,
and figural creations such as originality and word fluency.
Data handling
The systematic review process, including article searching
and assessment of inclusion criteria, was completed indepen-
dently by 3 researchers (JK, CN, and MPP) with disagree-
ments resolved according to consensus of the entire research
group. Four (4) authors (MPP, JK, CN, and JS) independently
rated the methodologic quality of each study using the mod-
ified Jadad scale again, with results later compared and a final
score agreed upon according to group consensus. The data
gathered from each study included general study descriptives
as well as all cognitive outcomes and their reported signifi-
cance. Cognitive outcomes from each study were grouped into
the true cognitive abilities by 2 neuroscientists (MPP and CS).
To limit the likelihood of a Type I error, the following protocol
was followed. First, when a study had multiple testing time
points, only the results from the longest follow-up time point
were included in review. Second, a single cognitive test, from
any given study, was only grouped into the one cognitive
ability most representative of the original task.
Of the 64 located studies, 10 were deemed to be relevant
randomized controlled trials (Fig. 1). Of these 10 trials, 4
were excluded for not meeting the inclusion criteria, leaving
6 studies for review.
The characteristics of the six studies included in this review
are shown in Table 1. Studies were relatively homogeneous. All
were conducted over an intervention period of 12 weeks and all
were randomized, parallel group, double-blind, and placebo-
controlled trials. Sample populations were comparable both in
age range and in that subjects tended to be healthy without any
chronic illnesses. Although one study recruited a sample with
subjective memory complaints, the sample was apparently free
from cognitive impairment.
Despite no studies using intention-
to-treat analysis, the average quality of trials was high (modified
Jadad scale mean score =8.5/10).
With respect to the interventions, three studies used
KeenMindBacopa supplements, two used BacoMind,
one used Mediherb
. Across supplements, extract dosages
ranged from 300 to 450 mg per day. The KeenMind Bacopa
supplement is derived from the stems, leaves, and roots of
Bacopa and is extracted with 50% ethanol. BacoMind is a
Bacopa supplement, extracted from alcohol and standardized
to contain nine active constituents.
Both KeenMind and
BacoMind have an herb-to-extract ratio of 20:1, and both
provide a daily oral dosage equivalent to 6000–9000 mg of
dried herb. The Mediherb supplement is manufactured from
the dried aerial portions of Bacopa extracted with a methanol-
to-water ratio of 70:30. The one study to use the Mediherb
Bacopa extract supplemented at 300 mg extract per day. The
dry extract ratio is 50:1, providing a daily oral dosage
equivalent to 1500 mg of dried herb.
Table 2 outlines the cognitive tests used in each study
grouped into the true cognitive abilities defined by Carroll.
This method of grouping allows for all cognitive outcomes to
be compared across studies. As seen in Table 2, bold font is
used to indicate when performance on a cognitive test was
significantly improved by Bacopa, as reported in the original
study. Across trials, there were no cognitive tests in the areas
of auditory perceptual abilities or abilities in producing and
retrieving words, ideas, and figural creations. Only two
studies examined the effects of Bacopa on reasoning abilities,
with no evidence of any enhancement following Bacopa
Only one study investigated the effects
of Bacopa on language behavior
and one study investigated
its effects on number facility,
again without any evidence of
improvement in either of these cognitive abilities following
Bacopa. Five (5) studies used a total of nine cognitive tests
indicative of visual perceptual abilities.
The only two
of these tasks to show any enhancement following Bacopa
were the Stroop (reduced reaction time)
and rapid visual
information-processing tasks (fewer false alarms).
Three (3)
studies (six cognitive tests in total) measured the effects of
Bacopa on mental speed.
The only task showing im-
provement after Bacopa was inspection time,
with no re-
ductions evident in choice or simple reaction time.
Every study included in this review administered tests of
memory. Given the richness of information available, this
factor was subdivided into the more specific facets of
memory identified by Carroll.
These domains include (1)
memory span: the quantity of information one can recall in
order following a single exposure to the information; (2)
associative memory: the ability to recall or recognize infor-
mation paired (associated) with other arbitrary information;
(3) free recall memory: recall of arbitrary information when
the information to be recalled exceeds the quantity of one’s
memory span; (4) meaningful memory: the ability to recall or
recognize information when the information to be remem-
bered has meaning; and (5) visual memory: recall or recog-
nition of visual material that cannot be easily recoded into a
nonvisual modality.
The long-term effects of Bacopa ad-
ministration on these abilities of memory are also presented
in Table 2. Again, a cognitive task is highlighted in bold font
if performance on the task was improved by Bacopa, as re-
ported in the original study.
As displayed in Table 2, the majority of tests were in the
domain of free recall memory, with the most frequently used
test being the auditory verbal learning test. Of the 17 tasks in
this domain, 9 reported a significant effect of Bacopa on free
recall memory.
Of the six tests representative of mem-
ory span, performance on only one task was significantly
improved by Bacopa.
