Ayurvedic Neuroprotection in Parkinson’s Disease: A PRISMA-Based Systematic Review of Clinical and Experimental Evidence

Abstract

Background Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by tremor, rigidity, and bradykinesia, primarily resulting from dopaminergic neuronal loss. In Ayurveda, PD is closely correlated with Kampavata, a Vata-dominant neurodegenerative condition caused by Kapha-avaranajanya Vata prakopa. Increasing evidence suggests that Ayurvedic interventions such as Panchakarma and Rasayana therapy may offer neuroprotective and restorative effects in PD. This systematic review aimed to critically evaluate and synthesize the available literature from 2015 to 2025 on Ayurvedic approaches in the management of PD.

Objectives To systematically review clinical, preclinical, and conceptual studies evaluating the efficacy, safety, and mechanistic insights of Ayurvedic interventions in Parkinson’s disease (Kampavata), and to identify the most effective therapeutic strategies within Ayurvedic frameworks.

Methods A systematic search was conducted across PubMed, Scopus, Google Scholar, AYUSH Research Portal, and DHARA databases from 2015 to 2025 following PRISMA 2020 guidelines. Search terms included Parkinson’s disease, Kampavata, Ayurveda, Mucuna pruriens, Ashwagandha, Rasayana, Panchakarma, and Basti therapy. Studies in English involving Ayurvedic interventions with measurable neurological or clinical outcomes were included. Both clinical (case reports, trials) and preclinical (animal, in vitro, in silico) studies were analyzed. Data extraction covered study design, sample, interventions, outcomes, and key findings. Qualitative synthesis was performed due to heterogeneity in study designs.

Results A total of 39 studies met inclusion criteria, comprising 12 clinical studies, 10 case reports, 9 preclinical/experimental studies, 3 in silico analyses, and 5 systematic or conceptual reviews. Key Ayurvedic interventions included Mucuna pruriens, Withania somnifera, Bacopa monnieri, Ashwagandha, Rajayapana Vasti, Ksheeravasti, Abhyanga, Nasya, and Shirodhara.

• Clinical outcomes: Most studies reported significant improvements in tremor, rigidity, postural balance, and UPDRS/PDQ-39 scores, along with enhanced quality of life.
• Experimental evidence: Mucuna and Ashwagandha demonstrated dopaminergic restoration, reduced NF-κB/TNF-α, increased pAkt, TH, SOD, and GSH, and decreased oxidative stress and neuroinflammation.
• Mechanistic insights: Rasayana therapies modulated mitochondrial function, reduced α-synuclein aggregation, and improved neuronal resilience through antioxidant and anti-inflammatory pathways.
• Integrative findings: Panchakarma procedures combined with Rasayana formulations yielded superior results compared to monotherapy.

Conclusion The synthesis of recent evidence strongly supports the neuroprotective, symptomatic, and disease-modifying potential of Ayurvedic therapies in Parkinson’s disease. Mucuna pruriens and Withania somnifera, along with individualized Panchakarma protocols such as Vasti, Nasya, and Shirodhara, demonstrate consistent efficacy in alleviating motor and non-motor symptoms while enhancing neurochemical balance. Mechanistic findings correlate Ayurvedic Rasayana principles with modern neurobiology, particularly through modulation of oxidative stress, mitochondrial dysfunction, and neuroinflammation. However, well-designed randomized controlled trials (RCTs) with larger sample sizes and standardized interventions are warranted to validate these findings and establish integrative clinical protocols for PD management.