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Journal of Natural & Ayurvedic Medicine Research Article 8 min read

Parkinson Disease and Ayurveda

Avinash Shankar*, Amresh Shankar and Anuradha Shankar
* Corresponding author
ISSN: 2578-4986  10.23880/jonam-16000195  Received: July 11, 2019  Published: August 28, 2019
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Keywords
Parkinson Disease Substantia Nigra Dopamine Livodopa Carbidopa MAOB Inhibitor COMT Inhibitor Deep Brain Stimulation
Abstract

Parkinson’s disease, a degenerative brain disease of dopamine secreting brain cells Substantia nigra is increasing progressively and presents therapeutics-levodopa, carbidopa, MAOB inhibitor, COMT inhibitors, surgery and deep brain stimulations, though improve presenting feature but not quality of life. Present study using herbal composite containing Mucuna pruriens, Herpestis monnieri, Acors calamus, Nardostachys jatamansi and Withania somnifera taken in equal part shows better quality of life in all most all with marked improvement in movement disorder in 92% cases as compared to 39% cases on conventional therapy. In addition Herbal composite also improve the haematological, hepatic and Renal function by bioregulating body biomechanics and neural cell function, revitalizing neural cell damage in substantia nigra check destruction of dopamine and facilitate optimal level of Dopamine for normal brain function.

Avinash Shankar1*, Amresh Shankar2 and Anuradha Shankar3

India

dravinashshankar@gmail.com check destruction of dopamine and facilitate optimal level of Dopamine for normal brain function.

Deep Brain Stimulation

Introduction

Parkinson disease is a chronic progressive and degenerative disease of Central Nervous System and presents with movement disorders which prompt handicap in long time [1, 2, 3]. This is considered as a combination of genetic susceptibility, exposure to one or more disease triggering environmental factor [4, 5]. Clinical manifestations are solely due to degenerative change in substantia nigra, a seat of an important neuro transmitter synthesis i.e. Dopamine and 60-80% loss of dopamine secreting cells presents with dreaded presentation of movement disorder i.e.- tremor, rigidity, bradykinesia, postural instability. In addition changing dietary habits and lifestyle causes free radical accumulation also triggers the clinical presentation [6, 7, 8, 9, 10, 11, 12, 13, 14] (Figure 1).

Figure 1
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Figure 1

Inspite of all the available therapeutic modalities incidence of Parkinson’s disease increasing and affects 1% of the people above the age of 65 years and presently it is 247per lakh. There is no homogenous and large epidemiological data on PD from India. Razdan, et al. reported a crude prevalence rate of 14.1 per 100,000 amongst a population of 63,645 from rural Kashmir in the northern part of India. The prevalence rate over the age of 60 years was 247/100,000.

Thus today’s need is safe affordable and curative therapeutics.

  • Objective of the study: Evaluate the comparative therapeutic efficacy of herbal composite in management of parkinsons disease.
  • Design of the study: comparative
  • Interest of conflicts: None
  • Ethical committee: Ethical committee approves the evaluation of status of safe herbal composite in management of Parkinson disease.

Material & Methods

Material

Patients attending neuro clinic of RA Hospital & Research Centre Warisaliganj (Nawada) and Aarogyam Punrjeevan, Patna 14 having complaints of movement disorders were considered for the proposed study.

Patients with severe debility, bed ridden and associated other disease like diabetes mellitus and hypertension were excluded from the study.

Methods

Selected patients and their attendants were thoroughly interrogated for their presenting features, their duration, age of onset, disease progression, treatment taken, their effects and adversity. Patients were clinically examined and investigated for their basic bioparameters to adjudge the effect of drug or drug related adversity (Table 1).

StageCharacteristics
Isymptoms of one side of the body
IIsymptoms on both side of the body, no balance impairment
IIIbalance impaired, physically independent
IVsevere debility and still able to walk or stand
Vwheel chair or bed ridden

Table 1: Selected patients were graded as per clinical presentation (as per Hochu and Yahr sstaging).

Group A: conventional treatment with Levodopa /carvidopa Group B: herbal composite

Figure 2
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Figure 2

Each patient were given a follow up card to enter the changes in movement, stability and handwriting with an instruction to attend the centre on every alternate Friday for first 6 months and every 3 months afterward. Patients were followed by the Medical social worker of the organization to ascertain the changes in clinical presentation. To adjudge the improvement in CNS function handwriting was analysed digitally on tab (Table 2).

Dose schedule: 1 cap every 8 hours

Clinical gradeCharacteristics
Excellentcomplete absence of movement abnormality without any adjuvant, drug adversity and
withdrawal or relapse
Goodmarked improvement in clinical presentation with occasional dystonia No drug adversity
Pooronly transient relief with frequent recurrence and adversity

Table 2: Clinical response was adjudged.

Observation

Selected patients were of age group 40->60 years with male predominance over the female and majority patients were of age >60 years, 73.7% male and 26.3% female were of age group 55-60 years, 6.6% of 40-45 years, 26.3% were of >60 years (Figures 3 & 4). Out of all 12.5% were taking treatment since last 1-2 years, 27% sine 4-5 years while 24.3% since >5 years (Figure 5). Figure 3: Bar diagram showing age and sex wise distribution of patients.

