Abstract
For neurological disorders, pharmacological tests have shown promising results in the reduction of side effects when using plants with known therapeutic effects in the treatment of some types of dementia. Therefore, the goals of this study are to gather data about the major medicinal plants used in the nervous system as described in ethnopharmacological surveys from South America and Brazil and to compare this data with the results from pharmacological tests on the active principles of those same plants found in the scientific literature. After collecting the data about each plant, their respective popular indication was compared with the results found through pharmacological tests. The discrepancy rate between the effects observed by ethnopharmacological and pharmacological methods in this study is greater than 50%. In conclusion, despite the importance of ethnopharmacological data, it is important to make comparisons with pharmacological tests for the same plants, since the pharmacological studies, although few, have shown a high rate of discrepancy in the results.
1. Introduction
The knowledge of medicinal plants for therapeutic purposes originated from indigenous tribal cultures [1–4] or ancient civilizations such as those once found in Iran, India, or China [1–3, 5–7] and was passed from generation to generation mostly by means of oral tradition. Presently, knowledge is commonly limited to a village and rural areas or by families isolated from urban centers [8]. Most likely, original information of plants used for therapeutic purpose underwent modifications through time. This was due to their discovery by trial and error over many generations and the oral transmission of information rather than through writing.
A previous study associated culturally propagated therapeutic effects of different medicinal plants obtained by ethnopharmacological/ethnobotanical means with those found in laboratory tests, showing approximately 66% discrepancy in the results [9]. Trading and distribution mistakes [10], similarity of plant names for different species [11], presence of impurities during preparation from other plants, insects, and mushrooms [12], and unexpected reactions and interactions with the active compounds [13] are all examples of commonly encountered problems in the therapeutic use of medicinal plants.
It is not suggested that the medicinal use of plants should be banned, decreased, or hampered. However, there is a need for each procedure to be evaluated by government agencies, institutions, and specialists who understand the therapeutic use of biodiversity in societies with an increasing interest in alternative treatments [6, 14, 15] or in populations with limited or no access to other types of therapeutic resources. Medicinal plant-based therapy may offer benefits, like decreased side effects [16–18], higher autonomy for individuals in caring for their own health [3], reduced or nonexistent costs, and easy access for social groups located in inaccessible areas or away from urban centers and for people in poor urban areas with limited or no access to a healthcare system [6, 14, 15, 19, 20]. Indeed, those groups rely on alternative therapeutic methods for their health care, especially those derived from local medicinal plants, which is a major issue in countries with higher income gaps.
Many ethnopharmacological surveys were performed in countries and regions representing the greatest biodiversity to identify plants used, with the aim of preserving the cultural heritage of the plant therapy [1–3, 5–7, 21, 22] and acquiring new active compounds for the pharmaceutical industry [8]. Brazil presents the largest biodiversity on the planet [23] and has a large amount of unexplored resources available for ethnopharmacological and herbal studies given that only 16% of Brazil's medicinal plants or just 8% of Brazilian national flora [24] has been evaluated for therapeutic potential [25]. This country represents around 47% of all territories of the South American continent.
Countries in South America present important data about medicinal plants, because of their specific locations in the Andean region, close/into the Amazon Forest [8] or the pampas. Indeed, the use of some medicinal plants was first found in the population in the Andes Ridge, in the pampas, Patagonia [10], or Brazilian's savanna (cerrado) [9]. Probably because of the large population or size, most of the studies in South America are found in Brazil, while ethnopharmacological studies are incipient in other countries in this continent [8, 10].
However, quality or reliability of medicinal plant effects cannot be ensured if ethnobotanical studies do not provide laboratory verification of the effects when prescribing compounds derived from those medicinal plants. Healthcare professionals and patients should note that studies about the correspondence or discrepancy between ethnopharmacological knowledge and laboratory tests for the same plant are lacking [9] and must be done for each class of drug.
There is a growing evidence from in vitro, animal, and clinical studies reporting that medicinal plants might be beneficial for treating various mental and neurological disorders including Alzheimer disease, depression, anxiety, and insomnia [363–366]. For neurological disorders, in particular, pharmacological tests have shown promising results in the reduction of side effects when using plants with known therapeutic effects in the treatment of some types of dementia [18, 22, 367–372]. Medicinal plants have been sought as an alternative therapy [18, 373–375] owing to the inefficacy of some industrial medications on certain diseases, such as degenerative ones. Examples are the use of Melissa officinalis, Salvia officinalis, Ginkgo biloba, and Huperzia serrata for treating the symptoms of Alzheimer disease [18, 373–375].
The problem is that, especially in developing and/or populated countries, people rely on medicinal plants as primary healthcare [376]. The situation is true for mental and neurological disorders. Patient complaints associated directly or indirectly with neurological or neuropsychiatric disorders, such as headache, insomnia, amnesia, anxiety, or depression, are very common [146, 298, 377, 378], and the use of medicinal plants for these purposes is very frequent in populated countries such as Brazil, India, and China [1–3, 5–7, 22] but without support of adequate pharmacological tests.
Considering the errors in the use and sale of alternative medicines as a whole, we hypothesize that the same errors could happen with plants that act directly on the nervous system. Therefore, the goal of this study is to gather data about the major medicinal plants used in the neural system, as described in ethnopharmacological surveys from South America like in Brazil and compare this data with the results from pharmacological tests on the active principles of those same plants found in the scientific literature. Specifically, this study intends to present reliable data for the use of medicinal plants in primary healthcare and assisting conventional treatments of neurological disorders.
