Abstract
Parkinsonism encompasses a group of neurological disorders characterized by tremors, rigidity, bradykinesia, and postural instability, most commonly exemplified by Parkinson's disease (PD). This review offers an in-depth exploration of Parkinsonism, detailing its etiology, pathophysiology, clinical presentation, and treatment options from both modern medical and Ayurvedic perspectives.
Introduction
Parkinsonism is primarily identified by motor dysfunction and is caused by degeneration of dopaminergic neurons in the substantia nigra of the midbrain, although secondary causes also exist 1. Its prevalence increases with age, affecting 1% of the population over 60 years2. Ayurveda categorizes Parkinsonism symptoms under Kampavata and offers holistic approaches for management, combining lifestyle modification, herbal treatments, and Panchakarma therapy3.
Etiology and Pathophysiology
Modern Perspective: Parkinsonism results from a deficiency in dopamine due to degeneration of the nigrostriatal pathway4. Genetic factors (e.g., mutations in the LRRK2 and PARK7 genes) and environmental factors, such as exposure to toxins, contribute to its development5.
Ayurvedic Perspective: Ayurveda attributes the disease to an imbalance in Vata dosha, specifically deranged Prana Vata, which leads to tremors, rigidity, and other neurodegenerative symptoms6. The imbalance in Vata impacts nerve function, linking to the progressive neurodegeneration seen in Parkinsonism7.
Clinical Presentation
The hallmark features include:8-11
1. Motor Symptoms
Tremor: Often starting in one hand or fingers, known as a "resting tremor."
Bradykinesia: Slowness of movement, making everyday tasks take longer.
Rigidity: Stiffness in the limbs and trunk, which can cause discomfort and pain.
Postural Instability: Difficulty with balance and coordination, increasing the risk of falls.
Masked Face: Reduced facial expressions, giving a "masked" appearance.
Gait Abnormalities: Shuffling steps, reduced arm swing, and trouble initiating movement.
2. Non-Motor Symptoms
Cognitive Changes: Memory problems, slowed thinking, and difficulties with planning.
Mood Disorders: Depression, anxiety, and apathy are common.
Sleep Disorders: Trouble falling or staying asleep, REM sleep behavior disorder, and restless legs.
Autonomic Dysfunction: Issues like constipation, low blood pressure upon standing, and bladder control problems.
Sensory Symptoms: Loss of sense of smell (anosmia) is common early on.
Fatigue: Persistent, unexplained tiredness that does not improve with rest.
These symptoms can vary in severity and progression among individuals. Treatment is often personalized to help manage symptoms and maintain quality of life.
In Ayurveda, symptoms of Kampavata overlap with these motor impairments and are explained as manifestations of aggravated Vata dosha in the body12.
Diagnosis
Modern Diagnostic Tools: Clinical diagnosis based on motor symptoms supported by brain imaging such as MRI and DAT scans, which help exclude secondary causes of Parkinsonism13.
Ayurvedic Assessment: Diagnosis involves an examination of Prakriti (constitution) and Vikriti (imbalance), focusing on the identification of Vata predominance14.
Treatment Modalities
Modern Approach
Pharmacotherapy
Levodopa: The most effective drug for motor symptoms, often combined with carbidopa to prevent peripheral degradation15.
Dopamine agonists and MAO-B inhibitors as supplementary or alternative treatments16.
Surgical Interventions
Deep Brain Stimulation (DBS): Primarily targets the subthalamic nucleus or globus pallidus to reduce motor symptoms17.
Future Directions: Stem cell therapy and gene therapies targeting dopamine replacement and neuroprotection18.
Ayurvedic Approach
Herbal Medications
Mucuna pruriens (Kapikachhu): Known for containing natural L-dopa, providing symptomatic relief in tremors and rigidity19.
Ashwagandha (Withania somnifera): An adaptogen that enhances mental function and mitigates stress20.
Panchakarma Therapies
Abhyanga (oil massage) and Shirodhara: Improve circulation and reduce tremors through the calming of Vata21.