There were four tasks in the domain of
meaningful memory involving the recall of short stories and
None of these tasks was improved by Bacopa.In
FIG. 1. Systematic review
flowchart. RCT, randomized
controlled trial.
Table 1. Study Characteristics of Trials Included in Review
Author/year Herb/daily dose
content Design
(%) Sample
(%) ITT
Barbhaiya 2008
450 mg
12 65 5 Memory complaints but no
severe cognitive problems
Visual P
Number F
65 yr 66 N 9/10
Calabrese 2008
300 mg
Min. 50% DB
12 54 11 Adults over 65 without
memory complaints or
signs of dementia
Visual P
74 yr 40 N 9/10
Morgan 2010
300 mg
40%–50% DB
12 98 17 Healthy adults over 55 yr
without neurological or
psychiatric illness
Visual P
65 yr 47 N 10/10
Roodenrys 2002
300 mg if subject <90 kg
& 400 mg if >90 kg
55% DB
12 84 10 Healthy adults not taking
medications or herbal
Mental S
49 yr 37 N 6/10
Stough 2001
300 mg
Min. 55% DB
12 46 NS Healthy. No physical or
psychiatric conditions and
no medications
Language B
Visual P
Mental S
39 yr 24 N 8/10
Stough 2008
300 mg
Min. 55% DB
12 107 42 Healthy. No neurological or
psychiatric disease. No
cognitive enhancing drugs
Visual P
Mental S
43 yr 34 N 9/10
Duration of supplementation.
All cognitive abilities investigated are listed, regardless of significance.
Quality rating based on augmented Jadad scale.
BM, Bacopa monnieri; DB, double-blind; PC, placebo-controlled; PG, parallel groups; ITT, intention-to-treat analysis used; NS, not specified; yr, years; Visual P, Visual perception; Mental S, mental
speed; Language B, language behavior; Number F, number facility.
Performance on only one of these tasks was
significantly enhanced by Bacopa supplementation.
The current systematic review of randomized, controlled
trials revealed some evidence to suggest that Bacopa is effica-
cious in improving the learning and free recall of information.
This suggests that Bacopa could potentially be clinically pre-
scribed as a memory enhancer. At present, there is insufficient
evidence to suggest that Bacopa improves other domains of
cognitive performance in healthy nondemented subjects. Al-
though this may reflect heterogeneity in the cognitive tests used
across studies, available evidence suggests that Bacopa is more
efficacious in improving memory free recall than other aspects
of cognitive performance. This review also highlights the focus
on testing the memory-enhancing effects of Bacopa at the ex-
pense of other cognitive domains.
The focus toward testing memory over other cognitive
domains most probably stems from Bacopa’s long-standing
Ayurvedic reputation as a potent ‘‘memory enhancer.’’ Al-
though the first randomized controlled human clinical trial
to explore the long-term effects of Bacopa on cognition re-
ported both enhancement in memory and cognitive speed,
follow-up research has not given mental speed (or other
cognitive domains) the same attention as memory.
Between studies, there was remarkable homogeneity in
the durations of supplementation and dosage sizes with all
trials supplementing for 12 weeks. Studies using the same
Bacopa extracts tended to supplement at comparable dosages,
with KeenMind used at 300–400-mg extract across three
studies and BacoMind used at 300–450-mg extract across two
studies. This indicates that trials in the area have generally
adhered to the recommended daily dosages. To advance
current knowledge, future research in the area is required to
manipulate dosage sizes and supplementation durations.
Given that studies using Bacopa acutely have not produced
significant findings
and that long-term studies have all
been of short duration (3 months), future studies are needed
to explore the effects of Bacopa on human cognition over
longer supplementation periods. The implementation of
longer supplementation periods may also allow for exami-
nation of the effects of Bacopa on cognitive decline.
The current review provides future studies with the jus-
tification for examining the effects of Bacopa on memory free
recall. However, future research is also required to investi-
gate the effects of Bacopa on those cognitive abilities that have
been overlooked, including reasoning, mental speed, idea
production, language behavior, and number facility.