2. Materials and Methods
This study was done through literature review of ethnopharmacological surveys on the medicinal plants used by groups in South America (with emphasis on Brazil) found in academic databases (MEDLINE, LILACS, Scopus, SciELO, Google Academic, and Elsevier). The terms searched were ethnobotanical studies, medicinal plants, ethnopharmacology, neural system, South America, and Brazil. The search was restricted to the most recent and classical articles/books written in Portuguese, English, or Spanish. After collecting the data about each plant, their respective popular indication was compared with the results found through pharmacological tests.
For the first phase, 55 ethnobotanical survey articles were selected and then the most commonly used plants by the population for treating neural system disorders were identified. A table was prepared with data regarding family, scientific name, part of the plant utilized, preparation method, indications, and comparison with pharmacological tests.
In the second phase, 181 articles in which pharmacological tests had been performed with the chosen plants were selected. Unfortunately, scientific tests for the proposed indication or toxicity for all the plants could not be found.
Statistical analysis was done using central tendency measures such as modal frequency.
3. Results
Data on South American medicinal plants that act on the nervous system was summarized by family, scientific name, part of the plant utilized, preparation method, indications, and comparison with pharmacological tests (Table 1). The most cited families were Lamiaceae (24/138), Asteraceae (16/138), and Verbenaceae (6/138), representing 33.7% of the medicinal plants analyzed (Figure 1).
Table 1.
Family Scientific name/common name |
Forms of preparation/used part | Medicinal effects cited by population | Pharmacological tests | Divergences |
---|---|---|---|---|
Acanthaceae | ||||
| ||||
Hygrophila tyttha Leonard/Tame-male | Infusion/Part air plant | Calmative [26] | Anxiolytic effect, anticonvulsant and sedative [26] | No |
| ||||
Justicia pectoralis Jacq./Anador | Decoction/Leaf | Headache [27] | Anxiolytic and depressor Neural Central System [28], analgesic and anti-inflammatory [29], estrogenic, progestagenic and anti-inflammatory effects [30], antioxidant [31] | No |
| ||||
Alismataceae | ||||
| ||||
Echinodorus grandiflorus (Cham. & Schltdl.) Mich./Hat leatherback | Decoction/Leaf | Analgesic [21] | Anti-inflammatory and analgesic [32, 33], diuretic [33], antihypertensive [34, 35] | No |
| ||||
Amaranthaceae | ||||
| ||||
Alternanthera paronychioides St-Hil./Anador | Not found/Leaf, stalk | Analgesic [36] | Antioxidant [37] | Yes |
| ||||
Apiaceae | ||||
| ||||
Apium graveolens L./Celery | Not found/Complete plant | Calmative [36] | Vasorelaxant and antihypertensive [38] | Yes |
| ||||
Coriandrum sativum L./Coriander | Infusion/Seed | Headache [39] | Antioxidant [40], anti-inflammatory [41], antibacterial [42], anxiolytic, sedative and muscle relaxant [43], antifungal [44], hypoglycemic, hypolipidemic and hepatoprotective [45], analgesic [46] | No |
| ||||
Pimpinella anisum L./Fennel | Infusion/Seed | Calmative [7, 27, 39, 47–49] | Antibacterial [50], neuroprotective and anticonvulsant [51], antiviral and immunostimulating [52], antioxidant [53], anticancer [54] | No |
| ||||
Foeniculum vulgareMill./Fennel | Decoction/Stalk | Headache and calmative [13, 36, 55–60] | Antimicrobial [61], diuretic [62], antihelminthic [63], antioxidant [64], anxiolytic [65] | No |
| ||||
Aquifoliaceae | ||||
| ||||
Ilex paraguariensis/Erva Mate | Infusion/leaves, branches | Stimulant [66] | Stimulant [66] | No |
| ||||
Araliaceae | ||||
| ||||
Didymopanax macrocarpum (C. & S.) Seem./ Five leaves |
Compress, bathe/Leaf | Analgesic [67] | Not found | Not found |
| ||||
Hedera helix/Hiedra | Cataplasm/Leaf | Analgesic, neuritis, neuralgia [68] | Expectorant and antitussive [69], mucolytic and bronchodilator [70], anti-inflammatory [71] | No |
| ||||
Aristolochiaceae | ||||
| ||||
Aristolochia esperanzae O. Kuntze./Papo de peru, cipo-millhomem | Decoction/Complete plant | Analgesic [67] | Antiophidic activity [72], antimicrobial [73] | Yes |
| ||||
Aristolochia gilbertii Hook/Milhomem | Infusion/Root | Headache [7] | Not found | Not found |
| ||||
Aristolochia melastoma Manso ex. Duchtra/Capitãozinho |
Decoction/Root, leaf | Sedative [67] | Not found | Not found |
| ||||
Asteraceae | ||||
