This document provides information on various neurological disorders and the central nervous system. It discusses the basic structure and function of the brain and neurons. It then summarizes several major neurodegenerative disorders like Alzheimer's disease, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, multiple sclerosis, and their symptoms, causes, prevalence worldwide, and current treatment approaches. Some key points covered include the role of oxidative stress in neurodegeneration, epidemiology of these disorders in India, and potential herbal treatments from traditional Indian medicine.

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2. Central Nervous System
The Brain & Nervous System in Everyday Life
The brain as a central computer that controls all the functions of
our body, then the nervous system is like a network that relays
messages back and forth from it to different parts of the body.
INTRODUCTION
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3. Brain is The Boss of Our Body
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4. Neurons
our brain is made of approximately 100 billion nerve cells,
called neurons. Neurons have the amazing ability to gather
and transmit electrochemical signals -- think of them like the
gates and wires in a computer.
Neurons share the same characteristics and have the same
makeup as other cells, but the electrochemical aspect lets
them transmit signals over long distances (up to several feet
or a few meters) and send messages to each other.
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5.  The World Health Organization estimates that 737 million persons worldwide
are estimated to be 60 years of age and older in 2009 .
This is projected to increase to 2 billion in 2050.
Disorder 2005 2030 2005-2030
Alzheimer’s and
other dementias
3.79 5.56 46.7
Parkinson’s
disease
0.81 0.91 12.3
Multiple sclerosis 0.39 0.41 5.13
Migraine 50.64 52.15 2.98
Neurological
injuries
26.45 30.66 15.91
Global prevalence of neurodegenerative disease 2005-2030
Source: WHO. Neurological disorders: public health challenges.
Geneva: WHO; 2006.
Prevalence of Neurodegenerative World Wide
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6. Epidemiology of Neurodegenerative disease in India
The prevalence of neurological disorders is rising in India. Presents data from six
of epidemiological studies conducted between 1987 - 2004. According to these
studies, the prevalence Parkinsonism, peripheral neuropathies and stroke is rising
within India.
Disability Adjusted Life Years (DALY) for neurological disorders
Source: World Health Organization. Neurological disorders: public health
challenges. Geneva: World Health Organization; 2006.
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7. CNS & Neurodegenerative disorders (ND)
 ND diseases are characterized by progressive and
irrereversible
loss of neurons and abnormalities in specific populations of
neurons from specific regions of brain leading nervous system
dysfunction.
 Due to the prevalence, morbidity and mortality, they represent
significant medical, social and financial burden on the society.
 Some prototypical neurodegenerative disorders include:
Parkinson’s disease, Huntington’s disease, Alzheimer’s
disease, Amyotrophic lateral sclerosis, Epileptic Seizures,
Stroke, Dementia etc.,
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Alzheimer disease: dementia and disordered cognitive
function.
Parkinson’s disease: a disabling motor impairment disorder.
Huntington disease: excessive and abnormal movement.
Amyotrophic lateral sclerosis (ALS): progressive weakness
and muscle atrophy.
Multiple sclerosis: is an autoimmune inflammatory
demyelinating disease of the CNS.
Neurodegenerative Disorders

9. CNS & Oxidative Stress
 The brain is particularly susceptible to the effects of
ROS due to its high consumption of oxygen and
modest antioxidant defenses.
 These features are coupled with high concentration
of PUFA, which are easily oxidized and known to
generate oxygen radicals following and insult.
 Localized antioxidant enzymes:
SOD, CAT & GSHPx
 ROS include: O2
-
, •OH , H2O2 , •ONOO -
,
-
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10. Common mechanisms include:
 Selective vulnerability Abnormal energy metabolism
 Neuronal injury Ageing
 Oxidative stress Inflammation
 Genetic predisposition
Neuropathology
 The etiology of ND remains enigmatic; however defects
in energy metabolism, excitotoxicity, infection and
oxidative damage is increasingly compelling.
 It is likely that there is a complex interplay between these
mechanisms.
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11. CURRENT THERAPEUTIC APPROACHES FOR
MANAGEMENT OF
NEURODEGENERATIVE DISEASES
 Glutamate release inhibitors
 AChE inhibitors
 NMDAR-antagonists
 GABA-agonists
 Down regulators of COX, microglial and astrocyte activation
 DA precursors
 NSAIDs
At present, pharmacological therapy of ND disorder is limited to
symptomatic treatments – do not alter the course of underlying
diseases
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12. Parkinson´s disease
Researchers don´t know when Parkinson´s disease started but
medical scientists have been treating Parkinson´s disease for
thousands of years. Was known before as the «shaking palsy»
The first medical text appeared about 2,500 years ago in China.
Causes:
The lack of dopamine causes the motor symptoms of Parkinson's
disease. Genetic and pathological studies reveal that inflammation,
and stress can contribute to cell damage.
Scientists suspect that the loss of dopamine is due genetic and
environmental factors.
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14. Some of the symptoms are:
•Tremors
•Rigidity
•Bradykinesia (slowness in
voluntary movement)
•Postural instability
•Parkinsonian gait (people with
advanced Parkinson´s disease
develop a shuffling walk)
•Anxiety
•Depression
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15. Scientists and researchers haven
´t found the cure of Parkinson´s
Disease.
People with PD still attend to
therapies so that their dopamine
levels can increase!
The most effective therapy is
levodopa (Sinemet), because its
directly converted into dopamine
in the brain.
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16. PHARMACOLOGIC TREATMENT OPTIONSPHARMACOLOGIC TREATMENT OPTIONS
Dopamine precursor: Levodopa
Peripheral decarboxylase inhibitors: Carbidopa,
Benserazide
Dopaminergic agonists:
Ergot derivatives: Bromocriptine, Pergolide, Piribedil
Non ergot derivatives: Ropinirole, Pramipexole
MAO-B inhibitors: Selegiline
COMT inhibitors: Entacapone, Tolcapone
Dopamine facilitator: Amantadine

