Role of an herbal formulation in the prevention and management of age related neurodegenerative disorders with special reference to senile dementia

09675657 ยท 2017-06-13

Assignee

Inventors

Cpc classification

International classification

Abstract

According to this invention there is provided a herbal formulation for the prevention and management of neurodegenerative disorders comprising, hydro-methanolic extract of at least one plant selected from Curcuma longa, Bacopa monnieri and Valeriana jatamansi, at 70-80 C., maintaining the pH of the solution between 7-10, Separating the active compounds chromatographically and Subjecting the active compounds to the step of molecular characterization.

Claims

1. A pharmaceutical capsule or tablet for the treatment of a neurodegenerative disorder consisting essentially of an effective amount of hydro-methanolic extracts of Valeriana jatamansi, Curcuma longa, and Bacopa monnieri; wherein the ratio of the hydro-methanolic extracts of Curcuma longa to Valeriana jatamansi is 1:3 to 2:1, and the ratio of the hydro-methanolic extracts of Bacopa monnieri to Valeriana jatamansi is 1:1.8 to 2.5:1.

2. The pharmaceutical capsule or tablet as claimed in claim 1, wherein the extracts are from the plant parts: TABLE-US-00023 1. Curcuma longa (Haridra) rhizome 2. Valeriana jatamansi (Tagar) rhizome 3. Bacopa monnieri (Brahmi) whole plant.

3. The pharmaceutical capsule or tablet as claimed in claim 1, wherein the effective amount provides at least one of anti-oxidant activity, neuromodulatory activity, and restoring acetylcholine levels, thereby slowing the process of memory and learning deficit.

4. The pharmaceutical capsule or tablet as claimed in claim 1, wherein the effective amount provides neuromodulatory activity by regulating the neurotransmitters.

5. The pharmaceutical capsule or tablet as claimed in claim 1 wherein the effective amount provides a tranquilizing effect for the management of sleep disorders.

6. The pharmaceutical capsule or tablet as claimed in claim 1 wherein the effective amount provides a neuro-protective effect in ageing and neurodegenerative pathologies by ameliorating pathways selected from the group consisting of neuro-chemical modulation, mitochondrial dysfunction, antioxidant activity and reduction in neuro-inflammation.

7. The pharmaceutical capsule or tablet as claimed in claim 1, wherein the effective amount elevates neuro-chemical contents in the brain thereby having neuromodulatory activity.

8. The pharmaceutical capsule or tablet as claimed in claim 1, wherein the effective amount provides anti-oxidant activity.

9. The pharmaceutical capsule or tablet as claimed in claim 1, wherein the effective amount provides anti-neuroinflammatory activity to reduce brain inflammation.

10. The pharmaceutical capsule or tablet as claimed in claim 1, wherein the effective amount provides anti-psychotic effects and improving behavioral disorders among demented patients.

11. The pharmaceutical capsule or tablet of claim 1, wherein the effective amount provides at least one of anti-oxidant activity; neuromodulatory activity; restoring acetylcholine levels thereby slowing the process of memory and learning deficit; regulation of neurotransmitters; a tranquilizing effect for the management of sleep disorders; a neuro-protective effect in ageing and neurodegenerative pathologies by ameliorating neuro-chemical modulation, mitochondrial dysfunction, antioxidant activity or reduction in neuro-inflammation; elevates neuro-chemical contents in the brain thereby having neuromodulatory activity; reducing brain inflammation; anti-psychotic effects; and improving behavioral disorders.

Description

BRIEF DESCRIPTION OF THE FIGURES

(1) FIG. 1 is a flow diagram of the process.

(2) FIG. 2 is showing the effect of test drug on mini mental state examination in SDAT cases.

(3) FIG. 3 is showing the effect of test drug on mini mental state examination and attention span in SDAT cases.

(4) FIG. 4 is showing the effect of test drug on short term memory in SDAT cases.

(5) FIG. 5 is showing the effect of test drug on long term memory in SDAT cases.

