Traditional Memory Tonic to Modern Neurotherapeutic: Bacopa monnieri in Alzheimer’s Disease

Abstract

Alzheimer’s disease (AD) is associated with cognitive decline and dementia, typically seen in the elderly due to ongoing neurodegeneration. It progressively deteriorates the patient's memory capabilities. The key diagnostic indicators include the presence of senile plaques and Neurofibrillary tangles (NFTs). A significant reduction in Acetylcholine (Ach), a neurotransmitter in the brain, occurs due to its breakdown by the enzyme Acetylcholine esterase before it can exert its effects, along with neural cell death, which are the main contributors to AD. Although there are various categories of Anti-Alzheimer’s medications available for managing AD, successful outcomes have been limited due to poor patient adherence. Additionally, incorporating Nutraceuticals into daily diets, engaging in Aromatherapy, adjusting daily routines, and practicing yoga regularly can help alleviate stress, insomnia, improve blood circulation, detoxify organs through rhythmic breathing, and reduce headache frequency, as evidenced by surveys. Currently, herbal medicine has emerged as a preferred option for managing AD due to its accessibility, cost-effectiveness, high patient compliance, ease of preparation, and minimal adverse side effects. Innovative methods can be employed to enhance the development of herbal medicine. Bacopa monnieri is a native plant that grows across India. For centuries, it has been recognized in Ayurveda as a “Medhya Rasayan” (nootropic). Research has demonstrated several effects of Bacopa monnieri, including its ability to inhibit the enzyme cholinesterase. This inhibition can lead to a reduction in the breakdown of acetylcholine, a crucial neurotransmitter, the levels of which are diminished in Alzheimer’s disease.  key active ingredients in this plant include triterpene saponins known as bacosides, along with alkaloids like bramine and herpestine, as well as flavonoid and steroid compounds. Research conducted in vivo has demonstrated that an extract of B. monnieri containing 25% bacoside A produces an anxiolytic effect similar to that of lorazepam. While lorazepam is often associated with side effects such as amnesia, B. monnieri does not lead to these adverse effects and, in fact, offers memory-enhancing benefits.

Keywords: Alzheimer’s disease (AD), Bacopa monnieri, Medhya Rasayan, Bacosides A, bramine and herpestine, Neurofibrillary tangles (NFTs), Acetylcholine (Ach).