Sunday June 24, 2012
Protecting our nerves
By MENG YEW CHOONG
Tocotrienols, a form of vitamin E, might be the key to protecting our nerves from further neurological damage.
OUR nervous system is a complex and delicate structure of nerve cells, also known as neurons, and support cells that governs every part of our body.
Everything that we feel and everything that we do, is transmitted and interpreted through this intricate informational highway that connects every cell within us.
Therefore, you can imagine that any insult or injury to it could result in devastating consequences.
Neuroprotection refers to the mechanisms and strategies used to protect against injury to nerve cells, or degeneration in the central nervous system (CNS).
These injuries could be the result of acute disorders such as stroke, or any other form of injury or trauma to the nervous system, as well as from chronic neurodegenerative diseases such as Parkinson’s, Alzheimer’s, and multiple sclerosis.
The aim of neuroprotection is to limit the level of damage or death of neurons after a CNS injury, as well as to maintain the highest possible integrity of cellular interactions in the brain for undisturbed neural function as we age.
There are a wide range of products touted as having possible neuroprotective abilities, with some claiming to have the potential to be used in more than one disorder, based on the premise that many of the underlying mechanisms of damage to neural tissues are similar.
Currently, there is a high level of interest in applying neuroprotective principles in the prevention and treatment of diseases involving the CNS, such as Alzheimer’s, Parkinson’s, schizophrenia, and stroke.
Strokes are of particular concern, considering that they are the number one cause of disability, and number three killer disease, in the United States.
It is also the third-ranked killer disease for Malaysia, estimated to afflict around 40,000 each year.
A stroke occurs when a blood clot, or ruptured artery or blood vessel, interrupts blood flow to an area of the brain, causing it to be starved of oxygen and nutrients.
Looking into vitamin E
A researcher at the Ohio State University Medical Center, United States, Prof Chandan K Sen first started to look seriously into tocotrienols — a natural form of vitamin E found in abundance in palm oil — and neuroprotection since 1998.
Having spent more than a decade studying tocotrienols’ potential neuroprotective abilities against stroke-induced injuries, he began receiving funding from the US National Institute of Neurological Disorders and Stroke (NINDS) for his research involving palm tocotrienol complexes from 2004.
With over 250 publications under his name, Prof Sen is the highest cited author in scientific work involving tocotrienols and neuroprotection.
In a lengthy interview hosted on a health-focused educational video channel called iHealthTube.com, Prof Sen talks about the possible role of tocotrienols in neuroprotection in a manner that would be of interest to anyone currently pursuing or intending to pursue medical research using tocotrienols.
In the portion of the 13-part video interview on stroke, Prof Sen shares how he started the NINDS-funded stroke prevention research, and the direction of his investigations into the role tocotrienols can play in stroke protection and post-stroke rehabilitation.
“While the burden of stroke on the survivor, caregivers and the healthcare system is enormous, there is very little study being done on this disease, especially when it comes to nutritional supplementation.
“And when you analyse the situation closely, you will see that there is no single category of drug — for example, neuroprotectants — that are able to give adequate protection against strokes.
“Hence, it seems that the ideal treatment for stroke would have to be multi-targeted, and as of now, there are lots of studies in this regard,” he says.
Prof Sen adds that initial observations from his teams’ work on tocotrienols show that nerve cells can be rescued from injury after being insulted, or in simpler terms, the cells could fully recover after suffering damage caused by a stroke.
“Lots of compounds have been shown to have neuroprotective abilities.
“However, the concentrations at which tocotrienols can work to protect someone is as low as nanomolars.
“There is nothing else as far as I know in the nutritional industry that can rescue neural cells at nanomolar levels,” he says in the video.
Being able to partly rescue nerve cells for stroke survivors could mean a lot.
“It could mean that someone who cannot talk, could now talk. Or if he cannot lift his left hand, he could do so now,” says Prof Sen.
He is nonetheless careful to add that all these potentially positive effects of tocotrienols have only been seen so far in animal studies.
However, Prof Sen’s team is now well underway in their work to prove the efficacy of tocotrienols in humans.
With a grant from the Malaysian Palm Oil Board, the researchers are now into Phase II of a two-year US-based study to look at the value of supplementation with tocotrienols in reducing the volume of stroke-induced lesions, and/or stroke incidence, mortality and quality of life.
The study, when completed, will hold much value for those who have suffered from a transient ischaemic attack (TIA).
A TIA is defined as a temporary episode of neurologic dysfunction caused by reduced blood flow to the brain, but does not result in permanent damage to the brain.
The symptoms are very similar to those of a fullblown stroke, but normally resolve within a short time (from an hour up to 24 hours).
“Those who had a TIA are at a higher risk of having a bigger stroke, and the data on the recurrence is already out there.
“The study will provide these patients with tocotrienols, and look at the recurrence rate. If there is a stroke, we will look at lesion size,” shares Prof Sen.