(6) FIG. 6 is showing the effect of test drug on Anxiety level in SDAT cases.

(7) FIG. 7 is showing the effect of test drug on depression level in SDAT cases.

(8) FIG. 8 is showing the effect of test drug on hs C-Reactive Protein level in SDAT cases.

(9) FIG. 9 is showing the effect of test drug on Interleukin-6 level in SDAT cases.

(10) FIG. 10 is showing the effect of test drug on TNF- level in SDAT cases.

(11) FIG. 11 is showing the effect of test drug on Homocysteine level in SDAT cases.

DETAILED DESCRIPTION OF INVENTION

(12) The hydro-methanolic extract of three Ayurvedic plants Valeriana jatamansi, Curcuma longa and Bacopa monnieri by using 30:70 ratio of water and methanol respectively is utilized for present study. The water utilized for extraction was decontaminated for any type of bacterial or abnormal growth by using reverse osmosis plant. After extraction the presence of active molecules in various plant extracts were identified by HPLC, HPTLC and NMR procedures.

(13) The biological activity was studied on the basis of mode of action of single plant selected for combined formulation as well as combined formulation by assessing their role on various targets involved in neurodegeneration as well as neurodegenerative disorders. The bio-molecular reaction following the interaction between the chemical and biological markers like cholinergic, dopaminergic, glutamatergic system, oxidative stress markers, inflammatory cytokines and also the neuropyschological assessments were evaluated.

(14) The pre-clinical toxicological studies of single as well as combined formulation were carried out to determine safety profile of present novel test formulation. The efficacy profile of test formulation were also done in pre-clinical animal model of Alzheimer's disease and age consistent status of various targets like neurotransmitters, neuro-inflammatory markers and oxidative stress markers. The mode of action of single plant candidate and combined formulation was determined in animal studies.

(15) The beneficial role of test formulation on cholinergic, dopaminergic and glutamate excito-toxicity effect, anti-neuro-inflammatory activity and anti-oxidant activity was determined in various animal models before utilizing the test formulation for human consumption.

(16) Extraction Procedure:

(17) The dried rhizome of Valeriana jatamansi, dried rhizome of Curcuma longa, and dried whole plant of Bacopa monnieri, were utilized for extraction. The hydro-methanolic extract of the plants were utilized for the identification of active compound present in the plants. After extraction, the extracted parts were taken for chromatographic separation by using TLC, HPLC, and HPTLC. After identification and separation of active compound, the molecular characterization was carried out by using IR and NMR.

(18) The extraction was done at the temperature of 70-80 C. The pH of the solution was maintained between 7-10. The steps carried out to isolate the active compound to assess the activity of test formulation are shown in FIG. 1.

(19) According to this invention, there is provided an Ayurvedic formulation for the prevention and management of neurodegenerative disorders particularly for senile dementia and senile dementia of Alzheimer's type. The present test formulation comprising of the following ingredients:

(20) TABLE-US-00001 Name of the Plants Parts used 1. Curcuma longa (Haridra) rhizome 2. Valeriana jatamansi (Tagar) rhizome 3. Bacopa monnieri (Brahmi) whole plant
Preferably, the aforesaid plants are present in the formulation in the following doses

(21) TABLE-US-00002 Name of the Plants Dose range 1. Curcuma longa 150-400 mg/day 2. Valeriana jatamansi 200-450 mg/day 3. Bacopa monnieri 250-500 mg/day

(22) The formulation also comprise known additive such as minerals, vitamins, salts filler (for capsulation or to prepare syrup) and binders, if required to present in trace amount.

(23) Thus any known additive or supplement is added to prepare the final formulation as required and present in trace amount. Reference is made here in capsule form (500 mg each). However, it would be apparent that the preparation may also be in the form of syrup/tablet.

