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A comparative study to evaluate the efficacy of an oral Ayurveda compound and Panchakarma procedures in conjunction with physiotherapy in delayed milestones status of cerebral palsy
Abstract
Introduction: Cerebral palsy (CP) presents the basic problem of gross delay in the achievement of milestones according to age,
especially the motor ones. The study was planned to assess the comparative efficacy of Ayurveda drugs and procedures in the
achievement of milestones in conjunction with available standard management physiotherapy (PT). Materials and Methods: Three
basic milestones neck holding, sitting, and standing was assessed over statistical parameters with the help of the CDC scale of
milestone development. Three groups (Gp.) A B and C were made, Gp. A having PT alone was compared with Gp B with Panchkarma
(PK) and PT and Gp. C with PK, PT, and oral drugs. Standard available treatment PT was provided in all the groups. Treatment
was provided for 6 months and follow-up after every 2 months. Results within the group were assessed with the Student’s t test
and intergroup comparison with ANOVA. Results: Total 51 cases registered and randomly allocated to different groups having 17
cases in each, 6 cases in each group have discontinued and the results were drawn having 11 cases per group. After 6 months, Gp. C
presents with maximum improvement 75%, 75%, and 85% for neck holding, sitting, and standing, respectively, and holds statistically
better results (P < 0.05) in the neck holding scale in intergroup comparison. Discussion: Multimodal treatment is required for the
management of primary and associated problems of CP. No sole treatment plan can result in the expected outcome; however,
Ayurveda drugs and procedures with PT can provide safe, effective, and speedy achievement of delayed milestones ultimately gaining functional capacities.
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Moringa oleifera Lam., a plant native to tropical forests of India, is characterized by its versatile application as a food additive and supplement therapy. Accumulating evidence shows that Moringa plays a critical role in immune-related diseases. In this review, we cover the history, constituents, edibility, and general medicinal value of Moringa. The effects of Moringa in treating immune disorders are discussed in detail. Moringa can not only eliminate pathogens, including bacteria, fungi, viruses, and parasites, but also inhibit chronic inflammation, such as asthma, ulcerative colitis, and metabolic diseases. Additionally, Moringa can attenuate physical and chemical irritation-induced immune disorders, such as metal intoxication, drug side effects, or even the adverse effect of food additives. Autoimmune diseases, like rheumatoid arthritis, atopic dermatitis, and multiple sclerosis, can also be inhibited by Moringa. Collectively, Moringa, with its multiple immune regulatory bioactivities and few side effects, has a marked potential to treat immune disorders.
Valeriana officinalis L. root extracts are traditionally taken for their sedative and anxiolytic properties and are also used for muscle relaxation. Relaxant effects were clearly observed on smooth muscle whereas data on effects on skeletal muscle are scarce and inconsistent. The aim of this study was to assess whether a standardized extract (SE) of V. officinalis had myorelaxant effects by decreasing skeletal muscle strength and/or neuromuscular tone in mice. Mice received an acute dose of V. officinalis SE (2 or 5 g/kg per os) or tetrazepam (10 mg/kg ip), a standard myorelaxant drug. Thirty minutes later, the maximal muscle strength was measured using a grip test, while global skeletal muscle function (endurance and neuromuscular tone) was assessed in a wire hanging test. Compared to tetrazepam, both doses of V. officinalis SE induced a pronounced decrease in skeletal muscle strength without any significant effects on endurance and neuromuscular tone. This study provides clear evidence that the extract of V. officinalis tested has a relaxant effect on skeletal muscle. By decreasing skeletal muscle strength without impacting endurance and neuromuscular tone, V. officinalis SE could induce less undesirable side effects than standard myorelaxant agents, and be particularly useful for avoiding falls in the elderly. © 2017 Center for Food and Biomolecules, National Taiwan University.
