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166 Hartwig Schulz
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4 Nervous System Disorders Including
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Different Forms of Stresses and
Alzheimer’s Disease
Zahra Ayati
1
Department of Traditional Pharmacy, School of Pharmacy, Mashhad University of
1,2
*, Maryam Nikoosokhan3, and Seyed Ahmad Emami
1,4
Medical Sciences, Mashhad, Iran; 2NICM Heath Research Institute, Western Sydney
University,Westmead, Australia; 3Science and Technology Park of the University of
Tehran, College of Agriculture & Natural Resources, University of Tehran, Karaj, Iran;
4
Department of Pharmacognosy, School of Pharmacy, Mashhad University of
Medical Sciences, Mashhad, Iran
Abstract
Neuro-system conditions including neurodegenerative and neuropsychiatric disorders are a common
and growing cause of mortality and morbidity worldwide. e currently available pharmaceuticals are
of limited ecacy and associated with a range of adverse side eects. Traditional Persian Medicine
(TPM) including Persian herbal medicine, which has been used for various neuro-system disorders
over centuries, can oer alternative viable options. Moreover, Persian herbs can serve as a potential
and rich source for identifying novel pharmacologic interventions. In this chapter, some of the com
monly used herbal medicines for nervous system disorders mentioned in Canon of Medicine are discussed and the evidence of their eectiveness from preclinical and clinical studies is reviewed. Based
on the current ndings, these herbs have demonstrated therapeutic potential for the treatment of
nervous disorders; however, more research is needed to conrm their clinical ecacy and to establish
the underlying mechanisms of action.
-
Special Advantages of Traditional
Persian Medicine in the Treatment
of Nervous System Disorders
Nervous system disorders are pervasive and
functionally disabling conditions that create
considerable challenges for individuals and
*Email: z_ayati@yahoo.com.au
© CAB International 2023. Medicinal Plants Used in Traditional Persian Medicine
(eds. H. Schulz, Seyed Ahmad Emami and Farsad Nadjafi)
DOI: 10.1079/9781800621671.0004 167
tions for many nervous system disorders, such
as Alzheimer’s disease (AD), are generally lacking. While a range of pharmaceutical agents
are currently available to alleviate these conditions, the clinical outcomes are usually limited
to modest symptomatic relief and many of
168 Zahra Ayati et al.
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these interventions cause a range of undesirable side effects. As such, other novel treatments, as adjunctive or alternatives to existing
medications, are urgently warranted for patients with neuro-system dysfunction.
Complementary and traditional medicine is a valuable source of medical knowledge
that provides potentially feasible interventions which can lead to finding novel phytopharmaceuticals. Traditional Persian Medicine
(TPM) has been wildly practiced in vast geographic areas including Persia and India for
more than 12 centuries (Sigerist, 1987; Elgood, 2010). Combining the traditional knowledge of ancient Iran and Greece as well as archaic civilizations such as India and China,
and through clinical observation and practice
over many centuries, TPM has evolved into a
holistic and comprehensive medical system
with its own scientific theories (Gorji and
Ghadiri, 2001). Herbal medicine, a key modality of TPM that uses medicinal plants in simple and compound formulations, has been
used for the prevention and treatment of numerous diseases including nervous system
disorders. Canon of Medicine is a well-known
ancient literature that belongs to Avicenna,
the famous philosopher and physician of the
11th century . This chapter will provide an
overview of the scientific evidence for the
commonly recommended medicinal herbs
used for the management of nervous system
disorders in Canon of Medicine. It is worth noting that TPM including Canon of Medicine has
a holistic approach to the treatment/management of nervous system disorders and herbal
therapy is often combined with lifestyle modification (such as diet therapy) and psychotherapy (Ahmadian-Attari et al., 2014).
The bioenergetic basis for neurotransmission and energy consumption specific to
neuronal functioning is mostly provided by
deriving approximately 20% from glucose.