17. ALZHEIMER´S DISEASE
 Senile Dementia of the Alzheimer Type (SDAT) or simply
Alzheimer's, is the most common form of dementia. This
incurable, degenerative, and terminal disease.
 "Tangles" of a protein called "tau" occur in Alzheimer's patients'
brains-causing neurons to lose their function and increasing
memory loss.
Normal Alzheimer’s
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Enzymes act on the APP (amyloid
precursor protein) and cut it into
fragments.
The beta-amyloid fragment is crucial in
the formation of senile plaques in AD.

19. DRUGS FOR ALZHEIMER’SDRUGS FOR ALZHEIMER’S
I. Acetylcholinesterase inhibitors:
e.g., donepezil, rivastigmine, galantamine, tacrine
Adverse effects – nausea, diarrhea, abdominal cramps,
bradycardia, urine incontinence
II. NMDA receptor antagonists: Memantine (dimethyl adamantine
derivative related to amantadine) it is an uncompetitive
inhibitor of NMDA receptors

20. Multiple Sclerosis
 A chronic, progressive
neurologic disease
characterized by scattered
demyelination of nerve fibers
in the brain and spinal cord
 Peak onset 20-40 years of age
 70% between ages 21-40
 Rarely prior to age 10 or after
age 60
 F > M (approx. 2:1)
Stephen Hawking
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21. ResultsOf Demyelination
•Conduction block at site of lesion
•Slower conduction time along affected nerve
•Increased subjective feeling of fatigue secondary to
compensation for neurologic deficits
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23. Cerebellar signs
-Incoordination (problems with heel-to-shin test)
-Slowing of rapid repeating movements
-Scanning speech
-Loss of balance
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24. IMMUNOSUPPRESSIVE AGENTS USED IN MS
 CORTICOSTEROIDS
Corticosteroids, such as prednisone or methylprednisolone,
can also be effective in acute phases of the disease.
Chemotherapeutic agents, such as cyclophosphamide and
azathioprine, have also been used.
Symptomatic Treatments: Many different classes of drugs
are used to manage symptoms of MS such as spasticity,
constipation, bladder dysfunction, and depression.
 DALFAMPRIDINE is a potassium channel blocker that
readily enters the CNS to interact with demyelinated
neurons associated with MS. improves walking speeds in
patients with MS. It is the first drug approved for this use.

25. HUNTINGTON DISEASEHUNTINGTON DISEASE
-An inherited adult onset neurologic disease due to a single defect
on chromosome 4.
Characterized by:
 shuffling gait,
 stooped posture,
 resting tremor,
 speech impediments,
 movement difficulties,
 and an eventual slowing of mental processes and dementia.
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Treatment:
Dopamine blockers such as haloperidol or
tetrabenazine are used to treat this disorder.

26. WILSON’S DISEASEWILSON’S DISEASE
 It is a genetic disorder of copper
metabolism.
 Excess copper is deposited in the
liver, brain, kidneys, and eyes;
 symptoms include jaundice,
vomiting, tremors, muscle
weakness, stiff movements, liver
failure and dementia.
 Treatment: a copper chelating agent
known as penicillamine
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27. AMYOTROPHIC LATERAL SCLEROSIS (ALS)
 ALS is characterized by progressive degeneration of
motor neurons, resulting in the inability to initiate or
control muscle movement.
 Symptoms of the condition include muscle fasciculation,
hypotonia, muscle wasting and paradoxical reflexes. the
neurons of sufferers of ALS accumulate glutamate, which
may be the cause of the paralysis.
 Riluzole: an NMDA receptor antagonist, is currently the
only drug indicated for the management of ALS. It is
believed to act by inhibiting glutamate release and
blocking sodium channels.
 Riluzole may improve survival time and delay the need for
ventilator support in patients suffering from ALS.
 Riluzole is not effective against ALS when the onset of the
disease aspects the limbs.
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Herbal medicines
Acorus calamus, Azadirachta indica, Acanthopens radix,
Bacopa monniera, Butea frondosa, Clitoria ternatea,
Convolvulus pluricaulis, Eclipta alba, Emblica officinale,
Mucuna pruriens, Sida cordifolia, Vitis vinifera and
Wadelia calandulacae, Withania somnifera, etc.,
In Ayurveda, many herbs have been reported as nerve tonic
or memory enhancers. On this basis, a number of herbs
have been studied and validated for their neuroprotective
properties. The most promising medicinal plants with CNS
activity in traditional Indian medicine are the following:

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Conclusion
In the field of neuro scientific research, the field of
neurodegenerative diseases ares one of the most active in
respect of both medical and associated social issues.
Recent advances in the basic knowledge of such diseases
have led to a re-evaluation about new therapeutically
approaches.
These new therapies will include strategies based on better
knowledge of more effective neuroprotection.
Such mechanistic approaches to the diseases are still
probably too global to be fully efficient in the short term.

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32. Thank
you
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