Kampavata – The Science of Parkinson's

Mucuna-Pruriens-Mood-and-Hormone-Velvet-Bean

The motor features of Parkinson’s disease can be managed with treatments that replace the chemical dopamine in the brain.

While there are many medically approved dopamine replacement drugs available for people affected by Parkinson’s disease, there also are more natural sources.

In today’s post we will look at the science and discuss the research supporting one of the most potent natural source for dopamine replacement treatment: Mucuna pruriens

Plan.B-oneway

Source: Yourtimeladies

When asked by colleagues and friends what is my ‘plan B’ (that is, if the career in academia does not play out – which is highly probable I might add – Click here to read more about the disastrous state of biomedical research careers), I answer that I have often considered throwing it all in and setting up a not-for-profit, non-governmental organisation to grow plantations of a tropical legume in strategic places around the world, which would provide the third-world with a cheap source of levodopa – the main treatment in the fight against Parkinson’s disease.

Mucuna_pruriens_08

Plan B: A legume plantation. Source: Tropicalforages

The response to my answer is generally one of silent wonder – that is: me silently wondering if they think I’m crazy, and them silently wondering what on earth I’m talking about.

As romantic as the concept sounds, there is an element of truth to my Plan B idea.

I have read many news stories and journal articles about the lack of treatment options for those people with Parkinson’s disease living in the developing world.

South-Africa-hospital

Hospital facilities in the rural Africa. Source: ParkinsonsLife

Some of the research articles on this topic provide a terribly stark image of the contrast between people suffering from Parkinson’s disease in the developing world versus the modernised world. A fantastic example of this research is the work being done by the dedicated researchers at the Parkinson Institute in Milan (Italy), who have been conducting the “Parkinson’s disease in Africa collaboration project”.

The researchers at the Parkinson Institute in Milan. Source: Parkinson Institute

The project is an assessment of the socio-demographic, epidemiological, clinical features and genetic causes of Parkinson’s disease in people attending the neurology out-patients clinic of the Korle Bu Teaching and Comboni hospitals. Their work has resulted in several really interesting research reports, such as this one:

Ghana
Title: The modern pre-levodopa era of Parkinson’s disease: insights into motor complications from sub-Saharan Africa.
Authors: Cilia R, Akpalu A, Sarfo FS, Cham M, Amboni M, Cereda E, Fabbri M, Adjei P, Akassi J, Bonetti A, Pezzoli G.
Journal: Brain. 2014 Oct;137(Pt 10):2731-42.
PMID: 25034897 (This article is OPEN ACCESS if you would like to read it)

In this study, the researchers collected data in Ghana between December 2008 and November 2012, and each subject was followed-up for at least 6 months after the initiation of Levodopa therapy. In total, 91 Ghanaians were diagnosed with Parkinson’s disease (58 males, average age at onset 60 ± 11 years), and they were compared to 2282 Italian people with Parkinson’s disease who were recruited during the same period. In long-term follow up, 32 Ghanaians with Parkinson’s disease were assessed (with an average follow period of 2.6 years).

There are some interesting details in the results of the study, such as:

Although Levodopa therapy was generally delayed – due to availability and affordability – in Ghana (average disease duration before Levodopa treatment was 4.2 years in Ghana versus just 2.4 years in Italy), the actual disease duration – as determined by the occurrence of motor fluctuations and the onset of dyskinesias – was similar in the two populations.

Ghana2

Source: PMC

The motor fluctuations were similar in the two populations, with a slightly lower risk of dyskinesias in Ghanaians.
Levodopa daily doses were higher in Italians, but this difference was no longer significant after adjusting for body weight.
Ghanaian Parkinson’s sufferers who developed dyskinesias were younger at onset than those who did not.

Reading these sorts of research reports, I am often left baffled by the modern business world’s approach to medicine. I am also left wondering how an individual’s experience of Parkinson’s disease in some of these developing nations would be improved if a cheap alternative to the dopamine replacement therapies was available.

Are any cheap alternatives available?

Continue reading “Plan B: Itchy velvet beans – Mucuna pruriens” →

Something different for you today – a history lesson…with some science.

The history of Parkinson’s disease dates back well before Dr James Parkinson made his observations about 6 patients 199 years ago (oh, big anniversary coming up! Who knew)

But it may surprise you to know that the history of Parkinson’s disease dates back before even Jesus turned up.

