Nursing and Midwifery Studies

Nursing and Midwifery Studies

The effect of chamomile extract on motor function and quality of life in persons with Parkinson's disease: A randomized placebo-controlled trial

Document Type : Original Article

Authors
1 Department of Neurology, Kashan University of Medical Sciences, Kashan, Iran
2 Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
Abstract
Background: Parkinson's disease (PD) is a progressive neurological disorder that impairs motor function (MF) and reduces quality of life (QOL). Although animal studies suggest that chamomile extract may enhance MF and muscle endurance in PD models, its effects in humans remain unexplored.
Objectives: This study evaluated the impact of chamomile extract on MF and QOL in individuals with PD.
Methods: In 2022, a double-blind, randomized, placebo-controlled trial was conducted in Kashan, Iran, including 50 patients with PD, randomized into two groups via block randomization. One group received chamomile extract capsules, while the other received wheat flour capsules, for 28 days. Data were collected at baseline and after the intervention using a demographic questionnaire, the Short Parkinson's Evaluation Scale for Outcomes in Parkinson’s Disease (SPES/SCOPA), and the Parkinson's Disease Questionnaire (PDQ-39). Analyses followed intention-to-treat (ITT) principles and complete-case approaches, employing Kolmogorov-Smirnov, Chi-square, Fisher’s exact, Mann-Whitney U, Wilcoxon signed-rank, and Quade’s tests.
Results: Baseline QOL scores did not differ significantly between groups (chamomile: 92.02±11.27; placebo: 88.46±15.88; P=0.56). Post-intervention, QOL improved in both groups, although the between-group difference was not statistically significant (67.94±31.50 vs. 63.12±32.15; P=0.68). The chamomile group had a higher baseline MF score than the placebo group (65.16±6.59 vs. 59.32±10.42; P=0.03). By the end of the study, MF scores declined in both groups, without significant between-group differences (56.07±16.25 vs. 54.77±21.80; P=0.31).
Conclusion: Compared with placebo, chamomile extract was associated with modest improvements in MF and QOL. The observed changes in the placebo group may reflect psychological effects. Further studies with larger samples, higher dosages, and extended follow-up are warranted.
Keywords