(24) Preferably but without implying any limitation the preparation comprises

(25) TABLE-US-00003 Name of the plant Dose 1. Curcuma langa 250 mg/day 2. Valeriana jatamansi 325 mg/day 3. Bacopa monnieri 375 mg/day
Hypothesis:

(26) The present test formulation is based on the combined effect of three Ayurvedic plant extract namely Curcuma longa, Valeriana jatamansi and Bacopa monnieri. This formulation has been proven for its neuro-chemical, neuro-modulatory, anti-inflammatory and anti-oxidant activity and the most important potential role is for memory and attention span enhancing activity among aged people. These effects are mainly mediated through its glutamate inhibitory activity as well as amelioration of cholinergic and dopaminergic neurons. Further, the novel formulation prepared by using specific doses of three plant extracts have exerted anti-oxidant role by regulation of oxidative enzymes.

(27) A number of changes take place in the brain during neurodegeneration or aging at molecular, cellular, structural and functional level. Neurotransmitters such as acetylcholine glutamate, dopamine play an important role in the regulation of neuronal circuits and influence the neurodegenerative process. Glutamate and GABA, the major excitatory and inhibitory neurotransmitters are responsible for the protection of neuronal survival and synaptic plasticity. Decrease 5-HT receptors were found in dementia. Serotonergic neurons either inhibits or increase the release of dopamine concentration, thus influence dementia directly. GABA is the primary inhibitory neurotransmitter in the CNS and abnormality is significantly associated with behavioral changes in neurodegenerative disorders. Regulation of 5-HT results in the regulation of aggression, mood, feeding, sleep, temperature, motor activity etc.

(28) Decrease in cholinergic markers cholin-acetyl-transferase (AchE) in the cortex, loss of neurons in nucleus basalis of meynert and also reduction in muscarinic type-II pre-synaptic receptor density are estimated in various type of dementia. It is reported that Valeriana jatamansi is a potent nervine tonic and has sedative effects thus it produces mental relaxation and induces sleep.

(29) As vascular inflammation is significantly involved with neurodegenerative disorders, high level of Interleukins, Tumor Necrosis Factor are responsible for neuro-inflammation. Further, high sensitive C-reactive protein is an important neuro-inflammatory factor manifesting vascular inflammation in the brain, particularly in Alzheimer's disease and Parkinson's disease. Oxidative injury plays a major role in the death and degeneration of neurons and also contributes in platelet aggregation and mitochondrial dysfunction and glutamate excitotoxicity. Recently various studies have suggested that apoptosis rather than necrosis is primarily responsible for loss of neurons and that caspases are the major executioners of apoptosis in common neurodegenerative diseases. This mechanism is important when studied in relation to aging brain. A number of acetylcholine esterase inhibitors, MAO-B inhibitors chelaters etc are being used for their multi-targeted action that prevents loss of mitochondrial permeability, cytochrome C release and down regulated the expression of pro-apoptonic genes, but the application of such agents are restricted due to unsatisfactory results and side effects.

(30) Keeping the above facts in view and effective role of plants that acted on various targets involved with neurodegenerative process determined in pre-clinical models, it was thought to propose a better remedial measure for the prevention and management of neurodegenerative process as well as neurodegenerative disorders particularly Senile Dementia, SDAT and vascular dementia caused due to stroke.

(31) About the Plant:

(32) Curcuma longa: It belongs to Zingiberaceae family and found all over India in abundance. The active constituents of curcuma longa are flavonoid, curcumin and volatile oils including timerone, atlantone and zingiberone. It has anti-oxidant, hepato-protective, anti-oxidant and potent anti-inflammatory activity. It improves cognitive deficit and prevents amyloidal accumulation
Bacopa monnieri: Bacopa monnieri is one of the major ingredients of present test formulation that belongs to family scrophulariaceae. It has shown potential role in improving mental ability, intelligence, concentration and memory performance. It is a potent nervine tonic. It is reported that Bacopa monnieri crosses the blood brain barrier, regulates the cholinergic neuron, prevents the further loss of acetylcholine and thus is effective in the prevention and management of neurodegenerative disorders. It has also shown anti-oxidant role.
Valeriana Jatamansi belongs to family Valerianceae also known as jatamansi. Rhizome is used medicinally. This species is globally distributed at altitude range of 1500-3600 m. Valerian, active compound of V-Jatamansi has been shown to improve sleep quality and reduce blood pressure. The rhizome of Valeriana Jatamansi is antispasmodic, carminative, diuretic, hypnotic, powerfully nervine, sedative and stimulant. It is also used in the treatment of painful menstruation, cramps, hypertension and irritable bowel syndrome.

