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Abstract：
BACKGROUND: Comorbid occurrence of tinnitus and emotional symptoms of anxiety and depression is highly prevalent. The Ginkgo biloba extract EGb 761® has been shown to be effective in reducing neuropsychiatric symptoms in patients with dementia and tinnitus.
METHODS: We performed a mediation analysis to evaluate direct effects of EGb 761® on tinnitus severity, as well as indirect effects mediated by symptoms of depression and anxiety and by changed cognition. We pooled data from subsets of patients suffering from tinnitus that were enrolled in three double-blind, randomized, placebo-controlled clinical trials, which investigated the efficacy of EGb 761® (240 mg/day for 22-24 weeks) in dementia with concomitant neuropsychiatric symptoms.
RESULTS: In total, 594 patients suffered from tinnitus (EGb 761®, 289; placebo, 305). Direct effects of EGb 761® on tinnitus severity (p < 0.001) in patients with mild to moderate dementia were found to represent about 60% of the total effect, whereas the indirect effects (p < 0.001) mediated by improvement of anxiety, depression and cognition represented about 40% of the total effect.
CONCLUSIONS: EGb 761® could be considered as a supporting treatment for tinnitus in elderly patients suffering from dementia, with added benefit in those with symptoms of depression or anxiety.
METHODS: We performed a mediation analysis to evaluate direct effects of EGb 761® on tinnitus severity, as well as indirect effects mediated by symptoms of depression and anxiety and by changed cognition. We pooled data from subsets of patients suffering from tinnitus that were enrolled in three double-blind, randomized, placebo-controlled clinical trials, which investigated the efficacy of EGb 761® (240 mg/day for 22-24 weeks) in dementia with concomitant neuropsychiatric symptoms.
RESULTS: In total, 594 patients suffered from tinnitus (EGb 761®, 289; placebo, 305). Direct effects of EGb 761® on tinnitus severity (p < 0.001) in patients with mild to moderate dementia were found to represent about 60% of the total effect, whereas the indirect effects (p < 0.001) mediated by improvement of anxiety, depression and cognition represented about 40% of the total effect.
CONCLUSIONS: EGb 761® could be considered as a supporting treatment for tinnitus in elderly patients suffering from dementia, with added benefit in those with symptoms of depression or anxiety.
摘要：
背景：同时发生耳鸣和焦虑、抑郁的情绪症状非常普遍。银杏叶提取物EGb761®已被证明可有效减轻痴呆和耳鸣患者的神经精神症状。
方法：我们进行了中介分析，以评估EGb761®对耳鸣严重程度的直接影响，以及由抑郁和焦虑症状以及认知改变介导的间接影响。我们汇集了三个双盲患者的耳鸣患者亚群的数据，随机化，安慰剂对照临床试验，该研究调查了EGb761®（240mg/天，共22-24周）在伴有神经精神症状的痴呆中的疗效。
结果：总计，594名患者患有耳鸣(EGB761®，289；安慰剂，305).EGb761®对轻度至中度痴呆患者耳鸣严重程度（p<0.001）的直接影响约占总影响的60％。而由焦虑改善介导的间接效应(p<0.001)，抑郁和认知约占总效应的40%。
结论：EGb761®可作为老年痴呆症患者耳鸣的辅助治疗，对那些有抑郁或焦虑症状的人有额外的好处。
方法：我们进行了中介分析，以评估EGb761®对耳鸣严重程度的直接影响，以及由抑郁和焦虑症状以及认知改变介导的间接影响。我们汇集了三个双盲患者的耳鸣患者亚群的数据，随机化，安慰剂对照临床试验，该研究调查了EGb761®（240mg/天，共22-24周）在伴有神经精神症状的痴呆中的疗效。
结果：总计，594名患者患有耳鸣(EGB761®，289；安慰剂，305).EGb761®对轻度至中度痴呆患者耳鸣严重程度（p<0.001）的直接影响约占总影响的60％。而由焦虑改善介导的间接效应(p<0.001)，抑郁和认知约占总效应的40%。
结论：EGb761®可作为老年痴呆症患者耳鸣的辅助治疗，对那些有抑郁或焦虑症状的人有额外的好处。
