Unveiling new horizons: Investigating Ayurveda’s role in managing neurological disorders

Neurological disorders affect more than one in three individuals and are a leading cause of global illness and disability.[1] From 1990 to 2021, over 3 billion individuals worldwide experienced neurological conditions.[2] In India, these disorders rank among the top causes of disability-adjusted life years[3] and pose significant public health challenges.[4] In the realm of neurological disorders, conventional medicine has undoubtedly made significant strides. From pharmaceutical interventions to surgical procedures, modern medicine has provided invaluable solutions for numerous neurological conditions, enhancing longevity, and quality of life for countless individuals. Therapies such as brain stimulation,[5] polymeric devices and stem cells,[6] retraining and control therapy, cognitive-behavioral therapies, multidisciplinary rehabilitation, and oral medicines,[7] are practiced to treat various neurological disorders. Despite advancements, conditions like hemiplegia, Alzheimer's disease, depression, anxiety, insomnia, substance use disorders, attention deficit and hyperactivity disorder, and migraine pose alarming challenges, emphasizing the need for preventive and effective affordable alternative measures. Conventional medicine primarily relies on pharmacological interventions and symptomatic management for neurological disorders. While these approaches provide relief to some extent, they often fail to address root causes and holistic well-being. Moreover, concerns about the long-term efficacy and potential side effects of pharmaceutical drugs persist among many individuals. There are enigmatic realms where conventional approaches offer minimal solace in addressing the holistic needs of patients, particularly concerning long-term management and underlying causative factors. The inability of many therapies to penetrate the blood–brain barrier (BBB) prevents effective treatment for various neurological illnesses. The BBB constitutes continuous, nonfenestrated microvasculature within the central nervous system (CNS). Its unique characteristics enable it to closely regulate the flow of ions, chemicals, and cells between the CNS and the blood.[8] As the BBB blocks certain particles from entering the brain, oral medications aimed at treating neurological illnesses prove ineffective if they cannot reach the brain.[9] Recent research indicates that plants such as Bacopa monnieri and Centella asiatica contain phytoconstituents capable of crossing the BBB, presenting the potential for the treatment of neurological disorders.[10] Nanomedicines also possess characteristics that enable them to cross the BBB, offering a new therapeutic approach for managing CNS diseases.[11] Consequently, phyto-nanotechnology is emerging as a novel opportunity for addressing the need for neuroprotective and curative medications.[12] Ayurveda, a globally recognized healthcare system, primarily employs herbal medicines and specialized body purification techniques such as Nasya, Basti, and Shirodhara to address various disease conditions, including neurological disorders categorized as "Vata" disorders. Moreover, scientific studies increasingly support the efficacy of Ayurveda in managing numerous neurological disorders. Research exploring the neuroprotective properties of Ayurvedic herbs like Ashwagandha (Withania somnifera) and Brahmi (B. monnieri) has yielded promising outcomes in both animal models and clinical trials. Additionally, Ayurvedic therapies such as Shirodhara, Nasya, and Basti have shown significant improvements in symptoms and quality of life for patients with conditions like migraine, multiple sclerosis, and neuropathy. Nasya (the instillation of medicated oils through the nostrils) is a procedure specifically indicated for treating CNS diseases. Formulations for Nasya typically involve ghee or sesame oil. Ayurveda medicated oil/ghee preparation involves procedures that aim to extract water and fat-soluble active phytoconstituents. This process can be considered a form of phyto-nanotechnology, as the extracted constituents are in nano form. The medicated oil/ghee generally contains triglycerides, some free fatty acids, and phytoconstituents from herbal ingredients. Some of these free fatty acids and triglycerides can traverse the BBB. The nasal septum can absorb fat-soluble medicines, facilitating transport to the brain through the nasal route.[13] Therefore, administering medicated oil/ghee nasally or orally can significantly aid in the treatment of neurological diseases. Numerous clinical studies validate the effectiveness of Nasya in treating conditions such as cerebral palsy,[14] hemiplegia,[15] facial palsy,[16] generalized anxiety disorder,[17] depression,[18] insomnia,[19] and migraine.[20] Additionally, Ayurveda recommends brain-stimulating procedures to address CNS diseases, including Shirodhara (pouring liquid—usually oil, milk, buttermilk, or water onto the head), Shirobasti (keeping medicated oil/ghee on the head), Snehana (internal and external oleation), and Swedana (hot fomentation). These procedures exert hemodynamic action,[21] ensuring adequate cerebral oxygenation, which may significantly contribute to normalizing CNS functions. Ayurveda literature extensively discusses the pathology, symptoms, and treatment of diseases such as Unmada (hysteria), Apasmara (epilepsy), Atatwaabhinivesha (hallucinations or a lack of judgment and discrimination between what is good and bad), Avasada (depression), Chittodwega (anxiety), Smrutibransha (amnesia), Pakshaghata (hemiplegia), and Ardita (facial palsy). Numerous formulations in various dosage forms, alongside the previously mentioned measures, are available in the classical texts of Ayurveda. Examining the clinical efficacy of these formulations and procedures individually, in combination, and comparison to standard care can facilitate the development of novel, cost-effective approaches to treating neurological diseases. While acknowledging the significant contributions of conventional medicine, it is crucial to recognize the complementary role Ayurveda can play in addressing the unmet needs of patients with neurological disorders. By adopting a paradigm that integrates the best of both systems, we can unlock new horizons in patient care, offering personalized and holistic solutions that transcend the limitations of a singular approach. Utilization of phyto-nanotechnology to modify Ayurveda formulations or create innovative dosage forms from nootropic herbs presents a promising strategy for unlocking new possibilities in exploring Ayurveda's potential in managing neurological diseases. While there is much Ayurvedic literature left to explore, generating evidence-based applications is crucial for integrating Ayurveda into contemporary healthcare. Research and development through phyto-nanotechnology provide opportunities for both exploratory and applied research, with the potential to significantly influence the prevention and management of quality-of-life-altering illnesses. Building upon the success of several published studies cited previously, it is evident that Ayurvedic interventions have shown efficacy in managing various neurological diseases. However, the variation in treatment plans underscores the necessity of developing standardized protocols that can be uniformly applied in clinical practice. In conclusion, Ayurveda exhibits immense potential in managing neurological disorders through its holistic approach and emphasis on personalized care. Exploring Ayurveda's role in managing neurological disorders signifies a new era of exploration and collaboration in healthcare. Through rigorous scientific inquiry and evidence-based practice, there is a significant opportunity to combine the wisdom of ancient healing traditions with modern medical advancements, paving the way for enhanced outcomes and improved quality of life for individuals living with neurological conditions. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.