Cerebral palsy (CP) is the most common movement disorder in children that is associated with lifelong disability and multiple impairments. The clinical manifestations of CP vary among children. CP is accompanied by a wide range of problems and has a broad spectrum. Children with CP demonstrate poor fine and dross motor function due to psychomotor disturbances. Early rehabilitation programs are essential for children with CP and should be appropriate for the age and functional condition of the patients. Kinesio taping (KT) technique is a relatively new technique applied in rehabilitation programs of CP. This article reviews the effects of KT techniques on improving motor skills in children with CP. In this study, we used keywords "cerebral palsy, Kinesio Tape, KT and Taping" in the national and international electronic databases between 1999 and 2016. Out of the 43 articles obtained, 21 studies met the inclusion criteria. There are several different applications about KT technique in children with CP. Review of the literature demonstrated that the impact of this technique on gross and fine motor function and dynamic activities is more effective than postural and static activities. Also this technique has more effectiveness in the child at higher developmental and motor stages. The majority of consistent findings showed that KT technique as part of a multimodal therapy program can be effective in the rehabilitation of children with CP to improve motor function and dynamic activities especially in higher developmental and motor stages.
Objective of the study was to assess the efficacy of Samvardhana ghrita orally and by Matrabasti in motor disabilities of cerebral palsy in children. Study was carried out in the IPD. 40 children satisfying diagnostic criteria and age 2-10 years were included & randomly distributed into two groups of 20 patients each. Group A (Samvardhana ghrita orally) treated with 5 gms of Samvardhana ghrita with Madhu as anupana twice daily for 48 days. In Group B (Samvardhana ghrita as matrabasti), 20 ml of Samvardhana ghrita was administered through basti after local abhyanga with Moorchita Taila and local Swedana with Nadisweda method. For oral and matrabasti route, Group A and B shown improvements in language and performance (61.11%, 46.15%), speech (66.66%, 56.25%) and performance of skill (57.89%, 76.45%), in fine motor functions such as puts small object in a container (58.88%, 66.66%), throws ball in all direction (38.23%, 60.00%), uses thumb and index finger (34.21%, 68.75%), retain 2 one inch cube in fist (34.21%, 55.58%), folds paper inserts into envelope (66.66%, 38.88%), in gross motor functions such as in crawling (31.85%, 48.00%), sitting (55.55%, 57.89%), standing (36.36%, 61.90%), walking (34.61%, 44.00%) and claps hands (44.44%, 63.41%) respectively. Both oral administration and basti route of samvardhana ghrita have promising result in managing motor disabilities of cerebral palsy in children.
Cerebral pal sy (CP) is a common chronic motor disability among developmental disorder prevalent world widely a mong pediatric population. It is a group of condition characterized by motor dysfunction due to non progressive brain damage in its early developing period; often accompanied by other features like seizures, behavioral disorder, cognitive impairment and other secondary musculoskeletal problems restricting them from normal independency. The condition poses considerable therapeutic challenge to the treating physician. Currently there is no specific treatment available in modern medical science to counteract the brain insult leading to motor dysfunction in CP. The available therapeutic interventions are mostly symptomatic and costlier. Recent advances in Ayurvedic clinical research have shown increased understanding of etiopathogenesis, its causal pathway of presentation and the value of specific intervention strategies in the management of Cerebral palsy. Ayurveda recommends multiple treatment options for intervention at various levels. Out of them, Panchkarma therapy and oral herbal formulations with properties of anti spasticity, anti convulsant, neurogenerative capacity etc. plays a vital role in t he management. This paper provides a critical review on the effect of currently available treatment modalities of Ayurveda that can efficiently manage Cerebral palsy.
Objective of the study was to assess the efficacy of Samvardhana ghrita orally and by Matrabasti in motor disabilities of cerebral palsy in children. Study was carried out in the IPD of Dept. of Kaumarabhritya, SDM College of Ayurveda & Hospital, Hassan, Karnataka, India. 40 children satisfying diagnostic criteria and age 2-10 years were included & randomly distributed into two groups of 20 patients each. Group A (Samvardhana ghrita orally) treated with 5 gms of Samvardhana ghrita with Madhu as anupana twice daily for 48 days. In Group B (Samvardhana ghrita as matrabasti), 20 ml of Samvardhana ghrita was administered through basti after local abhyanga with Moorchita Taila and local Swedana with Nadisweda method. For oral and matrabasti route, Group A and B shown improvements in language and performance (61.11%, 46.15%), speech (66.66%, 56.25%) and performance of skill (57.89%, 76.45%), in fine motor functions such as puts small object in a container (58.88%, 66.66%), throws ball in all direction (38.23%, 60.00%), uses thumb and index finger (34.21%, 68.75%), retain 2 one inch cube in fist (34.21%, 55.58%), folds paper inserts into envelope (66.66%, 38.88%), in gross motor functions such as in crawling (31.85%, 48.00%), sitting (55.55%, 57.89%), standing (36.36%, 61.90%), walking (34.61%, 44.00%) and claps hands (44.44%, 63.41%) respectively. Both oral administration and basti route of samvardhana ghrita have promising result in managing motor disabilities of cerebral palsy in children.