Most communication between neurons by
synapse transmission is a highly energydemanding process. Unlike the skeletal muscles, the brain is always highly metabolically
active and has minimal energy reserves, and
is therefore dependent on the regular supply
of energy substrates from the circulation
through the blood–brain barrier. When glucose, the major energy fuel for the brain, is
reduced, the brain can use alternative energy
substrates such as lactate, medium-chain
triglycerides, and ketone bodies. As the
brain continuously consumes a considerable
amount of energy, even in the absence of any
particular task, it means that intrinsic electrochemical activity occurs continually, even
during sleep and mental work, thus only adding a small increment (less than 5%) to the
basal neural activity. Under sustained, intense mental processing, a measurable decrease in circulating levels of glucose and
oxygen takes place. The brain consumes approximately 3.5 ml of oxygen per minute and
per 100 g of tissue. When oxygen delivery is
damaged, not only cognitive and physical
performance decline, but also fatigue and
tiredness are perceived. Fatigue and perceived psychological or cognitive difficulties
are faced. Therefore, a selection of balanced
foods and medicinal plants with hot and cold
temperament based on TPM has several effects on some metabolic parameters and may
play an important role in modifying brain
function and/or delaying the onset of different types of dementia, particularly among
those who are at high risk for the disease
(Tardy et al., 2020).
From the viewpoint of Avicenna, medical rationalism is an important part of medicine. From the 1990s, medical practice based
on observation and experience became more
important. The rationalism of Persian phys
icians resulted from an experimental-based
educational method and clinical experiences
in different historical periods passed from
generation to generation. Rationalism as a
complementary method can further improve
the performance of physicians rather than
relying solely on evidence from randomized
controlled trials, meta-analyses, etc. For ex
ample, in the field of neurology, Avicenna
was the first physician to differentiate between central and peripheral facial palsy by
clinical examination (Ghaffari et al., 2022).
The brain and nervous system
disorders in the view of Canon
According to traditional theory, mental, psychiatric, and physical dimensions are affected
by temperament as the interplay between
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essential body elements. A sanguine or bloody
character is a person with cordiality, authoritative and dashing character, is self-confident
and not depressed. A phlegmatic person has a
lot of secretion in phlegm, is lazy and not active, and has slight irritability. A bilious or
choleric person is associated with a fiery temper and irritability, and nervousness. A black
bile character is a depressed person associated
with longing depression and sadness. Furthermore, there are some distinct properties considered for brain temperament identification.
Avicenna mentioned that the brain essence is created cold to moderate. There are
various theories for brain temperament creation. The first, describing the cold tendency, is the brain’s willingness to endure a
lot of work, which includes: (i) controlling
the strong movements of body organs and
many different actions and various functions in daily life that have a direct relationship with memory, thinking, and imagination;
and (ii) the reactions of the five senses,
which receive inspiration and orders from
the brain. The soul is warm, comes from the
heart to the brain, and needs to become
cold. If the brain were not naturally created
with a cold and moist temperament, it would
suffer from excessive heat and dryness despite
the huge amount of information entered
into it and its processing.
The second theory says that, compared
with other organs, the brain has a less cold
temperament, which means it is near to
a balanced temperament or a moderate
temperament.
According to yet another view for brain
temperament estimation, sensory actions,
motor movements, thinking, and cerebration are performed in the brain, which is
done with heat. According to this theory and
some clinical evidence of brain tempera
ment, the brain should be warm. It seems
that nature adjuncts fat and brain tissue
with each other and moves the brain away
from the center of the body, placing it near
the cold nature organ, like skeletal bones, to
act in the direction of balancing the brain
tissue (Attarfar and Ashrafzadeh, 2014).
The central nervous system (CNS), liver,
and heart are mentioned as cardinal organs
that need special care in both preventive and
treatment approaches. The health of the
CNS is affected by the healthy functions of
other cardinal organs.
Most of what results in forgetfulness is
due to cold and dampness, especially cold,
and it may be due to brain inflammation or
may be a symptom with health problems
that warns of brain diseases, such as epilepsy and stroke. In addition to the
principles of the traditional theory of body
composition and resultant quality (temperament) therefrom, which help to know the
conditions of the brain, some other indices
are also considered like sensory actions,
degree and quality of movement, thinking,
remembrance, imagination, hallucination,
the power of illusion, motor and spiritual actions, eye color and condition, and hair (considered cold to moderate), its curliness,
growth rate and fall, and color (black, blonde,
or red, and prone to graying). The state of
sleep and wakefulness, the largeness, smallness, heaviness, and lightness of the head,
smells, nasal discharge, psychic function,
speech communication, and expressive style
also could reveal the brain temperament and
related functions. When the brain becomes
cold, its optimal performance and ability are
diminished. People with a cold and moist
type of dementia have increased posterior
nasal discharge, lacrimation, intensified
deep sleep, and drowsiness. The signs of
cold phlegmatic substances are perceptible
cold, prolonged injury, lack of redness in the
face and eyes, heavier phlegm, laziness, dull
-
ness, lethargy, and forgetfulness.
