Memory Enhancing Medicine: Do they really work?

Memory is the ability of an individual to record sensory stimuli events information. This ability is shared to various extents, depending on the structural complexity of the nervous system memory is the central component of what we intend when we refer to cognitive function together with the other pillars of cognition constituted of problem-solving ability, creative imagination, intuition and attention. A large number of studies have shown that the cholinergic system plays an important role in learning and memory. More ever a loss of cholinergic neurons and reduce choline-acetyltransferase activity in the cerebral cortex and hippocampus are consistent with finding in Alzheimer disease recent news reports that an electrical brain stimulation technique improve memory draws attention to the extraordinary progress that neuroscience has made in understanding the structure and organization of memory from a medical point of view drugs able to improve cognitive functions sometime referred to as nootropic or smart drug the cognition enhancer may be used to combat health condition that interfere with the process learning of a healthy emotional state^.[1]

What Are Nootropics

Nootropics, often referred to as "smart drugs," comprise a diverse range of substances. The term “nootropic” was introduced by Cornelius E. Giurgea in 1972/1973 to characterize compounds that primarily enhance cognitive functions, such as memory and learning, particularly in cases where these functions are compromised. Essentially, they impact the metabolic processes of neurons within the central nervous system (CNS). The word is derived from two Greek terms: nöos, meaning thought, and tropein, meaning to direct. There is no standardized method for classifying these substances. Some researchers differentiate between traditional nootropics and those that boost brain metabolism, while others merge these categories or prefer the term cognitive enhancer over nootropic. ^[24]

Mechanisms of Action

Nootropics do not function directly by releasing neurotransmitters or as ligands for receptors, but instead enhance the availability of glucose and oxygen in the brain, exhibit antihypoxic properties, and safeguard brain tissue from neurotoxicity. They also have a beneficial impact on the synthesis of neuronal proteins and nucleic acids and promote phospholipid metabolism in neurohormonal membranes. Certain nootropics have been shown to influence the removal of oxygen free radicals, exhibit an anti-aggregation impact, and enhance erythrocyte flexibility. This enhances the rheological characteristics of the blood and promotes blood circulation to the brain. These compounds are active in metabolism, yet most nootropics do not exhibit immediate effects from a single dose, necessitating prolonged use to yield results. They must be capable of crossing the blood–brain barrier to enhance brain metabolism, and prolonged use is essential for attaining lasting changes.^[24]

Indications:-

Nootropics are utilized in acute or subacute situations to address issues related to memory, consciousness, and learning difficulties. They are suggested for early brain damage, which presents as memory loss, intellectual impairment, and alterations in consciousness. This state is known as acute psychoorganic syndrome (POS). It is generally reversible, yet in certain instances, it may advance to dementia. Acute POS may result from brain injury, infection, stroke, or substance intoxication (such as alcohol, drugs with central anticholinergic properties, or carbon monoxide). Delirium tremens also fall under the POS group.  Additional signs may involve long-term conditions affecting cognitive abilities like intellectual disability or memory loss. Nootropics are frequently administered in such instances, yet their effectiveness, particularly in cases of advanced dementia, is debatable. They appear to be more successful in individuals with mild cognitive issues or what is referred to as benign senescent forgetting, where brain function is merely impaired without the onset of dementia. Nootropics are occasionally utilized for attention and memory issues caused by fatigue and tiredness. They are likewise utilized by children with minimal brain dysfunction syndrome and individuals with encephalopathy, and their impact on myalgic encephalomyelitis (chronic fatigue syndrome) has also been evaluated. Nootropics are used as cognitive enhancers for individuals diagnosed with Alzheimer’s disease, schizophrenia, hyperkinetic disorder, or senile dementia. ^[24]

Nootropic Treatment:-

Nootropics are generally quite well accepted. Their effectiveness relies on the dose size, and in reality, giving too small a dose is a frequent error. Treatment must persist for a minimum of 2–3 weeks after the impairment of consciousness has resolved. A clinical tool has been created to evaluate the extent and length of diminished awareness. Three aspects of behavior, including motor response, verbal performance, and eye-opening, are assessed separately. These are documented and regularly assessed based on the chart. Adverse effects of nootropics are infrequent and seldom severe. Besides individual intolerance, there may sometimes be an upsurge in unwanted activity, a sleep disturbance, or a rise in libido. Nootropics are not recommended for those with hypersensitivity, during pregnancy, or while nursing. ^[24]

Memory enhancement is possible…?