Optimum sample size is an essential component of any research. The main purpose of the sample size calculation is to determine the number of samples needed to detect significant changes in clinical parameters, treatment effects or associations after data gathering. It is not uncommon for studies to be underpowered and thereby fail to detect the existing treatment effects due to inadequate sample size. In this paper, we explain briefly the basic principles of sample size calculations in medical studies.
Traditional knowledge suggests that Bacopa monnieri enhances cognitive performance. Such traditional beliefs have now been scientifically tested through a handful of randomized, controlled human clinical trials. The current systematic review aimed to examine the scientific evidence as to whether Bacopa can enhance cognitive performance in humans.
A systematic review of randomized controlled trials is presented. Multiple databases were systematically searched by multiple authors. Relevant trials were objectively assessed for methodological quality.
The subjects studied were adult humans without dementia or significant cognitive impairment. Interventions: B. monnieri, including Bacopa extracts, were administered over long-term supplementation periods.
Any validated cognitive test, whether a primary or secondary outcome.
Six (6) studies met the final inclusion criteria and were included in review. Trials were all conducted over 12 weeks. Across trials, three different Bacopa extracts were used at dosages of 300-450 mg extract per day. All reviewed trials examined the effects of Bacopa on memory, while other cognitive domains were less well studied. There were no cognitive tests in the areas of auditory perceptual abilities or idea production and only a paucity of research in the domains of reasoning, number facility, and language behavior. Across studies, Bacopa improved performance on 9 of 17 tests in the domain of memory free recall. There was little evidence of enhancement in any other cognitive domains.
There is some evidence to suggest that Bacopa improves memory free recall with evidence for enhancement in other cognitive abilities currently lacking perhaps due to inconsistent measures employed by studies across these cognitive domains. Research into the nootropic effects of Bacopa is in its infancy, with research still yet to investigate the effects of Bacopa across all human cognitive abilities. Similarly, future research should examine the nootropic effects of Bacopa at varied dosages and across different extracts.
Attention deficit/hyperactivity disorder (ADHD) is a behavioral disorder of children. It is the most common neurological disorder of childhood. The present study was conducted to examine the increase in attention span in 43 ADHD-affected children treated with different approaches. The reaction time was measured using a Vernier chronoscope (electronic). Selected children of both sexes in the age-group of 6-16 years were divided into three groups. In group A, 17 patients received syrup Ayurvedic compound I; in group B, 14 patients were treated with syrup Ayurvedic compound I + Shirodhara with milk; and in group C, 12 patients received syrup Ayurvedic compound II (placebo). The dose of the drug was 1.0 ml/kg body weight and the duration of treatment was 3 months. Group B showed highly significant (P<.001) improvement in total reaction time, while in group C the change was statistically nonsignificant P > 0.10. It was found that while the drug and Shirodhara were both effective in improving the reaction time of ADHD-affected children, the drug combined with Shirodhara was superior to the drug used alone.
