Role of Panchakarma in Alzheimer's Disease.

1. Role of Panchakarma in Alzheimers Disease

2.  Alzheimer’s disease is an irreversible,
progressive brain disease that slowly
destroys memory, thinking skills and
eventually even the ability to carry out
the simplest tasks in routine.
 It is one of the major neurodegenerative
disorders in the present era.

3.  First person to report AD was a
German psychiatrist Alois Alzheimer.
 Most common cause of dementia
among people above 65 yrs of age.
 In 2015, there were approximately 48
million people worldwide with AD

4.  Etiology – exact cause still unknown
 Risk factors
▪ Age
▪ Genetics
▪ Lifestyle

5. 1. Early onset AD
▪ Rare
▪ Usually affecting people aged 30 to 60
▪ Usually running in families
2. Late onset AD
▪ Common
▪ Usually affects people over 65 yrs of age

6. • The brain has billions of
neurons, each with an axon
and many dendrites.
• To stay healthy, neurons
must communicate with
each other

7.  The brains of people with AD have an
abundance of two abnormal structures:
1. Beta-amyloid plaques - dense deposits
of protein and cellular material that
accumulate outside and around nerve
cells
2. Neuro fibrillary tangles - twisted fibers
that build up inside the nerve cell

8. Beta-amyloid Plaques
Amyloid precursor protein (APP) is the
precursor to amyloid plaque.
1. APP sticks through the neuron
membrane.
2. Enzymes cut the APP into fragments
of protein, including beta-amyloid.
3. Beta-amyloid fragments come together
in clumps to form plaques.
In AD, many of these clumps form,
disrupting the work of neurons. This affects
the hippocampus and other areas of the
cerebral cortex.

9. Neurons have an internal support structure partly made up of
microtubules. A protein called tau helps stabilize microtubules. In
AD, tau changes, causing microtubules to collapse, and tau proteins
clump together to form neurofibrillary tangles.

13. 1. Prodormal symptoms/ Pre dementia
2. Early stage/ MildAlzheimer's
3. Middle stage/ ModerateAlzheimer's
4. Late stage/ SevereAlzheimer's

14.  Not remembering episodes of forgetfulness
 Forgets names of family or friends
 Changes may only be noticed by close friends or
relatives
 Some confusion in situations outside the familiar

15.  Greater difficulty remembering recently
learned information
 Deepening confusion in many circumstances
 Problems with sleep
 Trouble knowing where they are

16.  Poor ability to think
 Problems in speaking
 Repeats same conversations
 More abusive, anxious, or paranoid

17.  Detailed history and examination
 Eight cognitive domains
▪ Memory
▪ Language
▪ Perceptual skills
▪ Attention
▪ Constructive abilities
▪ Orientation
▪ Problems solving
▪ Functional abilities
 Neuropsychological tests – Mini mental state
examination
 Investigations – MRI, PET scan

19.  No direct reference for AD
 On the basis of its clinical presentation, it
can be correlated with different entities
 SingleAyurvedic corelation- Difficult

20.  सर्वेन्द्रियाणाां शून्यत्वां ज्ञात्वा स्मृतिबलक्षयम्।
व्याने प्राणार्वृिे तलङ्गम् कमम ित्रोर्ध्वमतत्ररुककम्
(च तच 28/202)

21.  उन्मादां परुकन: मनोबरुकन्द्रिसांज्ञाज्ञानस्मृतितन्द्रशशील
चेष्टाचारतर्वभ्रमां तर्वद्याि्। (च तन 7/5)
 बरुकन्द्रि: ऊहापोहर्विी (discriminatory knowledge)
 स्मृति अिीिार्मतर्वषयज्ञान
 सांज्ञा नामोल्लेखेन ज्ञान

22.  ित्वज्ञाने स्मृतियमस्य रतोमोहार्वृिात्मन:।
भ्रांश्यिे स स्मृतिभ्रांश: स्मिमव्यां तह स्मृिौ न्द्रथर्िम्
(च शा 1/101)
 ध्यायिे तर्वषयान् परुकांस: सांगस्तेषूपतायिे।
सांगाि् सांतायिे काम: कामाि् क्रोधो अतततायिे
क्रोधाि् तर्वति सांमोह: सांमोहाि् स्मृतितर्वभ्रम:।
स्मृतिभ्रांशाि् बरुकन्द्रिनाशो बरुकन्द्रिनाशाि् प्रणश्यति
(तगर्वि् गीि 2/60)

23.  तर्वतेति दरुक:बमलो अतीक्ष्णां ध्यायति व्यतर्िेन्द्रिय:।
दरुक:च्छायो दरुक:ममना रूक्षो तर्वेि् क्षामश्च ित्क्षये
(अ हृ सू 11)
 Shiromarma abhighata

24.  Dosha – manasika dosha, vata dosha
 Dushya – Manas
 Agni – Jataragni
 Srotas – Manovaha
 Srorodushti – Sanga
 Adhishtana - Manas

25.  Shiro marma abhighata chikitsa
 Snehapana
 Shodhana chikitsa
 Rasayana prayoga
 Medhya rasayana
 Satvavajaya chikitsa

26. Shiro marma abhighataChikitsa
 न बन्द्रस्तसमां तकतिि् कमम मममपररपालनमन्द्रस्त।
( च तस 9/7)
 मूद्मति िरुक र्वािोपसृष्टे अतयङ्ग स्वेदनोपनाह स्नेहपान
नस्त:कमामर्वपीडनधूमादीतन।
(च तस 9/8)

27.  Ritu shodhana for prevention and to arrest
progression
 Snehapana – Kalyanaka gritha (AH U 6/26)
Mahakalyanaka gritha (A H U 6/28)
Brahmi gritha (A H U 6/23)
Panchagavya gritha (A H U 7/18)
Mahapaishachika gritham
Purana gritha

28.  Vamana and virechana – age to be
considered (7yrs to 70yrs)
 Nasya - Brahmi gritha
- Jyothishmati thaila
- Anu thailam
- Shadbindu thailam
 Basti – Yapana basti - Mustadi yapana basti
- Raja yapana basti….
Ksheera basti (guduchi )
 Matra basti - for prevention

29.  Abhyanga
 Shirodhara symptomatic relief
 Shirobasti reduce stress and anxiety
 Pizhichil
Formulations -Ksheerabala thaila
Tungadrumadi thaila
Himasagara thaila
Bala thaila

30.  Lashuna rasayana
 Chitraka rasayana
 Amalaki Rasayana
 Medhya rasayana- Mandookaparni swarasa
Yashtimadhu churna
Guduchi kalka
Shankapusphpi kalka

31.  Smritisagara rasa
 Sidhamakaradwaja
 Manasamitra vatakam
 Brahmi vati
 Saraswatharishta