INTEGRATIVE NEUROLOGY YOGA AND MEDIATION’S ROLE IN HEALTH SHRI KANT MISHRA, ABMS, MD, MS (ADMIN. MEDICINE) (ADMIN. MEDICINE) PROFESSOR OF NEUROLOGY /COORDINATOR PROFESSOR OF NEUROLOGY /COORDINATOR INTEGRATIVE MEDICINE INTEGRATIVE MEDICINE KECK USC SCHOOL OF MEDICINE, LOS ANGELES, CALIF KECK USC SCHOOL OF MEDICINE, LOS ANGELES, CALIF DIRECTOR NEUROMUSCULAR PROGRAM DIRECTOR NEUROMUSCULAR PROGRAM VA GLA AND OLIVE VIEW UCLA MEDICAL CENTER VA GLA AND OLIVE VIEW UCLA MEDICAL CENTER
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INTEGRATIVE NEUROLOGYYOGA AND MEDIATION’S
ROLE IN HEALTH
SHRI KANT MISHRA, ABMS, MD, MS (ADMIN. MEDICINE) (ADMIN. MEDICINE)
PROFESSOR OF NEUROLOGY /COORDINATOR PROFESSOR OF NEUROLOGY /COORDINATOR INTEGRATIVE MEDICINE INTEGRATIVE MEDICINE
KECK USC SCHOOL OF MEDICINE, LOS ANGELES, CALIFKECK USC SCHOOL OF MEDICINE, LOS ANGELES, CALIFDIRECTOR NEUROMUSCULAR PROGRAMDIRECTOR NEUROMUSCULAR PROGRAM
VA GLA AND OLIVE VIEW UCLA MEDICAL CENTERVA GLA AND OLIVE VIEW UCLA MEDICAL CENTER
HISTORICAL BACKGROUND
VARIOUS NATURAL MEDICINE REMEDIES
IN EXISTENCE SINCE THE BEGINNING OF
THE CIVILIZATION
VARIOUS ETHNIC MEDICINE HAS BEEN
PRACTICED FOR AT LEAST 2,000-5,000 YRS
LIKE CHINESE, KOREAN, AYURVEDA
(INDIAN SYSTEM OF MEDICINE) AMERICAN
INDIAN MEDICINE
HISTORICAL BACKGROUND
MANY OF THESE SYSTEMS OF MEDICINE
ARE WELL ORGANIZED WITH
RELATIVELY GOOD PHARMACOPEA BASIC
PRINCIPLES AND TRETMENT MODALITIES.
MANY MODERN MEDICINES HAVE
ORIGINATED FROM PLANT SOURCES AND
FROM ETHENIC MEDS
EXAMPLE - RESERPINE, EPHEDRINE, ETC.
FACTS AND FIGURES
CAM VISITS1993 425 MILLION VISITS (NEJM)
THIS WILL DOUBLE BY 2010. 1997 625 MILLION VISITS (JAMA)
STUDIES SHOW: SLOWS DEVELOPMENT OF 20% OF DEMENTIA BY 6-12
MONTHS
META ANALYSIS BARRY OKEN 1998, ARCHIVES OF NEUROLOGY
OVERALL THERE WAS A SIGNIFICANT EFFECT SIZE OF 0.40 (P<.0001). THIS MODEST EFFECT SIZE TRANSLATED INTO A 3% DIFFERENCE IN THE ALZHEIMER DISEASE ASSESSMENT SCALE-COGNITIVE SUBTEST.
SOLOMON JAMA 2002 NEGATIVE STUDY: TOTAL 26 TRIAL MAJORITY OF STUDIES NEGATIVE?
MIGRAINE HEADACHE
HOMEOPATHIC TREATMENT IN A DOUBLE-BLIND, PLACEBO-CONTROLLED
TRIAL ON 60 PTS SHOWED THAT 93% OF PATIENTS GIVEN AN INDIVIDUALIZED HOMEOPATHIC MEDICINE EXPERIENCED GOOD RESULTS.
ISOMETRIC NECK EXERCISE / BIOFEEDBACK A COMBINATION PRODUCT CONTAINING MAGNESIUM, RIBOFLAVIN, AND FEVERFEW; MELETONIN, GINGER AND GINKO
TRAGER THERAPY
TREATMENT OF PATIENTS WITH CHRONIC HEADACHES IN A HOSPITAL FOR TRADITIONAL
CHINESE MEDICINE IN GERMANY
A RANDOMISED, WAITING LIST CONTROLLED TRIAL SHOWED PATIENTS WITH MIGRAINE AND A COMBINATION OF MIGRAINE AND EPISODIC TENSION-TYPE HEADACHES HAD LASTING IMPROVEMENTS MORE THAN PATIENTS WITH OTHER HEADACHES, WITH TREATMENT OF TRADITIONAL CHINESE MEDICINE IN KOTZTING
MELCHART D, HAGER S, MUNICH, GERMANY.
