Research Article Effectiveness of Gotu Kola Extract 750 mg and 1000 mg Compared with Folic Acid 3 mg in Improving Vascular Cognitive Impairment after Stroke Kun Marisa Farhana, Rusdy Ghazali Malueka, Samekto Wibowo, and Abdul Gofir Department of Neurology, Faculty of Medicine, Universitas Gadjah Mada, Dr. Sardjito General Hospital, Yogyakarta 55284, Indonesia Correspondence should be addressed to Abdul Gofr; gofr@ugm.ac.id Received 10 December 2015; Revised 1 April 2016; Accepted 10 May 2016 Academic Editor: Avni Sali Copyright © 2016 Kun Marisa Farhana et al. Tis 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. Tis study aimed to determine the efectiveness of gotu kola (Centella asiatica) in improving cognitive function in patients with vascular cognitive impairment (VCI). Tis study uses a quasi-experimental design. Subjects in this study were patients with poststroke cognitive impairment who were treated at two hospitals in Yogyakarta, Indonesia. Te number of subjects was 48: 17 subjects were treated with 1000 mg/day of gotu kola extract, 17 subjects treated with 750 mg/day of gotu kola extract, and 14 subjects treated with 3 mg/day of folic acid for 6 weeks. A Montreal Cognitive Assessment-Indonesian version (MoCA-Ina) was conducted at the beginning of treatment and afer 6 weeks of therapy. It was found that all trials efectively improved poststroke VCI based on MoCA-Ina scores over the course of the study. Tere is no signifcant diference in ΔMoCA-Ina (score at the 6th week of treatment − score at the beginning) mean score among the three groups, indicating that gotu kola is as efective as folic acid in improving poststroke VCI. Gotu kola was shown to be more efective than folic acid in improving memory domain. Tis study suggested that gotu kola extract is efective in improving cognitive function afer stroke. 1. Introduction Stroke can cause cognitive decline. Te frequency of cognitive impairment afer an ischemic stroke ranges from 20 to 30%, with an increasing risk in the two years afer stroke [1]. In their research, Ballard et al. found that 25% of patients sufered from poststroke dementia, and the risk of poststroke patients developing dementia within the following fve years is nine times higher than in the healthy population, especially for cognitive domains such as memory and attention [2]. Management of cognitive impairment following cerebrovas- cular disease should be aimed at the prevention of secondary strokes and specifc treatment for the improvement of cogni- tive function. Secondary stroke prevention includes control of risk factors such as blood pressure, cholesterol levels, and hyperhomocysteinemia. Homocysteine is an independent risk factor for stroke; incidences of stroke due to hyperhomocysteinemia are fol- lowed by cerebral microangiopathy and multiple infarction that can reduce cognitive function in various domains [3]. Ingestion of 0.5–5 mg folic acid per day will decrease serum total homocysteine levels by 15–40% within 6 weeks [4]. Use of neuroprotective drugs, antianxiety medicine, hypnoseda- tives, and antidepressants has side efects and is expensive [5]. Consequently, there is a trend towards the use of natural medicines, especially in the more efective herbal form rather than the active component (isolation of the pure compound) [6]. One medicinal herb commonly used is gotu kola (Cen- tella asiatica). Te main group of components in gotu kola is the triterpenes including asiaticoside, madecassoside, asiatic acid, and madecassic acid, which have antioxidant, anti- infammatory, and antiapoptotic properties [7–9]. Tis may explain why gotu kola has a positive infuence on brain plasticity, as well as in increasing the length of dendrites and an enhancement of hippocampal CA3 neuronal dendritic arborization in mice inficted with neurodegenerative dis- eases and memory disorders [10]. Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine Volume 2016, Article ID 2795915, 6 pages http://dx.doi.org/10.1155/2016/2795915