Strengths of the current review include the breadth of
literature searched, the conformity to Preferred Reporting
Items for Systematic Reviews and Meta-Analyses (PRISMA)
the objective assessment of trial quality by nu-
merous authors, and the stringent inclusion criteria em-
ployed. Importantly, trials were rather homogeneous in
terms of sample populations, supplementation periods, and
administered dosages. Furthermore, included trials were of
high quality and all were randomized, placebo-controlled,
and double-blind, extending confidence to the cumulative
results. The following limitations warrant discussion. This
review was limited to qualitative analysis, given the varia-
tion in cognitive tests used between studies and the fact that
different extracts of Bacopa were compared. An objective
meta-analysis in this area is impractical, given that most
Table 2. Neuropsychologic Tests of Each Study Grouped into True Cognitive Abilities
Ability Cognitive tests
Reasoning Trail-making test B (Stough, 2001); Trail-making test B (Morgan, 2010)
Visual Perception DS coding & Digit cancellation (Barbhaiya, 2008); Stroop** & Divided attention task (Calabrese,
2008); Trail-making A (Morgan, 2010); Trail-making A & DS coding (Stough, 2001); Digit
vigilance & RVIP* (Stough, 2008)
Language behavior Speed of comprehension test sentences (Stough, 2001)
Number Facility Serial subtraction (Barbhaiya, 2008)
Mental Speed Inspection time,* SRT, CRT (Stough, 2001); SRT & CRT (Stough, 2008); speeded coding task
(Roodenrys, 2002)
Free recall Memory AVLT IR & AVLT DR* (Barbhaiya, 2008); AVLT DR* & AVLT IR (Calabrese, 2008); AVLT trial 1,
AVLT trial 2, AVLT trial 3, AVLT trial 4,*** AVLT trial 5,* AVLT trial 6*** & AVLT trial 7
(DR)** (Morgan, 2010); AVLT learning rate,* AVLT forgetting rate,* AVLT proactive
interference* & AVLT retroactive interference (Stough, 2001); immediate word recall & delayed
word recall (Stough, 2008)
Associative Memory Paired associates similar IR, Paired associates dissimilar IR, Paired associates similar DR & Paired
associates dissimilar DR* (Barbhaiya, 2008); Word pairs DR,* Word pairs trial 1, Word pairs
trial 2 & Word pairs trial 3 (Roodenrys, 2002)
Memory Span DS backward** & DS forward (Barbhaiya, 2008); DS forward & DS backward (Roodenrys, 2002);
DS forward, DS backward
Visual Memory Visual retention I,* Visual retention II (Barbhaiya, 2008); WAIS letter-digit (Calabrese, 2008); Rey
complex figure copy, Rey complex figure IR, Rey complex figure DR (Morgan, 2010); Visual
span (Roodenrys, 2002); Spatial WM, Numeric WM, Delayed Picture rec (Stough, 2008)
Meaningful Memory Passages IR & Passages DR (Barbhaiya, 2008); Short story DR & Short story IR (Roodenrys, 2002)
DS, digit symbol; RVIP, rapid visual information processing; SRT, simple reaction time; CRT, choice reaction time; AVLT, auditory verbal
learning test; IR, immediate recall; DR, delayed recall; WAIS, Wechsler Adult Intelligence Scale; WM, working memory; rec, recognition.
*p<0.05, **p<0.01, ***p<0.001. Bold font is used to indicate when performance on a cognitive test was significantly improved by bacopa, as
reported in the original study.
relevant studies have utilized multiple cognitive tests indic-
ative of a single cognitive ability. Thus, hand picking one of
many cognitive tests to include in meta-analysis, in order to
satisfy the independence of samples assumption, would be a
subjective and therefore flawed exercise. As variations in
quality and bacoside content exist between Bacopa products,
different products may differentially affect cognitive out-
comes. This is something not accounted for when results were
pooled in the current review. Only through continued re-
search into the cognitive-enhancing effects of Bacopa will any
differential effects between supplements become evident.
ThereissomeevidencetosuggestthatBacopa enhances
memory free recall in nondemented subjects, and thus Bacopa
could potentially be clinically prescribed as a memory en-
hancer. At present, there is insufficient evidence to suggest that
Bacopa can enhance other domains of cognitive performance.
This may reflect heterogeneity in the measures employed by
studies across these cognitive domains. Research into the cog-
nitive-enhancing effects of Bacopa is still in its infancy, with
future research required to explore the cognitive-enhancing
effects of Bacopa at different dosages, over longer supplemen-
tation periods, and in specific populations. Future research is
also required to explore the effects of Bacopa on those cognitive
domains shown to be under-researched in the current review.
Matthew P. Pase is funded by a Menzies Foundation
Scholarship in Allied Health Science. Jerome Sarris is funded
by an Australian National Health & Medical Research
Council Trainee Fellowship (NHMRC funding ID 628875).
The review was funded in part by an Australian Research
Council (ARC DP1093825) Discovery grant to Con Stough
and Andrew B. Scholey.
Disclosure Statement
No competing financial interests exist for any authors. All
authors declare no conflicts of interest.
1. Russo A, Borrelli F. Bacopa monniera, a reputed nootropic
plant: An overview. Phytomedicine 2005;12:305–317.
2. Prakash J, Sirsi M. Comparative study of the effects of
Brahmi and chlorpromazine on motor learning in rats. J Sci
Ind Res 1962;21:93–96.
3. Singh HK, Dhawan BN. Neuropsychopharmacological ef-
fects of the Ayurvedic nootropic Bacopa monniera Linn.
(Brahmi). Ind J Pharmacol 1997;29:S359–S365.