Nasya and Basti: Therapies targeting central nervous system rejuvenation and detoxification, recommended for neurodegenerative disorders22.
Diet and Lifestyle Modifications
Emphasis on a Vata-pacifying diet: warm, nourishing, and easily digestible foods that stabilize the nervous system23.
Yoga and Meditation: Practicing specific asanas and pranayama techniques to maintain balance and reduce stress, supporting motor and cognitive health24.
Integrative Approaches
Combining Ayurvedic and modern medical treatments may offer synergistic effects, providing symptomatic relief and slowing disease progression. Integrative therapies, such as using Levodopa in conjunction with Ayurvedic neurotonic herbs, are explored in emerging studies but warrant further clinical trials for efficacy validation25.
Conclusion
Parkinsonism remains a challenging condition with no definitive cure. Modern treatment focuses on symptomatic management and improving quality of life, while Ayurveda aims to balance Vata dosha and rejuvenate the nervous system. A comprehensive, integrative approach involving both modern and Ayurvedic therapies could potentially offer a new avenue for enhancing patient outcomes. Further research is essential to establish the safety and efficacy of these combined approaches.
References
Kalia LV, Lang AE. Parkinson’s disease. Lancet. 2015;386(9996):896-912.
Wirdefeldt K, Adami HO, Cole P, Trichopoulos D, Mandel J. Epidemiology and etiology of Parkinson’s disease: a review of the evidence. Eur J Epidemiol. 2011;26(Suppl 1).
Sharma RK, Dash B. Charaka Samhita of Agnivesha (Text with English Translation and Critical Exposition based on Chakrapani Datta’s Ayurveda Dipika). Vol. 3. Chowkhamba Sanskrit Series Office; 2014. p. 115-9.
Fearnley JM, Lees AJ. Ageing and Parkinson’s disease: substantia nigra regional selectivity. Brain. 1991;114(5):2283-301.
Lesage S, Brice A. Parkinson's disease: from monogenic forms to genetic susceptibility factors. Hum Mol Genet. 2009;18(R1).
Lad V. Textbook of Ayurveda: Fundamental Principles. 1st ed. Albuquerque: The Ayurvedic Press; 2002. p. 172-4.
Sharma PV. Dravyaguna Vijnana (Fundamentals of Pharmacology in Ayurveda). Vol. 2. Chaukhambha Bharati Academy; 2003. p. 132-5.
Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry. 1992;55(3):181-4.
Zhang X, Yang X, Zhu C, Ye H, Zhang Z. Nonmotor symptoms and the quality of life in movement disorder patients. Parkinsonism Relat Disord. 2017;35:41-5.
DeMaagd G, Philip A. Parkinson's disease and its management: part 1: disease entity, risk factors, pathophysiology, clinical presentation, and diagnosis. P T. 2015;40(8):504-32.
Bloem BR, Hausdorff JM, Visser JE, Giladi N. Falls and freezing of gait in Parkinson's disease: a review of two interconnected, episodic phenomena. Mov Disord. 2004;19(8):871-84.
Mishra LC, Singh BB, Dagenais S. Scientific basis for the therapeutic use of Withania somnifera (ashwagandha): a review. Altern Med Rev. 2000;5(4):334-46.
Brooks DJ. Imaging approaches in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2010;81(7):771-7.
Sharma PV. Charaka Samhita. 6th ed. Vol. 1. Varanasi: Chaukhambha Orientalia; 2001. p. 356-61.
Poewe W, Antonini A, Zijlmans JC, Burkhard PR, Vingerhoets F. Levodopa in the treatment of Parkinson's disease: an old drug still going strong. Clin Interv Aging. 2010;5:229-38.
Stocchi F, Olanow CW. Pharmacologic treatment of Parkinson disease: new therapies. Arch Neurol. 2004;61(6):844-8.
Deuschl G, Schade-Brittinger C, Krack P, et al. A randomized trial of deep-brain stimulation for Parkinson’s disease. N Engl J Med. 2006;355(9):896-908.