| ||||
Achillea millefolium L./Ponta-alívio | Decoction/Complete plant | Calmative, analgesic [21, 36, 47, 57, 74, 75] | Immunostimulating [76] | Yes |
| ||||
Achyrocline satureioides D.C./Macela | Infusion/Flower | Sedative, calmative, headache [56, 67, 75, 77, 78] | Anticancer [79], calmative effect, anti-inflammatory and antispasmodic [80], antiviral [81] | No |
| ||||
Artemisia absinthium L./Losna | Decoction/Leaf | Analgesic [21, 82] | Anticancer [83], antifungal [84], antibacterial [85], antileishmanial [86] | Yes |
| ||||
Artemisia camphorata Vill./Camphor | Infusion/Leaves | Calmative [58] antiepileptic [87] | Not found | Not found |
| ||||
Artemisia vulgaris L./Artemisia | Not found | Headache [88] | Antifungal [89] | Yes |
| ||||
Chamomilla recutita (L.) Rauschter/Camomile | Infusion/Flower | Calmative, sedative [36, 39, 48, 57, 90–92] | Antibacterial and anti-inflammatory [92, 93], gastroprotection [94], antihyperglycemic and antioxidant [95] | Yes |
| ||||
Chrysanthemum parthenium Bernhadi/Artemisia | Decoction, infusion/Leaves | Calmative [78] | Not found | Not found |
| ||||
Cynara scolymus L./Artichoke | Not found | Calmative [74] | Diuretic [96], prolonged satiety sensation and hypoglycemic [97], antioxidant [98] | Yes |
| ||||
Lactuca sativa L./Lettuce | In nature, infusion/Leaves, root | Calmative, sedative [74, 99] | Antioxidant [100] | Yes |
| ||||
Matricaria chamomilla L./Camomile | Infusion/Leaves | Calmative [56, 75, 78, 101, 102] | Antibacterial and antioxidant [103] | Yes |
| ||||
Mikania hirsutissima DC./Cipó-cabeludo | Not found | Calmative [67, 104] | Antiophidic activity and antidiarrheal [105] | Yes |
| ||||
Solidago chilensis Meyen/Arnica | Compress/Complete plant | Analgesic [106] | Anti-inflammatory [107] | Yes |
| ||||
Spilanthes oleracea/Anestesiol | Not found | Anesthetic [108] | Peptic antiulcer and contraception [109] | Yes |
| ||||
Tanacetum sp./Macelinha | Decoction/Complete plant | Analgesic [23] | Not found | Not found |
| ||||
Tanacetum vulgare L./Catinga-de-mulata | Decoction, maceration/Leaves | Analgesic [23] | Antibacterial and antifungal [110], antiviral [111], cytotoxic [112], treatment of infections caused by Trypanosoma cruzi and Leishmania amazonensis [113], immunomodulatory [114], antihelminthic [115] | Yes |
| ||||
Vernonia cf. condensata Baker./Boldo do chile | Infusion/Bark | Calmative [57] | Antitumor and anti-inflammatory [116], antioxidant [117] | Yes |
| ||||
Bignoniaceae | ||||
| ||||
Anemopaegma arvense/Catuaba | Infusion, decoction/Root, bark, leaves | Nervous exhaustion [118] | Increased weight and testicular parenchyma [119], antifungal [120] | Yes |
| ||||
Bombacaceae | ||||
| ||||
Eriotheca candolleana (K. Schum.)/Catuaba | Infusion/Root | Nervous exhaustion [121] | Not found | Not found |
| ||||
Boraginaceae | ||||
| ||||
Cordia verbenacea DC./Maria preta | Bathe/Leaves | Analgesic [49] | Antimicrobial [122], anti-inflammatory [123] | No |
| ||||
Brassicaceae | ||||
| ||||
Coronopus didymus (L.) Smith/Mastruz |
Maceration/Leaves | Analgesic [49] | Healing [124], anti-inflammatory [125] | No |
| ||||
Bromeliaceae | ||||
| ||||
Tillandsia usneoides (L.) L/Barba de velho | Not found | Antiepileptic [49] | Abortion [126], antiviral [127] | Yes |
| ||||
Buddlejaceae | ||||
| ||||
Buddleja brasiliensis Jacq./Verbasco | Infusion, cataplasm/Part air plant | Calmative [67] | Low potential hemolytic [128] | Yes |
| ||||
Burseraceae | ||||
| ||||
Commiphora myrrha (T. Nees) Engl/Myrrh | Infusion/Leaves | Calmative [49] | Antioxidant [117], analgesic [129] | Yes |
| ||||
Caesalpiniaceae | ||||
| ||||
Bauhinia forficata Link./Pata de vaca | Decoction/Leaves | Analgesic [23] | Antioxidant and increased liver glycogen [130], antimutagenic [131] | Yes |
| ||||
Bauhinia rutilans Spruce ex. Benth/Escada-de-macaco | Infusion/Part air plant | Analgesic [99] | Not found | Not found |
| ||||
Canellaceae | ||||
| ||||
Capsicodendron dinissi Occhioni/Pepper | Not found | Migraine [104] | Not found | Not found |
| ||||
Capparaceae | ||||
| ||||
Cleome spinosa Jacq./Mussambê | Infusion/Complete plant | Headache [132] | Cytotoxic [49], antioxidant [133], anti-inflammatory and antinociceptive [134] | No |
| ||||
Caprifoliaceae | ||||
| ||||
Sambucus nigra L./Elderberry | Decoction/Leaves | Analgesic [23, 49] | Anti-inflammatory and antioxidant [134], parasiticidal [135] | No |
| ||||
Chenopodiaceae | ||||
| ||||
