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Abdul Wahab1,2,3*, Rizwan Ul Haq1,3, Aftab Ahmed1, Rafeeq Alam Khan2 and Mohsin Raza4
1
Section of Pharmacology, International Center for Chemical Sciences, H.E.J. Research Institute of Chemistry, University of
Karachi, Pakistan
2
Department of Pharmacology, Faculty of Pharmacy, University of Karachi, Pakistan
3
Institute of Neurophysiology, Charite-Universitatsmedizin Berlin, Germany
4
Applied Neuroscience Research Center, Baqiyatallah Medical Sciences University, Tehran, Iran
The purpose of this study was to investigate the anticonvulsant activity of the volatile oil of nutmeg, the dried
seed kernel of Myristica fragrans Houtt, using well-established animal seizure models and to evaluate its potential
for acute toxicity and acute neurotoxicity. The volatile oil of nutmeg (nutmeg oil) was tested for its effects in
maximal electroshock, subcutaneous pentylenetetrazole, strychnine and bicuculline seizure tests. All the experi-
ments were performed at the time of peak effect of nutmeg oil. Nutmeg oil showed a rapid onset of action and short
duration of anticonvulsant effect. It was found to possess significant anticonvulsant activity against electroshock-
induced hind limb tonic extension. It exhibited dose dependent anticonvulsant activity against pentylenetetrazole-
induced tonic seizures. It delayed the onset of hind limb tonic extensor jerks induced by strychnine. It was
anticonvulsant at lower doses, whereas weak proconvulsant at a higher dose against pentylenetetrazole and
bicuculline induced clonic seizures. Nutmeg oil was found to possess wide therapeutic margin, as it did not
induce motor impairment when tested up to 600 µL/kg in the inverted screen acute neurotoxicity test. Further-
more, the LD50 (2150 µL/kg) value was much higher than its anticonvulsant doses (50–300 µL/kg). The results
indicate that nutmeg oil may be effective against grand mal and partial seizures, as it prevents seizure spread
in a set of established animal models. Slight potentiation of clonic seizure activity limits its use for the
treatment of myoclonic and absence seizures. Copyright © 2008 John Wiley & Sons, Ltd.
Keywords: epilepsy; anticonvulsant; Myristica fragrans; nutmeg oil; seizure; acute toxicity.
electroshock seizure (MES) test, and pentylenetetrazole of PTZ (100 mg/kg) to three groups of eight animals
(PTZ), bicuculline (BIC) and strychnine (STN) seizure each. The time at which the greatest response was
tests were investigated. The toxic potential of nutmeg observed was taken as the time of peak effect (TPE)
oil was investigated by determining its acute toxicity (Loscher et al., 1991). The time of maximum protection
and acute neurotoxicity. from PTZ-induced seizures was then used for quantifi-
cation of anticonvulsant potencies in all the seizure
models.
Experimental animals. Studies were carried out on NMRI Maximal electroshock seizure (MES) test. The MES test
(Naval Medical Research Institute, USA) male mice was carried out via transauricular electrodes by means
weighing 20–30 g, obtained from the animal house of a stimulator (ECT unit, model 7801, Ugo Basile, Varese,
facility of the Section of Pharmacology, H.E.J. Research Italy) using a fixed supramaximal current of 50 mA with
Institute of Chemistry, University of Karachi. Animals a frequency of 60 Hz for 0.2 s. This stimulus was suffi-
were kept in groups of 5–6 in plastic cages and pro- cient to produce hind limb tonic extension in control
vided standard 12 h light/dark cycle beginning at 8 a.m. animals. The animals were administered three doses
Standard food and water were available ad libitum. All of nutmeg oil (50, 100 and 200 µL/kg) i.p. in groups of
experiments for anticonvulsant activity were carried 10 to calculate the anticonvulsant effect. Nutmeg oil
out between 8 a.m. and 1 p.m. Each animal was used was tested in this test at the previously determined TPE
only once. All animals were treated in accordance (5 min, as indicated in the Results) in the PTZ test.
with ethical principles and regulations specified by the Animals not displaying electroshock induced hind
Animal Care and Use Committee of our Institution. limb tonic extension phase were considered protected
(White et al., 1998). Phenytoin (20 mg/kg) was used as
Chemicals. Pentylenetetrazole (PTZ), bicuculline (BIC), a positive control and administered i.p. 30 min before
strychnine (STN) and polyethylene glycol 400 were the electroshock.