The cognitive impairment seen in epileptics may be a consequence of either the underlying epileptogenic process alone or it could manifest on account of the use of antiepileptic drugs that cause cognitive impairment as an adverse effect or both. Thus, there is a need for drugs that can suppress epileptogenesis without contributing to or, if possible, by acting to prevent the development of cognitive impairment. Emblica officinalis, an Indian medicinal plant, has marked antioxidant property. The effect of seven days pretreatment of 300, 500 and 700 mg/kg doses of hydroalcoholic extract of E. officinalis (HAEEO) administered intraperitoneally to rats was evaluated on pentylenetetrazole (PTZ) induced seizures, cognitive deficit and oxidative stress markers viz malondialdehyde (MDA) and glutathione. The 500 and 700 mg/kg ip doses of HAEEO completely abolished the generalized tonic seizures and also improved the retention latency in passive avoidance task. Further, HAEEO dose-dependently ameliorated the oxidative stress induced by PTZ. These findings suggest the potential of HAEEO to be used as an adjuvant to treatment with antiepileptic drugs.
This study assessed the psychoneuroimmunologic changes achieved by Shirodhara, an Ayurvedic treatment, characterized by dripping oil on the forehead, in a randomized, controlled protocol involving a novel approach using a robotic system.
In the first experiment for the determination of the most appropriate conditions of Shirodhara, 16 healthy females (33 +/- 9 years old) underwent a 30-minute treatment. In the second study, another 16 healthy females (39 +/- 9 years old) were assigned to either the Shirodhara treatment or control supine position for 30 minutes, with monitoring of physiologic, biochemical, immunologic, and psychometric parameters including anxiety and altered states of consciousness (ASC).
The subjects receiving Shirodhara treatment showed lowered levels of state anxiety and higher levels of ASC than those in the control position. Plasma noradrenaline and urinary serotonin excretion decreased significantly more after Shirodhara treatment than in the control. Plasma levels of thyrotropin-releasing hormone, dopamine, and natural killer (NK) cell activity were different between control and Shirodhara treatment. The correlation between anxiolysis and the depth of ASC was significant in the Shirodhara treatment group (r = 0.52, p < 0.05, N = 16), while in the control no correlation was obtained (r = 0.13, p = 0.64, N = 16). The increase in foot skin temperature after Shirodhara showed a significant correlation with anxiolysis and the depth of Trance of ASC (r = 0.58, p < 0.01, r = 0.43, p < 0.01, respectively). NK cell activity after Shirodhara treatment showed a significant correlation with anxiolysis and the depth of Trance of ASC (r = 0.33, p < 0.05, r = 0.56, p < 0.01, respectively).
These results indicate that Shirodhara has anxiolytic and ASC-inducing effects, and it promotes a decrease of noradrenaline and exhibits a sympatholytic effect, resulting in the activation of peripheral foot skin circulation and immunopotentiation.
Many coaches, athletes and sports medicine personnel hold the belief, based on observations and experiences, that massage can provide several benefits to the body such as increased blood flow, reduced muscle tension and neurological excitability, and an increased sense of well-being. Massage can produce mechanical pressure, which is expected to increase muscle compliance resulting in increased range of joint motion, decreased passive stiffness and decreased active stiffness (biomechanical mechanisms). Mechanical pressure might help to increase blood flow by increasing the arteriolar pressure, as well as increasing muscle temperature from rubbing. Depending on the massage technique, mechanical pressure on the muscle is expected to increase or decrease neural excitability as measured by the Hoffman reflex (neurological mechanisms). Changes in parasympathetic activity (as measured by heart rate, blood pressure and heart rate variability) and hormonal levels (as measured by cortisol levels) following massage result in a relaxation response (physiological mechanisms). A reduction in anxiety and an improvement in mood state also cause relaxation (psychological mechanisms) after massage. Therefore, these benefits of massage are expected to help athletes by enhancing performance and reducing injury risk. However, limited research has investigated the effects of pre-exercise massage on performance and injury prevention.
Massage between events is widely investigated because it is believed that massage might help to enhance recovery and prepare athletes for the next event. Unfortunately, very little scientific data has supported this claim. The majority of research on psychological effects of massage has concluded that massage produces positive effects on recovery (psychological mechanisms). Post-exercise massage has been shown to reduce the severity of muscle soreness but massage has no effects on muscle functional loss. Notwithstanding the belief that massage has benefits for athletes, the effects of different types of massage (e.g. petrissage, effleurage, friction) or the appropriate timing of massage (pre-exercise vs post-exercise) on performance, recovery from injury, or as an injury prevention method are not clear. Explanations are lacking, as the mechanisms of each massage technique have not been widely investigated. Therefore, this article discusses the possible mechanisms of massage and provides a discussion of the limited evidence of massage on performance, recovery and muscle injury prevention. The limitations of previous research are described and further research is recommended.