Example-I

(33) When the hydro-methanolic extract of Bacopa monnieri (40 mg/kg) and Curcuma longa (20 mg/kg) mixed and orally administered to experimental animals it restored the level of acetylcholine, dopamine, 5-HT and nor-adrenaline in aged mice brain where as it reduced the elevated glutamate content in the same experimental model. The drug also revealed reduction in inflammatory markers as well as the anti-oxidant activity in aged brain.

Example-II

(34) When the hydro-methanolic extract of Bacopa monnieri (35 mg/kg), Curcuma longa (20 mg/kg) and Valeriana jatamansi (25 mg/kg) mixed and given to streptozotocin neurotoxin induced Alzheimer's disease model rats a significant elevation in acetylcholine, ChAt activity, serotonergic, nor-adrenaline concentration were estimated in drug treated group. The rats exerted better learning ability following test formulation treatment.

Example-III

(35) In clinical trial when the hydro-methanolic extract of Valeriana jatamansi (350 mg/day) and Bacopa monnieri (450 mg/day) mixed and prescribed for oral administration to diagnosed senile dementia cases improvement in short and long term memory, attention span and reduction in anxiety and depression scores were noticed.

Example-IV

(36) The organic extract of Bacopa monnieri (425 mg/day) and Curcuma longa (400 mg/day) mixed and given orally to senile dementia cases a significant anti-oxidant role was observed as glutathione level increased and lipid peroxidase levels decreased following test formulation treatment.

Example-V

(37) The organic extract of Curcuma longa (425 mg/day) and Valeriana jatamansi (450 mg/day) mixed and prescribed for oral administration in two divided doses exerted significant reduction in inflammatory cytokines IL-6, and TNF- indicating improvement in neurodegenerative process. CRP also reduced in test drug treatment group suggesting improved vascular inflammation.

Example-VI

(38) When the organic extract of Bacopa monnieri (425 mg/day) and Valeriana jatamansi (425 mg/day) mixed and given to diagnosed cases of Senile Dementia of Alzheimer's Type improvement in clinical symptoms like aggression, sleep disturbance, communication difficulties, psychotic feature (hallucination and delusion) was observed.

Example-VII

(39) When the hydro-methanolic extract of Curcuma longa (375 mg/day), Bacopa monnieri (450 mg/day) mixed and given to SDAT cases elevation in 5-HT, nor-adrenaline and dopamine level was noticed. A decrease in glutamate level was also estimated.

Example-VIII

(40) When the organic extract of Valeriana jatamansi 450 mg/day and Bacopa monnieri 425 mg/day mixed and given to SDAT cases improvement in sleep pattern, behavioral abnormalities were recorded after 3-6 months treatment.

Example-IX

(41) The most beneficial and promising results were noticed when the hydro-methanolic extract of Bacopa monnieri in the dose of 375 mg/day, Valeriana jatamansi in the dose of 325 mg/day and Curcuma longa 250 mg/day mixed and given to neurodegenerative disorder patients both senile dementia and SDAT cases. An improvement in Mini Mental Scores, memory span, attention span was recorded and no further decline is reported. Further, an elevation in 5-HT, nor-adrenaline levels were estimated. The test drug exerted reduction in inflammatory bio-markers IL-6 and TNF-. The test drug has shown overall improvement in mental health status by improving memory and cognition and also general feeling of well being among senile dementia, SDAT and other neurodegenerative disorders. The test formulation has anti-oxidant, anti-inflammatory and neuromodulatory activity. The drug is safe and can be given for longer time.

