Investigating the Neuroprotective and Cognitive-Enhancing Effects of Bacopa monnieri: A Systematic Review Focused on Inflammation, Oxidative Stress, Mitochondrial Dysfunction, and Apoptosis

Abstract

The aging of the global population has increased the prevalence of neurodegenerative conditions. Bacopa monnieri (BM), an herb with active compounds, such as bacosides A and B, betulinic acid, loliolide, asiatic acid, and quercetin, demonstrates the potential for brain health. Limited research has been conducted on the therapeutic applications of BM in neurodegenerative conditions. This systematic review aims to project BM's beneficial role in brain disorders. BM has anti-apoptotic and antioxidant actions and can repair damaged neurons, stimulate kinase activity, restore synaptic function, improve nerve transmission, and increase neuroprotection. The included twenty-two clinical trials demonstrated that BM can reduce Nuclear Factor-κB phosphorylation, improve emotional function, cognitive functions, anhedonia, hyperactivity, sleep routine, depression, attention deficit, learning problems, memory retention, impulsivity, and psychiatric problems. Moreover, BM can reduce the levels of pro-inflammatory biomarkers and oxidative stress. Here, we highlight that BM provides notable therapeutic benefits and can serve as a complementary approach for the care of patients with neurodegenerative conditions associated with brain disorders. This review adds to the growing interest in natural products and their potential therapeutic applications by improving our understanding of the mechanisms underlying cognitive function and neurodegeneration and informing the development of new therapeutic strategies for neurodegenerative diseases.

Keywords: Alzheimer’s disease; Bacopa monnieri; cognition; inflammation; mitochondrial dysfunction; neurodegenerative diseases; oxidative stress.

Figure 1

BM plant. (A) whole plant; (B) stem detail; (C) flower detail.

Figure 2

Flow diagram showing the study selection (PRISMA Guidelines) [53,54].

Figure 3

Anti-inflammatory effects of B. monieri on declined cognition and neuron loss. GSK-3β, glycogen synthase kinase; MMP: metalloproteinase; NF-kB, Nuclear Factor Kappa Beta; Nrf2: Nuclear factor erythroid 2-related factor 2. ↑: increase; ↓: decrease.

Figure 4

The effects of B. monieri on oxidative processes: bacosides can downregulate ROS production and elevate the expression of antioxidant enzymes. CAT, catalase; GPx, Glutathione peroxidase; ROS, Reactive oxygen Species; SOD, superoxide dismutase.

Figure 5

The effects B. monieri on the regulation of apoptosis events. B. monieri exerts a protective effect on neuronal cells by shielding them from apoptosis, a programmed cell death process, and senescence, the aging-related deterioration of cellular function. This botanical extract demonstrates neuroprotective properties, safeguarding the integrity and viability of neurons. BAX, Bcl-2-associated X protein; FADD, FAS-associated death domain protein; IKK, The inhibitor of nuclear factor-κB (IκB) kinase; NF-kB, Nuclear Factor; TNF-α, Tumor Necrosis Factor-α; TRADD, TNFR1-associated death domain protein.

Figure 6

General effects of the use of B. monieri on humans. The plant can improve general brain functions as hyperactivity, depression, dementia and Alzheimer´s disease due to several actions such as anti-inflammatory and antioxidant. CREB, Cyclic AMP response element-binding protein; MMSE, Mini-Mental State Examination; NF-KB, Nuclear Factor-KB; PSQ, Perceived Stress Questionnaire; ROS, Reactive oxygen Species. ↑: increase; ↓: decrease.