Energy Supplement Studied for Parkinson’s Disease
Whether a supplement used by athletes to boost energy levels and build muscle can slow progression of Parkinson’s disease is the focus of a North American study.
Creatine, under study for neurological and neuromuscular diseases such as Lou Gehrig’s and muscular dystrophy, may give an energy boost to the dying cells of Parkinson’s patients, says Dr. Kapil D. Sethi, MCG neurologist and director of the Movement Disorders Program.
“We think it may help cells that are damaged or overworked,” says Dr. Sethi, a site principal investigator on the National Institute of Neurological Disorders and Stroke study. MCG hopes to recruit 45 patients for the study that will enroll 1,720 patients at 51 sites in the United States and Canada.
Mitochondria, the powerhouse for cells, become dysfunctional in the brain, muscle and platelet cells of many patients with Parkinson’s disease. The dysfunction is discernible in postmortem brain studies and in living muscle biopsies and platelet activity measurements.
“By giving more energy to the cell, you are giving them a safety margin,” Dr. Sethi says. “If a cell is dying, it takes another route to survive.”
The goal is to slow progression of a disease that affects about 1 million people in North America. Symptoms include tremors, rigidity and slowed movement. Late in the disease, most patients develop dementia and behavior disorders.
Therapies – including the gold standard, a synthetic dopamine called levodopa and MAO-B inhibitors that forestall breakdown of dopamine – treat the symptoms. Dopamine, a neurotransmitter critical to movement, is depleted in Parkinson’s. Researchers hope newer therapies, including creatine, can be added to the mix to help slow the disease.
The study will enroll patients who have been on standard therapies from 90 days to two years and follow them for five years. Half the enrollees will get creatine and half placebo. Researchers hope for at least a 20 percent reduction in disease progression so that in five years, patients on creatine will look like placebo patients at four years, says Buff Dill, study coordinator.
Following disease progression long term and measuring endpoints such as falls, nursing home placement, dementia and death is the only way to assess treatment, Dr. Sethi says. The study may be extended five additional years, based on preliminary results and funding.
Those who get creatine may have the added benefit of increased muscle, as it is true of athletes, Dr. Sethi says, noting that many patients experience muscle atrophy and weight loss.
Creatine is available over the counter, but “patients realize that we don’t know if it works,” Dr. Sethi says. “They are willing to take the risk of being on placebo for the cause of science and to learn more about the disease. They want to beat this disease and if they can’t, they want to help somebody else beat it.”
Avicena Group, Inc., will provide creatine and placebo for this first large study in a series of National Institutes of Health-sponsored exploratory trials in Parkinson’s.
MCG will soon participate in a similar study of coenzyme Q10, another natural supplement that boosts energy production. Dr. Sethi, project director of the Parkinson Research Alliance of India, which is working to bring more clinical trials to his homeland, will incorporate these supplements into innovative treatment cocktails that will be studied there.
Visit doctor at first sign of Parkinson’s
Many people suffer with symptoms of early-stage Parkinson’s disease for up to a year before seeking medical attention. But that’s exactly what you shouldn’t do.
Parkinson’s is a progressive illness that occurs when dopamine-producing cells in the brain die or are damaged. Over time, this affects the body’s ability to control movement. Parkinson’s disease is most common among the elderly, but 15 percent of patients are younger than 50.
Early symptoms may include tremor in an arm or leg, slower-than-normal movement, longer time periods to complete tasks, stiffness and difficulty balancing.
Because these signs are commonly associated with aging, many patients ignore them. But early diagnosis means taking advantage of the latest medications to slow the disability associated with Parkinson’s. Don’t wait to see if these symptoms go away; talk to a physician today. A referral to a movement disorders specialist may be necessary. |
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