In cold and dry temperament of the
brain, the most important clinical manifestations are loss of power of expression by
speech, insomnia or hyposomnia, and dry
nasal discharge. Some conditions are revealed during clinical examination, and they
clearly show the state of the brain. Other
conditions are hidden, whose action will appear in the brain later. For example, sadness
and a lot of avoidance by people indicate melancholy or epilepsy, which is about to happen
and will appear soon. Getting angry for no
reason is followed by epilepsy, hot melancholy, or mania. Laughing without any reason is an alarm of the deterioration of the
mind and the weakness of the brain. Confusion of thought may also occur in diseases of
cold brain temperament. The temperament
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of elderly people is usually cold and dry and
the temperament of the main body organs is
cold. According to physiological changes during senile ages, and regarding TPM, their
main organs, such as CNS, tend to be dry.
However, their gastrointestinal tract tends to
be cold and wet due to abnormal moisture
and phlegm accumulation in it. Paying attention to mental health is necessary in older
adults because they are more susceptible to
stress and anxiety. The following are some indices for brain temperament identification.
Warm brain temperament is indicated
by thick, dark colored, and fast-growing
hair, but premature hair loss. Cold brain
temperament is indicated by light colored,
slow-growing, weak, and thin hair. Baldness
has a direct relationship with warmness and
wetness of the brain. Wet brain temperament has thin, slow-growing, light, and
sparse hair. Curliness is the sign of dry
hairs. Premature hair loss decreases in wet
temperament.
According to Avicenna’s theory, the optimal brain temperament is cold and wet.
Warm and dry brain dystemperament causes
insomnia. Light and short sleep is due to
warm brain temperament. Severe insomnia
is a sign of dry temperament. In cold brain
temperament sleepiness is too much. In wet
brain temperament, laziness and lethargy
are excessive and deep sleep is obvious. The
patients nap all the time, not having deep
and pleasant sleep (Feyzabadi et al., 2014).
Dementia is not a single disease but is a
clinical syndrome characterized by impairment of several brain functions. Cognition
skills such as thinking, memory, calculation,
learning, language, and judgment change.
Personality and social interactions and emotional abilities are also severely changed
(Geldmacher and Whitehouse, 1996).
Alzheimer’s disease or AD is the most
common type of degenerative dementia and
is estimated to account for 50–60% of dementia cases in persons over 65 years of age.
The elderly population growing rapidly
worldwide and care of the gray population
causes significant psychological, social, and
financial burdens. The incidence of AD is expected to accelerate over the next 30 years,
especially in developing countries. There is
currently no cure for most forms of dementia. Pharmacotherapy has been suggested as
a useful plan for the management of AD and
chronic disease, focused on symptomatic
benefit and slowing disease progression
(Taheri-Targhi et al., 2019).
Although AD has not been defined as a
distinct illness in the past, it has existed as
long as the history of human beings. In
1907, Alois Alzheimer, the German physician, differentiated it from the general term
“dementia” for the first time (AhmadianAttari et al., 2020). Explanation of different
types of dementia had never been linked
with the concept of modern medicine before,
but common symptoms such as tremors, reduced memory, and cognition destruction
have always been affirmed. The most commonly recognized risk factors are midlife
hypertension, low educational skills, diabetes mellitus, tobacco use, physical inactivity, obesity, unhealthy diets, and harmful
use of alcohol, as well as midlife depression,
social isolation, and cognitive inactivity
(WHO, 2018).
Nesyan in Persian means forgetfulness
and dementia is the syndrome of cognitive
disorders accompanied by forgetfulness and
memory problems and cognitive inability. Avicenna considered mental disorders and mental damage as fisad-ol-zekr (a corruption of
memory), fisad-ol-fekr (the corruption of
thinking), and fisad-ol-takhayol (the corruption of imagination). Generally, memory
problems are categorized as the result of brain
cold/moist or cold/dry dystemperament.
