An Overview on Corticobasal degeneration - Prevention With Ayurveda

Overview

Corticobasal degeneration is a neurological disorder characterized by cell loss and deterioration of areas of the brain. This is a rare neurodegenerative disease in which areas of the brain shrink and nerve cells degenerate and die over time. It generally affects the area of the brain which is responsible for processing the information and the structure that control movements. It results in growing difficulty in movement of one or both sides of the body. Initially, symptoms typically appear in people. This disorder is also classified as a Parkinson plus syndrome (group of neurological degenerative diseases featuring the classical Symptoms of Parkinson Disease such as rigidity, tremors, bradykinesia and postural inability)

In Ayurvedic text Acharya Charak mentioned vata vyadhi as neurological disorders

Above quoted shlokas mean vitiated vata dosha leads to vata disorders, and the Vitiation of vayu takes place from either wasting of dhatus or obstruction in passage.

Introduction

Rebeiz et al. first described it in 19671. He termed it as cortico nigral degeneration. Then in 1989 Marsden et al. introduced the term corticobasal degeneratio 2. This disease is frequently caused by other neurodegenerative disorders so researchers use the term "corticobasal syndrome" to indicate the clinical diagnosis based on the signs and symptoms. Basically, the condition may cause poor movements, poor coordination, stiffness, difficulty in thinking, trouble with speech. The affected individuals often experience motor abnormalities in one limb that gradually spreads to other limbs also. Such motor abnormalities include muscle rigidity and inability to perform voluntary movements.

Epidemiology

The data on corticobasal degeneration is lacking due to the rarity of this disease. Its incidence is estimated at 0.6-0.9/100,000/year3. Mean age for this disease onset is around 64 years of age. Men and women both can be affected with the disease but some analysis has shown a predominant appearance of Corticobasal degeneration more in women.

Clinical Features

Corticobasal degeneration is progressive in nature disease and shows symptoms that may vary from person to person. The severity of the symptoms is based on the affected part of the brain as they develop due to progressive deterioration of tissue present in different areas of the brain. Nerve cell loss occurs in specific parts of the brain leading to shrinkage.

This is important to note that all the affected patients may not have all the symptoms discussed below.

• Poor coordination
• Trouble with speech and language
• Inability to think
• Muscle stiffness
• Muscle jerk
• Difficulty in swallowing
• Dystonia (uncontrollable muscle movements)
• Difficulty in buttoning a shirt
• Abnormal eye movement
• Positional Tremors

Ancient Verse for the symptoms of neurological disorders as mentioned by Acharya Charak

Above quoted shloka means contractures, stiffness in joints, tearing in bones and joints, horripilation, delirium, stiffness in hands, back and head, limping, crippledness, humpedness, drying of organs, sleeplessness, destruction of fetus, sperms and ovum, pulsation, numbness in organs, crookedness of head, nose, eyes, clavicular region and neck, tearing, piercing pain, distress, convulsion, mental confusion and exhaustion- are the symptoms produced by the vitiated vayu.

Etiology

The exact and underlying cause of corticobasal degeneration is unknown or idiopathic. Researchers suggest that multiple different factors are responsible for this disease including genetic, environmental as well as aging. Also, research suggests that a protein in the brain called Tau, may play a role in this disease, but the function of the Tau within the nerve cell of the brain is not fully understood in this disease. Although abnormal levels of the Tau accumulates in certain parts of the brain cells, eventually causing their deterioration.

Ancient Verse showing the causes of neurological disorders according to Acharya Charak

Above shloka states that the rough, cold, little food, excessive coitus and vigils, faulty therapeutic management, excessive elimination of impurity and blood, over-movements such as leaping, jumping, wayfaring and physical exercise, wasting of dhatus, excessive emaciation due to anxiety, grief and illness, uncomfortable bed and seat, anger, day sleep, fear, suppression of urges, and ama dosha - are responsible for causing neurological disorders.

Complications

The symptoms of this disease progresses into serious complications such as pneumonia, severe sepsis, pulmonary embolism and life threatening response to an infection. These can ultimately lead to death also.

Pathology

Corticobasal degeneration appears to be a neutral network specific disorder, similar to many other neurodegenerative diseases. It initially affects the dorso lateral prefrontal cortex and basal ganglia circuits, leading to more posterior regions affected as the disease progresses. Importantly, the initial pathological disorder is the astrocytic plaque, with neurons and oligodendroglia being affected in more advanced disease stages. Phenotypical variation in this Disease depends on the topography and burden of the pathological lesions.

Samprapti (Pathophysiology) according to Acharya Charak

Above shloka states that vayu gets aggravated and fills up the vacant channels in the body producing various disorders pertaining to the entire body or one of its parts.

Differential Diagnosis

The Differential Diagnosis for Corticobasal degeneration are

• Multiple system atrophy(MSA)
• Parkinson disease
• Progressive supranuclear palsy(PSP)
• Pick disease

Diagnosis Criteria

A diagnosis of corticobasal degeneration is made basically depending upon the signs and symptoms of the patient. However, the signs and symptoms could be due to another degenerative disease. A clinical diagnosis is also required including neurological examination and various specialized tests for clarification.