ACUPUNCTURE FOR PATIENTS WITH MIGRAINE
ACUPUNCTURE IS WIDELY USED TO PREVENT MIGRAINE ATTACKS.
THE PROPORTION OF RESPONDERS (REDUCTION IN HEADACHE DAYS BY AT LEAST 50%) WAS 51% IN THE ACUPUNCTURE GROUP, 53% IN THE SHAM ACUPUNCTURE GROUP, AND 15% IN THE WAITING LIST GROUP.
ACUPUNCTURE AND SHAM ACUPUNCTURE IN REDUCING MIGRAINE HEADACHES ALTHOUGH BOTH INTERVENTIONS WERE MORE EFFECTIVE IN REDUCING MIGRAINE HEADACHES THAN A WAITING LIST CONTROL.
LINDE K, STRENG A, MUNICH, GERMANY
MULTIPLE SCLEROSIS
ACUPUNCTUREMAIL SURVEY INCLUDED 217 PATIENTS
RESULT 37 HAD REDUCED PAIN 34 DECREASED SPASTICITY 14 IMPROVED BLADDER AND BOWEL
DYSFUNCTION 34 IMPROVED WALKING AND MOBILITY 48 EXPERIENCED ELEVATED ENERGY LEVEL
AND REDUCED FATIGUE YOGA AND MS >MEDITATION
AYURVEDIC HERBS IN NEURODEGENERATIVE DISEASES
AYURVEDIC PLANTS USED FOR THE MANAGEMENT OF NEURODEGENERATIVE DISEASES SUCH AS: PARKINSON'S, ALZHEIMER'S, LOSS OF
MEMORY DEGENERATION OF NERVES AND OTHER
NEURONAL DISORDERS
GENERALLY POSSESSES STRONG ANTIOXIDANT ACTIVITY.
AYURVEDA IN PARKINSON'S DISEASE. CLINICAL PROSPECTIVE STUDY, OF AYURVEDA
TREATMENT (A CONCOCTION IN COW'S MILK
OF POWDERED MUCUNA PRURIENS AND
HYOSCYAMUS RETICULATUS SEEDS WITHANIA
SOMNIFERA AND SIDA CORDIFOLIA ROOTS)
IN 18 CLINICALLY DIAGNOSED (WITH A MEAN
HOEN AND YAHR VALUE OF 2.22) PARKINSONIAN
PATIENTS SHOWED:
PARKINSON’S DISEASE
HP - 200
DERIVED FROM MUCUNA PRURIENT(AYURVEDIC HERB)
A CLINICAL TRIAL OF 60 PATIENTS SHOWED THAT HP-200 MAY HAVE SOME BENEFITS. (BALA MANYAM PI)
AYURVEDA IN PARKINSON'S DISEASE.
RESULTS SIGNIFICANT IMPROVEMENT IN ACTIVITIES
OF DAILY LIVING (ADL) AND ON MOTOR
EXAMINATION AS PER UPDRS RATING.
SYMPTOMATICALLY, THEY EXHIBITED
GOOD RESPONSE IN TREMOR,
BRADYKINESIA, STIFFNESS AND CRAMPS.
CURCUMIN AND ALZHEIMER DISEASE
CURCUMIN, IN VITRO, INCUBATED WITH ABETA 40 AND A BETA42, SIGNIFICANTLY DECREASES AMYLOID AGGREGATION (GREG COLE ET AL).
CAPABLE OF INDUCING THE DISAGGREGATION OF PRE-AGGREGATED AMYLOID.
SIGNIFICANTLY REDUCES ABETA OLIGOMERS FORMATION.
INHIBITED THE CELL TOXICITY OF AMYLOID OLIGOMERS. POSSESSES POTENT ANTI-AMYLOIDOGENIC ACTIVITY, IN
ALZHEIMER AGED APP TRANSGENIC MICE TG2576. RATIONALE FOR CURCUMIN USE IN CLINICAL TRIALS
PREVENTING OR TREATING IN AD ,WHICH IS UNDERWAY AT UCLA
EPIDEMEOLOGICAL STUDY IN INDIA GANGULI ETAL
CURCUMIN AND ALZHEIMER DISEASE
THE INHIBITION OF EGR-1 DNA-BINDING ACTIVITY BY CURCUMIN WAS DEMONSTRATED, IN VITRO, IN HUMAN THP-1 MONOCYTES AND HUMAN PERIPHERAL BLOOD MONOCYTES.
