Plant-derived therapies in Parkinson's disease: What does the clinical evidence actually say?

[anajimenahdz]

Hi folks!

I just read a systematic review that came out yesterday: “Plant-derived therapies in Parkinson’s disease: a systematic review of clinical evidence.” It provides a comprehensive overview of the current clinical evidence on plant-derived interventions for Parkinson’s disease.

A few findings caught my attention:

1. Mucuna pruriens had the strongest clinical signal. The review assigned Grade A evidence for motor improvement, with benefits comparable to levodopa and longer ON time without worsening dyskinesia. It also received Grade B evidence for reducing dyskinesia.
2. Apium graveolens (celery) was supported by a single randomized clinical trial showing improvements in motor symptoms, sleep quality, and quality of life, corresponding to Grade B evidence.
3. Bacopa monnieri did not improve motor symptoms but showed a possible benefit for emotional symptoms, earning Grade B evidence for that specific domain.
4. Curcuma longa (turmeric/curcumin) presented a weaker signal, mainly for autonomic and other non-motor symptoms (Grade C). The review also notes that the available pilot clinical evidence has not demonstrated clear clinical efficacy.
5. Glycine max (soybean) did not improve core motor symptoms but appeared to prolong ON time and reduce dyskinesia, resulting in Grade C evidence focused on motor complications rather than overall symptom improvement.
6. Cannabis sativa was perhaps the most surprising finding. Across multiple studies, the review found Grade A evidence for no motor benefit, while results for non-motor symptoms remained inconsistent or inconclusive.

Importantly, the authors emphasize that these interventions should currently be viewed as adjunctive, symptom-targeted therapies rather than disease-modifying treatments, and that larger, well-designed randomized trials are still needed before routine clinical implementation can be recommended.

I’d love to hear from this community:

• Are there other plant-derived therapies that your patients commonly use, or that you’ve encountered in your own research?

• Have you analyzed the use of herbal or plant-based therapies in your cohorts? If so, what have you found?

• Do you think some promising candidates deserve more rigorous clinical evaluation?

Looking forward to learning from your experiences!

[gginnan]

Thanks for this post, @anajimenahdz! Very intriguing line of research to investigate which plant-derived therapies could be used to target symptoms.

Tagging some other community members with stated research interest and/or experience in movement disorders and/or clinical practice to see if they’ve considered (or come across) these alternative therapeutic strategies:
@efernandez @psaffie @TremorSwift @SLeslie @Benjamin_Adebisi @ilsgomes @clinmed9 @Maouly @Vrutang @MubasherQ @TugceGulD @ajbilson

[ajbilson]

Thank you for sharing this comprehensive review @anajimenahdz @gginnan. Here in Ghana, one plant-derived therapy that comes to mind is Mucuna pruriens, which has also been the focus of research in sub-Saharan Africa. In that regard, a study worth emphasizing is the 12-month multicenter randomized phase 2 trial led by Roberto Cilia and colleagues (with contributions from @Vidash ). The study found that Mucuna pruriens powder produced improvements in motor symptoms, non-motor symptoms, and quality of life comparable to standard levodopa plus a dopa-decarboxylase inhibitor, while highlighting its potential as a cost-effective alternative in settings where access to commercial levodopa formulations is limited. Like the review, the authors concluded that larger, multicenter, double-blind trials with more diverse populations are still needed to establish long-term safety and efficacy. I think this is a particularly promising area for further investigation, especially in low- and middle-income countries where treatment access remains a major challenge.

[vcatterson]

Wow, this is fascinating! Thanks for the summary of the results of this study!

There is a lot to be said for the investigation of natural products for therapeutics. But one of the hurdles they may face is the lack of good understanding of mechanism of action, and hence the regulatory process can be much more challenging than a “typical” drug approval process. More research and larger studies are definitely required!