Neurological Disorders

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    Neurological diseases are disorders of the brain, spinal cord, and nerves throughout the body. These diseases can affect almost any function of the human body, including voluntary control of muscles, perception of sensations, cognition, and autonomic functions such as heartbeat and digestion.

    Definition and Overview

    A neurological disorder is any disorder of the nervous system. Structural, biochemical, or electrical abnormalities in the brain, spinal cord, or other nerves can result in a range of symptoms. These may include paralysis, muscle weakness, poor coordination, loss of sensation, seizures, confusion, pain, and altered levels of consciousness.

    Classification of Neurological Diseases

    Neurological diseases can be classified based on the primary location affected, the primary type of dysfunction involved, or the primary cause when known.

    By Location

    • Central Nervous System Diseases: These affect the brain and spinal cord. Examples include stroke, multiple sclerosis, and Parkinson's disease.
    • Peripheral Nervous System Diseases: These affect the peripheral nerves. Examples include peripheral neuropathy, Guillain-Barré syndrome, and carpal tunnel syndrome.

    By Dysfunction

    • Functional Disorders: Such as epilepsy, where there may be intermittent malfunctioning.
    • Structural Disorders: Such as brain or spinal cord injury, where there is physical damage.
    • Degenerative Disorders: Such as Alzheimer's disease and Amyotrophic Lateral Sclerosis (ALS), where there is progressive loss of structure or function.

    By Cause

    • Genetic Diseases: Such as Huntington's disease and Duchenne Muscular Dystrophy.
    • Infections: Such as meningitis or polio.
    • Lifestyle or Environmental Factors: Such as the effects of substance abuse or prolonged exposure to toxic substances.

    Common Age-Related Neurological Disorders

    Neurological disorders that are predominantly age-related typically manifest and progress with advancing age, reflecting changes in neurological function over time. These conditions often result from the cumulative effect of various biological processes such as neuronal loss, protein misfolding, vascular changes, or inflammatory mechanisms.

    • Alzheimer's Disease: A progressive degenerative disease that primarily affects individuals over 65, impacting memory, thinking, and behavior. Early-onset Alzheimer's can occur in individuals between 30 and 65 years of age, although it is less common.
    • Parkinson's Disease: This degenerative disorder of the central nervous system predominantly affects middle-aged and elderly people, usually presenting itself after the age of 60. Symptoms such as impaired motor skills and speech progressively worsen over time.
    • Stroke: The risk of stroke increases significantly with age, particularly after the age of 55. It occurs when there is a loss of blood flow to a part of the brain, resulting in tissue damage and loss of function in the affected area.
    • Amyotrophic Lateral Sclerosis (ALS): Also known as Lou Gehrig's disease, ALS leads to the progressive loss of muscle control due to nerve cell damage in the brain and spinal cord and is most common between the ages of 40 and 70, though it can occur at any age.
    • Vascular Dementia: The second most common form of dementia after Alzheimer's disease, vascular dementia is caused by problems in the supply of blood to the brain, often due to strokes or small vessel disease.
    • Frontotemporal Dementia: An umbrella term for a range of disorders that primarily affect the frontal and temporal lobes of the brain, which are generally associated with personality, behavior, and language. While it can start as early as 45 years old, it becomes more common in older adults.
    • Lewy Body Dementia: Characterized by the presence of Lewy bodies (abnormal aggregates of protein) in the brain, it affects cognition, behavior, movement, and sleep. It is typically a disease of older adults, most commonly appearing after the age of 60.
    • Normal Pressure Hydrocephalus: Although it can occur at any age, it is more prevalent in the elderly population and is caused by the build-up of cerebrospinal fluid in the brain ventricles, leading to walking difficulties, urinary incontinence, and cognitive impairment.
    • Multiple System Atrophy (MSA): A rare degenerative neurological disorder affecting adults, typically in their 50s. MSA is characterized by a combination of symptoms affecting movement, blood pressure control, and other bodily functions.
    • Huntington's Disease: This is a hereditary disorder caused by a faulty gene for a protein called huntingtin. Symptoms usually start between 30 and 50 years of age and can include movement disorders, cognitive decline, and psychiatric problems.