The brains incredible ability to reshape itself holds true when it comes to learning and memory. You can harness the natural power of neuroplasticity to increase your cognitive abilities enhance your ability to learn new information and improve your memory at any age. Eat a brain boosting diet you probably already know that a diet based on fruits, vegetables, grain such diet can also improve memory research shown that omega-3 fatty acid health, meat, butter, cheese, cream, milk increase your risk of dementia and impair concentration and memory. The brain boosting diet is powerful antioxidants that protect against free radical that can enhance memory and mental alertness and slow brain aging.^{3,4, 11}

       
           
       
 Neurobiology of Memory :-

The formation of long-term memories a function necessary for an adaptive survival memories exist in different  form and rely on distinct neural system on the basis of their duration memories can be classified into short and long term while short memory is the ability to hold and recall information for a short period at the time and long term memories store information for long lasting periods. Memories can also be classified occurring to their behavioral manifestation. Which reflects the use of distinct underlying network. Major dysfunction is between explicit (eg. declarative) and implicit (eg. Procedural memories.) Researches on the biochemical basis of LTP in the hippocampus have allow to obtain important regarding the molecular process sub serving memory through synaptic plasticity further work is needed to elucidate the biology of memory formation in pathological condition and early development phases.

Table No. 1 The 14 best Nootropic and smart drugs ^10,15,24

Biochemical Action Of Memory Enhancing Herbs

Memory Enhancing Effect of Emblica officinalis :-

Amla churna produced a dose-dependent improvement in memory of young and aged rat. Amla churna may prove to be a useful remedy for the management of alzheimers disease due to its multifarious beneficial effect such as memory improvement and reversal of memory deficits, it reversed the dementia induced by scopolamine and diazepam.^{1, 2, 13, 20}

Ashwagandha

1. Total alkaloid extract (Ashwagandha, Ashwagandholine) at within somnifera roots has been studied for its effect on central nervous system.
2. The effect of sitoindosides-VII-x and within isolated  from aqueous methanol extract of roots.
3. Study on brain cholinergic, glutamatergic and GABA receptors in male wistar rat.
4. M1-muscarnic - cholenergic receptors binding in lateral and medial septum as well as in frontal cortices.
5. M2- Muscarinic receptors binding sites were increased in a number of cortical region including cigulate frontal, piriform parital.
6. The compound slightly enhanced acetyalcholinesterase (AChE) activity in the lateral septum.^{2, 24, 9}

 Ginkgo Biloba (Ginkgoaceae)

1. Ginkgo Biloba (Ginkgoaceae) is also known as maidan hair tree, kew tree, ginkyo, yinsing.
2. The ginkgo shoes the memory enhancing action by increasing the supply of oxygen.
3. The ginkgo biloba increase the or improve the memory in stressful situation.
4. In vitro study indicates that ginkgo extract had an anti amyloid aggregation effect.
5. Ginkgo biloba can improve behavioral adaptation despite adverse environmental events shown in rat through reward versus stress testing to obtain drinking water.
6. The main medicinal constituents are found in the gink go leaf these includes flavonides.
7. G-biloba extract has also been reported to increase transthyretin RNA levels in mouse hippocampus this mechanism may also protect against amyloid deposition in brain with improvement in sentence repetition, logical memory.^{7, 2, 13, 6}

1. According to Arabian folklore, singer has been claim to improve memory.
2. Zingiber officinale significantly improve learning and memory. Its major active constituentare gingerian, gingerolzingerone.
3. Ginger have congnitive enhancing effect and neuroprotective effect at ginger is partly due to its antioxidant activity.^{23, 22}

Rhodiola Rosea

1. Rhodiola rosea it enhances the effect of these neurotransmitter on the brain by increasing the permeability of the blood brain barrier to precursor at DA and 5-HT.
2. Effect of Rhodiola rosea if stimulate the neurotransmitters such as epinepherin, serotonin and nicotinic cholinergic effect.²
3. The cognitive Functions of the Cerebral cortex and the attention memory and learning function of the prefrontal and frontal cortex were found to be enhanced .
4. The agents (memory retrieval) that block Ach suppress the activity of these ascending pathway and interfere with memory.

Table No. 2 Benefits and Side effects of memory enhancing medicine  ^{19, 24}