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Evidence-Based Complementary and Alternative Medicine
Volume 2017 (2017), Article ID 6083629, 21 pages
Review Article

A Systematic Review of Intervention Studies Examining Nutritional and Herbal Therapies for Mild Cognitive Impairment and Dementia Using Neuroimaging Methods: Study Characteristics and Intervention Efficacy

1National Institute of Complementary Medicine (NICM), Western Sydney University, Penrith, NSW 2751, Australia
2School of Science and Health, Western Sydney University, Penrith, NSW 2751, Australia
3War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
4School of Medicine, Stanford University, Stanford, CA 94305, USA
5Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104, USA
6School of Psychology and Illawarra Health & Medical Research Institute (IHMRI), University of Wollongong, Wollongong, NSW 2252, Australia
7Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorne, VIC 3122, Australia
8School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China
9School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia
10Department of Medicine, Campbelltown Hospital, South Western Sydney Area Health Service, Campbelltown, NSW 2560, Australia

Correspondence should be addressed to Genevieve Z. Steiner

Received 2 September 2016; Accepted 25 October 2016; Published 19 February 2017

Academic Editor: Michał Tomczyk

Copyright © 2017 Genevieve Z. Steiner et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Neuroimaging facilitates the assessment of complementary medicines (CMs) by providing a noninvasive insight into their mechanisms of action in the human brain. This is important for identifying the potential treatment options for target disease cohorts with complex pathophysiologies. The aim of this systematic review was to evaluate study characteristics, intervention efficacy, and the structural and functional neuroimaging methods used in research assessing nutritional and herbal medicines for mild cognitive impairment (MCI) and dementia. Six databases were searched for articles reporting on CMs, dementia, and neuroimaging methods. Data were extracted from 21/2,742 eligible full text articles and risk of bias was assessed. Nine studies examined people with Alzheimer’s disease, 7 MCI, 4 vascular dementia, and 1 all-cause dementia. Ten studies tested herbal medicines, 8 vitamins and supplements, and 3 nootropics. Ten studies used electroencephalography (EEG), 5 structural magnetic resonance imaging (MRI), 2 functional MRI (fMRI), 3 cerebral blood flow (CBF), 1 single photon emission tomography (SPECT), and 1 positron emission tomography (PET). Four studies had a low risk of bias, with the majority consistently demonstrating inadequate reporting on randomisation, allocation concealment, blinding, and power calculations. A narrative synthesis approach was assumed due to heterogeneity in study methods, interventions, target cohorts, and quality. Eleven key recommendations are suggested to advance future work in this area.