    Other Common Neurological Disorders

    • Epilepsy: Characterized by recurrent seizures, which are sudden bursts of electrical activity in the brain that temporarily affect how it works.
    • Migraine: A type of headache associated with sensory disturbances, often a chronic condition with recurrent episodes.
    • Multiple Sclerosis (MS): An autoimmune disease where the immune system attacks the protective sheath (myelin) that covers nerve fibers, causing communication problems between the brain and the rest of the body.
    • Traumatic Brain Injury (TBI): Caused by a blow to the head or a penetrating head injury that disrupts the normal function of the brain.
    • Spinal Cord Injury: Damage to any part of the spinal cord or nerves at the end of the spinal canal, often causing permanent changes in strength, sensation, and other body functions below the site of the injury.
    • Peripheral Neuropathy: A result of damage to the peripheral nerves, often causing weakness, numbness, and pain, usually in the hands and feet.
    • Bell's Palsy: A sudden weakness in the muscles on one half of the face, resulting in a drooping appearance.
    • Guillain-Barré Syndrome: A rare disorder where the body's immune system attacks the peripheral nerves.
    • Cerebral Palsy: A group of disorders that affect movement and muscle tone or posture, caused by damage that occurs to the immature brain as it develops, most often before birth.
    • Huntington's Disease: A genetic disorder causing the progressive breakdown (degeneration) of nerve cells in the brain.
    • Duchenne Muscular Dystrophy: A genetic disorder characterized by progressive muscle degeneration and weakness due to alterations of a protein called dystrophin that helps keep muscle cells intact.

    Supplementation in Neurological Diseases

    Supplementation can play a role in the management of neurological diseases, particularly in cases where dietary deficiencies are identified or where evidence supports their use in symptom management or disease progression. It's important to note that while some supplements may help reduce symptoms or support neurological health, they are not a substitute for medical treatment but rather a complementary approach.

    Vitamins and Minerals

    • Vitamin B12 and Folate: These are essential nutrients for nerve function, playing a critical role in the synthesis of DNA and neurotransmitters. Vitamin B12 is crucial for maintaining the integrity of the myelin sheath that surrounds and protects nerve fibers, while folate is vital for cell division and repair. Deficiencies in either can lead to neurological problems such as peripheral neuropathy, cognitive impairment, and mood disorders.
    • Vitamin D: This vitamin is not only crucial for bone health but also plays an important role in the nervous system and immune regulation. Low levels of Vitamin D have been linked to an increased risk of multiple sclerosis, a condition characterized by immune-mediated destruction of the myelin sheath. There is also growing evidence suggesting its role in modulating the severity and progression of neurodegenerative diseases like Alzheimer's and Parkinson's.
    • Magnesium: Magnesium is a key mineral for nerve transmission and has been studied for its potential in preventing and treating migraines. It regulates various neurotransmitters and can help stabilize the nerve cells. Magnesium deficiency has been linked to heightened migraine episodes, muscle cramps, and increased susceptibility to stress and anxiety.
    • Omega-3 Fatty Acids: Found abundantly in fish oil, these fatty acids are essential components of cell membranes, particularly in the brain. They have anti-inflammatory properties and are believed to be beneficial in neurological conditions like multiple sclerosis and potentially in cognitive decline. Omega-3s may help maintain neurological function and reduce neuroinflammation.
    • Vitamin B6 (Pyridoxine): Vitamin B6 is crucial for normal brain development and function. It assists in the production of neurotransmitters, which are chemicals that transmit signals from one nerve cell to another. It's also involved in the synthesis of myelin, a protective sheath that covers nerves. Vitamin B6 deficiency can lead to a range of neurological symptoms such as depression, confusion, and a weakened immune response. There is also interest in the role of Vitamin B6 in reducing the risk of certain neurological conditions like Parkinson's disease, although more research is needed to establish its effectiveness.
    • Zinc: Zinc is an essential trace element that plays a significant role in the brain and central nervous system. It's crucial for neurotransmitter function and brain signaling. Zinc is also important for neurogenesis, the process of generating new neurons. Deficiency in zinc can lead to a variety of neurological symptoms, including altered cognition, mood disorders, and learning difficulties. In neurodegenerative diseases such as Alzheimer's, zinc has been noted for its potential role in modulating synaptic function and in the pathogenesis of the disease. However, the exact mechanisms and therapeutic potential of zinc supplementation in these contexts are still subjects of ongoing research.

