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Evidence-Based Complementary and Alternative Medicine
Volume 2018, Article ID 1875928, 19 pages
https://doi.org/10.1155/2018/1875928
Review Article

Potential Application of Yokukansan as a Remedy for Parkinson’s Disease

1Department of Korean Internal Medicine, Dunsan Korean Medical Hospital, Daejeon University, Daejeon 35235, Republic of Korea
2Immunoregulatory Materials Research Center, Korea Research Institute of Bioscience and Biotechnology, 181 Ipsin-gil, Jeongeup-si, Jeonbuk 56212, Republic of Korea
3K-herb Research Center, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
4Department of Korean Neuropsychology, Dunsan Korean Medicine Hospital, Daejeon University, Daejeon 35235, Republic of Korea
5College of Veterinary Medicine and BK21 Plus Project Team, Chonnam National University, Gwangju 61186, Republic of Korea

Correspondence should be addressed to Horyong Yoo; moc.liamg@ooy.gnoyroh and Changjong Moon; rk.ca.mannohc@cnoom

Received 12 July 2018; Revised 27 November 2018; Accepted 10 December 2018; Published 20 December 2018

Academic Editor: Yoshiji Ohta

Copyright © 2018 Jung-Hee Jang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Parkinson’s disease (PD), the second most common progressive neurodegenerative disorder, is characterized by complex motor and nonmotor symptoms. The clinical diagnosis of PD is defined by bradykinesia and other cardinal motor features, although several nonmotor symptoms are also related to disability, an impaired quality of life, and shortened life expectancy. Levodopa, which is used as a standard pharmacotherapy for PD, has limitations including a short half-life, fluctuations in efficacy, and dyskinesias with long-term use. There have been efforts to develop complementary and alternative therapies for incurable PD. Yokukansan (YKS) is a traditional herbal medicine that is widely used for treating neurosis, insomnia, and night crying in children. The clinical efficacy of YKS for treating behavioral and psychological symptoms, such as delusions, hallucinations, and impaired agitation/aggression subscale and activities of daily living scores, has mainly been investigated in the context of neurological disorders such as PD, Alzheimer’s disease, and other psychiatric disorders. Furthermore, YKS has previously been found to improve clinical symptoms, such as sleep disturbances, neuropsychiatric and cognitive impairments, pain, and tardive dyskinesia. Preclinical studies have reported that the broad efficacy of YKS for various symptoms involves its regulation of neurotransmitters including GABA, serotonin, glutamate, and dopamine, as well as the expression of dynamin and glutamate transporters, and changes in glucocorticoid hormones and enzymes such as choline acetyltransferase and acetylcholinesterase. Moreover, YKS has neuroprotective effects at various cellular levels via diverse mechanisms. In this review, we focus on the clinical efficacy and neuropharmacological effects of YKS. We discuss the possible mechanisms underpinning the effects of YKS on neuropathology and suggest that the multiple actions of YKS may be beneficial as a treatment for PD. We highlight the potential that YKS may serve as a complementary and alternative strategy for the treatment of PD.