Chenopodium ambrosioides L./Yerba Santa Maria | Maceration, infusion/Leaves, bark, seed | Analgesic, calmative [23, 48, 57] | Antitumor [79], hypotensive [136], antipyretic and anxiolytic [137] | Yes |
| ||||
Compositaceae | ||||
| ||||
Baccharis trimera (Less) D.C./Gorse | Infusion/Leaves | Headache [138] | Antiulcer and antioxidant [139], anti-inflammatory [140], anti-inflammatory and analgesic [141] | No |
| ||||
Vernonia condensata B./Boldo | Infusion, decoction/Leaves | Calmative [138] | Antioxidant [117], analgesic [142] | Yes |
| ||||
Cucurbitaceae | ||||
| ||||
Cayaponia tayuya (Vell.) Cogn./Taiuia | Infusion, decoction/Root | Neuralgia [67] | Hepatotoxic [142], anti-inflammatory [143] | Yes |
| ||||
Dilleniaceae | ||||
| ||||
Davilla rugosa Poir./Vine cabloco | Bathe/Root | Sedative [67] | Antioxidant [144], antiulcer [145] | Yes |
| ||||
Euphorbiaceae | ||||
| ||||
Jatropha curcas L./Pião-bravo | Infusion/Seed | Headache [102, 132] | Acetylcholinesterase inhibitor [146], antibacterial, antioxidant and antitumor [147, 148], cytotoxic [149] | Yes |
| ||||
Ricinus communis L./Castor beans | Infusion/Leaves | Headache [77, 87] | Antimicrobial and anticancer [150], antimicrobial [151] | Yes |
| ||||
Fabaceae | ||||
| ||||
Caesalpinia ferrea Mart. ex. Tul./Pau ferro | Not found | Analgesic [57] | Nutritional supplementation of iron, zinc and manganese [152] anti-inflammatory and healing [153], antihyperglycemic [154], antimicrobial [155] | No |
| ||||
Cajanus flavus De Candolle/Andu beans | Infusion/Leaves | Headache [99] | Not found | Not found |
| ||||
Erythrina falcata Benth/Surina, mulungu | Not found | Sedative and antiepileptic [67, 104] | Depressant CNS [156] | No |
| ||||
Indigofera anil/Anil | Not found | Sedative [107] | Not found | Not found |
| ||||
Indigofera suffruticosa Mill./Anileira | Decoction, infusion/Complete plant | Sedative [67] | Anti-inflammatory [157], lectin activity [158], antiepileptic [159], antiparasitic [160] | Yes |
| ||||
Pterodon emarginatus/Sucupira | Infusion/leaves, fruit | Headache [120] | Antimicrobial [161–163], analgesic and anti-inflammatory [164]; antileishmanial, anticancer, hypoglycemic [165] | No |
| ||||
Ginkgoaceae | ||||
| ||||
Ginkgobiloba/Ginco | Decoction, infusion/Leaves | Vasodilator, brain dysfunction, dizziness and concentration and memory [160] | Treatment of Alzheimer disease [166], prevention of dementia [167], antioxidant, vasodilator, stimulant of SNC [168] | No |
| ||||
Geraniaceae | ||||
| ||||
Pelargonium graveolens L'Her/ Mauve smelling |
Not found | Sedative [87] | Anxiolytic and antidepressant [159], antibacterial [169], hypoglycemic and antioxidant [170] | No |
| ||||
Mimosa pudica L./Dormideira | Infusion/Complete plant | Sedative [99] | Reduction of fertility [171], hepatotoxic [172], lipid-lowering [173], anxiolytic and antipyretic [137], antiophidic [174] | No |
| ||||
Iridaceae | ||||
| ||||
Calydorea sp./Jabotitana | Decoction/Rhizome | Analgesic [23] | Not found | Not found |
| ||||
Labiatae | ||||
| ||||
Agastache mexicana Kunth/Toronjil | Not found | Sedative [102] | Antihypertensive [175], vasorelaxant [176], anti-inflammatory and antinociceptive [177], antinociceptive [178], anxiolytic [179] | No |
| ||||
Lavandula latifolia/Lavanda | Oil | Stimulant [68] | Anxiolytic [180], antifungal [181], antioxidant [182] | Yes |
| ||||
Origanum vulgare/oregano | Infusion/Leaf | Sedative [68] | Antimicrobial [183] proapoptotic effect and cytotoxic [184], antiurolithic [185] | Yes |
| ||||
Lamiaceae | ||||
| ||||
Coleus barbatus Benth./Falso-boldo | Tisane mate/Leaf | Headache, calmative [56] | Hepatoprotective [186] | Yes |
| ||||
Cunila microcephala Benth./Hortelã-miúdo, hortelã-pimenta, poejo | Decoction/Complete plant | Analgesic [23, 58] | Anti-inflammatory and antioxidant [187] | No |
| ||||
Hyptis suaveolens Poit./Samba-coité | Tea/Leaf | Headache [188] | Hypoglycemic and antioxidant [189], hepatoprotective and antioxidant [190], gastroprotective activity [191], neuroprotective and antioxidant [192], antifungal [193] | Yes |
| ||||
Lavandula officinalis Chaix & Kitt/Alfazema | Tea/Leaf, stalk | Calmative [49] | Antimicrobial [194], antioxidant [195], sedative and hypnotic [196] | No |
| ||||
Leonotis nepetifolia (L.) R. Br./Cordão de São Francisco | Infusion, decoction/Leaf, branches | Sedative, headache [132, 138] | Antimicrobial [197], anti-inflammatory [198] | Yes |
| ||||
