More than half of adults with neurological conditions use some type of complementary and integrative therapy. This article will discuss what integrative neurology is, the common conditions that it focuses on, and common treatments that are utilized, including nutraceuticals, acupuncture, physical therapy, and meditation. Integrative testing will then be discussed to help assess what treatment is appropriate.

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What is Integrative Neurology?

Integrative neurology is the combination of evidence-based conventional medicine with the best available integrative methods. It is well known that many neurological conditions have complicated and often hard-to-treat symptoms, leaving gaps in healthcare for these patients. This is where integrative therapies can shine, and this is why many neurologists currently employ integrative therapies in their practice.

What Conditions Does Integrative Neurology Commonly Focus on

As mentioned above, integrative neurology takes into account the whole person when addressing neurologic disorders. Let’s take a look at some of the most common neurologic conditions seen in integrative medicine.

Migraines

Migraines are a type of headache defined as throbbing head pain, usually localized to one side. There are many different types of migraine headaches, and they can last from hours to days. There does seem to be a genetic component to migraines, and stress, hormone fluctuations, and food sensitivities seem to be triggers. Almost 40 million Americans have migraine headaches, most of whom (70%) are women. Conventional treatment includes acute pharmaceuticals aimed at stopping the progression of the migraine and prophylactic pharmaceuticals which seek to stop the occurrence and lower the severity of migraine headaches. There are also procedures that can help with the acute pain from the migraine headache.

Parkinson’s Disease

Parkinson’s disease is a disease characterized by damage to brain cells called neurons that produce the neurotransmitter dopamine. Dopamine affects feelings of reward, pleasure, motivation, and other cognitive functions, but it is also involved in motor control and reproduction. The damage to neurons seems to be induced by various mechanisms, including inflammation and oxidation. Oxidation leads to reactive oxygen species production, which can damage cells and cause further inflammation. Symptoms of Parkinson’s disease include muscle rigidity, muscle tremors, urinary incontinence, changes in voice, changes in gait (walking), and other symptoms. Four percent of people over the age of 50 have Parkinson’s disease. Conventional treatment includes pharmaceuticals that aim at increasing levels of dopamine.

Dementia

Dementia is defined as a decrease in cognitive functioning, often characterized by problems with perception, understanding, or awareness of their own thoughts and ideas. The progression of dementia can range from slow to quick, and the symptoms can also vary from mild to severe. It’s estimated that one to five million Americans have mild to moderate dementia, and an additional two million have severe dementia. Dementia may be a result of an underlying condition, like Alzheimer’s disease or injury. Conventional therapies focus on slowing the progression of dementia.

The Most Common Herbs & Supplements Used In Integrative Neurology

Integrative medicine takes in to account nutritional and dietary consideration. The following are commonly used herbs and supplements used to treat migraines, Parkinson’s disease, and dementia.

Magnesium for Migraines

Magnesium is a mineral that is required by our bodies in order to function properly, as it is required for over 300 different reactions in the body that influence blood sugar regulation, energy, DNA and RNA production, and detoxification pathways. Because of these reactions, magnesium is important for the heart, muscles, bones, and, most relevant to this article, nerves. The American Academy of Neurology (AAN) reviewed the evidence of different nutraceuticals and found that magnesium was effective in treating two types of migraines—menstrual migraines and migraines with aura. The standard dose is 400-600 mg/day, and the gastrointestinal side effect of diarrhea and cramping may occur.

Curcumin for Parkinson’s Disease

Curcumin, an active ingredient in the spice turmeric, has been used medicinally for thousands of years. Due to its wide array of effects, including anti-inflammatory, anti-cancer, anti-microbial, and antioxidant effects, it has been referred to as the “spice of life”. Specific to Parkinson’s Disease, curcumin has the ability to cross the blood-brain barrier and lower neuroinflammation, or inflammation of the brain. Curcumin lowers inflammation by inhibiting a number of pro-inflammatory mediators. Additionally, curcumin's potent antioxidant properties help to fend off reactive oxygen species that may be causing damage to neurons as well as inducing neuronal death.

Ginkgo biloba for Dementia

Ginkgo biloba is a tree whose components have been historically used medicinally in Chinese medicine. Ginkgo has been traditionally used for bladder, kidney, cognitive and pulmonary disorders. Recent evidence shows its benefit in neurological conditions. A meta-analysis published in the Journal of Pharmaceutical Health Care and Sciences reviewed nine studies with over 3,700 participants that showed that not only was Gingko biloba safe but also effective in the treatment of dementia. The effective dose is at least 240 mg daily for 22 weeks.

Complementary and Integrative Medicine for Neurological Conditions

Many complementary appraoches are used in integrative neurology. Acupuncture, physical therapy, and meditation are amung them that have shown to be beneficial in treating neurologic conditions.

