Nicotinamide adenine dinucleotide (NAD) is an important cofactor in numerous metabolic reactions. NAD concentrations decline with age, which may contribute to age-associated conditions such as Parkinson’s disease. Preclinical studies show that replenishing NAD by supplementation with nicotinamide riboside (NR), a biosynthetic precursor to NAD, can promote health span and neuroprotection. Brakedal et al. performed a randomized, double-blind phase 1 clinical trial of NR supplementation in 30 patients newly diagnosed with Parkinson’s disease. They found that NR supplementation was safe and that concentrations of NAD in the brain increased in most patients receiving NR. These patients had signs of altered cerebral metabolism and mild clinical improvement, although further testing is needed with a larger cohort to confirm any clinical benefit.