You actually have to go back a long back in order to get to the beginning…

If you were demonstrating the early features of Parkinson’s disease in the year 500 BCE, there was really only one place in the world that you wanted to be:

india-2do290z

India. Source: blogs.umb.edu

Not only did India have a extremely sophisticated system of diagnosis for what we call Parkinson’s disease, but they also have a VERY effective treatment!

Don’t believe me? Read on.

The diagnosis

Around 5000 BCE, the wise and farsighted members of the Indian medical establishment began pooling their collective knowledge – firstly in an oral form, but then eventually in a written format. That written material became the text known as the Ayurveda (/aɪ.ərˈveɪdə/; Sanskrit for “the science of life” or “Life-knowledge”).

It can not be understated how sophisticated the Ayurveda was for its time. This was a period bridging the ‘new stone age’ and the ‘Bronze age’. People’s understanding of medical afflictions was basically limited to what the Gods and evil spirits were doing to them.

The earliest account of Parkinson’s disease features in the Ayurveda was compiled by Susruta (the 600 BC author of “Susruta Samhita”). He described slowness (cestasanga in Sanskrit) and akinesia (cestahani) in certain individuals, and also (curiously) reported that certain poisons could cause rigidity and tremor.

To demonstrate to you just how sophisticated the Ayurveda was, consider this: when faced with a person exhibiting tremor a practitioner using the Ayurveda could chose between six different types of tremor:

Vepathu (a generalised tremor)
Prevepana (excessive shaking)
Kampa vata (tremors due to vata)
Sirakampa (head tremor)
Spandin (quivering)
Kampana (tremors)

Number 3 (Kampa vata) on that list is what we now refer to as Parkinson’s disease. Kampa basically means ‘tremor’, while Vata is more difficult to define – it is essentially the property/force that governs all movement in the mind and body (blood flow, breathing, etc – even the movement of thoughts).

The treatment

Since the 3rd century BCE, practitioner of the Ayurveda have been using the seeds of Mucuna pruriens in treating conditions of tremor.

Mucuna-fruit

Mucuna Prurien seeds. Source: Kisalaya

Commonly known as the cowhage plant, Mucuna pruriens are a tropical legume. They are called atmagupta in Sanskrit. Powdered seeds of atmagupta mixed in milk was generally given to treat Kampa vata. And it worked very effectively!

How did it work?

In 1937, a pair of chemist discovered the secret ingredient that allowed Mucuna pruriens seeds to work their magic.

Title: Isolation of l-3:4-dihydroxyphenylalanine from the seeds of Mucuna pruriens.
Authors: Damodaran M, Ramaswamy R.
Journal: Biochem J. 1937 Dec;31(12):2149-52. No abstract available.
PMID: 16746556 (this article is OPEN ACCESS and available to read if you would like)

They found that the seeds contained very high concentrations of a chemical that you and I are familiar with: L-dopa.

Remarkably, Mucuna Pruriens are approximately 4-6% L-dopa, making them mother nature’s natural treatment for Parkinson’s disease. And remember that for over 2000 years, this treatment (atmagupta) has been utilised in the treatment of Kampa vata in India!

EDITORIAL NOTE: This will probably get me in trouble with the major drug companies, but it would be a worthwhile enterprise for an NGO to set up some Mucuna pruriens plantations in strategically located positions around the world, in order to supply the growing number of people with Parkinson’s disease in the 3rd world. Just a thought.

How does atmagupta compare with modern L-dopa?

Interesting question.

One that has already been tested:

Title: Mucuna pruriens in Parkinson’s disease: a double blind clinical and pharmacological study.
Authors: Katzenschlager R, Evans A, Manson A, Patsalos PN, Ratnaraj N, Watt H, Timmermann L, Van der Giessen R, Lees AJ.
Journal: J Neurol Neurosurg Psychiatry. 2004 Dec;75(12):1672-7.
PMID: 15548480 (this report is OPEN ACCESS if you would like to read it)

In this double blind clinical study, the researchers gave 8 people with Parkinson’s disease with a short duration L-dopa response and dyskinesias single doses of 200/50 mg L-dopa or 15-30 g of mucuna preparation. They gave these treatments in a randomised fashion at weekly intervals. They found that mucuna seed powder formulation had a more rapid onset of action and a longer period without dyskinesias. The researchers concluded that ‘this natural source of L-dopa might possess advantages over conventional L-dopa preparations in the long term management of PD’. A grand conclusion, but they also note that a more long term assessment is required.

And that concludes your history lesson for today – hope you liked it!

Tag: Kampavata

Plan B: Itchy velvet beans – Mucuna pruriens

Diagnosed 2500 years ago? No problem.