(42) Experimental Evidence:

Study-I

(43) TABLE-US-00004 TABLE 1 Age consistent status of neurotransmitter and beneficial role of test formulation Nor- Glutamate Acetylcholine Dopamine adrenaline 5-HT (mol/gm Groups (nm/gm) (g/gm) (g/gm) (g/gm) wt. tissue) Group-I * (4 26.82 3.88 0.42 0.08 0.45 0.16 0.67 0.09 10.73 2.15 months old mice) Group-II ** (10 16.82 2.81 0.31 0.09 0.19 0.07 0.44 0.08 16.83 3.41 months old mice) Group-III *** 23.59 2.93 0.39 0.25 0.38 0.25 0.59 0.05 14.09 2.45 (10 months old mice + test drug) Comp. * vs ** P < 0.01 P < 0.05 P > 0.05 P < 0.05 P < 0.05 ** vs *** P < 0.01 P > 0.05 P > 0.05 P > 0.05 P > 0.05

(44) TABLE-US-00005 TABLE 2 Age consistent oxidative injury and benefits of novel Ayurveda formulation on oxidative stress markers Catalase (M GPx (M H2O2 glutathione TBARS Glutathione oxidized/ oxidized/ (nm/mg (g/mg SOD (IU/mg min/mg min/mg Groups protein) protein) protein) protein) protein) Group-I * (4 0.297 0.042 4.251 1.085 47.994 9.310 17.091 2.954 3.194 0.982 months old mice) Group-II ** (10 0.578 0.039 2.649 0.102 28.773 5.901 11.801 1.013 2.045 0.172 months old mice) Group-III *** (10 0.429 0.033 3.287 0.350 36.801 4.612 14.914 2.876 2.985 0.103 months old mice + test drug) Comp: * vs ** P < 0.001 P > 0.05 P > 0.05 P > 0.05 P > 0.05 ** vs *** P < 0.05 P > 0.05 P > 0.05 P > 0.05 P > 0.05

(45) TABLE-US-00006 TABLE 3 Age consistent elevation in inflammatory cytokines, homocysteine and beneficial role of novel formulation. Homocysteine Groups IL-6 (pg/ml) hs CRP (mg/L) TNF- (pg/ml) (mmol/L) Group-I * (4 111.0 12.15 4.87 0.85 342.8 15.26 7.93 1.05 months old mice) Group-II ** 302.0 8.53 7.99 0.93 604.85 12.96 13.81 1.63 (10 months old mice) Group-III *** (10 187.0 9.86 5.69 0.95 481.21 18.78 9.85 0.98 months old mice + test drug) Comp * vs ** P < 0.001 P > 0.05 P < 0.001 P < 0.001 ** vs *** P < 0.001 P > 0.05 P > 0.05 P < 0.01

Study-II

(46) TABLE-US-00007 TABLE 1 Changes in Ach concentration following test formulation Acetylcholine concentration (n mol/gm.) Frontal cortex Hippocampus Treated groups Day 14 Day 21 Day 14 Day 21 Vehicle (ACSF) * 22.84 3.45 26.92 5.06 30.44 4.98 28.94 3.75 Td. with STZ ** 11.84 2.11 6.92 1.82 15.87 2.65 12.99 2.87 Td. with test drug *** 24.94 3.45 26.22 4.04 29.84 3.11 31.75 4.14 Td. with STZ + test drug **** 17.87 2.85 16.92 3.01 23.97 3.75 22.20 2.97 Comp. * vs ** p < 0.001 p < 0.001 p < 0.001 p < 0.001 ** vs ** p < 0.001 p < 0.001 p < 0.001 p < 0.001 *** vs **** p < 0.001 p < 0.01 p < 0.01 p < 0.01