purchased from Sigma Chemical Company (St Louis, MO,
USA). Sodium valproate and phenytoin sodium were STN and BIC seizure tests. The STN and BIC tests
received as gifts from Abbott Laboratories and Adamjee were carried out by s.c. administration of 1.2 mg/kg of
Pharmaceuticals (Pakistan) Ltd, respectively. Nutmeg STN and 2.7 mg/kg of BIC, respectively, at the pre-
oil was dissolved in polyethylene glycol 400, which was determined TPE (5 min) of nutmeg oil in the PTZ test.
diluted in water at a ratio of 30:70; this dilution has no Three doses of nutmeg oil were tested in each seizure
effect on seizure threshold (Loscher et al., 1990). PTZ, test. Nutmeg oil was tested for its ability to block clonic
STN, sodium valproate and phenytoin sodium were seizure in the BIC seizure test and hind limb tonic
dissolved in normal saline, whereas BIC was dissolved extensor jerks in the STN test (White et al., 1998).
in saline slightly acidified with 0.1 N HCl and was used Latency to hind limb tonic extensor jerk and mortality
within 60 min after preparation. All the solutions used were also calculated in the STN test. The latency to
were freshly made on the day of testing and administered hind limb tonic extensor jerk or mortality is defined
to a final volume of 0.1 mL/10 g body weight of mice. as the interval between the end of the STN-injection
and the occurrence of first episode of hind limb tonic
Time course of anticonvulsant activity of nutmeg oil. extensor jerk or death.
PTZ was administered subcutaneously (s.c.) at a dose
of 100 mg/kg in mice. At this dose the control animals
exhibited five different types of seizure patterns: (1) one Toxicity profile
or more generalized myoclonic body twitch, (2) threshold
seizure (it is defined as an episode of continuous clonic Acute neurotoxicity. The potential of testing material
spasms without loss of righting reflex lasting for at least to induce motor impairment was determined using an
5 s), (3) generalized clonic seizure with loss of righting inverted screen acute neurotoxicity test (Coughenour
reflex, (4) loss of righting reflex with tonic fore limb et al., 1977). Briefly, the apparatus consisted of 13 cm
seizure, (5) loss of righting reflex with tonic fore and square screen of 0.6 cm wire mesh supported by metal
hind limb seizure. The time course of anticonvulsant bars. Mice were individually placed on a wire mesh
action of nutmeg oil was determined by administering screen elevated a few cm above the ground, then
an appropriate intraperitoneal (i.p.) dose (200 µL/kg) of the screen was inverted through an arc of 180°. Mice
nutmeg oil 5, 30 and 60 min before s.c. administration unable to climb at an upright position within 1 min were
Copyright © 2008 John Wiley & Sons, Ltd. Phytother. Res. 23, 153 –158 (2009)
DOI: 10.1002/ptr
ANTICONVULSANT ACTIVITIES OF NUTMEG OIL 155
rated as failures. Animals were pretested on the appa- a rapid onset of anticonvulsant action and a short dura-
ratus on the day preceding the experiment, and those tion of effect against PTZ-induced seizures with TPE at
failing the task were not used for the subsequent drug 5 min and duration of action less than 1 h, as no protec-
test. Testing was carried out at 5, 30, 60 and 120 min tion was evident at 1 h.
following i.p. administration of different doses of
nutmeg oil in groups of 10 mice. PTZ seizure test. Nutmeg oil showed dose-related effects
against different patterns of PTZ-induced seizures. As
LD50. The dose that caused death in 50% of animals illustrated in Fig. 2, 200 µL/kg of nutmeg oil provided
within 24 h (LD50) was calculated using the method 30% protection from myoclonic twitch, whereas 100 and
described by Lorke (1983). Briefly, nutmeg oil at a dose 300 µL/kg were ineffective. 100 and 200 µL/kg of nutmeg
of 10, 100 and 1000 µL/kg was administered i.p. to oil provided 70% and 100% protection, respectively,
groups of three mice each. Based on the results of from threshold seizure and generalized clonic seizures
mortality in each group after 24 h, four more mice were with loss of the righting reflex, whereas 300 µL/kg of
administered different doses of nutmeg oil in order nutmeg oil was not only ineffective but also slightly
to obtain the least and most toxic values and the LD50 increased the frequency and severity of threshold seizure.
was calculated by the geometric mean of these values Furthermore, 100 and 200 µL/kg afforded complete
(Lorke, 1983). protection, whereas 300 µL/kg provided 60% and 70%
protection from loss of the righting reflex with tonic
HD50. The HD50, i.e. dose at which 50% of animals loss fore limb and tonic fore and hind limb seizures respec-
their righting reflex, was calculated after i.p. adminis- tively (Fig. 2). In valproic acid treated animals, only
tration of different doses of nutmeg oil. The loss of myoclonic twitches were observed in 40% of animals
righting reflex was assessed on the tabletop by placing (data not shown in the graph).