4. Bhattacharya SK, Bhattacharya A, Kumar A, Ghosal S. An-
tioxidant activity of Bacopa monniera in rat frontal cortex,
striatum and hippocampus. Phytother Res 2000;14:174–179.
5. Russo A, Izzo AA, Borrelli F, et al. Free radical scavenging
capacity and protective effect of Bacopa monniera L. on DNA
damage. Phytother Res 2003;17:870–875.
6. Kapoor R, Srivastava S, Kakkar P. Bacopa monnieri modu-
lates antioxidant responses in brain and kidney of diabetic
rats. Environ Toxicol Pharmacol 2009;27:62–69.
7. Dhanasekaran M, Tharakan B, Holcomb LA, et al. Neuro-
protective mechanisms of Ayurvedic antidementia botanical
Bacopa monniera. Phytother Res 2007;21:965–969.
8. Holcomb LA, Dhanasekaran M, Hitt AR, et al. Bacopa mon-
niera extract reduces amyloid levels in PSAPP mice. J Alz-
heimer’s Dis 2006;9:243–251.
9. Limpeanchob N, Jaipan S, Rattanakaruna S, et al. Neuro-
protective effect of Bacopa monnieri on beta-amyloid-induced
cell death in primary cortical culture. J Ethnopharmacol
10. Bhattacharya SK, Kumar A, Ghosal S. Effect of Bacopa mon-
niera on animal models of Alzheimer’s disease and per-
turbed central cholinergic markers of cognition in rats. Res
Commun Pharmacol Toxicol 1999;4:II1–II12.
11. Uabundit N, Wattanathorn J, Mucimapura S, Ingkaninan K.
Cognitive enhancement and neuroprotective effects of Ba-
copa monnieri in Alzheimer’s disease model. J Ethno-
pharmacol 2010;127:26–31.
12. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality
of reports of randomized clinical trials: Is blinding neces-
sary? Control Clin Trials 1996;17:1–12.
13. Sarris J, Byrne GJ. A systematic review of insomnia and
complementary medicine. Sleep Med Rev 2011;15:99–106.
14. Carroll JB. Human cognitive abilities: A survey of factor ana-
lytic studies. New York: Cambridge University Press, 1993.
15. Joshua Allan J, Damodaran A, Deshmukh NS, et al. Safety
evaluation of a standardized phytochemical composition
extracted from Bacopa monnieri in Sprague-Dawley rats.
Food Chem Toxicol 2007;45:1928–1937.
16. Barbhaiya HC, Desai RP, Saxena VS, et al. Efficacy and
tolerability of BacoMind
on memory improvement in el-
derly participants: A double blind placebo controlled study.
J Pharmacol Toxicol 2008;3:425–434.
17. Stough C, Lloyd J, Clarke J, et al. The chronic effects of an extract
of Bacopa monniera (Brahmi) on cognitive function in healthy
human subjects. Psychopharmacology 2001;156:481–484.
18. Morgan A, Stevens J. Does Bacopa monnieri improve memory
performance in older persons? Results of a randomized,
placebo-controlled, double-blind trial. J Altern Complement
Med 2010;16:753–759.
19. Calabrese C, Gregory WL, Leo M, et al. Effects of a stan-
dardized Bacopa monnieri extract on cognitive performance,
anxiety, and depression in the elderly: A randomized, dou-
ble-blind, placebo-controlled trial. J Altern Complement
Med 2008;14:707–713.
20. Stough C, Downey LA, Lloyd J, et al. Examining the nootropic
effects of a special extract of Bacopa monniera on human cog-
nitive functioning: 90 day double-blind placebo-controlled
randomized trial. Phytother Res 2008;22:1629–1634.
21. Roodenrys S, Booth D, Bulzomi S, et al. Chronic effects of
Brahmi (Bacopa monnieri) on human memory. Neuropsycho-
pharmacology 2002;27:279–281.
22. Nathan PJ, Clarke J, Lloyd J, et al. The acute effects of an extract
of Bacopa monniera (Brahmi) on cognitive function in healthy
normal subjects. Hum Psychopharmacol 2001;16:345–351.
23. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting
items for systematic reviews and meta-analyses: The
PRISMA statement. PLoS Med 2009;6:1–6.
Address correspondence to:
Matthew P. Pase, BSc, BA(Hons)
Centre for Human Psychopharmacology
Faculty of Life and Social Sciences
Swinburne University of Technology
Hawthorn 3122
... Pase et al. (2012) The cognitive-enhancing effects of Bacopa monnieri: a systematic review of randomized, controlled human clinical trials. J Altern Complement Med.2 Aguiar & Borowski (2013). ...
