Abstract Details

Title The use of NAD, NADH, and NAD Precursors in Parkinson’s Disease: A Systematic Review and Meta-analysis

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 13-005

Objective To evaluate the efficacy and safety of nicotinamide adenine dinucleotide (NAD?), NADH, and NAD? precursors in improving motor and non-motor symptoms in Parkinson’s disease (PD).

Background Mitochondrial dysfunction and reduced NAD? levels contribute to Parkinson’s disease pathogenesis by modified energy metabolism, oxidative stress, and neuronal loss. NAD? and its precursors—such as nicotinamide riboside and niacin—may restore mitochondrial bioenergetics and mitigate disease progression.

Design/Methods A systematic review and meta-analysis were done in accordance with PRISMA and Cochrane guidelines. PubMed, Scopus, and Web of Science were searched from inception through March 2025. Studies evaluating NAD?, NADH, or NAD? precursors in PD were included. Twelve studies met inclusion criteria; four randomized controlled trials (n = 136) were pooled quantitatively. Primary outcomes were changes in motor performance (UPDRS III, MDS-UPDRS III) and disease severity (Hoehn and Yahr scale). Data were synthesized using the DerSimonian–Laird random-effects model.

Results Nicotinamide riboside demonstrated a non-significant trend toward motor improvement compared with placebo (mean difference = –4.49, 95% CI [–11.01, 2.04]; p = 0.18; I² = 24%). Niacin supplementation yielded a similar trend (mean difference = –0.91, 95% CI [–4.21, 2.38]; p = 0.59). The pooled change in Hoehn and Yahr stage favored treatment (mean difference = –0.047; p = 0.739; I² = 0%). Adverse events were comparable and mild between groups, with fewer reports of headache and nausea in treatment arms.

Conclusions Although statistical significance was not recognized, NAD? and its precursors showed consistent trends toward improved motor outcomes and favorable tolerability in PD. These results support the potential of NAD?-based interventions as safe, mitochondria-targeted adjunct therapies and highlight the need for larger, long-term randomized trials to confirm efficacy of the treatment.

Authors/Disclosures
Ulla Nazzal (Jordan University of Science and Technology (JUST)) PRESENTER	Ulla Nazzal has nothing to disclose.
Suha Giselle Ghanem	Ms. Ghanem has nothing to disclose.
Lara H. Hamzeh, MD	Miss Hamzeh has nothing to disclose.
Omar Sayed, MD	Dr. Sayed has nothing to disclose.
Abdullah H. Maghrabi	Dr. Maghrabi has nothing to disclose.
Nada G. Abdelmaksoud, MBBS	Miss Abdelmaksoud has nothing to disclose.
Osama Hassan, MD	Dr. Hassan has nothing to disclose.
Alexandra Chira (Iuliu Hațieganu University of Medicine and Pharmacy)	No disclosure on file

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