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The N-DOSE Study: A Dose Optimisation Trial of Nicotinamide Riboside in Parkinson’s Disease

The objective of the N-DOSE study is to determine the Optimal Biological Dose (OBD) for NR.

Disease: Parkinson's disease 
Type of study: Interventional trial 

Coordinating investigator: Haakon Berven
Study director: Charalampos Tzoulis

Background: While our previous findings nominate NR as therapy for PD, the observed effects were heterogeneous across the study population, raising the question of individualised dose-dependent responses. Thus, the optimal NR dose for neurological intervention is unknown. N-DOSE is a dose-optimisation trial of NR in PD, which will address this important knowledge gap. 

The objective of the N-DOSE study is to determine the Optimal Biological Dose (OBD) for NR, defined as the dose required to achieve maximal cerebral NAD increase (measured by 31P-MRS or CSF metabolomics), or maximal alteration in cerebral metabolism patterns (measured by FDG-PET), or maximal proportion of MRS-responders, in the absence of unacceptable toxicity. 

Design: N-DOSE is a randomised double-blinded placebo-controlled trial (RCT) to assess the optimal biological dose for nicotinamide riboside (NR) in PD. Individuals with PD (n = 80) will be randomised in a 1:1:2 ratio to three groups: placebo, 1000 mg NR daily, or a dose escalation group starting with 1000 mg daily and escalate to 2000 mg and 3000 mg at one-month intervals. Measures will include clinical, neuroimaging (31P-MRS, FDG-PET), molecular, and biochemical endpoints. Study duration will be three months. 

Primary endpoint: The between-visit change in cerebral NAD levels measured by 31P-MRS).

Status: The study is fully enrolled and will be concluded in May 2025. 

Participating centre

  • Haukeland University Hospital, Bergen

Funding

  • The Research Council of Norway, Neuro-SysMed
  • The Research Council of Norway, KOMMERSFORSK
  • The Regional Health Authority of Western Norway
  • The Norwegian Parkinson’s Disease Association
  • Haukeland University Hospital
Last updated 4/2/2025