Subjects


1.       Ali F, Ahmed J, Ahmad S. Role of saffron and chamomile in Parkinson diseases. J Pak Med Assoc. 2023;73(3):720. doi:10.47391/JPMA.7035. PMID:36932796.
2.       Morris HR, Spillantini MG, Sue CM, Williams-Gray CH. The pathogenesis of Parkinson's disease. Lancet. 2024;403(10423): 293-304. doi:10.1016/S0140-6736(23)01478-2. PMID:38245249.
3.       Kuhlman GD, Flanigan JL, Sperling SA, Barrett MJ. Predictors of health-related quality of life in Parkinson's disease. Parkinsonism Relat Disord. 2019;65:86-90. doi:10.1016/j.parkreldis.2019.05.009. PMID:31118162.
4.       Najafi F, Mansournia MA, Abdollahpour I, Rohani M, Vahid F, Nedjat S. Association between socioeconomic status and Parkinson's disease: findings from a large incident case-control study. BMJ Neurol Open. 2023;5(1):e000386. doi:10.1136/bmjno-2022-000386. PMID:36817512; PMCID:PMC9933671.
5.       Armstrong MJ, Okun MS. Diagnosis and treatment of Parkinson disease: A review. JAMA. 2020;323(6):548-60. doi:10.1001/jama.2019.22360. PMID:32044947.
6.       Cassidy I, Doody O, Richardson M, Meskell P. Quality of life and living with Parkinson's disease: a qualitative exploration within an Irish context. BMC Neurol. 2024;24(1):275. doi:10.1186/s12883-024-03769-y. PMID:39118093; PMCID:PMC11308529.
7.       Henry RS, Lageman SK, Perrin PB. The relationship between Parkinson's disease symptoms and caregiver quality of life. Rehabil Psychol. 2020;65(2):137-44. doi:10.1037/rep0000313. PMID:32068420; PMCID:PMC7195231.
8.       Teoli D, Bhardwaj A. Quality of life. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. [Last access date: 27 Mar 2023].  Available from: https://www.ncbi.nlm.nih.gov/books/NBK536962/
9.       Kaplan RM, Hays RD. Health-related quality of life measurement in public health. Annu Rev Public Health. 2022;43:355-73. doi:10.1146/annurev-publhealth-052120-012811 PMID:34882431.
10.     Word Health Organization. Essential medicines and pharmaceutical policies; 2025. Available from: https://www.emro.who.int/essential-medicines/strategy-access/
11.     Khan MSA, Ahmad I. New look to phytomedicine. Academic press; Chapter 1, Herbal medicine: Current trends and future prospects. 2019. p. 3-13. doi:10.1016/B978-0-12-814619-4.00001-X.
12.     Nissen M. Factors responsible for increased use of herbal medicines and self-medication. Adv Pharmacoepid Drug Saf. 2022;11(3):1000272.
13.     Khan SS, Ikram R, Naeem S, Khatoon H, Anser H, Sikander B. Effect of M. chamomilla L. tea on chlorpromazine induced catalepsy: A neuroprotective study. Pak J Pharm Sci. 2020;33(5):1945-53. PMID:33824100.
14.     Sah A, Naseef PP, Kuruniyan MS, Jain GK, Zakir F, Aggarwal G. A comprehensive study of therapeutic applications of chamomile. Pharmaceuticals (Basel). 2022;15(10):1284. doi:10.3390/ph15101284. PMID:36297396; PMCID:PMC9611340.
15.     Araújo PC, Ramos CC, de Oliveira DB. Investigation into the sleep-promoting effects of the traditional use of passionflower (Passiflora spp.), chamomile (Matricaria chamomilla L.) and Mulungu (Erythrina spp.) in Brazil. Drugs Drug Candidates. 2025;4(1):11. doi:10.3390/ddc4010011
16.     Adib-Hajbaghery M, Mousavi SN. The effects of chamomile extract on sleep quality among elderly people: A clinical trial. Complement Ther Med. 2017;35:109-14. doi:10.1016/j.ctim.2017.09.010. PMID:29154054.
17.     Saadatmand S, Zohroudi F, Tangestani H. The effect of oral chamomile on anxiety: A systematic review of clinical trials. Clin Nutr Res. 2024;13(2):139-47. doi:10.7762/cnr.2024.13.2.139. PMID:38784853; PMCID:PMC11109927.
18.     Zhao W, Cui H, Liu J, Sun H, Zhang Z, Zhang Z, et al. Herbal interventions in Parkinson's disease: A systematic review of preclinical studies. Cell Mol Neurobiol. 2025;45(1):50. doi:10.1007/s10571-025-01556-y
19.     NCCIH. Chamomile; 2020. Available from: https://www.nccih.nih.gov/health/chamomile
20.     Ostovar M, Rezaee Z, Najibi SM, Hashempur MH. Chamomile: A systematic review of adverse events. Complement Ther Med. 2025;91:103192. doi:10.1016/j.ctim.2025.103192. PMID:40374153.
21.     Rafii F, Ameri F, Haghani H, Ghobadi A. The effect of aromatherapy massage with lavender and chamomile oil on anxiety and sleep quality of patients with burns. Burns. 2020; 46(1):164-71. doi:10.1016/j.burns.2019.02.017. PMID:31859096.
22.     Kramer DJ, Johnson AA. Apigenin: a natural molecule at the intersection of sleep and aging. Front Nutr. 2024;11:1359176. doi:10.3389/fnut.2024.1359176. PMID:38476603; PMCID:PMC10929570.
23.     Mohammadkhanizadeh A, Sheibani M, Taherkhani S, Nourabadi D, Mohamadi-Zarch SM, Nikbakht F, et al. Protective effects of apigenin in neurodegeneration: An update on the potential mechanisms. Brain Disorders. 2025;17:100189. doi:10.1016/j.dscb.2025.100189.
24.     Javed H, Meeran MFN, Azimullah S, Bader Eddin L, Dwivedi VD, Jha NK, et al. α-Bisabolol, a dietary bioactive phytochemical attenuates dopaminergic neurodegeneration through modulation of oxidative stress, neuroinflammation and apoptosis in Rotenone-induced Rat Model of Parkinson's disease. Biomolecules. 2020;10(10):1421. doi:10.3390/biom10101421. PMID:33049992; PMCID:PMC7599960.
