The 26th World Parkinson's Day was celebrated on 11 April.Parkinson's disease is the third most common disease among the elderly, after tumours and cardiovascular disease.

In recent years, a number of researchers have found that NMN is also beneficial in difficult to overcome neurodegenerative diseases such as Alzheimer's and Parkinson's disease.

High Levels of NMN(NAD+) Help Protect the Nervous System

Parkinson's disease (PD) is known to be a degenerative disease (or neurodegenerative disease) of the nervous system, most commonly seen in the elderly.

However, many people still think of Parkinson's syndrome in terms of the simple symptom of hand tremors. In fact, the common symptoms of Parkinson's are very frightening and include tremors, muscle tonus, slow movements and dyskinesia.

Although the etiology and pathogenesis of Parkinson's disease is still not well understood, there has been much evidence to support the neuroprotective effect of high NMN(NAD+) levels.

On 1 March 2022, a team of researchers from the University Hospital of Hoekland and other institutions in Norway published a paper in Cell Metabolism (IF=27.287) entitled "The NADPARK study: a randomized phase I trial of nicotinamide riboside supplementation in Parkinson's disease".

The paper published the results of a phase I clinical study: by ingesting NMN(NAD+) precursors, it was possible to increase NMN(NAD+) levels in the brains of Parkinson's disease patients, thus providing neuroprotection and improving the effects of Parkinson's disease.

In fact, NAD+ (nicotinamide adenine dinucleotide) is an important cofactor in the body's metabolic redox reactions (including mitochondrial respiration) and is heavily depleted during DNA repair, histone and other protein deacylation, and RNA processing, requiring constant replenishment through NAD+ biosynthesis.

Among the many precursors of NAD+, NMN and NR have been proven in numerous studies to be safe to administer in high doses and to be effective in boosting NAD+ levels. Since NR requires conversion to NMN before synthesis of NAD+, NMN is synthesised more efficiently than NR.

Several animal studies have shown that by supplementing with NAD+ precursors (NMN and NR), it helps to protect the nervous system and prevent and improve neurodegenerative diseases.

It also raises great expectations as to whether boosting NMN(NAD+) levels will have the same protective effect on the human nervous system.

Clinical Study Phase I Out: Improving Parkinson's Disease

Both NMN and NR have several clinical studies underway, and this study, published in March 2022, uses NR for the first time in patients with Parkinson's disease (PD). 30 eligible PD patients were recruited to the study, with data ultimately available for 27 individuals.

Of the 13 participants in the NR group, 10 had increased brain NAD+ levels, with nine of them demonstrating a 10% change above baseline levels.

Increased brain NAD+ levels in PD patients

In a further study, the team analysed NAD+ metabolomic levels in cerebrospinal fluid, muscle tissue and peripheral blood mononuclear cells (PBMC).

In cerebrospinal fluid samples, levels of the metabolite Me-2-PY were significantly elevated in the NR addition group. In muscle tissue, levels of several NAD metabolites were significantly elevated in the NR group. in PBMC samples, levels of mainly NAAD and Me-Nam were elevated.

Overall, the elevated brain NAD+ levels showed improvements in cerebrospinal fluid, peripheral blood mononuclear cells, and muscle tissue, with the most pronounced in muscle tissue. In contrast, there was no significant change in the placebo group.

In addition, considering that inflammation and mitochondrial dysfunction are very relevant to the pathology of Parkinson's disease, the investigators measured changes in relevant biomarkers in serum and cerebrospinal fluid of PD patients, showing that levels of inflammation-related markers were reduced in both cerebrospinal fluid and serum, and that mitochondrial dysfunction markers were decreased in serum samples.

The clinical phase I results are encouraging and the study is now in clinical phase II with the hope that further studies will be conducted in larger clinical trials.

In conclusion, this study provides preliminary evidence of the protective effect of increased NMN(NAD+) levels on the nervous system, and more studies are expected in the future.