Full-text available
Memostim® is a phytonootropic agent, containing standardized BM extract (150 mg per capsule) and Ginkgo biloba extract (120 mg per capsule), providing the whole daily dose of both components. Memostim® is registered in United Kingdom and sold in United States under trade name Memoboost®. As shown in a clinical trial of Memostim® (Memoboost®)[1], its use in the patients with dyscirculatory encephalopathy (term, commonly used in Ukraine, which corresponds more widely used term “cerebral small vessel disease”) during 3 months can ameliorate the clinical signs of this disturbance, particularly, increasing the level of neurotrophic factors (nerve growth factor-beta) up to 67%. Memostim® (Memoboost®) reduced manifestations of cognitive dysfunction, improving memory and attention. Positive influence of BM extract on the cognitive functions was followed by decreasing of manifestations of anxiety-depressive syndrome, as well increasing of the quality of life of the patients. Bacopa is a very promising medicine for cognitive dysfunction, and has a favorable safety profile with a long history of use in humans. If you or your patients suffer from cognitive dysfunction, consider performing a study on their cognitive function before and after a period of Bacopa use (>1 month is required to notice statistically significant improvements in prior clinical trials). Dosing should not be on an empty stomach, which can result in gastrointestinal upset, as Bacopa is a pro-cholinergic agent. Bacopa should be taken with food. Absorption and bioavailability of the active constituents of Bacopa, such as the bacosides, may be enhanced by co-administering a lipid such as coconut milk / medium chain triglycerides, fish oil (EPA/DHA), avocado, or other fatty foods. Bacopa can be taken any time of day, but some users report improved sleep quality when dosed prior to bed.
... [55] A systematic review of six randomized controlled trials observed that Bacopa improves memory-free recall and cognitive abilities in studies across the cognitive domains. [56] Evidence from animal trials has consistently suggested its anxiolytic or antidepressant effects. [57,58] One trial has explored its safety and efficacy in enhancing cognitive performance in participants with age 65 or more. ...
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Background: Insomnia is connected with a lifted hazard for neurocognitive dysfunction and psychiatric disarranges. Clinical observations of psychosomatic patients indicate that their distorted somatopsychic functioning necessitates their practice of yoga-like therapy. Sleep and its modifications and management have also been explained well in ayurveda. This study aimed to compare the effectiveness of Yoga and Nasya Karma on the sleep quality, stress, cognitive function, and quality of life of people suffering from acute insomnia. Material and methods: It was an open-label, randomized controlled trial. A total of 120 participants were randomly (computer-generated randomization) equally allocated to three groups, yoga group (G-1), ayurveda group (G-2), and control group (G-3). All the groups were assessed on the first day before the start of the yoga regime and the 48th day. Participants in the study were included in the age group of 18 to 45 years, fulfilling DSM-V criteria for insomnia, physically fit for the yoga module, and Nasya procedure. Outcomes were measured by the Pittsburgh Sleep Quality Index (PSQI) questionnaire, Perceived Stress Scale (PSS), cognitive failure questionnaire, and WHO Quality of Life Scale-Brief (WHOQOL-Brief). Proportions and frequencies were described for categorical variables and compared using the Chi-square test. ANOVA (one-way) and post hoc analysis, Bonferroni test, were performed for multiple comparisons in groups at a significance level of P < 0.05 using SPSS (23 version). Results: A total of 112 participants were analyzed as per protocol analysis. All groups have observed significant mean differences for stress (<0.05) and sleep quality (<0.05). All five aspects of quality of life - general health (<0.05), physical health (<0.01), psychological health (<0.05), social health (<0.05), and environmental health (<0.05) - had a significant mean difference in all three groups. All three aspects of cognitive failure, forgetfulness (<0.05), distractibility (<0.05), and false triggers (<0.01) had a significant mean difference in scores for all three groups. Conclusion: Yoga practice was effective, followed by ayurveda and the control group in reducing stress and improving sleep, cognitive function, and quality of life.
... The study of Bacopa's nootropic effects is still in its early stages, with more research needed to look at the impacts of Bacopa across all human cognitive capacities. [400] Srinibash Sahoo et al., also reported the efficacy of Brahmi ghrita and Jyotishmathitaila in cognitive deficit children's. Brahmi ghrita has given orally in a dose of 10 gms twice daily with warm water/milk before food and Jyotishmatitaila given as Pratimarsha Nasya (2-2 drops) in each nostril twice daily for a period of 12 weeks to evaluate the effect on clinical symptoms of cognitive deficit and changes in mini-mental state examination. ...