the animals in a supine position at 5, 10, 60 and 120 min
after administration of nutmeg oil (Swinyard and MES test. Nutmeg oil showed dose-dependent anti-
Kupferberg, 1985). convulsant activity against electroshock induced hind
limb tonic extension phase. As shown in Fig. 3, nutmeg
Statistics. The latency to seizures and death in the STN oil, at the dose of 50 and 100 µL/kg, provided 60% and
test were expressed as mean ± SEM. A difference between 90% protection, respectively, and at a dose of 200 µL/
the control and experimental groups were tested for kg afforded complete protection against hind limb tonic
statistical significance by Student’s t-test. Difference was extension phase. Phenytoin provided complete protec-
considered significance when p < 0.05 and < 0.01. The tion in this test (Fig. 3).
LD50 value of nutmeg oil was determined by Lorke’s (1983)
method, which requires a few animals to give median STN and BIC seizure tests. Nutmeg oil offered no pro-
values and has been proved valid for its accuracy (van tection but showed dose-related effect in increasing
Noordwijk et al., 1988). The HD50 value was calculated the latency to STN-induced first tonic extensor jerk and
by graphic presentation method. death. 100 µL/kg dose of nutmeg oil had no effect, whereas
200 and 300 µL/kg significantly increased the latency to
first tonic extensor jerk and death (Fig. 4A, B).
100 and 200 µL/kg of nutmeg oil protected 62.5%
RESULTS and 50% of mice, respectively, from BIC-induced clonic
seizures, whereas 300 µL/kg of nutmeg oil did not pro-
Anticonvulsant activity vide any protection and slightly increased the frequency
and severity of clonic seizures. Valproic acid (450 mg/
Time course of anticonvulsant activity of nutmeg oil. kg i.p.) showed complete protection from BIC-induced
As illustrated in Fig. 1, nutmeg oil 200 µL/kg exhibited clonic seizures (n = 8/group) (Fig. 5).
Figure 1. Time course of anticonvulsant effect of nutmeg oil Figure 2. Anticonvulsant effects of nutmeg oil on different pat-
(200 µl/kg) against different patterns of PTZ-induced seizures terns of PTZ-induced seizures, 5 min after i.p. administration to
(n = 8/group). GBT, one or more generalized myoclonic body mice (n = 10/group). GBT, one or more generalized myoclonic
twitch; TS, threshold seizure; GSR, generalized clonic seizure body twitch; TS, theshold seizure; GSR, generalized clonic sei-
with loss of righting reflex; LFS, loss of righting reflex with zure with loss of righting reflex; LFS, loss of righting reflex with
tonic fore limb seizure; LHS, loss of righting reflex with tonic tonic fore limb seizure; LHS, loss of righting reflex with tonic
fore and hind limb seizure. fore and hind limb seizure.
Copyright © 2008 John Wiley & Sons, Ltd. Phytother. Res. 23, 153 –158 (2009)
DOI: 10.1002/ptr
156 A. WAHAB ET AL.
Toxicity profile
DISCUSSION
inhibit voltage dependent Na+ channels, such as phenytoin, The dose of test material at which 50% of animals
carbamazepine, lamotrigine and valproic acid (White, exhibit a loss of the righting reflex (HD50) is also a matter
1999). Thus the activity of nutmeg oil in MES test may of concern in the initial stages of anticonvulsant identi-
be due to the presence of compounds that block Na+ chan- fication and quantification (Swinyard and Kupferberg,
nel. The strong inhibitory effect of nutmeg oil against 1985). The HD50 of nutmeg oil was calculated to be
MES-induced hind limb tonic extension suggests that 1265 µL/kg; hence the anticonvulsant doses of nutmeg
it may be useful for the treatment of grand mal and oil are much smaller than its HD50. This effect of nutmeg
partial seizures. The significant anticonvulsant activity oil may be due to the presence of constituents that enhance
of nutmeg oil (100% protection at 200 µL/kg) against GABA-mediated inhibition, as standard AEDs benzo-
loss of righting reflex with tonic fore limb and tonic diazepines and phenobarbital cause loss of righting
fore and hind limb seizures in PTZ test also demon- reflex in high doses (Swinyard et al., 1986).