25.     Marinus J, Visser M, Stiggelbout AM, Rabey JM, Martínez-Martín P, Bonuccelli U, et al. A short scale for the assessment of motor impairments and disabilities in Parkinson's disease: the SPES/SCOPA. J Neurol Neurosurg Psychiatry. 2004;75(3):388-95. doi:10.1136/jnnp.2003.017509. PMID:14966153; PMCID:PMC1738938.
26.     Ruotolo I, Sellitto G, Berardi A, Simeon R, Panuccio F, Amadio E, et al. Psychometric properties of the Parkinson's disease Questionnaire-39 and its short form Parkinson's disease Questionnaire-8: A systematic review and meta-analysis. J Clin Neurosci. 2024;123:100-17. doi:10.1016/j.jocn.2024.03.032. PMID:38564966.
27.     Dehghan A, Ghaem H, Borhani-Haghighi A, Safari-Faramani R, Moosazadeh M, Gholami A. Evaluation of reliability and validity of PDQ-39: Questionnaire in Iranian patients with Parkinson’s disease. Zahedan J Res Med Sci. 2016;18(3):e6245. doi:10.17795/zjrms-6245.
28.     Huneke NTM, Amin J, Baldwin DS, Bellato A, Brandt V, Chamberlain SR, et al. Placebo effects in randomized trials of pharmacological and neurostimulation interventions for mental disorders: An umbrella review. Mol Psychiatry. 2024;29(12): 3915-25. doi:10.1038/s41380-024-02638-x. PMID:38914807; PMCID:PMC11609099.
29.     Shen Zh, Xu Q, Jin L. Structured procedures promote placebo effects. J Experiment SocPsychol. 2020;91(104029).  doi:10.1016/j.jesp.2020.104029.
30.     Bräscher AK, Ferti IE, Witthöft M. Open-label placebo effects on psychological and physical well-being: A conceptual replication study. Clin Psychol Eur. 2022;4(4):e7679. doi:10.32872/cpe.7679. PMID:36762351; PMCID:PMC9881123.
31.     Knezevic NN, Sič A, Worobey S, Knezevic E. Justice for placebo: Placebo effect in clinical trials and everyday practice. Medicines. 2025;12(1):5. doi:10.3390/medicines12010005.
32.     Alami Rostami S, Rafieirad M. Investigating effect of chamomile hydroalcoholic extract on movement disorders in the animal model of Parkinson's disease. J Herb Drugs. 2016;7(1):37-43.
33.     Amsterdam JD, Shults J, Soeller I, Mao JJ, Rockwell K, Newberg AB. Chamomile (Matricaria recutita) may provide antidepressant activity in anxious, depressed humans: an exploratory study. Altern Ther Health Med. 2012;18(5):44-9. PMID:22894890; PMCID:PMC3600408.
34.     Tennigkeit J, Feige T, Haak M, Hellqvist C, Seven ÜS, Kalbe E, et al. Structured care and self-management education for persons with Parkinson's disease: Why the first does not go without the second-systematic review, experiences and implementation concepts from Sweden and Germany. J Clin Med. 2020; 9(9): 2787. doi:10.3390/jcm9092787. PMID:32872258; PMCID:PMC7563525.
35.     Chaves PFP, Hocayen PAS, Dallazen JL, de Paula Werner MF, Iacomini M, Andreatini R, et al. Chamomile tea: Source of a glucuronoxylan with antinociceptive, sedative and anxiolytic-like effects. Int J Biol Macromol. 2020;164:1675-82. doi:10.1016/j.ijbiomac.2020.08.039. PMID:32795578.
36.     Lidstone SC. Great expectations: the placebo effect in Parkinson's disease. Handb Exp Pharmacol. 2014;225:139-47. doi:10.1007/978-3-662-44519-8_8. PMID:25304530.
37.     El Mihyaoui A, Esteves da Silva JCG, Charfi S, Candela Castillo ME, Lamarti A, Arnao MB. Chamomile (Matricaria chamomilla L.): A review of ethnomedicinal use, phytochemistry and pharmacological uses. Life (Basel). 2022;12(4):479. doi:10.3390/life12040479. PMID:35454969; PMCID:PMC9032859.
38.     Wolff A, Schumacher NU, Pürner D, Machetanz G, Demleitner AF, Feneberg E, et al. Parkinson's disease therapy: what lies ahead? J Neural Transm (Vienna). 2023;130(6):793-820. doi:10.1007/s00702-023-02641-6. PMID:37147404; PMCID:PMC10199869.
39.     McFarthing K, Buff S, Rafaloff G, Dominey T, Wyse RK, Stott SRW. Parkinson's disease drug therapies in the clinical trial pipeline: 2020. J Parkinsons Dis. 2020;10(3):757-74. doi:10.3233/JPD-202128. PMID:32741777; PMCID:PMC7458531.
40.     Siddiqui RA. It's time to foster pride and let go of prejudice. Disability pride month: Why Pakistan needs it? J Pak Med Assoc. 2023;73(5):1170. doi:10.47391/JPMA.7955.
41.     Milane T, Hansen C, Correno MB, Chardon M, Barbieri FA, Bianchini E, et al. Comparison of sleep characteristics between Parkinson's disease with and without freezing of gait: A systematic review. Sleep Med. 2024;114:24-41. doi:10.1016/j.sleep.2023.11.021. PMID:38150950.
42.     Dai YL, Li Y, Wang Q, Niu FJ, Li KW, Wang YY, et al. Chamomile: A review of its traditional uses, chemical constituents, pharmacological activities and quality control studies. Molecules. 2022;28(1):133. doi:10.3390/molecules28010133. PMID:36615326; PMCID:PMC9822300.
43.     Amara AW, Chahine LM, Videnovic A. Treatment of sleep dysfunction in Parkinson's disease. Curr Treat Options Neurol. 2017;19(7):26. doi:10.1007/s11940-017-0461-6. PMID:28567500; PMCID:PMC6371969.
Volume 14, Issue 4
Autumn 2025
Pages 265-274

  • Receive Date 29 January 2025
  • Revise Date 08 June 2025
  • Accept Date 20 August 2025