Fisad-ol zekr (memory corruption) is one
type of memory disorder. The memory, in
the posterior part of the brain, is responsible
for retention, reproduction, and recognition
of past experiences, which has been damaged
in this case. All five senses of a person are in
optimal condition, and all the things they
hear and see are accurate. The objects in
dreams are correct and real-world, but the
problem is that everything that has been
seen and heard does not remain in mind. In
cold and dry brain temperament, the patient
is sleepless, remembers events in the past
but cannot recall recent events. If brain temperament becomes cold and wet, the person
experiences moderate or excessive forgetfulness ,
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the predominance of sleep, and can identify
past events but cannot keep and recollect
current events to mind. If healthy individuals suffer from forgetfulness, there is a risk
for severe brain disorders like epilepsy,
stroke, and meningitis.
Another type of memory disorder is
fisad-ol-fekr (thinking corruption). In this
kind of cognition disorder, an inability to
distinguish between wrong and right exists,
so patients of this type are incapable of
distinguishing between appropriate and
inappropriate behaviors. As a consequence
they often fail to explain exactly what they
have seen or heard.
To be distinguished from this is fisad-
ol-takhayol (imagination corruption). Here,
patients are unable to fully process the impressions they perceive, they sleep less, and
forget very quickly. Avicenna believed that
this could be the result of brain atrophy.
Melancholia in the View of Canon
Depressive and anxiety disorders ranked
among the top 25 leading causes of burden worldwide in 2019. This burden of
the two most disabling mental disorders
was high across the entire lifespan, for
both sexes, and across many locations.
More interestingly, since 2019 there has
been no reduction in the global prevalence or burden of either disorder (Santomauro, 2021).
Neuropsychiatric disorders are discussed precisely in the Canon of Medicine.
Melancholia means “blackness of the bile”,
from (melan-, “black, dark, murky”) and
(kholḗ, “bile”), which comes from the ancient
Greek word, melankholía.
Today, melancholia describes unspecified major depressive episodes (MDE), defined by the Diagnostic and Statistical
Manual of Mental Disorders Text Revision
Fourth Edition (DSM-IV-TR) as a mild form
of depression today. Pure melancholics and
atypical depressives take an intermediate
position, being very similar in many characteristics. Therefore, this means that depressive
disorders and melancholia have different
types (Angst et al., 2007).
At the first stage of melancholia, suspicion, fear with no reason, and anger are indicated. Typical clinical manifestations are
guilty feelings, sadness, sleep disturbance,
agitation or retardation, irritation, anorexia, and weight loss.
Avicenna wrote more than 23 books in
the field of psychology and was the first
physician who introduced the concept of hal-
lucinations and delusions (Yarhosseini and
Arbabi, 2019).
Even though Avicenna lived in the Middle Ages, he avoided introducing slang or
seemingly scientific beliefs in explaining psychiatric issues. In the case of delirium, he
mentioned the disease crisis in a person who
wants to pick up something that does not
exist, Avicenna believed this phase is dangerous and prone to the patient dying. According to traditional medicine, the melancholic
disorder results from excess black bile in the
brain due to moist burning in this organ. In
the simple cold and wet brain distemperament, black bile humor is produced systematically and spread all over the body, it enters
the brain and makes the temperament of the
brain pathologic. When black bile is formed
in the brain, due to the material cold and
damp abnormal temperament, in addition to
the signs of simple upset, there are symptoms due exclusively to the humor. In melancholic dry and cold brain detuning, there is
no thirst, but dryness and a stinging sensation in the nose, and insomnia is more pronounced (Salmannegad et al., 2016).
Another type of melancholia is maraqi,
where black bile accumulates in organs like
the stomach, liver, spleen, and maraq (in
TPM, the extraperitoneal layer of the abdomen is referred to as maraq). By the accumulation of black bile in any of these organs
that the body organ cannot expel, flatulence
occurs in maraq (therefore, this disorder is
known as melancholia-l-maraqi), while primary substances exist in the brain (Yousofpour, 2015).
Pathologic black bile in melancholia
sometimes comes from the phlegm or blood
humor that had been converted to normal
black bile humor.
