Effects of Boswellia serrata on Improvement of Memory Impairment in Patients with Mild Cognitive Impairment: A Double-blind, Randomized, Placebo-controlled Study

Document Type: Original Article

Authors

1 Assistant Professor, Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Ir

2 Associate Professor, Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran

3 Professor, Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran

4 Assistant Professor, Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran

10.22062/jkmu.2020.91021

Abstract

Background: Mild cognitive impairment (MCI) is the stage between the expected cognitive decline of normal aging and the more serious decline of dementia. In the present study, the effect of Boswellia serrata (BS) on improvement of memory impairment in patients with MCI was investigated.
Methods: In this single-center randomized double-blind placebo-controlled clinical trial study, 118 patients with mild cognitive impairment (MCI) were included and randomly divided into two groups (case and control). Control group (n=59) received BS 300 mg/kg body weight twice a day and control group (n=59) received placebo for a period of three and six months. Montreal Cognitive Assessment (MoCA) test for detecting cognitive impairment was done at baseline, three and six months after the intervention.
Results: A significant difference was reported in the MoCA mean score between the groups after three months (24.64 vs. 22.83) and six months of the intervention (25.22 vs. 22.7). Memory item had the greatest impact on the average final score (P≤0.0001).
Conclusion: BS has a significant effect on the improvement of memory impairment in patients with MCI. Further studies are required with higher doses of BS and longer duration of treatment to assess the effects of BS on memory of patients with MCI.

Keywords


  1. Victor M, Adams R, Collins G. Mild Cognitive Impairment. 10th ed. Philadelphia: Davis; 2014.
  2. Petersen RC. Mild cognitive impairment. Continuum (Minneap Minn) 2016; 22(2 Dementia):404-18.
  3. Freitas S, Simões MR, Alves L, Santana I. Montreal cognitive assessment: influence of sociodemographic and health variables. Arch Clin Neuropsychol 2012; 27(2):165-75.
  4. Feldman HH, Ferris S, Winblad B, Sfikas N, Mancione L, He Y, et al. Effect of rivastigmine on delay to diagnosis of Alzheimer's disease from mild cognitive impairment: the InDDEx study. Lancet Neurol 2007; 6(6):501-12.
  5. Singh GB, Singh S, Bani S. Anti-inflammatory actions of boswellic acids. Phytomedicine 1996; 3(1):81-5.
  6. Sharma R, Singh S, Singh GD, Khajuria A, Sidiq T, Singh SK, et al. In vivo genotoxicity evaluation of a plant based antiarthritic and anticancer therapeutic agent Boswelic acids in rodents. Phytomedicine 2009; 16(12):1112-8.
  7. Safayhi H, Mack T, Sabieraj J, Anazodo MI, Subramanian LR, Ammon HP. Boswellic acids: novel, specific, nonredox inhibitors of 5-lipoxygenase. J Pharmacol Exp Ther 1992; 261(3):1143-6.
  8. Farshchi A, Ghiasi G, Farshchi S, Malek Khatabi P. Effects of boswellia papyrifera gum extract on learning and memory in mice and rats. Iran J Basic Med Sci 2010; 13(2):9-15.
  9. Karima O, Riazi G, Yousefi R, Movahedi AA. The enhancement effect of beta-boswellic acid on hippocampal neurites outgrowth and branching (an in vitro study). Neurol Sci 2010; 31(3):315-20.
  10. Mahmoudi A, Hosseini-Sharifabad A, Monsef-Esfahani HR, Yazdinejad AR, Khanavi M, Roghani A, et al. Evaluation of systemic administration of Boswellia papyrifera extracts on spatial memory retention in male rats. J Nat Med 2011; 65(3-4):519-25.
  11. Hosseini Sharifabad M, Esfandiary E. A morphometeric study on CA3 hippocampal field in young rats following maternal administration of Boswellia serrata resin during gestation. Iranian Journal of Basic Medical Sciences 2007; 10(3):176-82.
  12. Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, et al. The montreal cognitive assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am GeriatrSoc 2005; 53(4):695-9.
  13. Smith T, Gildeh N, Holmes C. The montreal cognitive assessment: validity and utility in a memory clinic setting. Can J Psychiatry 2007; 52(5):329-32.
  14. Petersen RC, Thomas RG, Grundman M, Bennett D, Doody R, Ferris S, et al. Vitamin E and donepezil for the treatment of mild cognitive impairment. N Engl J Med 2005; 352(23):2379-88.
  15. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult ClinPsychol 1988; 56(6):893-7.
  16. Basch E, Boon H, Heerema TD, Foppo I, Hashmi S, Hasskarl J, et al. Boswellia: An evidence-based systematic review by the natural standard research collaboration. J Herb Pharmacother 2004; 4(3):63-83.
  17. Paul R, Lane EM, Tate DF, Heaps J, Romo DM, Akbudak E, et al. Neuroimaging signatures and cognitive correlates of the Montreal cognitive assessment screen in a nonclinical elderly sample. Arch Clin Neuropsychol 2011; 26(5):454-60.
  18. Peila R, Launer LJ. Inflammation and dementia: epidemiologic evidence. Acta Neurol Scand Suppl 2006; 185:102-6.
  19. Karplus TM, Saag KG. Nonsteroidal anti-inflammatory drugs and cognitive function. Drug Saf 1998; 19(6):427-33.
  20. Poeckel D, Werz O. Boswellic acids: biological actions and molecular targets. Curr Med Chem 2006; 13(28):3359-69.
  21. Rainer E. Use of Francincence (olibanum) in the treatment of alzhaimer s disease. Chem ABS 1996; 125:1327-94.
  22. Sedighi B, Pardakhty A, Kamali H, Shafiee K, Hasani BN. Effect of Boswellia papyrifera on cognitive impairment in multiple sclerosis. Iran J Neurol 2014; 13(3):149-53.
  23. Gupta I, Parihar A, Malhotra P, Singh GB, Lüdtke R, Safayhi H, et al. Effects of Boswellia serrata gum resin in patients with ulcerative colitis. Eur J Med Res 1997; 2(1):37-43.
  24. Gupta I, Parihar A, Malhotra P, Gupta S, Lüdtke R, Safayhi H, et al. Effects of gum resin of Boswellia serrata in patients with chronic colitis. Planta Med 2001; 67(5):391-5.
  25. Gerhardt H, Seifert F, Buvari P, Vogelsang H, Repges R. Therapy of active Crohn disease with Boswellia serrata extract H 15. Z Gastroenterol 2001; 39(1):11-7. [In German].
  26. Qiu C, De Ronchi D, Fratiglioni L. The epidemiology of the dementias: an update. Curr Opin Psychiatry 2007; 20(4):380-5.
  27. Taghizadeh M, Maghaminejad F, Aghajani M, et al. The effect of tablet containing Boswellia serrata and Melisa officinalis extract on older adults' memory: A randomized controlled trial. Archives of Gerontology and Geriatrics 2017; 75: 146-150.