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

Box 1

Recommendations for future chronic CM neuroimaging research on people with MCI or dementia.
(1) Study Characteristics:
 (a) Research needs to follow the most recent guidelines stipulating diagnostic criteria for subjective cognitive complaints, MCI, and dementia, and should be closely adhered to when formulating protocols to ensure that the study population is as homogeneous as possible.
 (b) Essential baseline characteristics, particularly ones known to increase the risk of dementia, should be reported.
 (c) Recruitment setting needs to be carefully considered and always reported.
(2) Methodologies:
 (a) All information on neuroimaging data collection, pre- and post-processing pipelines, and quantification needs to be reported to ensure that the results can be adequately scrutinised and replicated.
 (b) Optimal analytic techniques should be utilised for the quantification of neuroimaging data.
 (c) Standardised neuropsychological tests that are appropriate clinical trial endpoints for the level of cognitive impairment should be used.
(3) Intervention Efficacy:
 (a) Standardised herbal extracts should be used to reduce the variability between studies.
 (b) Multi-herb formulas require substantial preclinical research to optimise ratios of active components, and determine their efficacy and safety as a formula.
 (c) Dosage should be kept similar to other research (unless there is a rationale for adjusting dose) to reduce variability between studies.
 (d) The length of trials should be carefully determined and have a rationale to allow for greater comparability between studies.
 (e) An appropriate control group, such as a placebo matched to colour, shape, taste and smell of the active treatment, should always be included.