Mania is a complicated type of melancholic disorder due to ehteragh or black bile
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burning. In the view of Avicenna, mania
manifests as anxiety, immorality, uncontrolled physical actions, and aggression, but
melancholia is accompanied by fear, corruptive thinking, and problem-concentrating,
and they are usually pessimistic.
Avicenna was the first physician who
extensively explained the clinical description and appropriate treatment of the “love
disorder” known as adjustment disorder
today. Clinical descriptions are weak, ill, and
disabled patients with prolonged fever.
When the beloved one arrives, the patient
suddenly returns to life. Adjustment disorders are characterized by an emotional response to a stressful event. Typically, the
stressor involves financial issues, a medical
illness, or a relationship problem, and the
symptom complex may involve anxious or
depressive affect or may present with a disturbance of conduct (Sadock et al., 2017).
Depression and the heart
in the view of Canon
According to the Canon of Medicine, the various mental and emotional states such as
fear, sadness, and anger emanate mainly
from the heart and the brain. Avicenna was
also the first physician to explain the role of
the heart in melancholia and to assume the
origin of the spirit there. Thus he postulated
the following relationships: when the heart
temperament changes and becomes sodawi
due to black bile, the temperament of the
vital spirit in the heart is also changed. It
reaches the brain, and the psychic soul is altered in the brain after that, making it melancholic. Abnormal humor in the brain
reaches the heart through the vessels and
raises an abnormal heart rate, causing sadness, wrong thinking, and depression.
Therefore, Avicenna believed that it would
be impossible to treat melancholia without
considering participation of the heart.
In the book by Avicenna on cardiovascular drugs, Kitab al-Adviyt-ol-Qalbiye, which
was translated into Latin under the title
Medicamenta cordialia, drugs associated with
psychiatric and cardiovascular diseases are
mentioned for the first time. Although main
prescriptions related are cardiologic drugs,
they also have a meaningful role in the treatment of depression (Khodaei et al., 2017).
Non-pharmacologic depression
treatment in Canon
Many years ago, Avicenna recognized that lifestyle change was an important factor in reducing sources of inflammation and the risk of
depression. Inflammation and free radicals are
mediating pathways for both risk and neuroprogression in depression (Berk et al., 2013).
Melancholic patients are mostly saddened by the events that happen to them or
are afraid of something for no reason. In any
case, preventing them from thinking by
keeping them engaged in work is the main
cure for this disease. Demanding work, staying awake, sorrow, fear, and anger prone the
person to melancholia. A melancholic patient should have some entertainment,
whatever it is. In all the stages necessary to
create joy and happiness, other treatment
plans include hearing soft and pleasant
sounds, seeing beautiful sights, being in
fresh and moderate air, humidifying the air
in the house, wearing soft and cotton
clothes, showering before meals with moderately warm water for relaxation, eating
and drinking delightful foods having the wet
and mild warm temperament like sweet and
greasy foods, and always smelling pleasant
essential oils and scents that today is known
as aromatherapy. Such interventions amuse
the patient and prevent them becoming engaged in deep thoughts, and reinforce the
brain. Furthermore, sleep is one of the most
evolving treatments for melancholic patients. Avicenna mentioned that pleasure results from understanding the perfections of
the five senses. They are obtained from
inner satisfaction, such as the feeling of
sweetness, smelling pleasant for the sense of
taste and smell, and feeling revenge for the
power of anger. Nothing is worse than loneliness for these patients because they soon
start thinking about unforeseen events
characterized by hopelessness and sadness.
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Pharmacologic depression treatment
in Canon
Currently, a useful first-line therapy for the
treatment of depression is pharmacotherapy or psychotherapy, as indicated in clinical
guidelines. Various types of psychosocial
stressors can stimulate the pro-inflammatory
cytokine network and increase levels
of interleukin (IL)-6 and tumor necrosis
factor-α (TNF-α). Depression is usually as-
sociated with a chronic low-grade inflammator y
response, activation of cell-mediated immunity
and the compensatory anti-inflammatory
reflex system (CIRS), which is characterized
by negative immunoregulatory processes
(Berk et al., 2013).
When melancholy is due to extreme
cold and dryness, medicines known as mo-
farreh or cardiotonics are helpful, depending
on the individual temperament of the patient. Generally, any factor that reduces sadness, anxiety, anger, and fatigue improves
mental faculties and keeps the mind bright,
produces joy, and improves alertness
(Kamaneh et al., 2019).