INHIBITION RESULTED IN A DECREASE IN MRNA EXPRESSION OF CYTOKINES (TNFALPHA AND IL-1BETA) AND CHEMOKINES (MCP-1, IL-8 AND MIP-1BETA).
CURCUMIN COULD THUS AMELIORATE INFLAMMATION.
CURCUMIN DID NOT AFFECT THE VIABILITY OF CELLS.
MEDITATION IN NEUROLOGICAL DISORDERS
ACCORDING TO STUDIES CONDUCTED BY HERBERT BENSON, M.D., [HARVARD MEDICAL SCHOOL]
MEDITATION PROCESS COUNTERACTED THE EFFECTS OF THE SYMPATHETIC NERVOUS SYSTEM.
WHEREAS THE SYMPATHETIC SYSTEM DILATES THE PUPILS AND GETS THE HEART RATE, RESPIRATION, AND BLOOD PRESSURE UP, THE PARASYMPATHETIC SYSTEM, ACTIVATED WHEN WE MEDITATE, DOES JUST THE OPPOSITE.
ALS AND CURCUMIN
FAMILIAL FORMS OF ALS DEMONSTRATE UP-REGULATION OF TUMOR NECROSIS FACTOR ALPHA (TNFALPHA).
CURCUMIN ANTAGONIZED TNF ALPHA, IN VITRO, IN THE MICROGLIAL CELL LINE, DERIVED FROM MOUSE WALKER EOC-20 CELLS.
ANTAGONISM WAS POSSIBLY DUE TO THE INHIBITION OF 5LOX.
CURCUMIN COULD THUS BE USED FOR CLINICAL BENEFIT IN ALS. (WEST ET AL )
BACKGROUNDBACKGROUND THE TRIGEMINAL NERVE PROJECTS TO THE THE TRIGEMINAL NERVE PROJECTS TO THE
NUCLEUS TRACTUS SOLITARIUS (NTS), THE LOCUS NUCLEUS TRACTUS SOLITARIUS (NTS), THE LOCUS CERULEUS, AND THE VAGUS NERVE.CERULEUS, AND THE VAGUS NERVE. Stimulation of NTS reduces seizures induced by
amygdala stimulation.
STIMULATION OF LC SUPPRESSES COBALT AND STIMULATION OF LC SUPPRESSES COBALT AND PENICILLIN INDUCED EPILEPTIC DISCHARGES.PENICILLIN INDUCED EPILEPTIC DISCHARGES. Lesioning the LC blocks the effect of vagus nerve Lesioning the LC blocks the effect of vagus nerve
stimulation.stimulation.
TRIGEMINAL NERVE STIMULATION BLOCKS PTZ INDUCED SPIKES AND SEIZURES IN RATS
Fanselow, Nicolelis, et al 2000
SUDDEN DEATH IS A MAJOR PROBLEM IN
EPILEPSY SUDDEN DEATH SUDDEN DEATH
RATES ARE RATES ARE SIGNIFICANTLY SIGNIFICANTLY HIGHER IN HIGHER IN EPILEPSY THAN EPILEPSY THAN AGE MATCHED AGE MATCHED POPULATIONPOPULATION SPERLINGSPERLING ANNEGERSANNEGERS
Major Categories of Mortality in Epilepsy
Seizures20%
Sudden Death20%
Underlying Causes of Epilepsy
20%
Usual Causes:CancerHeart
DiseaseStroke
STROKE
AYURVEDIC SPICE: TURMERIC INHIBITS PLATELET AGGREGATION AND
RANDOMIZED SINGLE-BLIND CONTROLLED TRIAL 42 PTS WITH CTS
RESULT: YOGA-BASED REGIMEN MORE EFFECTIVE THAN WRIST SPLINTING OR NO TX IN RELIEVING SOME S/SXS OF CTS
PHALEN SIGN IMPROVEMENT IN 12 PTS WITH YOGA TX VS. 2 PTS IN CONTROL
YOGA
YOGA'S ROLE IN THE MANAGEMENT OF DEPRESSION HAS BEEN INVESTIGATED AND REPORTED TO BE BENEFICIAL FOR COLLEGE STUDENTS WHO EXHIBIT A HIGH LEVEL OF DEPRESSIVE SYMPTOMS.
CASE REPORT DESCRIBING AN APPLICATION OF YOGA THERAPEUTICS TO A PATIENT WITH PARKINSON DISEASE.