Melissa officinalisL./Erva-cidreira, melissa | Decoction/Leaf | Calmative, migraine, sedative [23, 36, 55, 58, 59, 87, 89, 90, 101, 102, 138, 199] | Anti-inflammatory [200], calmative [201], antioxidant [202], antigenotoxic and antimutagenic [203], neuroprotective [199, 204] | No |
| ||||
Mentha arvensis L./Hortelã-mentol | Tea/Leaf | Headache [188] | Antibacterial [205], antifungal [206], anti-inflammatory and sedative [207], peptic antiulcer [208] | Yes |
| ||||
Mentha cf. suaveolens Ehrh./Hortelã, hortelã-grande | Decoction, maceration/Leaf | Calmative, Analgesic [23, 199] | Antifungal [209, 210], antioxidant [211], antibacterial [212] | Yes |
| ||||
Mentha piperita L./Hortelã, hortelã-roxo | Decoction/Complete plant | Analgesic [23, 102] | Antifungal [213, 214], antioxidant [211], anthelmintic [215], hypoglycemic and hypolipidemic [216], anticancer [217] analgesic [218] | No |
| ||||
Mentha pulegium L./Poejo | Decoction/Stalk | Calmative, sedative [47, 56, 58, 78] | Antioxidant [211], antimicrobial [219] | Yes |
| ||||
Mentha sp./Hortelã | Decoction/Stalk | Headache, Calmative [36, 47, 49, 55–57] | Anthelmintic [215] | Yes |
| ||||
Mentha spicata L./∗ | ∗∗∗ | Headache [87] | Hypoglycemic and hypolipidemic [216], antioxidant [220], antiemetic [221] | Yes |
| ||||
Mentha × villosa Huds./Hortelã | Tea/Leaf | Headache [188] | Antifungal and antibacterial [222], antimicrobial and antioxidant [223], analgesic and antispasmodic [153] | No |
| ||||
Ocimum basilicum L./Alfavaca | Decoction, maceration/Leaf | Calmative, analgesic [23, 39] | Antidepressant and anticonvulsant [224] | Yes |
| ||||
Ocimum gratissimum L./l Louro |
Tea/Leaf | Headache, calmative [49, 87, 188] | Anticonvulsant [225, 226], antifungal [227] | Yes |
| ||||
Ocimum minimum L./Manjericão | Maceration/Leaf | Headache [94] | Antiulcerogenic and antioxidant [35] | Yes |
| ||||
Ocimum selloi Benth./Alfavaca | Infusion, tea/Leaf | Calmative [138] | Antibacterial [219], analgesic and antidiarrheal [220] | Yes |
| ||||
Origanum majoranaL./Manjerona | Decoction/Stalk | Calmative [56] | Antibacterial [228], antioxidant [49], antimetastatic and antitumor [229], antihyperglycemic and antihyperlipidemic [230] | Yes |
| ||||
Plectranthus barbatus Andr./Boldo | Decoction, maceration/Leaf | Analgesic [23, 57, 60] | Cytotoxic [231], acetylcholinesterase inhibitor [232], antimicrobial [233] | Yes |
| ||||
Plectranthus neochilus Schlechter/Boldo do Chile | Infusion/Leaf | Headache [89] | Analgesic [234] | No |
| ||||
Rosmarinus officinalis L./Alecrim | Decoction/Leaf | Analgesic, calmative [23, 39, 48, 58, 59, 102, 138, 235] | Antibacterial [236], antioxidant [237], antifungal [238], anticancer [239], antidepressant [240], analgesic [241], antioxidant, anti-inflammatory, metal chelation [242], prevention and treatment of dementia [243], neuroprotective [244] | No |
| ||||
Salvia lachnostachys Benth./Melissa | Decoction/Leaf | Somniferous [23, 78] | Anti-inflammatory and analgesic [244] | Yes |
| ||||
Salvia lavandulifolia Vahl./Mariselva | Oil/∗∗ | Nervous disorders [245] | Hypoglycemic [245], neuroprotective [246] | No |
| ||||
Salvia officinalis L./Salvia, barcelona | Decoction/Leaf | Calmative, Analgesic [23] | Antibacterial [228], anti-inflammatory [247], antidiarrheal and antispasmodic [185], analgesic and anti-inflammatory [248] | No |
| ||||
Lauraceae | ||||
| ||||
Cinnamomum zeylanicum Breyn./Canela | Infusion, maceration/Stalk | Calmative [39] | Antifungal [249] antimicrobial [250], antioxidant [251], antidiabetic [252] | Yes |
| ||||
Nectandra megapotamica (Spreng.) Mez/Canela-preta | Infusion/leaf | Calmative [253] | Anesthetic [254] | Yes |
| ||||
Leguminosae | ||||
| ||||
Acosmium subelegans (Mohlenbr) Yakovl/Perobinha do campo | ∗∗∗ | Sedative, epilepsy and nervous exhaustion [255] | Depressant effect SNC and anticonvulsant [255] | No |
| ||||
Hymenaea courbaril L./Jatobá | Infusion, maceration/Bark, fruit | Sedative [132] | Not found. | Not found |
| ||||
Tamarindus indica/Tamarindo | Compress, bathe, infusion/Stalk, leaves, fruit | Treatment of fever, stomach upset, diarrhea, jaundice and as skin cleansers [256], inflammation, urinary tract infection and laxative [257], headache and stress [258] | Antibacterial [256], antihelminthic [257], antioxidant [259], antinociceptive [260], analgesic and anti-inflammatory [261], antihistaminic and antianaphylactic [262], antiulcer [263] | No |
| ||||
Liliaceae | ||||
| ||||
Allium sativum L./Alho | ∗∗∗ | Headache [59] | Hypotensive [264], synergism with antibiotics [265], antioxidant [266] | Yes |