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Throughout history, complementary and alternative therapies have been widely utilised. In recent years, there has been a surge in interest in the usage of herbal treatments all around the world. Various natural chemicals, such as those produced from plants, have been investigated as potential therapies for a myriad of ailments. The essence of this review was to methodically describe everything we know about Bacopa monnieri (L.) Pennell, a mysterious holistic Vedic herb belonging to the Plantaginaceae family, a well-known nootropic and effective memory enhancer, which has recently emerged as one of the most important medical herbs, widely used therapeutically in the Orient and growing in popularity around the world. Literature was gathered from sources such as Scopus, PubMed, Google Scholar, and ScienceDirect, and reviewed using the Prisma quality metacritic paradigm. It is now plainly obvious that current therapies fall short of meeting the demands of the vast majority of individuals with health problems, and traditional medicines are gaining appeal as a result of their reduced toxicity. Bacopa is a traditional herb used in Ayurvedic medicine to treat brain and nerve weariness, as well as in Siddha medicine to treat impaired memory. It's also used to cure brain and nerve exhaustion in Unani medicine. We improved Brahmi micropropagation and secondary metabolite biosynthesis by compiling pharmacobotanical and pharmacognostical descriptions, as well as ethnoarchaeological data and nanotechnology domination. This critique also highlights our contemporary information of pharmacological activity, preclinical and clinical investigations, significant bioactives, reported mechanisms of action, clinical effectiveness, safety, and the potential for herb-drug interactions. At the same time, the current incarnation of research at the plant is reviewed, as well as future research possibilities. Brahmi offers a lot of potential for treating a range of illnesses, including neuro-pharmacological, depression, inflammation, hepatoprotective, antidiabetic, and others. According to the presumptions of this review, further clinical trials and research are needed. While the impact of Brahmi as an anxiolytic and antidepressant has to be explored further, its potential as an anti-epileptic therapy and a treatment for antiepileptic drugs side effects is also being researched. Furthermore, Brahmi's antioxidant ability may explain, at least in part, the antistress, immunomodulatory, cognition-facilitating, anti-inflammatory, and anti-aging benefits documented in experimental animals and clinical circumstances, necessitating further study into its other therapeutic characteristics.
... In pharmacological and clinical trials, Centella asiatica has been found to improve the power of concentration, general ability and behaviour of mentally retarded children [54] . Bacopa monnieri can improve attention, cognitive processing, and working memory partly via the suppression of plasma Acetylcholinesterase activity [55] hence, its consumption can enhance memory recall [56,57] . Withania somnifera stimulates the growth of axons and dendrites in human neuroblastoma cells and rat neurons [58,59] and it also enhances cognition and improves memory effects [60,61] . ...
Medicinal plants are rich sources of secondary metabolites which are commonly used in treating and preventing various diseases. Among different secondary metabolites, terpenoids play an important role as signaling compounds and growth regulators in plants. Besides these, terpenoids also have medicinal properties which are effectively used in treating common Central Nervous System disorders such as anti-Parkinson´s disease, anti-Alzheimer’s disease, anti-malarial, anti-ulcer, hepaticidal, etc. Terpenoids were also known for their potential role in improving intelligence, memory-enhancing, and exerting antidepressant and antianxiety effects. The availability of medicinal plants in nature is an indication for combating various diseases since synthetic drugs have serious side effects that negatively affect the treatment outcome. Thus, the need to strengthen the research on reservoirs of phytochemicals that are present abundantly in medicinal plants is important for their identification, isolation, and characterization of particular drug-yielding compounds against several diseases. In this review, we have summarised the important potential of medicinal plants’ terpenoids and their effects on Central Nervous System disorders.
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Background The effects of herbs on brain function are often investigated in isolation, yet herbal preparations are often complex combinations of phytochemicals, designed to target widespread mechanisms. Objective To assess the effects of chronic, 12 weeks, supplementation of a multi-ingredient herbal supplement (containing Bacopa monnieri , Gotu kola leaf, Turmeric whole powder, Reishi full spectrum, Rosemary, Cardamom, Holy Basil, Turmeric Wholistic ™ extract, Green Tea & Seagreens) on cognitive function in older adults with subjective memory decline. Secondly, to investigate whether effects are underpinned by shifts in microbial composition and/or metabolism of the herbs. Methods Male and female participants ( N = 128) aged between 55–75 years completed lab-based cognitive assessments, and provided stool and urine samples, at baseline and then following 90 days of multi-ingredient herb, or placebo, supplementation. Results Deficits in memory were observed in response to 90 days of multi-ingredient herbal supplement supplementation but the positive effects were all focused on speed of cognitive task performance, with an additional improvement in the false alarm rate on the rapid visual information processing task. These improvements coincided with an increased presence of tyrosine in the urinary metabolome and this may implicate the role of dopamine in these processing and/or motor speed increases. Finally, multi-ingredient herbal supplementation significantly reduced levels of 3 bacterial species in the gut microbiome and one of these, Sutterella , coincides with lower levels of constipation reported in the multi-ingredient herbal supplement condition. Conclusion A multi-ingredient herbal supplement increases speed of cognitive task performance and increased metabolism of tyrosine suggests that this is modulated by increased dopaminergic activity. Reduced levels of Sutterella in the gut is associated with improved bowel movements of participants. Interpretation of the negative effects on memory are, however, stymied by an unequal randomization of participants into treatment groups pre- and post-COVID 19. Clinical trial registration : identifier NCT05504668.
