Changes in MoCA scores with sequential administration of Trikatu Cūrṇa and Brahmi Ghṛta in mild cognitive impairment: an exploratory single-arm clinical study.

Abstract

Mild cognitive impairment (MCI) is an intermediate clinical state between normal cognitive aging and dementia. MCI can impair complex daily activities and social functioning. Ayurveda recognizes age-related changes (Jarā) as a natural phenomenon; however, pathological cognitive decline is considered when influenced by doṣa-vaiṣamya. Descriptions of Buddhi-bhraṁśa and Smṛti-bhraṁśa can be correlated with cognitive decline. Current pharmacological and non-pharmacological approaches show variable outcomes, highlighting the need for supportive and integrative strategies. The single-arm, open-label clinical study evaluated 24 participants diagnosed with mild neurocognitive disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. The patients were administered Trikatu Cūrṇa 3 g twice daily, after food, for 7 days, followed by Brahmi Ghṛta 5 mL twice daily with milk as Anupāna, after food, for 90 days. Out of the 27 enrolled participants, 24 completed the study and 3 dropped out. Cognitive assessment was carried out using the Montreal Cognitive Assessment (MoCA) Scale. This study is registered in the Clinical Trial Registry of India under CTRI/2024/07/070223 before enrolment of the first participant. Post-intervention assessment demonstrated a statistically significant improvement in overall cognitive scores compared to baseline ( p < 0.001), with a large effect size and no adverse events. However, these findings are strictly limited by the open-label, single-arm design, lack of lifestyle standardization, and unrecorded concomitant medications. Trikatu Cūrṇa, through its Dīpana-Pācana action, may support Agni and help in Āma reduction, thereby improving metabolic efficiency and drug absorption. Brahmi ( Bacopa monnieri ) formulation, Brahmi Ghṛta, is traditionally described as a Medhya Rasāyana, and based on experimental and pharmacological evidence, it may support cognitive function through mechanisms such as modulation of cholinergic pathways, enhancement of synaptic plasticity, and neuroprotective effects in hippocampal circuits relevant to MCI. https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MTEwODI2&Enc=&userName=.