Centella asiatica (CeA) is a creeper, growing in moist places in India and other Asian countries. Leaves of CeA are used for memory enhancement in the Ayurvedic system of medicine, an alternate system of medicine in India. In the present study, we investigated the role of CeA fresh leaf extract treatment on the dendritic morphology of hippocampal CA3 neurons, one of the regions concerned with learning and memory, in adult rats.
In the present study, adult rats (2.5 months old) were fed with 2, 4 and 6 mL/kg body weight of fresh leaf extract of CeA for 2, 4 and 6 weeks, respectively. After the treatment period, the rats were killed, brains were removed and hippocampal neurons were impregnated with silver nitrate (Golgi staining). Hippocampal CA3 neurons were traced using camera lucida, and dendritic branching points (a measure of dendritic arborization) and intersections (a measure of dendritic length) were quantified. These data were compared with those of age-matched control rats.
The results showed a significant increase in the dendritic length (intersections) and dendritic branching points along the length of both apical and basal dendrites in rats treated with 6 mL/kg body weight/day of CeA for 6 weeks. However, the rats treated with 2 and 4 mL/kg body weight/day for 2 and 4 weeks did not show any significant change in hippocampal CA3 neuronal dendritic arborization.
We conclude that constituents present in Centella asiatica fresh leaf extract has neuronal dendritic growth-stimulating properties.
An imbalance in Dosh equilibrium is termed as 'Roga'. Among Tridosha, Vata is responsible for all Cheshtas (activities) and most of the diseases. General treatments of Vatavyadhi are Snehana, Svedana, Mridu Samshodhana, Basti, Vatahara Aushadha, Ahara and Vihara. Snehana and Svedana are specific line of treatment for Vatavyadhi besides being the chief Purvakarma procedure for Panchakarma therapy. Sneha Dravya possesses Drava, Sukshma, Sara, Snigdha, Manda, Mridu and Guru properties which are just opposite to those of Vata, therefore, it alleviates the Vata. Snehana therapy is administered to a person in two different ways, external applications as Abhyanga(massage), Unmardana(rubbing), Lepa(paste), Pariseka(pouring of oil), Janu vasti, Kati vasti, Griva vasti, Moordha tail, Shiropichu,Shirodhara, Shiro vasti, Gandusha(gargling), Akshitarpana(application of medicine over the eyelids), Karnapoorana(filling the ear with oil) etc. Internal application has been divided into three varieties on the basis of their effect viz., Brimhana, Shamana and Shodhana. Both external and internal Snehana are effective in Vatavyadhi. Svedana is the process by which perspiration is induced in the body which removes stiffness, heaviness and coldness of the body, by opening of the blocked channels. Acharya Charaka has classified Svedana in two groups-Agni Sveda and Niragni Sveda.
Objective
To determine the pooled-prevalence of cerebral palsy in Indian children.
Methods
The authors searched the published literature from different databases (PubMed, Ovid SP and EMBASE) and also tried to acquire information from the unpublished literature about the prevalence of cerebral palsy. They screened prospective/retrospective, cross-sectional, and cohort studies of children with cerebral palsy in the Indian population. Data were extracted from the included studies, and quality assessment was performed. Data were analysed using STATA MP12 (Texas, College Station).
Results
Of the 862 publications searched, eight studies were qualified and included for quantitative analysis. The overall pooled prevalence of cerebral palsy per 1000 children surveyed was 2.95 (95% CI 2.03–3.88). Sub-group analysis for rural, urban and mixed rural-urban study population demonstrated the pooled prevalence as 1.83 (95% CI 0.41–3.25), 2.29 (95% CI 1.43–3.16) and 4.37 (95% CI 2.24–6.51) respectively.