    Antioxidants

    • Vitamin E and Selenium: These antioxidants play a crucial role in protecting the brain and nervous system against oxidative stress, which can damage cells and is implicated in conditions like stroke, Alzheimer's disease, and Parkinson's disease. Vitamin E, in particular, has been shown to support cognitive health and may slow the progression of Alzheimer's disease.
    • Coenzyme Q10: CoQ10 is involved in energy production within cells and acts as an antioxidant. It has been studied for its potential benefits in neurodegenerative disorders such as Parkinson's and Huntington's diseases, where mitochondrial dysfunction and oxidative stress are key features.
    • Alpha-Lipoic Acid (ALA): Alpha-Lipoic Acid is a naturally occurring compound that functions as an antioxidant in the body. It plays a crucial role in mitochondrial energy metabolism and is known for its ability to regenerate other antioxidants, such as Vitamin C and Vitamin E, enhancing their effectiveness. ALA has been particularly studied for its benefits in peripheral neuropathy, especially diabetic neuropathy. It helps improve nerve blood flow, reduce oxidative stress, and alleviate pain, burning, and numbness associated with neuropathy. Additionally, due to its antioxidant properties, ALA is being explored for potential benefits in other neurological conditions characterized by oxidative stress.

    Herbal Supplements

    • Ginkgo Biloba: This herb is widely used for cognitive impairment and dementia. Ginkgo Biloba is believed to improve blood flow to the brain and act as an antioxidant. However, the evidence for its effectiveness is mixed, with some studies showing benefits in cognitive function and others showing minimal effect.
    • Turmeric (Curcumin): Curcumin, the active ingredient in turmeric, has potent anti-inflammatory properties and has been researched for its potential neuroprotective benefits. It's thought to reduce the inflammatory response in the brain and has been studied in various neurological conditions, including Alzheimer's disease and depression.

    Amino Acids and Proteins

    • Creatine: Often associated with muscle strength, creatine has also shown neuroprotective effects in various models of neurological diseases. It supports energy metabolism in brain cells and may offer benefits in conditions like Parkinson's disease, Huntington's disease, and ALS.
    • Acetyl-L-Carnitine: This supplement is involved in mitochondrial energy metabolism and has been explored for its benefits in peripheral neuropathy, especially related to diabetes, and in Alzheimer's disease. It helps transport fatty acids into mitochondria for energy production and has potential neuroprotective properties.
    • NAD+ Precursors: Nicotinamide Adenine Dinucleotide (NAD+) is a vital coenzyme in cellular energy metabolism and plays a significant role in various cellular processes, including DNA repair, cell signaling, and aging. NAD+ levels naturally decline with age, and this reduction is linked to various age-related diseases, including neurodegenerative disorders. Supplementation with NAD+ precursors is thought to boost NAD+ levels in the body. This can potentially support cellular health, improve energy metabolism in brain cells, and offer neuroprotective effects. Studies are exploring their efficacy in conditions like Alzheimer's disease, Parkinson's disease, and other neurodegenerative and cognitive disorders. These precursors are a promising area of research for their potential to mitigate age-related decline in neurological function.

    Other Supplements

    • Probiotics: The gut-brain axis is an area of growing research interest, and probiotics may play a role in influencing neurological health. They are believed to impact mood, cognitive function, and even the course of neurodegenerative diseases through their effects on gut health and systemic inflammation.
    • Cannabidiol (CBD): CBD, a non-psychoactive component of cannabis, has gained attention for its potential effects in neurological disorders. It's been particularly noted for its use in certain forms of epilepsy, as well as its potential in managing anxiety and neuroinflammation.
    • Melatonin: Best known for its role in regulating sleep, melatonin also has antioxidant properties and has been explored for its potential benefits in neurodegenerative diseases. It's believed to help regulate circadian rhythms, improve sleep quality, and possibly provide neuroprotection.

