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To assess whether EGb761 could protect elderly diabetic mice with cognitive disorders and explore the role of beclin-1-mediated autophagy in these protective effects. Two-month-old male db/db -/- mice and wild-type C57/BL6 mice were randomly divided into six groups: db/db -/- control, db/db -/- 50 mg, db/db -/- 100 mg, wild-type (WT) control, WT 50 mg, and WT 100 mg. EGb761 (50 mg/kg or 100 mg/kg of bodyweight) was given by gavage once a day for 1 month from the age of 6 months. Y-maze and social choice tests were performed at 8th months. The blood pressure was measured. The imaging changes in the brain were measured using magnetic resonance imaging (MRI). The expression and distribution of beclin-1, LC3, and NF-κB were detected using immunohistochemistry staining and western blotting. Ultrastructure alterations in the hippocampus were observed using transmission electron microscopy. Compared with WT mice, the learning ability, memory and overall cognitive function of db/db -/- mice decreased (P &lt; 0.05), and EGb761 could significantly improve the learning and memory function of db/db -/- mice (P &lt; 0.05). EGb761 significantly improved systolic blood pressure in db/db -/- mice (P &lt; 0.01). In addition, fMRI-bold showed a decline in the hippocampus of mice in the db/db -/- group compared with WT. EGb761 could improve these above changes. Immunohistochemistry staining and western blotting confirmed that EGb761 significantly increased beclin-1 and reduced LC3-II/I levels in the brains of db/db -/- mice (P &lt; 0.05). NF-κB levels were obviously higher in the db/db -/- group than that in the WT group, and EGb761 significantly reduced NF-κB levels in db/db -/- mice (P &lt; 0.05). There was a trend of increased autophagosomes in db/db -/- mice, but EGb761 did not change obviously the number of autophagosomes. Compared with normal aged WT mice, aging db/db -/- mice had more common complications of cerebral small vessel disease and cognitive dysfunction. EGb761 could significantly improve the cognitive function of aging db/db -/- mice via a mechanism that may involve the regulation of beclin-1, LC3, and NF-κB.

EGb761 improves the cognitive function of elderly db/db−/− diabetic mice by regulating the beclin-1 and NF-κB signaling pathways