Conclusions
This systematic review observed a paucity of high-quality, prevalence studies of cerebral palsy in India, which is a limitation to estimate the inferences for a national estimate. The observed prevalence of cerebral palsy in India is near similar to global estimates. There is a need to re-allocate resources and revisit the implementation of the existing policies for the prevention and management of cerebral palsy, taking into account the current disease burden.
Created specifically for massage therapy students, the Third Edition of Anatomy & Physiology: The Massage Connection elucidates anatomy and physiology with clear, concise language complemented by an extraordinary multilayer art program. Organized to cover each body system and align with current massage therapy curricula, topics have been streamlined so that those areas critical for massage therapy-such as the musculoskeletal system-receive special coverage, whereas excessive detail in areas not relevant for massage is omitted. This edition also delivers a host of review activities in addition to a blockbuster ancillary package of online tools and complementary resources. Anatomy & Physiology: The Massage Connection is just that-the link between the science of medicine and the art of massage as well as a bridge for students to a successful career in massage therapy.
Naja commonly referred as Cobra is a genus of venomous elapid snakes found in the Middle East, India, and southern eastern Asia posse's complex mixture of toxin proteins which are found to have pharmacological activities. These neurotoxins bind specifically to the nicotinic acetylcholine receptors, thereby blocking synaptic nerve transmission. Short neurotoxin protein sequences of Cobra were retrieved from Swiss prot database and multiple sequence alignment was performed on the retrieved sequences using ClustalX. Phylogenetic relationships were analyzed using Phylip software and sequences were modeled through Modeller 9v8. The quality of the model was validated by the Structural analysis verification server. Tropine derived from Ashwagandha was investigated for its skeletal muscle relaxant property. The interaction between the inhibitors and the predicted structures of short neurotoxin were analyzed Insilco by ArgusLab. From this study we conclude that short neurotoxin of Naja oxiana showed the higher affinity towards Tropine.
Twenty young children (mean age = 32 months) with cerebral palsy (CP) recruited from early intervention programs received 30 minutes of massage or reading twice weekly for 12 weeks. The children receiving massage therapy showed fewer physical symptoms including reduced spasticity, less rigid muscle tone overall and in the arms, and improved fine and gross motor functioning. In addition, the massage group had improved cognition, social and dressing scores on the Developmental Profile, and they showed more positive facial expressions and less limb activity during face‐to‐face play interactions. These findings suggest that massage therapy attenuates physical symptoms associated with CP, enhances development and should be considered as an early intervention for children with CP.
We previously reported that the methanol extract of Ashwagandha (roots of Dunal) induced dendrite extension in a human neuroblastoma cell line. In this study, we found that six of the 18 compounds isolated from the methanol extract enhanced neurite outgrowth in human neuroblastoma SH-SY5Y cells. Double immunostaining was performed in rat cortical neurons using antibodies to phosphorylated NF-H as an axonal marker, and to MAP2 as a dendritic marker. In withanolide A-treated cells, the length of NF-H-positive processes was significantly increased compared with vehicle-treated cells, whereas, the length of MAP2-positive processes was increased by withanosides IV and VI. These results suggest that axons are predominantly extended by withanolide A, and dendrites by withanosides IV and VI.
Cerebral palsy is the commonest physical disability in childhood, occurring in 2.0 to 2.5 per 1000 live births. Although the total number of children with cerebral palsy has remained stable or increased slightly since 1970, there has been a consistent rise in the proportion of cerebral palsy associated with preterm and very preterm births. Known causes of cerebral palsy--whether prenatal, perinatal or postnatal--must be distinguished from risk factors or associations. Much is known about such risk factors which, alone or in combination, may indirectly result in cerebral palsy. Causes and risk factors implicated in cerebral palsy are discussed in detail, together with directions for future research.