    See Also

    Todo

    • Include links to senescent cells
    • 2022, The Impact of Supplements on Recovery After Peripheral Nerve Injury: A Review of the Literature [1]
    • 2022, SIRT1 activation and its circadian clock control: a promising approach against (frailty in) neurodegenerative disorders [2]
    • 2022, Mitochondrial Dysfunction and Neurodegenerative Disorders: Role of Nutritional Supplementation [3]

    References

    1. Abushukur Y & Knackstedt R: The Impact of Supplements on Recovery After Peripheral Nerve Injury: A Review of the Literature. Cureus 2022. (PMID 35733475) [PubMed] [DOI] [Full text] Peripheral nerve injury (PNI) can result from trauma, surgical resection, iatrogenic injury, and/or local anesthetic toxicity. Damage to peripheral nerves may result in debilitating weakness, numbness, paresthesia, pain, and/or autonomic instability. As PNI is associated with inflammation and nerve degeneration, means to mitigate this response could result in improved outcomes. Numerous nutrients have been investigated to prevent the negative sequelae of PNI. Alpha-lipoic acid, cytidine diphosphate-choline (CDP Choline), curcumin, melatonin, vitamin B12, and vitamin E have demonstrated notable success in improving recovery following PNI within animal models. While animal studies show ample evidence that various supplements may improve recovery after PNI, similar evidence in human patients is limited. The goal of this review is to analyze supplements that have been used successfully in animal models of PNI to serve as a reference for future studies on human patients. By analyzing supplements that have shown efficacy in animal studies, healthcare providers will have a resource from which to guide decision-making regarding future human studies investigating the role that supplements could play in PNI recovery. Ultimately, establishing a comprehensive understanding of these supplements in human patients following PNI may significantly improve post-surgical outcomes, quality of life, and peripheral nerve regeneration.
    2. Ribeiro RFN et al.: SIRT1 activation and its circadian clock control: a promising approach against (frailty in) neurodegenerative disorders. Aging Clin Exp Res 2022. (PMID 36306110) [PubMed] [DOI] [Full text] With the increase in life expectancy, the incidence of neurodegenerative disorders and their impact worldwide has been increasing in recent years. Neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, and Huntington's disease, have complex and varied mechanisms of pathogenesis. Importantly, they share the common feature of disrupted circadian rhythms. This hallmark is believed to underlie the symptoms of such diseases and even potentially contribute to their onset. In addition, the association of physical frailty with dementia and neurodegenerative disorders has been demonstrated. In fact, frail persons are 8 times more likely to have some form of dementia and population studies report a significant prevalence for frailty in older patients with AD and PD. SIRT1 regulates the acetylation status of clock components and controls circadian amplitude of clock genes. However, the mechanisms responsible for this circadian clock control have been the subject of contradictory findings. Importantly, the activation of SIRT1 has been shown to have very relevant therapeutic potential against neurodegeneration. Nevertheless, few studies have attempted to connect the therapeutic reestablishing of SIRT1 as an approach against circadian disruption in neurodegenerative diseases. In this review, we address: circadian rhythms as an important early biomarker of neurodegenerative disorders; mechanisms for SIRT1 activation and the novel sirtuin-activating compounds (STACs); SIRT1 circadian paradox and subsequent studies in an unprecedented way in the literature; the beneficial role of SIRT1 activation in neurodegeneration; innovative proposals of how circadian-based interventions (e.g., SIRT1 activators) may become an important therapeutic approach against neurodegenerative disorders and how non-pharmacologic interventions (e.g., Mediterranean-style diet) might help in the prevention and/or treatment of these high-burden disorders, while tackling frailty and enhancing robustness.
    3. Mantle D & Hargreaves IP: Mitochondrial Dysfunction and Neurodegenerative Disorders: Role of Nutritional Supplementation. Int J Mol Sci 2022. (PMID 36293457) [PubMed] [DOI] [Full text] Mitochondrial dysfunction has been implicated in the pathogenesis of a number of neurodegenerative disorders, including Parkinson's disease, Alzheimer's disease, amyotrophic lateral sclerosis, multisystem atrophy, and progressive supranuclear palsy. This article is concerned specifically with mitochondrial dysfunction as defined by reduced capacity for ATP production, the role of depleted levels of key nutritionally related metabolites, and the potential benefit of supplementation with specific nutrients of relevance to normal mitochondrial function in the above neurodegenerative disorders. The article provides a rationale for a combination of CoQ10, B-vitamins/NADH, L-carnitine, vitamin D, and alpha-lipoic acid for the treatment of the above neurodegenerative disorders.