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Randomized, Double-blind, Placebo-Controlled Trial on Symptomatic Effects of Coenzyme Q10 in Parkinson Disease
Abstract
BACKGROUND: Major hallmarks in the pathophysiology of Parkinson disease are cellular energy depletion and oxidative stress leading to cellular dysfunction and death. Coenzyme Q(10) (CoQ(10)) is an electron acceptor bridging mitochondrial complexes I and II/III and a potent antioxidant that consistently partially recovers the function of dopaminergic neurons. OBJECTIVE: To determine whether nanoparticular CoQ(10) is safe and displays symptomatic effects in patients with midstage Parkinson disease without motor fluctuations. DESIGN: Multicenter, randomized, double-blind, placebo-controlled, stratified, parallel-group, single-dose trial. SETTING: Academic and nonacademic movement disorder clinics. PATIENTS: One hundred thirty-one patients with Parkinson disease without motor fluctuations and a stable antiparkinsonian treatment. Intervention Random assignment to placebo or nanoparticular CoQ(10) (100 mg 3 times a day) for a treatment period of 3 months. Stratification criterion was levodopa treatment. MAIN OUTCOME MEASURE: The subjects underwent evaluation with the Unified Parkinson's Disease Rating Scale (UPDRS) at each visit on a monthly basis. The primary outcome variable was the change of the sum score of the UPDRS parts II and III between the baseline and 3-month visits. RESULTS: One hundred thirty-one subjects were randomized according to the protocol. The mean changes of the sum UPDRS parts II/III score were -3.69 for the placebo group and -3.33 for the CoQ(10) group (P = .82). Statistical analysis according to the stratification did not result in significant changes of the primary outcome variable. No secondary outcome measure showed a significant change between the placebo group and the CoQ(10) group. The frequency and quality of adverse events were similar in both treatment groups. CONCLUSIONS: Nanoparticular CoQ(10) at a dosage of 300 mg/d is safe and well tolerated and leads to plasma levels similar to 1200 mg/d of standard formulations. Add-on CoQ(10) does not display symptomatic effects in midstage Parkinson disease.
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“A recent study showed that CoQ10 does not exert symptomatic effects163.”
From Mitochondrial Approaches for Neuroprotection (2008) · cites this paper as [163]
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“This line of thinking has led to multiple clinical trials using antioxidants to scavenge ROS, yet these trials have consistently failed, and in some cases, actually increased mortality 84–87.”
From Mitochondrial reactive oxygen species regulate cellular signaling and dictate biological outcomes (2010) · cites this paper as [84]
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Naoi, M., Maruyama, W., & Shamoto‐Nagai, M. (2020) · Journal of Neural Transmission · doi:10.1007/s00702-020-02150-w · Cited by 58
Lipophilic antioxidants in neurodegenerative diseases
Chang, K., Cheng, M., Chiang, M.-C., & Chen, C. (2018) · Clinica Chimica Acta · doi:10.1016/j.cca.2018.06.031 · Cited by 59
Liu, J., & Wang, L. (2013) · CNS Drugs · doi:10.1007/s40263-013-0124-4 · Cited by 53
Karunaratne, T. B., Okereke, C., Seamon, M., Purohit, S. B., Wakade, C. G., & Sharma, A. (2020) · Nutrients · doi:10.3390/nu13010028 · Cited by 55
Targeting Ferroptosis in Parkinson’s Disease: Mechanisms and Emerging Therapeutic Strategies
Zhou, M., Xu, K., Ge, J., Luo, X., Wu, M., Wang, N., & Zeng, J. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms252313042 · Cited by 58
Swerdlow, R. H. (2013) · British Journal of Pharmacology · doi:10.1111/bph.12394 · Cited by 51
“A phase II placebo-controlled trial of CoQ in PD patients initially suggested those receiving it declined less over time than those receiving placebo (Shults et al., 2002), but this finding remains to be confirmed in a definitive trial (Storch et al., 2007).”
BackgroundYoung, J. M., Florkowski, C. M., Molyneux, S. L., McEwan, R. G., Frampton, C. M., Nicholls, M. G., Scott, R. S., & George, P. M. (2012) · American Journal of Hypertension · doi:10.1038/ajh.2011.209 · Cited by 59
Gorgone, G., Currò, M., Ferlazzo, N., Parisi, G., Parnetti, L., Belcastro, V., Tambasco, N., Rossi, A., Pisani, F., Calabresi, P., et al. (2012) · NeuroMolecular Medicine · doi:10.1007/s12017-012-8174-1 · Cited by 48
“observations deriving from two investigations (Shults et al. 2002; Storch et al. 2007).”