(47) TABLE-US-00008 TABLE 2 Effect of test formulation on ChAT activity ChAT activity (n mol/mg protein/hour) Frontal cortex Hippocampus Treated groups Day 14 Day 21 Day 14 Day 21 Vehicle (ACSF) * 21.84 3.01 23.97 4.11 22.05 2.92 19.85 2.82 Td. with STZ ** 13.82 2.02 10.75 1.68 8.92 1.72 6.08 1.01 Td. with test drug *** 20.85 3.12 22.70 2.91 18.22 2.75 19.75 2.10 Td. with STZ + test drug **** 15.58 2.33 16.93 3.11 14.88 3.14 13.87 2.91 Comp * vs ** p < 0.001 p < 0.001 p < 0.001 p < 0.001 ** vs *** p < 0.001 p < 0.001 p < 0.001 p < 0.001 *** vs **** p < 0.01 p < 0.05 p < 0.05 p < 0.01

(48) TABLE-US-00009 TABLE 3 Effect of test formulation on Nor-adrenaline level Nor-adrenaline ( gm/gm tissue) Frontal cortex Hippocampus Treated groups Day 14 Day 21 Day 14 Day 21 Vehicle (ACSF) * 0.264 0.032 0.271 0.041 0.262 0.050 0.265 0.036 Td. with STZ ** 0.123 0.022 0.106 0.028 0.148 0.031 0.102 0.026 Td. with test drug *** 0.271 0.048 0.284 0.038 0.275 0.037 0.288 0.041 Td. with STZ + test drug **** 0.152 0.030 0.164 0.034 0.150 0.036 0.162 0.028 Comp * vs ** p < 0.05 p < 0.01 p > 0.05 p < 0.05 ** vs *** p < 0.001 p < 0.05 p > 0.05 p > 0.05 *** vs **** p < 0.05 p < 0.01 p < 0.05 p < 0.001

(49) TABLE-US-00010 TABLE 4 Effect of test formulation on Serotonin level Serotonin ( gm/gm tissue) Frontal cortex Hippocampus Treated groups Day 14 Day 21 Day 14 Day 21 Vehicle (ACSF) * 0.432 0.036 0.442 0.020 0.315 0.024 0.327 0.021 Td. with STZ ** 0.289 0.011 0.221 0.014 0.240 0.017 0.210 0.015 Td. with test drug *** 0.489 0.032 0.479 0.027 0.392 0.036 0.385 0.030 Td. with STZ + test drug 0.354 0.021 0.362 0.024 0.288 0.022 0.268 0.019 **** Comp * vs ** p < 0.05 p < 0.01 p > 0.05 p < 0.05 ** vs *** p < 0.001 p < 0.05 p > 0.05 p > 0.05 *** vs **** p < 0.05 p < 0.01 p < 0.05 p < 0.001

(50) TABLE-US-00011 TABLE 5 Effect of test drug on Retention of active avoidance learning (RAAL) RAAL (no. of trials) Treated group Day 14 Day 21 Vehicle (ACSF) * 7.11 1.02 6.82 1.06 Td. with STZ ** 13.03 2.13 15.16 2.12 Td. with test drug *** 6.58 1.04 5.21 0.92 Td. with STZ + test drug **** 10.31 1.30 8.94 1.04 Comp * vs ** p < 0.001 p < 0.001 ** vs *** p < 0.001 p < 0.001 *** vs **** p < 0.001 p < 0.001

Clinical Evidence

(51) TABLE-US-00012 TABLE 1 Effect of test drug on clinical complaints in SDAT cases Complaints (In percent) Communi- Sleep cation Psychotic Aggression disturbance difficulties Depression features Treated groups BT AT BT AT BT AT BT AT BT AT Normal P td 24 24 9 10 16 17 6 9 aged (N = 62) 38.70 38.70x 14.51 16.12x 25.80 27.41x 9.67 14.51x T td 25 59 22 64 15 58 9 52 (N = 68) 36.76 86.76custom character 32.35 94.11custom character 22.05 85.29 13.23 76.47custom character SDAT Pl td 68 70 65 68 69 70 67 66 61 68 cases (N = 71) 95.77 98.59* 91.54 95.77* 97.18 98.59* 94.36 92.95* 85.91 95.77* T td 65 69 67 66 72 70 70 68 69 70 (N = 78) 83.33 88.46# 85.89 84.61# 92.30 89.74# 89.74 87.17# 88.46 89.74# (BT = Before therapy; AT = After 6 months therapy) Normal aged (Placebo treated) ATx = No improvement in percent; Normal aged (Test drug treated) ATcustom character = Improvement in percent SDAT (Placebo treated) AT* = No improvement in percent; SDAT (Test drug treated) AT# = Improvement in percent

