Has the NoPark study been discussed?

Hi, @jeffwillapa - I see you've joined Mayo Clinic Connect this month. Welcome.

I believe this is the publication of the Phase I trial from the same group of researchers.
The NADPARK study: A randomized phase I trial of nicotinamide riboside supplementation in Parkinson’s disease
https://www.cell.com/cell-metabolism/fulltext/S1550-4131(22)00045-6
@jeffwillapa - is nicotinamide riboside supplementation something you are following as a potential for you or a loved one? If so, what effects from this supplement would you hope to see?

Both of my parents had Parkinson's in their later years. I have followed the science regarding the co-enzyme NAD and its precursor NR (Niagen, nicotinamide riboside). It was discovered as a vitamin by Dr. Charles Brenner when he was on the faculty at Dartmouth. He now supervises a group at The City of Hope research facilities in California. I have read that while the other two variants in the B-3 group also are precursors to NAD, apparently they are less effective in nerve cells. Dr. Brnner has said that niacin is not very effective, which may be because another enzyme that is common throughout the body's cells, is in very limited supply in nerve cells. NAM (nicotinamide) is just not as effective as NR generally for some reason. Dr. Brenner has said that NR has a dedicated kinase pathway that opens and seeks NR into damaged cells. I am aware of various anecdotal instances that are consistent with these concepts. I know six people who get relief from restless legs syndrome, three from peripheral neuropathy, one from lupus, one from carpal tunnel syndrome, and other examples as well, by taking NR. Many active clinical trials are using NR regarding neurological and metabolic conditions listed at clinicaltrials.gov. I linked the Phase 1 trial, but there is also a Phase 2 trial that has been upgraded to Phase 3 which is projected to be completed with results in late 2025. I think this upgrade was made after I first posted about it here. I am optimistic. Following the science regarding NR has become something of a hobby for me. I became interested when I noticed that my mild psoriasis vanished when I took it long enough, and that my occasional electric-like pin-prick shots into the sole of. my feet stopped, and more subtle benefits. since the vitamin is safe (eg. we got it in mothers' milk and it has GRAS from the NIH) I take at least 1000 mg per day. I will disappointed if it doesn't prove efficacious regarding Parkinson's disease in the next 16 months. One of the trials that is being run parallel to the main NoPark Phase 2/3 is one where the dose was increased to 3000 mg per day since participants were getting varying results in the ongoing trial. It was shown to be safe at that dose in another trial. I would not wait 16 months to start supplementation with it for Parkinson's disease, since the disease is progressive and without adequate treatments. It hasn't been proven by FDA standards yet, but it is proven that the co-enzyme NAD is very important regarding cellular energy and repair, and NR is an effective precursor to NAD.

I cannot link it, but this excerpt is why I think it is advisable to start supplementation now rather than wait to see the results of the Phase 2/3 trial in a year and a half. "Principal Investigator: Charalampos Tzoulis
To test the potential of NR as a neuroprotective therapy for PD, we will perform NO-PARK (ClinicalTrials.gov: NCT03568968), a multi-centre, phase II randomized double-blinded clinical trial, comparing NR to placebo in individuals with early stage PD. The central hypothesis of NO-PARK is that oral administration of the NAD precursor NR can boost neuronal NAD levels and ameliorate mitochondrial dysfunction in PD. This, in turn, will rectify neuronal metabolism and inhibit neurodegeneration, resulting in amelioration of clinical symptoms and delayed PD progression.

Individuals with PD (n = 400) are being recruited from centres across all four health regions of Norway. After the initial assessment, participants are randomly assigned to either NR 500 mg x 2/day, or placebo and followed with regular clinical examination, brain imaging and blood tests for a total period of one year. This work aims to discover and develop a therapy with the potential to delay the progression of PD." Based on this, the delaying of the progression of symptoms is a primary goal.

When I tried to link when I first joined, I couldn't. Search at clinicaltrials.gov: "Parkinson's disease" "Nicotinamide riboside". That will bring up the various trials.

Hi, @jeffwillapa - for safety purposes, new Connect members wait a few days before they can post links.

@hopeful33250 has talked about Parkinson's disease and may have some input on nicotinamide riboside. Also, please meet @missbutterfly2be @bobweller @angood1969, who may be familiar with nicotinamide riboside from their own or a loved one's experience with Parkinson's.

My understanding, @jeffwillapa, is you do not have a Parkinson's diagnosis, but watched your parents experience Parkinson's in their later years. Were there any therapies that had helpful effects for your parents with this disease?

Hello @jeffwillapa,

As WebMD is a fairly easy to understand website, I've listed a link from their article regarding this supplement.
https://www.webmd.com/vitamins/ai/ingredientmono-1560/nicotinamide-riboside
Here is a quote from the "Overview" in this article:

"People use nicotinamide riboside for anti-aging effects, high cholesterol, high blood pressure, Alzheimer disease, obesity, and many other purposes, but there is no good scientific evidence to support these uses."

It would be a good idea to read the "Precautions" "Side Effects" and "Interactions." These include cautions about taking this supplement with blood pressure meds.

Have you mentioned this supplement to your neurologist? Are you currently taking prescription medication to reduce your PD symptoms?
https://www.webmd.com/vitamins/ai/ingredientmono-1560/nicotinamide-riboside

I don't think either of my parents had any useful treatments.

Regarding there is not any scientific evidence to support the uses, they are currently in various trial stages, but many are showing efficacy at those stages. At present, if one uses the vitamin as a therapy, it relies on anecdotal reports, early phase trials, or general information regarding the importance of the co-enzyme nicotinamide adenine dinucleotide (NAD). We should see the Phase 3 results in about 15 months from the Norway trials (NoPark Trials). Since the vitamin has GRAS safety rating from the NIH) and since it may slow or stop the progression fo Parkinson's disease, and perhaps give remedial benefits, I wish it would have been available for my parents.

General sites regarding it are ScienceofNAD dot com, and AboutNAD dot com. Searching nicotinamide riboside and Parkinson's disease should bring up several links.