Targeting Mitochondria for Neuroprotection in Parkinson's Disease
Schapira, A. H. V. (2012) · Antioxidants and Redox Signaling · doi:10.1089/ars.2011.4419 · Cited by 46
Coenzyme Q10 and Neurological Diseases
Mancuso, M., Orsucci, D., Calsolaro, V., Choub, A., & Siciliano, G. (2009) · Pharmaceuticals · doi:10.3390/ph203134 · Cited by 46
Attia, H. N., & Maklad, Y. A. (2017) · Behavioural Pharmacology · doi:10.1097/fbp.0000000000000342 · Cited by 46
Neuroprotection in Parkinson's disease
Schapira, A. H. V. (2009) · Parkinsonism & Related Disorders · doi:10.1016/s1353-8020(09)70834-x · Cited by 46
Liu, C.-Y., Lee, C.-F., & Wei, Y.-H. (2009) · Journal of the Formosan Medical Association · doi:10.1016/s0929-6646(09)60380-6 · Cited by 52
Dean, O. M., Turner, A., Malhi, G. S., Ng, C. H., Cotton, S., Dodd, S., Sarris, J. J., Samuni, Y., Tanious, M., Dowling, N. L., et al. (2014) · Brazilian Journal of Psychiatry · doi:10.1590/1516-4446-2013-1341 · Cited by 43
Does High-Dose Coenzyme Q 10 Improve Oxidative Damage and Clinical Outcomes in Parkinson's Disease?
Seet, R. C. S., Lim, E. C. H., Tan, J. J. H., Quek, A. M. L., Chow, A. W. L., Chong, W.-L., Ng, M. P.-E., Ong, C. N., & Halliwell, B. B. (2014) · Antioxidants and Redox Signaling · doi:10.1089/ars.2013.5801 · Cited by 39
“(using nanoparticular CoQ10 at a dose equivalent to 1200 mg/day of standard formulations) did not demonstrate symptomatic benefits in mid-stage PD subjects treated with CoQ10 for 3 months (9).”
MethodTreatment of Mitochondrial Disorders
Enns, G. M. (2014) · Journal of Child Neurology · doi:10.1177/0883073814538509 · Cited by 39
“Coenzyme Q10 has also been evaluated in randomized, controlled trials involving disorders associated with secondary mitochondrial dysfunction, such as Parkinson disease; treatment is well tolerated and safe, but no clear clinical benefit has been demonstrated.(24,25) A phase 3, placebo-controlled, double-blind, random…”
BackgroundMüller, T. H. (2013) · Expert Review of Neurotherapeutics · doi:10.1586/ern.13.50 · Cited by 40
Macronutrients intake and risk of P arkinson's disease: A meta‐analysis
Wang, A., Lin, Y., Wu, Y., & Zhang, D. (2014) · Geriatrics and gerontology international/Geriatrics & gerontology international · doi:10.1111/ggi.12321 · Cited by 38
Metadata
- Authors
- Storch, A.
- Affiliations
- Technische Universität Dresden (DE)
- Corresponding author
- Storch, Alexander
- ORCID
- Storch, Alexander
- Venue
- Archives of Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 2007-07-01
- Volume
- 64
- Issue
- 7
- Pages
- 938
- ISSN
- 0003-9942 (ISSN-L)
- OpenAlex
- W2144592798
- Cited by
- 205
- References
- 29
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 8 · 2023: 5 · 2022: 7 · 2021: 5 · 2020: 8 · 2019: 5 · 2018: 7 · 2017: 9 · 2016: 7 · 2015: 8 · 2014: 14 · 2013: 16 · 2012: 21
- FWCI
- 8.30
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Coenzyme Q10 studies and effects
- Health Sciences › Medicine › Clinical Neurology › Parkinson's Disease Mechanisms and Treatments
- Life Sciences › Neuroscience › Neurology › Neurological diseases and metabolism
- Keywords
- coenzyme Q10, Parkinson's disease, levodopa, dopaminergic neurons, oxidative stress, mitochondrial bioenergetics, antioxidants, adjunctive therapy, drug safety and tolerability, Unified Parkinson's Disease Rating Scale
- MeSH terms
- Adult, Aged, Antioxidants, Coenzymes, Dopamine, Dose-Response Relationship, Drug, Double-Blind Method, Drug Administration Schedule, Energy Metabolism, Female, Humans, Levodopa, Male, Middle Aged, Neurons, Parkinson Disease, Placebos, Substantia Nigra, Ubiquinone, Vitamins, Treatment Outcome, Oxidative Stress, Cell Respiration
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