Venesection is also useful when black
bile spreads throughout the body, and the
effect is significant when black bile “burns”
(ehteragh). Larj as a strong laxative and
Itrifel with Cuscuta epithymum have been ex-
tensively tested by Avicenna in various practical applications. The use of liquid dosage
forms and warm tempered medicinal oils
with energizing abilities such as dill and
chamomile are also recommended in this
context. They strengthen the head and make
the patient feel good. The combination of
rose water and saffron, known as “medicinal
jollab”, is the famous traditional syrup in
TPM. Rose water and essential oil of saffron,
in the form of syrup, are quickly and effectively absorbed through the mucous membrane of the tongue and may be one of the
most effective treatments for depression. It
also acts as a cardiotonic according to Avicenna’s treatment approach for depression.
This drink could also be classified as a functional drink (nutraceutical) today and marketed accordingly. Nutrition in general is
known to contribute to psychopathology,
especially in the two most common mental
disorders (depression and anxiety), as it
affects immune function and the level of
systemic inflammation, which in turn predisposes to depression.
If the discharges have been blocked
from menstruation or through the bowels,
these discharges should flow and be expelled. Evacuation should be done once a
week using softening laxatives, which are
medium and mild. Nymphaea alba, Cyperus
rotondus, Terminalia chebula, Echium amoenum, Centaurea behen, Nepeta menthoides,
Lavandula angustifolia, Citrus medica, Ocimum basilicum, Crocus sativus, Salix aegyptiaca, Melissa officinalis, Cinnamomum zeylanicum, Curcuma zedoaria, Cinnamomum cassia,
Sedum spurium, and Rosa × damascena are
among the most used medicinal plants in
formulations for melancholia treatment.
Herbal Medicines for
Neuro-System Health
Herbal medicines have been used in TPM for
thousands of years in the form of mono- or
augmentation therapies to promote nervous
system health and treat various nervous system disorders such as dementia, epilepsy,
migraine, and Parkinson’s disease. In the
Canon of Medicine, various herbal plants such
as Piper nigrum, Brassica nigra, Zingiber offici-
nale, Cinnamomum verum, Boswellia sp., and
Crocus sativus are recommended for nervous
system health.
1
Tables 4.1 and Table 4.2 pro-
vide an overview of the main bioactive constituents, their pharmacological activity, and
the mechanisms of action of these herbs.
Brassica nigra seed (black mustard) has
been used in therapeutic preparations for
centuries in different parts of the world and
is recommended in TPM for the treatment
of various neurological disorders (Mehri and
Shojaii, 2013). B. nigra possesses cognitiveenhancing, anti-Parkinson, and antimigraine
properties. Its key constituents include
phenolic compounds, glucosinolates, flavonoids, and brassinosteroids (Kumar and
Andy, 2012). The neuroprotective effects
of B. nigra were revealed in several studies.
The intraperitoneal administration of
hydroalcoholic extract of B. nigra seed
174 Zahra Ayati et al.
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Table 4.1. Scientific and traditional names, plant parts, and preparations of commonly used herbs in
Canon of Medicine for treatment of neuro-system disorders.
Scientific
name
Brassica
English
name Arabic name Family Plant part
Mustard Khardal Brassic
nigra
Cinnamomum
Cinnamon Dars ini Lauraceae Bark Oral
verum
Crocus
Saffron Za‘faran Iridaceae Stigma Oral (tablet
sativus
Lavandula
stoechas
Melissa
French
Ustukhuddus Lamiaceae Aerial
lavender
Lemon balm Badranjbuyah Lamiaceae Leaves Oral (infusion,
officinalis
Phyllanthus
Emblic, amla Amulaj Phyllanthaceae Fruit Oral (ma’joon) Dementia
emblica
Piper nigrum Black
Folfol aswad Piperaceae Fruit Oral
pepper
Syzygium
Clove Qaranful Myrtaceae Flower,
aromaticum
Terminalia
chebula
Zingiber
Black
Halilaj Combretaceae Fruit Oral (jam,
myrobalan
Ginger Zanjibīl Zingiberaceae Rhizome Oral (jam and
officinale
a
Semisolid traditional topical dosage form.
b
A warm mixture of plants for topical administration.