The types of imaging techniques that are most prominently used to diagnose corticobasal degeneration are

1. Magnetic resonance imaging (MRI)
2. Single-photon emission computed tomography (SPECT)
3. Flourodopa positron emission tomography (FDOPA PET)

1. MRI

This scan is helpful to find out the atrophied site of the brain, especially to identify the affected parts and also find out the negative effects due to the complications associated with disease. Typical findings are asymmetric cortical atrophy, bilateral atrophy of basal ganglia, and atrophy of corpus callosum.

2. SPECT

This scan is currently used to diagnose corticobasal degeneration. There are many areas in the basal ganglia which have difficulties receiving dopamine, SPECT is used to detect these abnormalities in dopamine transporters. Basically, SPECT reveals hypo perfusion within posterior regions of both frontal and parietal lobes.

3. FDOPA PET

The researchers suggest that the integrity of the dopamine releasing system has been damaged in this disorder, so FDOPA PET scan is a possible method to identifying corticobasal degeneration on analyzing the efficacy of neurons in the striatum that utilize the neurotransmitter dopamine.

Treatment

Because the exact cause of corticobasal degeneration is unknown, then the specific treatment of this disease is also not known in modern medicine. So, the treatment focuses on minimizing the appearance of symptoms resulting from this disease (basically symptomatic treatment). The most easily treatable symptoms of this disease is parkinsonism and most common choice of treatment is dopaminergic drugs. But, as the treatment of modern medicine has many adverse effects too, it is better to go for an alte ative treatment with least or no side effects.

Planet Ayurveda manufactures its own herbal products with adherence to ancient Ayurveda. All these formulations are made using natural herbs with ancient time-tested formulas. The formulations from the Ayurvedic Experts of Planet Ayurveda that are beneficial in corticobasal degeneration disease are as below

Herbal Products

• Neurogin capsules
• Brahmi capsules
• Gotukola capsules
• Ashwagandha capsules
• Neuroplan syrup
• Brahmi Chyawanprash
• Yogendra ras tablet
• Vrihat Vatchintamani Ras

1. Neurogin Capsules

These capsules contai 100% natural and vegetarian mixture of the pure extracts of Brahmi (Bacopa monnieri) and Ashwagandha(Withania somnifera). This formulation aids in relieving the symptoms like jerking, poor coordination, Muscle stiffness, etc and maintain normal functioning of nerve cells.

Dosage: - 1 capsule twice daily with plain water, after the meals

2. Brahmi Capsules

These capsules are manufactured from the pure and standardized extract of Brahmi (Bacopa monnieri). This helps to maintain the functioning of the nervous system and is considered as the best brain tonic.

Dosage: - 1 capsule twice a day after meal, with normal water

3. Gotukola Capsules

Gotukola capsules are made using the standardized extract of Gotukola (Centella asiatica). The herb is effective in stress and anxiety.

Dosage:- 2 capsules two times a day with plain water, after the meals

4. Ashwagandha Capsules

These capsules contain the pure extract of Ashwagandha (Withania somnifera) that help to normalize the functioning of neuroendocrine systems. These capsules have a great effect on the nervous system.

Dosage: - 1 capsule twice daily with normal water, after meals

5. Neuroplan Syrup

This syrup is a blend of the organic extracts of Brahmi

Ingredients

• (Bacopa monnieri)Mandookpa i
• (Centella asiatica)Shankhpushpi
• (Convolvulus pluricaulis)Jyotishmati
• (Celastrus paniculatus)
• Ashwagandha(Withania somnifera)
• Bhojpatra (Betula utilis)
• Madhuyashti (Glycyrrhiza glabra)
• Sonth (Zingiber officinale)
• Maricha (Piper nigrum)
• Pippali (Piper longum)
• Honey and sugar.

This syrup is good for mental health.

Dosage:- 2 teaspoonful two times a day with plain water, after the meals

6. Brahmi Chyawanprash

This is also known as Rasayan (Jam). Brahmi is a nerve tonic and a major ingredient used in this formulation along with 27 other herbs. This product is a cell rejuvenator and boosts the immune system.

Dosage: - 1 teaspoonful twice a day with lukewarm milk or water, after meals

7. Yogendra ras tablet

This ayurvedic medicine basically useful in neuro-muscular diseases. These tablets are made from

• Parada(mercury)
• Gandhaka(sulphur)
• Swa a bhasma
• Loha bhasma
• Abhrak bhasma
• Vanga bhasma
• Shudha mukta.

It helps in maintaining a healthy nervous system and improves the coordination of the body functions.

Dosage: - 1 tablet to be chewed with warm milk twice a day after meal

8. Vrihat Vatchintamani Ras

This is the classical ayurvedic formulation used in the treatment of various neurological disorders. It has anti-oxidant and anti-aging properties. It is a dietary supplement that contains

• Swa a bhasma
• Rajat bhasma
• Abhrak bhasma
• Loha bhasma
• Praval bhasma
• Mukta bhasma
• Suta bhasma

Dosage: - 1 tablet to be chewed with warm milk, two times a day after meals