ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Ethnopharmacology
Comparative Efficacy and Safety of Botanical Drugs for Mild Cognitive Impairment: A Systematic Review and Network Meta-analysis
Provisionally accepted
- 1Shaanxi Provincial People's Hospital, Xi'An, China
- 2Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
- 3Shaanxi University of Chinese Medicine, Xianyang, China
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Objective: This study evaluated the comparative efficacy and safety of eighteen botanical drug interventions in improving cognitive function, daily living activities, and psychological wellbeing in patients with mild cognitive impairment (MCI). Methods: Randomized controlled trials were identified from PubMed, Embase, Cochrane Library, and Web of Science up to September 2025. Methodological quality was assessed using the Cochrane Risk of Bias tool, and data were analyzed within a Bayesian framework. Results: Nineteen trials involving 4,956 participants were included. For cognitive function, measured as a standardized mean difference (SMD) to harmonize various assessment scales, Pycnogenol showed the most significant effect and the highest probability of being the best intervention (Surface Under the Cumulative Ranking Curve, SUCRA: 98.8%). It also ranked highest for improving daily living (SUCRA: 100%), whereas Cosmos caudatus Supplement ranked first for psychological well-being (SUCRA: 98.9%). Most included botanical drugs were generally well-tolerated, with adverse event rates comparable to placebo, although safety reporting was inconsistent across studies. Conclusion: Pycnogenol showed the highest probability of improving cognitive function and daily living scores in patients with MCI, while Cosmos caudatus supplementation ranked highest for psychological outcomes. Although these findings highlight potential benefits, heterogeneity among the included studies warrant cautious interpretation.
Keywords: Plant Extracts, Mild Cognitive Impairment, Cognitive Function, Neuroprotection, network meta-analysis and systematic review
Received: 03 Jul 2025; Accepted: 23 Oct 2025.
Copyright: © 2025 Wang, Yang, Wang, Yan, Lü and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Tao Wang, wt78213@126.com
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