| ||||
Malpighiaceae | ||||
| ||||
Banisteriopsis caapi/Mariri, ayahuasca |
Decoction, infusion/vine | Hallucinogen, emotional and cognitive sensory changes, psychoactive [267–269] aid in treatment of abuse of other Psychoactives [270] | Hallucinogen [271] inhibiting the reuptake of serotonin, in addition to inhibiting MAO [272] | No |
| ||||
Galphimia glauca/Amarilla | Maceration/Part air plants | Calmative [273] | Anxiolytic [273] | No |
| ||||
Meliaceae | ||||
| ||||
Cedrela fissilis/Cedro-rosa | Infusion/Bark | Headache [121] | Not found | Not found |
| ||||
Moraceae | ||||
| ||||
Cannabis sativa/maconha, marijuana, cânhamo | Oil, inhalation/Leaves, stalk, flowers | Treatment of pain, nausea and vomiting, multiple sclerosis and other neurological disorders, loss of appetite and eating disorders, Insomnia, anxiety and depression, neuroprotective action [274], antiemetic, appetite stimulant [275], clinical and experimental studies in the treatment of dementias [276], schizophrenia, antipsychotic, anxiety [277], antipsychotic [278] | Treatment of pain, nausea and vomiting, multiple sclerosis and other neurological disorders, loss of appetite and eating disorders, Insomnia, anxiety and depression, neuroprotective action [273], antiemetic, appetite stimulant [274], clinical and experimental studies in the treatment of dementias [275], schizophrenia, antipsychotic, anxiety [276], antipsychotic [277], psychoactive [278] | No |
| ||||
Dorstenia brasiliensis Lam./Carapiá | Cataplasm/Rhizome | Anesthetic [67] | Anti-inflammatory [278] | Yes |
| ||||
Myrtaceae | ||||
| ||||
Eucalyptus globulus Labill./Eucalipto | Infusion, Bathe/Leaf | Headache [48] | Toxic effect [279], antibacterial [280, 281] | Yes |
| ||||
Eugenia uniflora L./Pitangueira | Decoction/Leaf | Calmative [23, 282] | Antimicrobial and antioxidant [283], anti-Trypanosoma cruzi [206] | Yes |
| ||||
Orchidaceae | ||||
| ||||
Vanilla planifolia Jack. ex Andrews/Baunilha | ∗∗∗ | Calmative [67] | Not found | Not found |
| ||||
Oxalidaceae | ||||
| ||||
Averrhoa Carambola L./Carambola | Infusion/Leaf | Analgesic [99] | Analgesic [284] | No |
| ||||
Papaveraceae | ||||
| ||||
Papaver somniferum/Planta do ópio | ∗∗∗ | Analgesic and sedative [68] | Not found | Not found |
| ||||
Passifloraceae | ||||
| ||||
Passiflora alata Curtis/Maracujá | Fruit | Calmative [55, 59, 77, 90] | Sedative [285] | No |
| ||||
Passiflora caerulea L./Maracujá | Infusion/Part air plant | Sedative and calmative [91, 286] | Anxiolytic [287] | No |
| ||||
Passiflora edulis Sims./Maracujá | Tea/Leaf | Calmative and insomnia [39, 48, 74, 77, 78, 90, 99, 257] | Anxiolytic [288] | No |
| ||||
Passiflora miersii Mart./Maracujazinho | Infusion/Leaf | Calmative and antidepressant [67] | Not found | Not found |
| ||||
Pedaliaceae | ||||
| ||||
Sesamum orientale L./Gergelim | Seed/Juice | Anticonvulsant [99] | Hypoglycemic [289] | Yes |
| ||||
Phytolaccaceae | ||||
| ||||
Petiveria alliacea L./Guiné, tira capeta | Decoction/Complete plant | Analgesic [23, 74, 99, 290] | Antimicrobial [291], antinociceptive, sedative, anticonvulsant and depressant [292] | Yes |
| ||||
Piperaceae | ||||
| ||||
Pothomorphe umbellata Miq./Pariparoba | Infusion/Leaf | Headache [121] | Antioxidant [293], antitumor [294], antihelminthic [295] | Yes |
| ||||
Poaceae | ||||
| ||||
Cymbopogon citratusStapf./Capim santo, capim limão | Decoction/Leaf | Calmative, analgesic and sedative [7, 23, 27, 36, 39, 47–49, 55–58, 74, 77, 78, 88–90, 99, 101, 102, 138, 296] | Anxiolytic, sedative and anticonvulsant [297] | No |
| ||||
Polygalaceae | ||||
| ||||
Polygala paniculata L./Arnica | Decoction/Complete plant | Analgesic [23] | Analgesic and antidermatogenic [298], antinociceptive and gastric cytoprotective activity [299] | No |
| ||||
Polygonaceae | ||||
| ||||
Homalocladium platycladum Bailey/Carquejinha | Decoction/Stalk | Analgesic [23] | Antibacterial [300], analgesic, anti-inflammatory [301] | No |
| ||||
Rosaceae | ||||
| ||||
Rosa centifolia L./Rosa branca | Decoction/Leaf, flower | Analgesic [23] | Anti-inflammatory and antiarthritic [302], antioxidant [303], antiulcer and cytoprotective [304] | No |
| ||||
Sanguisorba minor Scop./Pimpinela | Tea/Leaf, flower | Calmative [102] | Inhibitory action of acetylcholinesterase [305] | Yes |
| ||||
Rubiaceae | ||||
| ||||
Coffea arabica L./Café | Cataplasm/Leaf | Headache [101] | Antioxidant [306], antioxidant and stimulant [307] | Yes |