Alcoholic extract of the fruits of the plant Piper longum and its component piperine was studied for their immunomodulatory and antitumor activity. Alcoholic extract of the fruits was 100% toxic at a concentration of 500 microg/ml to Dalton's lymphoma ascites (DLA) cells and 250 microg/ml to Ehrlich ascites carcinoma (EAC) cells. Piperine was found to be cytotoxic towards DLA and EAC cells at a concentration of 250 microg/ml. Alcoholic extract and piperine was also found to produce cytotoxicity towards L929 cells in culture at a concentration of 100 and 50 microg/ml, respectively. Administration of alcoholic extract of Piper longum (10 mg/dose/animal) as well as piperine (1.14 mg/dose/animal) could inhibit the solid tumor development in mice induced with DLA cells and increase the life span of mice bearing Ehrlich ascites carcinoma tumor to 37.3 and 58.8%, respectively. Administration of Piper longum extract and piperine increased the total WBC count to 142.8 and 138.9%, respectively, in Balb/c mice. The number of plaque forming cells also enhanced significantly by the administration of the extract (100.3%) and piperine (71.4%) on 5th day after immunization. Bone marrow cellularity and alpha-esterase positive cells were also increased by the administration of Piper longum extract and piperine.
Axonal regeneration is important for functional recovery following nerve damage. Centella asiatica Urban herb, also known as Hydrocotyle asiatica L., has been used in Ayurvedic medicine for centuries as a nerve tonic. Here, we show that Centella asiatica ethanolic extract (100 microg mL-1) elicits a marked increase in neurite outgrowth in human SH-SY5Y cells in the presence of nerve growth factor (NGF). However, a water extract of Centella was ineffective at 100 microg mL-1. Sub-fractions of Centella ethanolic extract, obtained through silica-gel chromatography, were tested (100 microg mL-1) for neurite elongation in the presence of NGF. Greatest activity was found with a non-polar fraction (GKF4). Relatively polar fractions (GKF10 to GKF13) also showed activity, albeit less than GKF4. Thus, Centella contains more than one active component. Asiatic acid (AA), a triterpenoid compound found in Centella ethanolic extract and GKF4, showed marked activity at 1 microM (microg mL-1). AA was not present in GKF10 to GKF13, further indicating that other active components must be present. Neurite elongation by AA was completely blocked by the extracellular-signal-regulated kinase (ERK) pathway inhibitor PD 098059 (10 microM). Male Sprague-Dawley rats given Centella ethanolic extract in their drinking water (300-330 mg kg-1 daily) demonstrated more rapid functional recovery and increased axonal regeneration (larger calibre axons and greater numbers of myelinated axons) compared with controls, indicating that the axons grew at a faster rate. Taken together, our findings indicate that components in Centella ethanolic extract may be useful for accelerating repair of damaged neurons.
There is growing interest in whether phytoestrogens, especially isoflavones, affect cognitive function and have beneficial effects on neurodegenerative diseases. Previous work from our laboratory showed that puerarin (Pur), a major component of the Pueraria lobata isoflavones, displayed protective effects on learning and memory in ovariectomized (Ovx) female mice. In the present study, we investigated the effects of Pur on the synaptic structural modifications of the hippocampus in Ovx female mice. One week after ovariectomy or sham operation, female mice were given a 4-week treatment of Pur (50 or 100 mg/kg, I. G.) or estradiol benzoate (EB, 120 microg/kg, S. C.). The results from synaptic structural measurement and analysis did not show any differences in the hippocampal volumes, the synaptic numeric density, and the curvature of synaptic interface among Sham, Ovx, and Ovx plus EB or Pur replacement female mice. However, Pur replacement effectively normalized some structural changes induced by Ovx, reducing the width of the synaptic cleft, enlarging the thickness of postsynaptic density (PSD), and lengthening the synaptic active zone of the pre-existing synapses in the hippocampus CA1 area (P < 0.05 or P < 0.01). Furthermore, through Western blotting, we found that the immunocontent of the NMDA receptor subunit NR2 was not altered by Pur (108 % and 114 % of Ovx); however, the content of postsynaptic protein PSD-95 (145 % and 176 % of Ovx) and phosphorylation of NMDA receptor subunit NR2B (141 % and 172 % of Ovx) strongly increased in Ovx mice following treatment with Pur (50 or 100 mg/kg) for 4 weeks. These results suggest that Pur possesses phytoestrogen activity with 1,000 -fold lower activity than EB, and the beneficial effects of Pur on improving memory behavior of Ovx female mice are associated with the changes of synaptic structural modifications in the hippocampus.
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