(52) TABLE-US-00013 TABLE 2 Effect of test drug on mini mental state examination in SDAT cases Mini-mental state examination (Score) Comp. initial vs 6 Treated groups Initial After 3 months After 6 months months treatment Normal P td 18.75 2.90 18.62 3.01 17.82 2.71 P > 0.05 aged (N = 62) TD td 18.89 3.01 19.83 2.77 20.42 3.04 P < 0.01 (N = 68) SDAT P td 10.45 1.34 9.23 2.02 8.25 1.01 P < 0.001 cases (N = 71) T td 11.02 1.66 11.68 2.05 12.29 2.26 P < 0.001 (N = 78)
Results of the effect of test drug on mini mental state examination in SDAT cases are shown in FIG. 2.

(53) TABLE-US-00014 TABLE 3 Effect of test drug on mini mental state examination and attention span in SDAT cases Attention Span (Score) Comp. initial vs 6 Treated groups Initial After 3 months After 6 months months treatment Normal P td 10.65 2.82 10.42 3.11 9.87 2.13 P > 0.05 aged (N = 62) Ttd 11.26 2.17 11.10 2.03 10.36 1.93 P < 0.05 (N = 68) SDAT P td 4.98 1.21 4.11 0.97 3.72 0.75 P < 0.001 cases (N = 71) T td 5.12 1.05 5.83 0.92 6.08 1.23 P < 0.001 (N = 78)
Results of the effect of test drug on mini mental state examination and attention span in SDAT cases are shown in FIG. 3.

(54) TABLE-US-00015 TABLE 4 Effect of test drug on short term memory in SDAT cases Short term memory (Score) Comp. initial vs 6 Treated groups Initial After 3 months After 6 months months treatment Normal P td 7.82 2.13 7.73 1.90 7.65 1.75 P > 0.05 aged (N = 62) T td 8.04 1.55 8.93 1.81 9.63 2.12 P < 0.001 (N = 68) SDAT P td 3.81 0.97 3.26 1.02 2.84 0.85 P < 0.001 cases (N = 71) T td 3.24 0.77 3.88 0.93 4.23 1.04 P < 0.001 (N = 78)
Results of the effect of test drug on short term memory in SDAT cases are shown in FIG. 4.

(55) TABLE-US-00016 TABLE 5 Effect of test drug on long term memory in SDAT cases Long term memory (Score) Comp. initial vs 6 Treated groups Initial After 3 months After 6 months months treatment Normal P td 6.13 2.12 6.05 1.75 5.48 0.98 P < 0.05 aged (N = 62) T td 5.85 1.35 6.75 1.22 6.90 2.01 P < 0.01 (N = 68) SDAT P td 1.75 0.61 1.66 0.25 1.52 0.55 P < 0.05 cases (N = 71) T td 1.68 0.69 1.90 0.52 2.23 0.85 P < 0.001 (N = 78)
Results of the effect of test drug on long term memory in SDAT cases are shown in FIG. 5.

(56) TABLE-US-00017 TABLE 6 Effect of test drug on Anxiety level in SDAT cases Anxiety Level (Score) Comp. initial vs 6 Treated groups Initial After 3 months After 6 months months treatment Normal P td 53.90 4.11 55.82 3.92 54.77 5.01 P > 0.05 aged (N = 62) T td 54.09 3.11 52.75 4.92 51.23 3.75 P < 0.05 (N = 68) SDAT P td 65.14 4.35 64.90 6.39 66.82 4.22 P < 0.01 cases (N = 71) T td 66.20 5.16 64.81 3.75 61.90 6.08 P < 0.001 (N = 78)
Results of the effect of test drug on Anxiety level in SDAT cases are shown in FIG. 6.