| ||||
Cinchona officinalis L./∗ | Decoction/Bark | Analgesic [23] | Not found | Not found |
| ||||
Psychotria viridis/chacrona, ayahuasca | Infusion/Leaves | Hallucinogen, emotional and cognitive sensory changes, psychoactive [267–269] aid in treatment of abuse of other Psychoactives [268] | Hallucinogen [308] | |
| ||||
Alibertia sp./Marmelo | Decoction, infusion/Root, fruit | Calmative [118] | Not found | Not found |
| ||||
Rutaceae (5) | ||||
| ||||
Casimiroa edulis Llave & Lex./Zapote blanco | ∗∗∗ | Sedative [102] | Vasodilator [309, 310], anticoagulants and antimicrobial [310], anxiolytic [311], anxiolytic and antidepressant [312] | No |
| ||||
Citrus aurantium L./Laranja | Decoction/Bark | Headache and calmative [36, 48, 56, 59, 78, 90, 194] | Low toxicity [313], anxiolytic [314, 315] | Yes |
| ||||
Citrus limon (L.) Burm. f./Limão-galego, | ∗∗∗ | Calmative and sedative [90, 194] | Neuroprotective activity and anticonvulsant [316] | Yes |
| ||||
Citrus sinensis (L.) Osbeck | Infusion/Leaf | Calmative, analgesic and sedative [23, 27, 49, 74, 99, 138] | Antioxidant, antithyroid and antihyperglycemic [317] | Yes |
| ||||
Ruta graveolens L./Arruda | Decoction, maceration/Leaf | Calmative and headache [23, 39, 48, 57, 60, 102] | Antimicrobial [318], antioxidant [319], antitumor [320], antinociceptive, anti-inflammatory and antipyretic [321] | Yes |
| ||||
Solanaceae | ||||
| ||||
Atropa belladonna L./Beladona | Decoction/Leaf | Calmative [23] | Healing [322] | Yes |
| ||||
Cestrum sendtnerianum Mart./Guiné-do-campo | Infusion, Decoction/Leaf | Sedative [67] | Not found | Not found |
| ||||
Solanum americanum Mill./Maria-pretinha | Decoction/Leaf, Stalk | Sedative, Analgesic [45, 67] | Antifungal [323], antioxidant and anticancer [324] | Yes |
| ||||
Solanum cernuum Vell/Pata de mono | ∗∗∗ | Calmative [87] | Antiulcerogenic [325] | Yes |
| ||||
Umbelliferae | ||||
| ||||
Anethum graveolens/Eneldo | ∗∗∗ | Sedative [68] | Antifungal [326], anticonvulsant [327], anti Helicabator pylori [328], decreased fertility rate [329], participates in the regulation of Diabetes Mellitus [330] | Yes |
| ||||
Coriandrum sativum/Cilantro | Infusion/Leaf, fruit | Stimulant [68] | Antioxidant [40], sedative and muscle relaxant [43], antibacterial [331], antiarthritic [332], anti-inflamatory [41], antifungal [333], hypoglycemic and hypolipidemic [334] | Yes |
| ||||
Petroselinum hortense/Salsa da horta | ∗∗∗ | Sedative [107] | Diuretic and hypotensive [335] | Yes |
| ||||
Urticaceae | ||||
| ||||
Urera baccifera (L.)/Urtiga | Leaf | Analgesic [36] | Antioxidant [336], anti-inflamatory [337] | No |
| ||||
Verbenaceae (6) | ||||
| ||||
Aloysia citrodora Palau/Erva luíza | ∗∗∗ | Calmative [74, 286] | Not found. | Not found |
| ||||
Aloysia triphylla Royle/Cidrão | ∗∗/Leaf | Sedative [55, 235] | Treatment of intestinal disorders [338], anti Trypanosoma Cruzi [339], anti-Helicobacter pylori [328], antibacterial [340], spasmolytic and anti-inflammatory [341], antinociceptive [244] | Yes |
| ||||
Lantana camara L./Camará | Infusion, Decoction/Leaf | Headache [132] | Antibacterial [342], antioxidant [343], anxiolytic [344] | Yes |
| ||||
Lippia alba (Mill.) N.E. Br./Erva-cidreira | Leaf/Infusion | Headache and calmative [39, 49, 55, 58–61, 75, 77, 94, 97] | Antimicrobial [345], antispasmodic [346], anxiolytic [347], anesthetic [348] | No |
| ||||
Lippia gracillis Schauer/Alecrim da serra | Infusion/Leaf | Headache [132] | Antimicrobial [349], antitumor [350], anti-inflammatory and healing [351] | Yes |
| ||||
Verbena cf. minutifolia Phil./∗ | Decoction/Complete plant | Analgesic [23] | Not found | Not found |
| ||||
Violaceae | ||||
| ||||
Viola odorata L./ | ∗∗∗ | Sedative [87] | Antitumoral [352], antioxidant and antibacterial [353], antimicrobial [354], vasodilator and antidyslipidemic [355] | Yes |
| ||||
Zingiberaceae | ||||
| ||||
Alpinia zerumbet (Pers.) Burtt & Smith/Colônia | Decoction/Leaf | Calmative [39, 48, 49, 101] | Hypotensive [356], vasodilator [357], antioxidant [358] | Yes |
| ||||
Zingiber officinale Rosc./Gengibre | Decoction/root | Analgesic and headache [23, 57, 78] | Antioxidant [359], antihyperglycemic [360], antibacterial [361], androgenic [362] | Yes |
| ||||
Costus brasiliensis Schum./Cana-de-macaco | Not found | Calmative [67] | Not found | Not found |
∗It is the popular name that was quoted. ∗∗It was not mentioned how to prepare. ∗∗∗It is the portion used or how to prepare that was quoted.