c
Combined traditional paste.
aceae
Seeds,
oil
parts
bud
Route of
administration
Oral, topical
(oil,
zemada,
komadb)
c
(ma’joon
,
decoction)
and
ma’joon),
smoke,
zemad
Oral
(decoction),
inhalation
ma’joon)
(ma’joon),
topical
(zemad),
sneezing
agent
Oral
(ma’joon),
topical
(zemad,
komad)
sachet, and
ma’joon)
ma’joon),
komad
Main
indications
Dementia,
migraine,
Parkinson’s
disease,
stroke
Dementia,
Parkinson’s
disease
Paralysis,
dementia,
depression
Dementia,
migraine,
Bell’s palsy,
epilepsy,
stroke,
anxiety,
depression
Dementia,
anxiety,
OCD
Bell’s palsy,
paralysis,
dementia,
migraine
Paralysis,
dementia
Bell’s palsy,
paralysis,
dementia,
epilepsy,
stroke
Bell’s palsy,
dementia,
paralysis
Table 4.2. Pharmacologic actions and mechanisms of action of commonly used herbs in Canon of
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Medicine for neuroprotective protection.
Possible neuroScientific
name
Brassica
nigra
bioactive
compound(s) Pharmacologic action
Phenolic
compounds
(quercetin, gallic
Memory improvement,
analgesic effect,
anti-Parkinson
Suggested mechanism(s)
DPPH and OH radical scavenging,
protease inhibition
acid, ferulic acid,
rutin, caffeic
acid), phytic acid
Cinnamomum
verum
Proanthocyanidin,
cinnamaldehyde
Memory improvement,
anti-Parkinson
↓ NO, inhibiting amyloid fibril
formation, antioxidant, anticholinesterase, ↓ MAO,
upregulation of Parkin and DJ-1
Crocus
sativus
Crocin, safranal,
crocetin
Memory improvement ↓ NO level and caspase-3 activity,
↓ oxidative stress, anti-inflammatory
effect, inhibiting Aβ fibrillogenesis,
inhibiting AChE
Antidepressant, anxiolytic,
anti-OCD
↑ Reuptake inhibition of
monoamines (norepinephrine,
dopamine, serotonin), GABA-α
agonism, NMDA receptor
antagonism
Lavandula
stoechas
Linalool, linalyl
acetate, perillyl
alcohol,
1,8-cineole,
Memory improvement,
anticonvulsant
Antidepressant, anxiolytic
Antioxidant, antiapoptotic activities,
↑ VEGF expression
GABAergic and cholinergic
modulation, ↑ dopamine
aromatic phenol
Melissa
officinalis
Flavonoids, volatile
oils, triterpenes
Anti-dementia,
anticonvulsant
Stimulation of acetylcholine
receptors, AChE inhibitory activity,
inhibition of MMP-2, antiinflammatory, antioxidant
Anxiolytic, antidepressant,
↓ MAO, ↑ GABA
anti-insomnia
Phyllanthus
emblica
Piper nigrum Piperine,
Ascorbic acid,
emblicanin A,
emblicanin B
piperettine,
piperettyline
Anti-dementia,
antiepilepsy
AChE inhibitory activity, antioxidant,
anti-inflammatory, attenuating
amyloid pathologies
Anti-dementia DPPH radical-scavenging activity,
Aβ aggregation inhibition,
anti-cholinesterase, NMDA
blocker
Syzygium
aromaticum
Terminalia
chebula
Eugenol Neuroprotective, memory
improvement,
antinociceptive
Ascorbic acid,
quercetin, tannins
Anti-dementia,
anticonvulsant,
↓ NO production, ↓ IL-1β, TNF-α,
and PGE
inhibition of Aβ, AChE inhibitory
, induces BDNF,
2
Antioxidant, anti-inflammatory,
AChE inhibitory
anti-Parkinson
Zingiber
officinale
6-Shogaol Anti-dementia, anti-
neuroinflammation
Inhibits level of TNF-α, IL-1β, COX-2,
NO, iNOS, PGE2, and NF-κB,
stimulates TrK-mediated neurites
175 Nervous System Disorders
VEGF, vascular endothelial growth factor; MMP-2, matrix metalloproteinase-2; TrK, receptor tyrosine kinase.
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