Bacopa monnieri (common name: Brahmi), is an herb containing a plethora of phytochemicals of extreme medicinal importance. It belongs to the family Scrophulariaceae and occurs in tropical nations. Its use has been well established in both traditional and ayurvedic medicine for its nootropic and neuroprotective attributes. Its age-old use has been as a memory booster and restoring cardiac and nervous system related disorders. In the modern therapeutics, clinical investigations have been carried out to evaluate its role managing Alzheimer’s disease, cancer, diabetes, also hepatotoxicity. The functional active compounds isolated from Brahmi include bacosides, bacopasides, saponins, alkaloids, flavonoids and glycosides.
Objectives: This study aimed to investigate the efficacy of taking Mind Lab Pro, a plant-based nootropic on memory in a group of healthy adults. Auditory, visual, visual working memory, immediate and delayed recall (DR) were assessed. Methods: The study employed a pseudo randomised, double blinded, placebo-controlled design. A total of 49 healthy individuals completed the study with 36 in the experimental group and 13 in the control group. Participants ranged between 20 and 68 years with a mean age of 31.4 ± 14.4 years. Pre and post taking either the Mind Lab Pro supplement or placebo for 30 days. All participants completed the Wechsler Memory Scale Fourth UK Edition (WSM-IV UK). Results: We found that the experimental group significantly improved in all memory subtests assessed (p < 0.05) whilst the control group only significantly improved in auditory memory and immediate recall (p = 0.004 and p = 0.014 respectively). A significant difference in immediate and DR was also found between the control and experimental group (p = 0.005 and 0.034 respectively). Conclusion: The use of Mind Lab Pro for 4 weeks improves memory with the experimental group significantly improving in all sub areas of memory as assessed by the WSM-IV UK.
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Alzheimer’s disease (AD) is a neurological condition that worsens with ageing and affects memory and cognitive function. Presently more than 55 million individuals are affected by AD all over the world, and it is a leading cause of death in old age. The main purpose of this paper is to review the phytochemical constituents of different plants that are used for the treatment of AD. A thorough and organized review of the existing literature was conducted, and the data under the different sections were found using a computerized bibliographic search through the use of databases such as PubMed, Web of Science, Google Scholar, Scopus, CAB Abstracts, MEDLINE, EMBASE, INMEDPLAN, NATTS, and numerous other websites. Around 360 papers were screened, and, out of that, 258 papers were selected on the basis of keywords and relevant information that needed to be included in this review. A total of 55 plants belonging to different families have been reported to possess different bioactive compounds (galantamine, curcumin, silymarin, and many more) that play a significant role in the treatment of AD. These plants possess anti-inflammatory, antioxidant, anticholinesterase, and anti-amyloid properties and are safe for consumption. This paper focuses on the taxonomic details of the plants, the mode of action of their phytochemicals, their safety, future prospects, limitations, and sustainability criteria for the effective treatment of AD.
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David Moher and colleagues introduce PRISMA, an update of the QUOROM guidelines for reporting systematic reviews and meta-analyses
Bacopa monniera L. (Syn Herpestis monniera L.) family Scrophulariaceae (Hindi: Brahmi) has been classified in Ayurveda as Medharasayana, drags used to improve memory and intellect. Bacopa monniera (BM), and its active chemical constituents, bacosides A and B, have been shown to facilitate learning acquisition and retention of learning (memory), in a variety of experimental paradigms. Since the mechanism of the cognition-facilitating effect of BM, and its active chemical moeties, remains conjectural, the present study investigated the effect of sub-chronic administration (14 days) of a standardized extract of BM (bacoside A content 82.0 ± 0.5%) on two animal models of Alzheimer's disease, induced by i.c.v. administration of colchicine and by lesioning of nucleus basalis magnocellularis (nbm) with ibotenic acid. Apart from noting the effect of BM on memory deficits induced in these models, the effects of the drug were also assessed on i.c.v. colchicine-induced depletion of acetylcholine (Ach) concentrations, reduction in choline acetyltransferase (ChAT) activity and decrease in muscarinic cholinergic receptor (MCR) binding, in frontal cortex and hippocampus of rats. Lesioning with colchicine or ibotenic acid induced marked deficits in the retention of active avoidance learning, which was evident on day 7, after lesioning, and increased progressively by day 14. Subchronic administration of BM reduced the magnitude of memory deficits induced by both colchicine and ibotenic acid, which was statistically significant at days 7 and 14 with the higher dose (10 mg/kg, p.o.), and on day 14 only with the lower dose (5 mg/kg, p.o.), of BM. BM (10 mg/kg, p.o.) reversed colchicine-induced reduction in frontal cortex and hippocampal Ach, ChAT activity and MCR binding. The effect of the lower dose of BM (5 mg/kg, p.o.) was evident only after 14 days administration. The results indicate that the memory- facilitating effect of BM, and its active chemical constituents, may be due an effect on central cholinergic modulation of memory functions.