The most common indications, according to ethnopharmacological surveys, were calmative/sedative (72/167), analgesic (39/167), and headache (35/167), representing 86,2% of all indications (Figure 2).
Ethnobotanical surveys revealed that the leaves (70/160) and the whole plant (13/160) amounted to 51.7% of all plant parts most commonly used, but, in 18% of the studied plants, there were no citations about the used part for making medicines (Figure 3).
The most common preparation methods provided in the surveys were infusion (59/167) and decoction (49/167), representing 63.7% of all the methods (Figure 4).
Common effects attributed to the plants in the ethnopharmacological surveys were antioxidant (42/401), anti-inflammatory (31/401), antibacterial (20/401), and antimicrobial (17/401), totaling 31.9% (Figure 5).
Comparison between ethnopharmacological data and pharmaceutical tests for the same plants and compounds found differences in 52.9% (73/138) of the cases and similarities in 30.4% (42/138) (Figure 6). No pharmacological tests were found for 16.9% (23/138) of the plants mentioned in the ethnopharmacological surveys (Table 1).
Table 1 shows a list of the medicinal plants analyzed in this study. The pharmacological effects including “anticonvulsant” and “anxiolytic” were considered to correspond to “calmative” in medicinal effects cited by population since both effects are attributed to the same action in the neural system, that is, inhibitory action. Furthermore, the pharmacological effect “anti-inflammatory” was also considered to correspond to “analgesic” in medicinal effects cited by population since anti-inflammatory agents are effective in treating pain diseases.
4. Discussion
The most frequent indications of medicinal plant use for neural system disorders in our survey (i.e., calmative, analgesic, headache, and insomnia) are associated with the most common occurrences seen in medical practice [7, 36, 47, 55, 68, 77, 104, 132, 235, 258] (Figure 2).
The plant families analyzed (Lamiaceae and Asteraceae) are in accordance with general ethnobotanical studies [4, 7, 379–382] (Figure 1), as well as the most utilized plant parts (leaves) [1, 7, 379, 383, 384], and preparation methods (infusion and decoction) [7, 253, 379, 383, 384] (Figure 4).
Despite that, the frequency of effects observed by most pharmacological tests does not coincide with those reported for the same plants when analyzed by ethnopharmacological means, (i.e., antioxidant, anti-inflammatory, antibacterial, and antimicrobial), demonstrating a high discrepancy between proven and popularly mentioned effects (Figure 6).
It is important to remember that results of pharmacological tests were not found for all the plants mentioned in the ethnopharmacological studies, although those represent a small minority (16.9%) (Figure 5).
The discrepancy rate between the effects observed by ethnopharmacological and pharmacological methods in this study is in agreement with a previous study [9] and, in both cases, a disagreement of over 50% was found. This data indicates the need for better control in the use of medicinal plants as a whole, especially in countries with a large proportion of economically backward population where such therapy is most common, such as China, India, and Brazil. However, there are possibilities that scientific studies are not enough or they are missing to corroborate the ethnopharmacological activities.
Tables like the one produced in this study can be used as a basis for the indication of medications for health professionals working in the neural area who choose to substitute alternative therapies with conventional methods. The tables can be used to maintain the patient's health and help make these treatments more accessible to people of all economic levels [385], bring medical practice closer to the care of cultural groups [386], and expand the idea of wholeness in healthcare.
Performing pharmacological tests in the medicinal plants mentioned in ethnopharmacological studies will help avoid prescription errors based only on popular knowledge, which, despite the importance, exhibits extensive methodological shortcomings from its propagation through generations (see Introduction). Although the pharmacological tests cannot solve problems related to contamination during preparation and/or mistakes when identifying plants by unskilled people, performing those tests would decrease the problems caused by adverse effects and wrong prescriptions.
Neurological disorders present complex etiologies often with aggravating social influences, requiring special care when making prescriptions; many critically ill patients are secluded from society and require medical monitoring and medications derived from modern pharmaceutical technology since indications for complex etiologies like dementias were not addressed in the ethnopharmacological articles analyzed in this study.
In conclusion, despite the importance of ethnopharmacological data, it is important to make comparisons with pharmacological tests for the same plants, since the pharmacological studies, although few, have shown a high rate of discrepancy in the results, nevertheless, to be important to cite that the scientific studies could not be enough, or are missing, to corroborate the ethnopharmacological activities. Tables containing the plants names and their effects according to pharmacological tests should be consulted by health professionals before prescribing those medications. No medicinal plants were mentioned in ethnopharmacological data for treating complex etiology neural disorders such as dementia, indicating the need for new studies of broader geographical amplitude and pharmaceutical classes all around the world. Emphasis of these studies should occur in developing countries in order to decrease prescription errors associated with medicinal plants and increase the coverage of plant-based therapy for the global population while prioritizing people in need.
Acknowledgments
Tales Alexandre Aversi-Ferreira acknowledges CNPq, Brazil, for scholarship in productivity research.
Conflicts of Interest
The authors declare that there are no conflicts of interest regarding the publication of this paper.
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