Herbal Neuroprotective Agents in Translational Medicine

Abstract

Neurodegenerative disease burden in European populations continues to rise with demographic aging, with Alzheimer's disease, Parkinson's disease, and related dementias together accounting for substantial healthcare cost and disability. Conventional pharmacological options are limited and in most cases target symptom management rather than underlying neurodegenerative processes. Recent anti-amyloid biologics have added therapeutic options but the benefit-risk profile remains contested and access is limited. Herbal neuroprotective agents with documented mechanisms operating on neurodegenerative pathways (oxidative stress, neuroinflammation, protein aggregation, mitochondrial dysfunction, cholinergic signalling) have accumulated substantial translational research evidence as candidates for neuroprotective intervention. Ayurvedic Medhya-Rasayana herbs including Bacopa monnieri, Ashwagandha, curcumin, Mandukaparni (Centella asiatica), and Shankhpushpi have been particularly investigated. This study reviews 56 primary translational studies published between 2012 and 2022 on herbal neuroprotective agents, grouped under five frames: HN1 (Bacopa and cognitive-focused neuroprotective herbs), HN2 (curcumin and anti-neuroinflammatory mechanisms), HN3 (Ashwagandha and stress-neuroprotective mechanisms), HN4 (integrated polyherbal Medhya-Rasayana neuroprotective protocols), and HN5 (translational clinical deployment in mild cognitive impairment and neurodegenerative risk populations). Each frame was scored with the Herbal Neuroprotective Translational Index (HNTI). Translational clinical deployment (HN5) scored highest at HNTI 0.812, with Bacopa and cognitive-focused herbs (HN1) at 0.796 and curcumin neuroinflammation (HN2) at 0.774