strates that this oil is capable of preventing the spread Previous studies on the constituents of nutmeg oil reveal
of seizure and may be good candidate to be used for the presence of CNS active compounds with multiple
the treatment of grand mal and partial seizures. mechanisms of action. Pinene analogues, the major
STN is a competitive glycine receptor antagonist constituents of nutmeg oil, have been reported for their
(Rajendra et al., 1997). Nutmeg oil showed a dose- anticonvulsant activities in audiogenic seizure suscepti-
dependent anticonvulsant effect in the STN test by ble mouse (Consroe et al., 1981). Terpineol, another
increasing the latency to first tonic extensor jerk and major constituent of nutmeg oil, induced the dose-
death. This further demonstrates the ability of nutmeg dependent and reversible blockade of the compound
oil to prevent the spread of seizure. action potential propagation of the rat sciatic nerve
BIC is a reversible GABAA receptor antagonist (Curtis (Moreira et al., 2001). Although linalool and eugenol
et al., 1970). At lower doses (100 and 200 µL/kg), derivatives were present in small amounts but they may
nutmeg oil provided significant protection from clonic give additive or synergistic action to other anticon-
seizures, whereas at higher dose (300 µL/kg), it showed vulsant constituents of nutmeg oil, as linalool has been
weak proconvulsant effect by slightly increasing the reported to provide protection against PTZ, electro-
frequency and severity of clonic seizures. The activity shock, NMDA and quinolinic acid induced and possess
of nutmeg oil in BIC test may be due to the presence activity in PTZ-kindling model seizures (Elisabetsky
of compound that mediates its effect through GABAA et al., 1995, 1999; Brum et al., 2001). Similarly, eugenol
related mechanism, as BIC-induced seizures can be derivatives have also been found to possess activity in
blocked by standard drugs that enhance GABAA receptor the PTZ seizure test (Dallmeier and Carlini, 1981). The
mediated inhibition, such as barbiturates, benzodiaze- weak proconvulsant activity of nutmeg oil for clonic
pines, valproic acid, vigabatrin and gabapentin (Loscher seizures may be due to the myristicin and elemicin,
and Schmidt, 1994). which are metabolized in vivo into amphetamine-like
The present results confirm the traditional use of compounds (Shulgin, 1966; Kalbhen, 1971; Braun and
nutmeg oil for the treatment of epilepsy and suggest Kalbhen, 1973). Another major constituent of nutmeg
it may be effective for the treatment of grand mal oil terpinene-4-ol, has not been studied extensively for
and partial seizures in human, the weak proconvulsant its CNS effects, and therefore may contribute to the
activity of nutmeg oil for clonic seizures at a higher CNS activity of nutmeg oil.
dose does not reduce its effectiveness since some stand- In conclusion, the present data indicate that nutmeg
ard AEDs (phenytoin, carbamazepine, oxcarbazepine) oil is active in multiple seizure models, and may be efficient
effective against grand mal and partial seizures against grand mal and partial seizures, as it prevents
potentiate the myoclonic and absence seizures at cer- seizure spread by inhibiting the tonic seizure activity in
tain doses in laboratory animals and humans (Rumke, well-established animal seizure models. The slight poten-
1967; Pranzatelli and Nadi, 1995; Genton, 2000; Gelisse tiation of clonic seizure activity limits its use for the
et al., 2004). treatment of myoclonic and absence seizures. Nutmeg
In the initial stages of anticonvulsant identification oil has an acceptable safety profile as evidenced by acute
and quantification particular attention is directed to toxicity and acute neurotoxicity tests. Although the
adverse effects, especially those characterized by neuro- exact mechanism(s) of action of nutmeg oil needs more
logical deficits (White et al., 1998). The inverted screen investigation the overall the effects of nutmeg oil in
acute neurotoxicity test, developed by Coughenour seizure models indicates that it mediates a part of its
et al. (1977), is used to quantify the effect of testing effect through GABA mediated neurotransmission and
material on motor function (Loscher and Schmidt, by interaction with neuronal sodium channels.
1988). In this test, compounds with ataxic properties
produce dose-dependent increases in screen test fail-
ures, whereas other classes of drugs (e.g. psychomotor Acknowledgements
stimulants) do not. Nutmeg oil did not induce motor
impairment and ataxia when tested up to 600 µL/kg This work was supported by an institutional grant from H.E.J. Research
Institute of Chemistry, International Center for Chemical Sciences,
in the inverted screen acute neurotoxicity test. This University of Karachi, Pakistan. The authors would like to thank Dr
indicates that nutmeg oil has a wide therapeutic Mesbah Alam of Institute of Neurophysiology, Charité Universitä-
margin. tsmedizin Berlin, Germany for critical comments on manuscript.
Copyright © 2008 John Wiley & Sons, Ltd. Phytother. Res. 23, 153 –158 (2009)
DOI: 10.1002/ptr
158 A. WAHAB ET AL.
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Copyright © 2008 John Wiley & Sons, Ltd. Phytother. Res. 23, 153 –158 (2009)
DOI: 10.1002/ptr