Nicotinamide Riboside (NR) for Parkinson's Disease
Also known as: NR, Niagen, TruNiagen
NAD+ depletion in PD dopaminergic neurons impairs mitochondrial function and energy production.
Mechanism of Action
NR elevates NAD+ in dopaminergic neurons, activating SIRT3 for mitochondrial quality control, enhancing PGC-1α-mediated mitochondrial biogenesis, and supporting dopamine synthesis (tyrosine hydroxylase requires BH4, which is NAD+-dependent).
General mechanism: NAD+ precursor via NR kinase pathway. SIRT1/3 activator, mitochondrial biogenesis enhancer, PARP1 substrate, DNA repair support.
Current Evidence
NADPARK Phase I trial showed NR supplementation increased blood NAD+ and improved some PD biomarkers. Larger trials planned. Safety and tolerability established.
Clinical Status: Phase I (NADPARK) positive for biomarkers. Phase II planned.
Safety Profile
Very safe at 300-1000mg/day. Mild GI effects. Well-tolerated in clinical trials. No significant drug interactions.
Key Research Questions
- Does NR improve mitochondrial function in PD neurons as measured by 31P-MRS?
- Can NR slow motor symptom progression in early PD?