Figure 3: ** Bar diagram showing age and sex wise distribution of patients.
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Figure 3: ** Bar diagram showing age and sex wise distribution of patients.
Figure 4: Pie diagram showing male: female composition.
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Figure 4: Pie diagram showing male: female composition.
Figure 5: Bar diagram shows duration of past treatment.
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Figure 5: Bar diagram shows duration of past treatment.

22.4% were presenting with movement disorder, 45.4% with movement disorders on both side and 29% with balance disorder (Tables 3 & 4). As per clinical severity 22.4 %, 45.4%, 29% and 3.2% are of stage I,II,III and IV respectively (Figure 6). Out of all basic bio parameters of the selected patients 77.6% patients had haemoglobin <10 gram %, Serum bilirubin >1mg%, SGOT and SGPT >30 IU, Alkaline phosphatase>130 in 5.3%, blood sugar (Fasting) >100mg% in 3.3% cases .

Clinical PresentationNumber of
patients
Movement disorder on one side of the body68
Movement disorder on both side of the body138
Balance impairment88
Severe debility10
Wheel chair Or bed ridden14

Table 4: Showing distribution of patients as per their presentation.

Basic bio parametersNumber of patients
Hematological
Hemoglobin
<10gm %236
>10gm%68
Hepatic profile
Serum bilirubin
<1mg %236
>1mg%68
SGOT
<30 IU/L236
>30 IU/L68
SGPT
<30 IU/L236
>30IU/L68
Alkaline phosphatase
< 100288
>10016
Diabetic profile
Blood sugar
Fasting
<100mg%294
>100mg%10
Renal profile
Blood urea
<30mg%304
>30mg %-
Serum Creatinine
<1.5mg%304
>1.5mg%-

Table 3: Showing basic bio –parameters.

Figure 6: Bar diagram showing Distribution of patients as per clinical severity.
Click to enlarge
Figure 6: Bar diagram showing Distribution of patients as per clinical severity.

Result

Patients on herbal composite shows early and better movement improvement as adjudged by handwriting or hand movement (ascertained digitally) than other group i.e.-92% patients on herbal composite had normal hand writing while on conventional therapy only 39% cases (Figures 7 & 8). Therapeutic outcome is better in both cases i.e. herbal composite alone or herbal composite with conventional drug than mere conventional therapy, almost 100 % than 22.4% on conventional therapy. Post therapy bioparameters get improved in all the cases on Herbal composite than 02 patients on conventional therapy had worsening of parameters.

Figure 7: Graph showing improvement in handwriting in mean duration of treatment.
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Figure 7: Graph showing improvement in handwriting in mean duration of treatment.
Figure 8: Showing hand writing changes.
Click to enlarge
Figure 8: Showing hand writing changes.

Conclusion

Herbal composite constituting equal parts of Mucuna pruriens, Herpestis monnieri, Acorus calamus, Nardostachys jatamansi and Withania somnifera proves worth in patients of Parkinson’s disease in alleviating clinical presentation and improving quality of life without any untoward effects or withdrawal manifestation.

Discussions

Parkinson disease affecting elderly and more male than female result in handicap and bed ridden in spite of advanced therapeutics like surgery and deep brain stimulation, current therapeutics though control movement disorder but fails to improve quality of life. Present study of comparative evaluation of herbal composite versus conventional therapeutics shows superiority of herbal composite than conventional i.e.- 92% patients on Herbal composite had grade I clinical recovery and better quality of life without any adversity or disease related sequel or required any adjuvant as compared to 39% on conventional therapeutics and is attributed to

  • Mucuna pruriens: Provides Natural Levodopa to suppliment Dopamine
  • Herpestis monnieri: Revitalize damaged neyral cells in substantia nigra
  • Nardostachys jatamansi: Check degeneration of neural cells in substantia nigra
  • Acorus calamus: Check metabolism of existing Dopamine
  • Withania simnifera: Bioregulate body biokinetics - improve quality of life Hence combinely produce sustained improvement and bioregulate movement synegy ,check degeneration of neural cells in substantia nigra ,trevitalize damaged cell with provision of natural Levodopa (Figures 9 & 10) [18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33].
Figure 9: Outcome of the study.
Click to enlarge
Figure 9: Outcome of the study.
Figure 10: Shows Herbal composite bio kinetics.
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Figure 10: Shows Herbal composite bio kinetics.

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@article{avinash2019,
  title   = {Parkinson Disease and Ayurveda},
  author  = {Avinash Shankar, Amresh Shankar and Anuradha Shankar},
  journal = {Journal of Natural & Ayurvedic Medicine},
  year    = {2019},
  volume  = {3},
  number  = {3},
  doi     = {10.23880/jonam-16000195}
}
Avinash Shankar, Amresh Shankar and Anuradha Shankar (2019). Parkinson Disease and Ayurveda. Journal of Natural & Ayurvedic Medicine, 3(3). https://doi.org/10.23880/jonam-16000195
TY  - JOUR
TI  - Parkinson Disease and Ayurveda
AU  - Avinash Shankar, Amresh Shankar and Anuradha Shankar
JO  - Journal of Natural & Ayurvedic Medicine
PY  - 2019
VL  - 3
IS  - 3
DO  - 10.23880/jonam-16000195
ER  -