KSHINAMATI (Dementia)

KSHINAMATI (Dementia) Impairment in the functioning of the Buddhi or Mati is denoted as Kshinamati which is found as clinical feature in the patient of Kampavata Basavrajiyam has considered the Kshinamati as a symptom of Kampavata.

• Prajna has three components – Dhi, Dhriti and Smriti

• Dhi – means intellect
• Dhriti – mean regulation
• Smriti – means memory
• The word Dhi means Mati or Buddhi Mati
• is related with Udapoha or reasoning or consideration of pros and cons (Dalhana Su.Su-3/53, Utt.-63/5) Mati discusses positive and Negative points of a problem.
• Vipulmati can be achieved by listening, collection, retention, reasoning (Carkrapani on Ca.Su.-1/23).
• Buddhi removes doubts and concludes the facts and thus take reasonable decision by choosing right objective (Arundatta), as Buddhi is related with Nishchaya or discrimination.
• Prana supports the Buddhi and Udana is related with Dhi and Manobodhana (A. S. Su. 20/3)
• Sadhaka Pitta is responsible for activities of Buddhi (intellect),
• Ahankara (Ego) and Utsaha (Energy) Thus impairment is Sadhaka Pitta Prana Vayu, and Udana Vayu can lead to Kshinamati in patients of Kampavata (Parkinson’s disease) Dementia generally occurs late in Parkinson’s disease.
• An estimated 20 to 30% of patients with Parkinson’s disease have dementia and an additional 30 to 40% have a measurable impairment in cognitive abilities.
• The term “Subcortical dementia” was first used to describe the cognitive and behavior deficits seen in patient with hungtington’s disease.
• A similar clinical pattern was soon described for other subcortical disease such as Parkinson’s disease.
• Subcortical dementia is now considered as a pseudoanatomical designation. It is clear from imaging and neuropathological studies that cortical dementia (for example Alzheimer’s disease) is not restricted pathologically to the cortex; major affected cholinergic fiber pathways are subcortical in origin.
• Subcortical diseases (for example Parkinson’s disease) similarly affect region outside the subcortex, especially the frontal lobe because of the brain’s robust frontal – subcortical connections.
• Neuropathology is notable for cell loss and gliosis and cerebellum.
• Subcortical dementia (Parkinson’s disease marked slowing of cognitive process, apathy lack of initiative have been described, associated with relative sparing of language, memory and praxis due to decline in memory and thinking both sufficient to impair personal activities of daily living.