Acupuncture for Migraines

Acupuncture has been used for over 5,000 in traditional Chinese medicine. Chinese medicine believes the body has a vital life force that runs within it, called qi (pronounced CHEE). Acupuncture is a treatment that aims to stimulate the movement of qi throughout the body by the application of tiny, stainless steel needles to specific points on the body. Qi is supposed to balance all sectors of life, including physical, mental, emotional, and spiritual health, and thus has been used for many health conditions. Relative to migraines, a meta-analysis in the Cochrane Database of System Reviews, including 4,985 participants, showed that acupuncture was more effective than a placebo in the treatment of migraines and is similar to prophylactic drugs in the treatment of migraines.

Physical Therapy for Parkinson's Disease

Since Parkinson’s disease affects motor function and control, including gait, physical therapy can be beneficial. Physical therapy can help to improve balance and coordination, as well as strength, thereby improving gait in those who have Parkinson’s disease.

Meditation for Dementia

Meditation is another modality with thousands of years of history. Meditation employs mindfulness in a specific activity that engages our five senses, such as breathing. Mindfulness has been defined as “paying attention on purpose”, and can impact how the brain works. A study published in Frontiers in Human Neuroscience split participants who had either Alzheimer’s disease or mild cognitive impairment into two groups, one group doing meditative practice and the other the placebo group. Brain MRIs were done prior to the start of the study and then after six months. Cortical thickness and gray matter volume were positively impacted by those participants in the mediation group as compared to the control group. Most of the changes were in the regions of the brain that controlled memory and executive control, the regions that are most affected by neurodegenerative diseases.

Top Integrative Medicine Labs Used in Integrative Neurology  

Various integrative medicine blood tests can help to assess the root cause and/or contributing mechanisms to many neurological diseases. Let’s take a look at the most benecial labs to address migraines, Parkinson’s, and dementia.

DUTCH Cycle Mapping Test

The DUTCH Cycle Map test by Precision Analytic is a dried urine test that assesses breakdown products called metabolites of hormones. As stated above, 70% of migraine sufferers are women, and one type of migraine, menstrual migraines, is specifically caused by fluctuations in the two main women's hormones, estradiol and progesterone. This test tracks these two hormones throughout one entire cycle and thus will show fluctuations of these hormones. These results can be looked at in combination with the occurrence of migraines to allow the practitioner and patient to assess if hormone fluctuations are at the root of the migraine.

Redox/Antioxidant Protection Assay

The Redox/Antioxidant Protection Assay by Cell Science Systems is a test that assesses antioxidant functioning in the body. This assay gives insight into a person's resistance to oxidative stress. Oxidative stress produces reactive oxygen species (ROS), which can damage cells, including DNA. Oxidative stress and ROS have been implicated in many conditions, including Parkinson’s disease.

Homocysteine

Homocysteine is an amino acid that should be found in small amounts in the body. However, when homocysteine levels are elevated, the risk of cardiovascular disease, including heart attack and stroke, increases, as homocysteine can induce clotting. High homocysteine levels have also been implicated as a risk factor for dementia. The Homocysteine test by Great Plains Laboratory can give the level of circulating homocysteine, which should be between 5-15 micromoles per liter (mcmol/L)

Neurotransmitters

The Comprehensive Neurotransmitter Profile by Doctor’s Data has 21 different markers analyzing the creation and metabolism of various neurotransmitters. As discussed above, the neurotransmitter dopamine is incredibly important to those suffering from Parkinson’s disease, and the neurotransmitters acetylcholine and glutamate have been implicated in Parkinson’s disease and Alzheimer’s disease. Serotonin, another neurotransmitter, can induce migraines in some people.

Micronutrients

The Micronutrient Panel by Spectracell Laboratories assesses 31 different nutrients including various vitamins, and minerals. Many micronutrients have been implicated in neurological diseases, including vitamin C in Parkinson’s disease and dementia and magnesium in migraines. This test gives a comprehensive view of the level of many micronutrients in one test.

Summary

Neurological conditions, including migraines, Parkinson’s disease, and dementia, are chronic diseases that greatly affect a person’s quality of life. Integrative medicine continues to be sought out at increasing rates in neurological conditions due to the limitation of conventional therapies. Integrative testing can help to assess many underlying mechanisms that play a role in the pathogenesis of various conditions, as in the case of oxidant mechanisms and Parkinson’s disease, homocysteine elevation in dementia, or hormonal fluctuations in migraine headaches. Due to the interest in integrative treatments, more studies are being done to assess and validate their effectiveness, leading to more bodies of evidence calling for integrative protocols in the treatment of neurological conditions.