A randomized double blind placebo controlled study was designed to evaluate the efficacy and tolerability of BacoMind®, an enriched phytochemical composition from Bacopa monnieri on memory improvement upon chronic administration in elderly subjects as memory loss in elderly people is one of the leading health problems worldwide and its uncertain recovery with conventional therapies has paved way to elucidate the use of complementary and alternative system of medicine. Elderly individuals with mini mental state exammation score of twenty four mid above were enrolled. BacoMind® or placebo was given as a single oral dose of 450 mg daily for the duration of 12 weeks. The combination of well established battery of neuropsychological tests revealed that BacoMind® improved performance in tests associated with attention and verbal memory in elderly participants. Significant interaction effects between group and time were observed in digit span backward test (p = 0.008), list learning delayed recall test (p = 0.014), paired associates dissimilar delayed recall test (p = 0.047) and in visual retention-I test (p = 0.035). In conclusion, the study findings suggested that BacoMind® improved the cognitive functions such as attention and verbal memory in elderly individuals and was also found to be well tolerated.
The active principles of Withania somnifera (WS, 20–50 mg/kg, p.o.), consisting of equimolar amounts of sitoindosides. VII–X and withaferin A, were investigated for putative nootropic activity in an experimentally validated Alzheimer's disease (AD) model. The syndrome was induced by ibotenic acid (IA) lesioning of the nucleus basalis magnocellularis (NBM) in rats. Cognitive deficits induced in NMB-lesioned rats were assessed by attenuation of a learned active avoidance task and a decrease in frontal cortical and hippocampal acetylcholine (ACh) concentrations, choline acetyltransferase (ChAT) activity and muscarinic cholinergic receptor (MCR) binding. IA-induced NBM lesioning in rats caused a marked cognitive deficit, as evidenced by severe reduction of the learned task, and was accompanied by a significant decrease in frontal cortex and hippocampal ACh levels, ChAT activity and MCR binding. WS (50 mg/kg) significantly reversed both IA-induced cognitive deficit and the reduction in cholinergic markers after 2 weeks of treatment. The findings validate the medharasayan (promoter of learning and memory) effect of W. somnifera, as has been reported in Ayurveda.
Role of oxidative stress has been reported in various diabetic complications including neuropathy, nephropathy and cardiopathy. This study was undertaken to evaluate the protective effect of Bacopa monnieri, a medicinal plant, on tissue antioxidant defense system and lipid peroxidative status in streptozotocin-induced diabetic rats. Extract of B. monnieri was administered orally, once a day for 15 days (at doses 50, 125 and 250mg/(kgbw)) to diabetic rats. Activity of antioxidant enzymes (SOD, Catalase, and GPx), levels of GSH and lipid peroxidation were estimated in kidney, cerebrum, cerebellum and midbrain of diabetic rats and compared to reference drug, Glibenclamide. Administration of plant extract to diabetic rats showed significant reversal of disturbed antioxidant status and peroxidative damage. Significant increase in SOD, CAT, GPx activity and levels of GSH was observed in extract treated diabetic rats. The present study indicates that extract of B. monnieri modulates antioxidant activity, and enhances the defense against ROS generated damage in diabetic rats.
In concert with growing public interest in complementary and alternative medicine (CAM), these therapies and products have been increasingly studied over the past two decades for the treatment of sleep disorders. While systematic reviews have been conducted on acupuncture and valerian in the treatment of insomnia, to date no comprehensive review has been conducted on all major CAM treatments. We sought to address this via a rigorous systematic review of hypnotic CAM interventions, including herbal and nutritional medicine, acupuncture, acupressure, yoga, tai chi, massage, aromatherapy and homoeopathy. The electronic databases MEDLINE (PubMed), CINAHL, PsycINFO, and The Cochrane Library were accessed during late 2009 for CAM randomized controlled trials (RCTs) in the treatment of chronic insomnia. Sixty-four RCTs were identified, of which 20 studies involving eight CAM interventions met final inclusion criteria. Effect size calculations (where possible) and a quality control analysis using a modified Jadad scale were undertaken. Many RCTs lacked methodological rigor, and were commonly excluded due to small sample size or an inadequate control condition. Among the studies that met inclusion criteria, there was evidentiary support in the treatment of chronic insomnia for acupressure (d=1.42-2.12), tai chi (d=0.22-2.15), yoga (d=0.66-1.20), mixed evidence for acupuncture and L-tryptophan, and weak and unsupportive evidence for herbal medicines such as valerian. Surprisingly, studies involving several mainstream CAM therapies (e.g., homoeopathy, massage, or aromatherapy) were not located or did not meet basic inclusion criteria. If CAM interventions are to be considered as viable stand-alone or adjuvant treatments for sleep disorders, future researchers are urged to use acceptable methodology, including appropriate sample sizes and adequate controls. RCTs evaluating other untested CAM therapies such as massage, homoeopathy, or osteopathy are encouraged, as is the exploration of using CAM therapies adjuvantly with conventional therapies.