The Role of NAD+ in Parkinsonʼs Disease: Exploring Potential Therapeutic Approaches

The Role of NAD+ in Parkinsonʼs Disease: Exploring Potential Therapeutic Approaches


Parkinson’s disease (PD) is a complex neurodegenerative disorder that affects millions of people worldwide. It is characterized by the loss of dopaminergic neurons in the substantia nigra, leading to motor symptoms such as tremors, rigid muscles, and slow movement. While the exact cause of PD is still not fully understood, researchers have identified a number of potential factors that contribute to the development and progression of the disease.

NAD+ and Mitochondrial Dysfunction in Parkinson’s Disease

One area of increasing interest in the study of PD is the role of nicotinamide adenine dinucleotide (NAD+), a key molecule involved in energy metabolism and cellular function. NAD+ is known to play a critical role in maintaining mitochondrial health and function, and emerging evidence suggests that mitochondrial dysfunction is a key feature of PD. Studies have shown that NAD+ levels are reduced in the brains of PD patients, and this decline is associated with impaired mitochondrial function and increased oxidative stress.

Potential Therapeutic Approaches

Given the central role of NAD+ in mitochondrial function and energy metabolism, there is growing interest in exploring NAD+-based therapies as a potential approach for treating PD. Several strategies are being investigated, including the use of NAD+ precursors such as nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) to boost NAD+ levels in the brain.

NAD+ Precursors and NAD+ Boosters

NR and NMN are NAD+ precursors that can be taken orally and have been shown to effectively raise NAD+ levels in various tissues, including the brain. Preclinical studies in animal models of PD have demonstrated that supplementation with NR or NMN can improve mitochondrial function, reduce oxidative stress, and protect against dopaminergic neuron loss. These findings have fueled interest in conducting clinical trials to evaluate the safety and efficacy of NAD+ precursors in PD patients.

In addition to NAD+ precursors, there are also several NAD+ boosters that have shown promise in preclinical models of PD. These compounds work by activating NAD+ biosynthetic pathways or enhancing NAD+ utilization within the cell. One example is nicotinamide riboside kinase (NRK) activators, which can stimulate the production of NAD+ from NR. Another example is sirtuin activators, which can increase NAD+ utilization by stimulating the activity of sirtuin enzymes that are involved in regulating mitochondrial function and cellular stress response.

Gut Microbiota and NAD+ Metabolism

Another emerging area of research is the link between gut microbiota and NAD+ metabolism in the context of PD. It is now well established that the gut microbiota plays a crucial role in modulating NAD+ levels in the host, and dysregulation of this axis has been implicated in various neurodegenerative disorders, including PD. Studies have shown that certain gut bacteria can produce NAD+ and its precursors, and modulation of the gut microbiota composition through probiotics, prebiotics, or fecal microbiota transplantation may offer a novel approach for manipulating NAD+ levels and mitigating neurodegenerative processes in PD.


In conclusion, NAD+ plays a critical role in maintaining mitochondrial health and energy metabolism, and its dysregulation has been implicated in the pathogenesis of Parkinson’s disease. A growing body of evidence suggests that NAD+ modulation has the potential to provide therapeutic benefits in PD by improving mitochondrial function, reducing oxidative stress, and protecting dopaminergic neurons. The development of NAD+-based therapies, including NAD+ precursors, NAD+ boosters, and gut microbiota modulation, represents an exciting and promising area of research for the treatment of PD. Further preclinical and clinical studies are warranted to fully explore the therapeutic potential of NAD+ targeting approaches in PD and to pave the way for the development of effective and safe NAD+ based therapies for this devastating neurodegenerative disorder.

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