RELAXATION MAY PROMOTE POSITIVE EFFECTS ON CAROTID ATHEROSCLEROSIS, HYPERTENSION, DIABETES, AND CORONARY ARTERY DISEASE, WHICH ARE IDENTIFIED AS RISK FACTORS ASSOCIATED WITH STROKE OCCURRENCE OR REOCCURRENCE
YOGA AND MS
DR. OKEN HYPOTHESIS: YOGA MIGHT BE BENEFICIAL IN TERMS OF
COGNITIVE FUNCTION IN MULTIPLE SCLEROSIS, WHERE THERE ARE SIGNIFICANT COGNITIVE PROBLEMS, SUCH AS DIFFICULTY CONCENTRATING.
COGNITIVE FUNCTION WAS THE PRIMARY OUTCOME MEASURE IN THE STUDY, AND ALL THE QUALITY OF LIFE MEASURES SUCH AS FATIGUE AND MOOD WERE SECONDARY OUTCOME MEASURES
FUTURE INVESTIGATIVE POTENTIALS
YOGA CAN BE USED TO PREVENT AND CURE VARIOUS INDIVIDUAL, COMMUNITY, AND SOCIETAL ILLNESSES.
INDIVIDUAL DEVELOPMENT TO UPLIFT ONESELF IS CRUCIAL AND NEEDS TO BE STUDIED.
YOGA WITH AYURVEDA AND MODERN MEDICINE CAN BE APPLIED TO AGING, DEMENTIA, STRESS ADAPTATION, G.I. DISORDERS, HIV/AIDS, AUTOIMMUNE DISORDERS, AND MANY OTHER AILMENTS.
W. SOMNIFERA IN MUSCLE SARCOPENIA
PRELIMINARY TRIAL ON 28 HEALTHY VOLUNTEERS (22 MALES) AND (6 FEMALES) BETWEEN 60 TO 75 YEARS WAS CONDUCTED.
THE HERB W. SOMNIFERA MAY HAVE THE POTENTIAL TO IMPROVE MUSCLE STRENGTH AND ENDURANCE FOR THE AGED SUBJECTS.
SHOWED POTENTIAL EFFECT IN IMPROVING MUSCLE FUNCTIONING AND MUSCLE STRENGTH TESTING
FUNCTIONAL MEASUREMENT UP AND GO TEST
NO SIDE EFFECT WAS OBSERVED FOR THE HERB AT 500 MG (BID) FOR THE AGED SUBJECTS FOR CONTINUOUS PERIOD OF 3 MONTHS. •MISHRA ETAL 2002
FIBROMYALGIA CLINICAL SURVEY SHOWS 98% PERCENT OF THE
PATIENTS USE SOME TYPE OF CAM THERAPY.
MOST FREQUENTLY USED CAM TREATMENTS: EXERCISE FOR A SPECIFIC MEDICAL PROBLEM (48%), SPIRITUAL HEALING (PRAYERS) (45%), MASSAGE THERAPY (44%), CHIROPRACTIC TREATMENTS (37%), VITAMIN C (35%), VITAMIN E (31%), MAGNESIUM (29%),
VITAMIN B COMPLEX (25%), GREEN TEA (24%), AND WEIGHT-LOSS PROGRAMS (20%). ACUPUNCTURE 20%
CONCLUSION: CAM USE IS COMMON IN PATIENTS REFERRED TO A FIBROMYALGIA TREATMENT PROGRAM.. WAHNER-ROEDLER DL, MAYO CLINIC COLLEGE OF
MEDICINE, ROCHESTER, MINN 55905, USA
FUTURE OF CAM
TM/CAM WILL UNDER GO RIGOROUS SCRUTINY AND WILL BE MORE EVIDENCE BASED
EFFICACY, QUALITY--- WILL BE INCORPORATED IN TM
SCIENTIFIC INTEGRATION OF TM/MODERN ALLOPATHIC MEDICINE
A PARADIGM SHIFT in HEALTH CARE
COST EFFECTIVE, EASILY ACCESIBLE
QUALITY HEALTH CARE WILL EVOLVE
WHO IS HELPING CAM / TM ??
SUMMARY
CAM IS CONSIDERED AS ANCIENT, TRADITIONAL HEALTHCARE DISCIPLINE PRACTICED FOR THOUSANDS OF YEARS
IN RECENT DECADES INCREASING AMOUNT OF INTEREST IN CAM IN WESTERN COUNTRIES, ESPECIALLY IN FIELD OF NEUROLOGY.
PROPER EDUCATION FOR MODERN HEALTH CARE PRACTITIONERS
INCREASING AMOUNT OF EVIDENCE-BASED RESEARCH BEING PERFORMED.
THERE IS NEED FOR FURTHER RESEARCH IN NEUROLOGICAL DISORDERS