Express Pharma

Pycnogenol® for cognitive function at every stage of life

Franziska Weichmann, Manager of Scientific Communications and Product Development, HORPHAG informs that Pycnogenol®has shown a broad spectrum of cognitive related benefits in all age groups and the underlying mechanism of action is based on its ability to regulate the endothelial function via adjusting nitric oxide (NO) production

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A normal cognitive function is a prerequisite for a healthy life. The brain function may be altered in case of either hyperactivity or hypo-activity of the brain. Hyperactivity is frequently observed in children, commonly referred to as Attention Deficit Hyperactivity Disorder (ADHD), whereas the decline of brain activity is related to the aging process.

Remarkably, Pycnogenol French maritime pine bark extract has shown a broad spectrum of cognitive related benefits in all age groups. These benefits range from reducing hyperactivity in children (1-3) to improving cognitive function in students, healthy adults and elderly people (4-9).

Pycnogenol regulates cellular NO concentration, which affects brain function

The underlying mechanism of action of Pycnogenol® is based on its ability to regulate endothelial function via adjusting nitric oxide (NO) production (10, 11). It has been shown that NO has beneficial effects on brain function (12). NO is capable of relaxing constricted blood vessels, normalising blood pressure and helping to protect tissues from damage, caused by low blood supply (13). By regulating vascular smooth muscle relaxation, NO leads to increased blood flow, which ensures sufficient supply of oxygen to neuronal cells (14). In addition, NO has been found to regulate neuronal functions and helps to modulate key neurotransmitters, thus contributing to processing signals in the brain (15, 16). Interestingly, the active metabolites of Pycnogenol® build up inside the endothelial blood cells and have been proven to pass the blood-brain barrier (11).

Pycnogenol® regulates the NO production in two ways. The endothelial NO synthase (eNOS), generating normal concentrations of NO from L-arginine in the cell, is stimulated by Pycnogenol®. At the same time, Pycnogenol® prevents a toxic overproduction of NO by downregulating the inducible NO synthase (iNOS) – a well-established source of nitric oxide (NO*) during inflammation (11, 17). In this way, Pycnogenol® naturally modulates the multiple effects of NO in the brain.

Improvement of ADHD symptoms in children

ADHD (attention deficit hyperactivity disorder) is a frequent brain hyperactivity disorder, mainly affecting children. A common medication for this condition is Methylphenidate (Ritalin), but it is associated with various adverse effects (18). A double-blind, randomized, placebo-controlled clinical study could show that intake of Pycnogenol® (1 mg per kg and day) for four weeks relieved hyperactivity and improved attention of children with ADHD by 29 per cent respectively, as rated by teachers and parents (1). No side effects were reported. Another study investigated the levels of stress hormones (catecholamines) after Pycnogenol® supplementation in ADHD affected children (2). The concentrations of this group of hormones (including adrenaline, noradrenaline, and dopamine) were normalised in ADHD patients with Pycnogenol® supplementation, which consequently leads to less hyperactivity. Oxidative stress (measured conversely as plasma total antioxidant status) and DNA damage incidents (as measured by the levels of 8-oxoG as representative of oxidatively damaged purines) were significantly reduced by 6.3 per cent and 35.4 per cent respectively (3).

Enhanced mental performance in students

In an observational study, 53 healthy students, aged 18 to 27 years were supplemented with 100 mg Pycnogenol® a day for 8 weeks; another group of 55 students was used as control subjects (4). The effects of Pycnogenol® on cognitive function and mental performance were investigated, using different tests. For example, the paced auditory serial addition task (PASAT) was used for assessing sustained attention. For evaluating spatial recognition and working memory abilities, CANTAB (Cambridge neuropsychological test automated battery) was applied. The students showed significantly improved attention (+52.9% vs +4.7% in the control group) and increased memory skills (+35.8% vs +11.6% for picture recall, +6.7% vs. 2.6% for spatial recognition memory and +4.4% vs +3.5% for pattern recognition memory). Consequently, the test results of the supplemented students were better by 7.6% compared to the ones from the control group. Pycnogenol® was shown to have beneficial effects on the mental performance of healthy students.

Advanced cognitive function in healthy professionals

Another study, including 60 subjects between 35 and 55 years evaluated the effects of Pycnogenol® 150 mg a day on cognitive function, attention and mental performance in healthy professionals (5). For this, cognitive battery tests, similar to those of the previous study with students were used, determining, among other things, improvements in spatial working memory (+13.5%), planning (+16%), mental flexibility (ID/ED) (+9.8%) and general cognitive function (10%). No significant changes were found in the control group. Additionally, the plasma oxidative stress levels were measured (as plasma free radicals in Carr units) and showed to be elevated at the beginning of the study, probably due to negative daily stress. After 12 weeks of supplementation with Pycnogenol®, a significant decrease of 30.4% to normal levels compared to a slight increase in the control group of 0.8% was measured.

Improvement of cognitive function in the aging baby boomer generation

Neurological hypoactivity – the decline of brain activity – usually mainly affects aged or elderly people. This can result in senility, dementia or in diseases like Alzheimer’s or Parkinson’s disease. Here, the abilities to remember, recall, combine and orientate are deteriorating. A few studies have shown that Pycnogenol® can help to keep a good mental performance and to manage mild cognitive impairment (6-9). A study with 150 healthy subjects from 55 to 70 years, who were supplemented with 100 mg Pycnogenol® per day for 12 months confirms the beneficial effects of Pycnogenol® on healthy aging and the maintenance of good cognitive function (6). The tested parameters included cognitive impairment, attention, mental performance, memory, and daily tasks (like making decisions or coping with problems), all of which improved significantly in the supplementation group, in contrast to the control group. Another similar study with 87 subjects (55 to 75 years) with mild cognitive impairment showed several positive effects of Pycnogenol® supplementation (150 mg per day) for two months (7). The improvements were assessed using cognitive tests, as described before (regarding memory, attention, and daily tasks), as well as the MMSE (mini-mental state examination), which helps to evaluate borderline cognitive impairments for apparently unaffected individuals. The MMSE score increased significantly by 18.5% for the Pycnogenol® supplemented subjects, in contrast to an increase of 2.5% in the control group, bringing the MMSE score back to a normal level in the Pycnogenol® group. In a recent study on the effect of Pycnogenol® (150 mg per day) in patients with Parkinson’s Disease, in addition to the standard medication with carbidopa/levodopa, beneficial effects could be observed in the supplement group after four weeks (8). The subjects, between 60 and 67 years old, described mild to moderate symptoms, including tremor, bradykinesia, alterations in cognitive function, rigidity, and speech changes. Using a scoring system, it was found that the cognitive function in these patients, supplemented with Pycnogenol® improved by 18.8% compared to inclusion. A double-blind, placebo-controlled trial with 101 subjects, between 60 and 85 with moderate decline of their cognitive function investigated the effects of 150 mg Pycnogenol® per day for three months on mental performance (9). The Australian study not only followed the cognitive abilities of the subjects but also the blood profiles, including the serum lipid profile and growth hormones. Statistically significant improvements, as compared to the placebo group could be found for memory-based cognitive functions, more precisely the spatial and numeric working memory, and lipid peroxidation products, confirming Pycnogenol’s role as a potent antioxidant. As impairment of the memory skills was connected to increased age and oxidative stress (19). These findings further support the beneficial effect of Pycnogenol® on cognitive functions in elderly people.