(57) TABLE-US-00018 TABLE 7 Effect of test drug on depression level in SDAT cases Depression Level (Score) Comp. initial vs 6 Treated groups Initial After 3 months After 6 months months treatment Normal P td 10.27 3.04 11.08 2.45 11.62 2.14 P < 0.01 aged (N = 62) T td 9.72 2.46 8.20 1.71 7.98 2.85 P < 0.001 (N = 68) SDAT P td 15.27 2.45 15.98 3.17 17.60 2.13 P < 0.001 cases (N = 71) T td 16.23 3.10 14.38 2.99 13.62 4.02 P < 0.001 (N = 78)
Results of the effect of test drug on depression level in SDAT cases are shown in FIG. 7.

(58) TABLE-US-00019 TABLE 8 Effect of test drug on hs C-Reactive Protein level in SDAT cases CRP (mg/L) Comp. initial vs 6 Treated groups Initial After 3 months After 6 months months treatment Normal P td 2.10 0.48 1.97 0.45 2.28 0.70 P < 0.05 aged (N = 62) T td 2.38 0.76 1.85 0.36 1.54 0.84 P < 0.001 (N = 68) SDAT P td 6.23 1.09 5.98 0.88 6.04 1.12 P > 0.05 cases (N = 71) T td 7.11 1.02 6.25 0.97 5.62 1.23 P < 0.001 (N = 78)
Results of the effect of test drug on hs C-Reactive Protein level in SDAT cases are shown in FIG. 8.

(59) TABLE-US-00020 TABLE 9 Effect of test drug on Interleukin-6 level in SDAT cases Interleukin-6 (pg/ml) Comp. initial vs 6 Treated groups Initial After 3 months After 6 months months treatment Normal P td 2.28 0.41 2.19 0.28 2.55 0.24 P < 0.001 aged (N = 62) T td 2.23 0.24 1.68 0.33 1.35 0.20 P < 0.001 (N = 68) SDAT P td 3.48 0.37 3.98 0.35 4.68 1.02 P < 0.001 cases (N = 71) T td 4.12 1.06 3.68 0.91 3.15 0.68 P < 0.001 (N = 78)
Results of the Effect of test drug on Interleukin-6 level in SDAT cases are shown in FIG. 9.

(60) TABLE-US-00021 TABLE 10 Effect of test drug on TNF- level in SDAT cases TNF- (pg/ml) Comp. initial vs 6 Treated groups Initial After 3 months After 6 months months treatment Normal P td 364.97 53.41 410.85 64.17 459.42 71.28 P < 0.001 aged (N = 62) T td 483.80 85.64 422.90 91.23 378.91 48.42 P < 0.001 (N = 68) SDAT P td 994.75 128.42 972.40 128.75 983.73 121.05 P > 0.05 cases (N = 71) T td 1124.06 105.87 835.71 128.45 744.55 101.73 P < 0.001 (N = 78)
Results of the Effect of test drug on TNF- level in SDAT cases are shown in FIG. 10.

(61) TABLE-US-00022 TABLE 11 Effect of test drug on Homocysteine level in SDAT cases Homocysteine (mmol/L) Comp. initial vs 6 Treated groups Initial After 3 months After 6 months months treatment Normal P td 21.99 2.85 23.41 3.52 20.90 3.05 P < 0.05 aged (N = 62) T td 23.41 2.75 21.06 3.12 18.42 3.29 P < 0.001 (N = 68) SDAT P td 38.42 4.16 37.88 3.96 39.42 4.11 P > 0.05 cases (N = 71) T td 42.90 5.62 34.82 3.87 29.08 4.16 P < 0.001 (N = 78)
Results of the Effect of test drug on Homocysteine level in SDAT cases are shown in FIG. 11.