Barker RA, Barrett J, Mason SL, Björklund A. Fetal dopaminergic transplantation trials and the future of neural grafting in Parkinson's disease. Lancet Neurol. 2013;12(1):84-91.
Katzenschlager R, Evans A, Manson A, et al. Mucuna pruriens in Parkinson’s disease: a double-blind clinical and pharmacological study. J Neurol Neurosurg Psychiatry. 2004;75(12):1672-7.
Kulkarni SK, Dhir A. Withania somnifera: an Indian ginseng. Prog Neuropsychopharmacol Biol Psychiatry. 2008;32(5):1093-105.
Dhiman KS. Effect of Abhyanga (Ayurvedic oil massage) and Shirodhara in the management of Kampavata (Parkinsonism). Ayu. 2011;32(3):390-3.
Chopra A, Saluja M, Tillu G. Ayurveda—modern medicine interface: a critical appraisal of studies of Ayurvedic medicines to treat osteoarthritis and rheumatoid arthritis. J Ayurveda Integr Med. 2010;1(3):190-8.
Ranade S, Rege N. Ayurvedic Concepts of Food and Nutrition. Mumbai: Anamaya Publishers; 2009. p. 85-9.
Khalsa SBS. Treatment of chronic insomnia with yoga: a preliminary study with sleep–wake diaries. Appl Psychophysiol Biofeedback. 2004;29(4):269-78.
Vaidya ADB, Devasagayam TPA. Current status of herbal drugs in India: an overview. J Clin Biochem Nutr. 2007;41(1):1-11.
Why Choose Our Hospital for Parkinsonism Treatment?
Highly Qualified Ayurvedic Experts: Our team of Ayurvedic doctors brings extensive expertise to Parkinsonism treatment, holding advanced qualifications such as BAMS (Bachelor of Ayurvedic Medicine and Surgery), MS (Ayurveda), MSc in Clinical Nutrition and Dietetics, MA in Sanskrit, and PhD credentials. This depth of knowledge ensures that each patient receives care grounded in a rich understanding of Ayurvedic principles, along with the latest clinical insights.
Multidisciplinary Expertise: We offer a collaborative team approach, bringing together, Ayurvedic specialists, physiotherapists, and mental health experts. This team works in unison to create personalized care plans, balancing modern and traditional treatments.
Comprehensive Care Approach: Our unique blend of modern medical therapies and Ayurvedic treatments offers maximum symptom relief and supports overall health. Our integrative approach addresses both the immediate symptoms and the holistic wellness of each patient.
Ayurvedic Rejuvenation Programs: We provide specialized Ayurvedic therapies, such as Abhyanga, Shirodhara, Basti, and herbal treatments like Mucuna pruriens and Ashwagandha, tailored to each patient’s unique needs.
Patient-Centered Rehabilitation Services: Our rehabilitation programs include physical therapy, occupational therapy, and cognitive training, all designed to improve patients' quality of life and maintain their independence.
Focus on Preventive Health and Lifestyle Modification: We guide patients in diet, lifestyle, yoga, and meditation practices that can strengthen the nervous system, reduce stress, and slow the progression of symptoms.
Commitment to Research and Innovation: Actively involved in research, our hospital seeks to bridge traditional Ayurvedic knowledge with modern clinical advancements to develop innovative treatments.
Contact Us Now
To book your appointment or learn more, contact us at
08352318471, 9538140510, 9538140520, 9110604310,
or visit for personalized guidance on Infertility.
Gujar International Ayurveda Foundation's Ayurveda Ashraya Hospital
Address: No.2, Bengaluru Road, near Ganesh Nagar Bus Stop, Ganesh Nagar, Vijayapura, Karnataka 586109.
Gujar International Ayurveda Foundation's Ayurveda Ashraya Hospital
Address: Shri Siddheshwara Main Road(S S Road), Opposite Dharwadakar Ayurvedic Medical Shop, beside Masjid,
Vijayapura, Karnataka 586101.
Gujar International Ayurveda Foundation's Ayurveda Ashraya Hospital
Address: 6th cross, Malleshwaram circle, sampige road,
Bangalore, Karnataka 560003.
Commenti