The difference in effectiveness of herbal medicine between genetic and non-genetic spinocerebellar ataxia. T. Okabe Dept Integrated Trad Med, Univ Tokoy, Tokyo, Japan.

   The spinocerebellar ataxias (SCAs) are clinically and genetically a heterogeneous group of neurodegenerative disorders. At present,we have no effective therapeutic tools. Previous studies have shown for the first time, the successful treatment by medicinal herbs of 2 Japanese patients with genetic spinocerebellar ataxia 6 (SCA6). Recently, we have succeeded in remission induction by the herbal medicine of an another case with CSA6. Ataxia of gait and stance disappeared and the total ataxia score was improved from 26 to 12 on a 100-point semiquantitative International Cooperative Ataxia Rating Scales(ICARS). The results suggest that the herbal therapy would be effective for this genetic spinocerebellar ataxia. In this study, we have examined the effect of the herbal therapy against sporadic spinocerebellar ataxia. Multiple system atrophy (MSA) is a sporadic progressive neurodegenerative disorder characterized by prominent cerebellar and extrapyramidal signs, dysarthria, and dysphagia and symptoms of autonomic nervous system failure (such as urinary incontinence or incomplete bladder emptying, orthostatic hypotension, constipation, erectile failure in men. Three Japanese patients with MSA were treated with the medicinal herbs, to see whether the herbal therapy would be effective against the sporadic spinocerebellar ataxia. Among these symptoms, cerebellar ataxias such as light-headedeness, ataxic gait and swallowing difficulty were slightly improved after the herbal therapy. However, autonomic nervous system failures were not ameliorated by the therapy. The formula used for these cases consisted of different types of herbs such as sedative, anticonvulsive, neuroprotective, neurorefgulatory and DNA binding herbs. Together with the successful treatment of SCA6, the results imply therapeutic potential of the herbal medicine especially for genetic cerebellar ataxia. Extensive studies are required for elucidation of the mechanisms by which medicinal herbs exert their therapeutic activities on this genetic disease of CAG repeat expansion mutation,.