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Long-Term Treatment with High-Dose Thiamine in Parkinson Disease: An Open-Label Pilot Study.
J Altern Complement Med. 2015 Dec; 21(12):740-7.JA

Abstract

OBJECTIVES

To investigate the potential clinical, restorative, and neuroprotective effects of long-term treatment with thiamine in Parkinson disease (PD).

DESIGN

Observational open-label pilot study.

SETTING

Outpatient neurologic rehabilitation clinic.

PATIENTS AND METHODS

Starting in June 2012, we have recruited 50 patients with PD (33 men and 17 women; mean age, 70.4 ± 12.9 years; mean disease duration, 7.3 ± 6.7 years). All the patients were assessed at baseline with the Unified Parkinson's Disease Rating Scale (UPDRS) and the Fatigue Severity Scale (FSS) and began treatment with 100 mg of thiamine administered intramuscularly twice a week, without any change to personal therapy. All the patients were re-evaluated after 1 month and then every 3 months during treatment.

RESULTS

Thiamine treatment led to significant improvement of motor and nonmotor symptoms: mean UPDRS scores (parts I-IV) improved from 38.55 ± 15.24 to 18.16 ± 15.08 (p = 2.4 × 10(-14), t test for paired data) within 3 months and remained stable over time; motor UPDRS part III score improved from 22.01 ± 8.57 to 9.92 ± 8.66 (p = 3.1 × 10(-22)). Some patients with a milder phenotype had complete clinical recovery. FSS scores, in six patients who had fatigue, improved from 53.00 ± 8.17 to 23.60 ± 7.77 (p < 0.0001, t test for paired data). Follow-up duration ranged from 95 to 831 days (mean, 291.6 ± 207.2 days).

CONCLUSIONS

Administration of parenteral high-dose thiamine was effective in reversing PD motor and nonmotor symptoms. The clinical improvement was stable over time in all the patients. From our clinical evidence, we hypothesize that a dysfunction of thiamine-dependent metabolic processes could cause selective neural damage in the centers typically affected by this disease and might be a fundamental molecular event provoking neurodegeneration. Thiamine could have both restorative and neuroprotective action in PD.

Authors+Show Affiliations

1 Department of Neurological Rehabilitation, Villa Immacolata Clinic , Viterbo, Italy .1 Department of Neurological Rehabilitation, Villa Immacolata Clinic , Viterbo, Italy .2 Bracco Foundation , Milan, Italy .3 Centro Diagnostico Italiano , Milan, Italy .4 Lab Analysis, Villa Immacolata Clinic , Viterbo, Italy .1 Department of Neurological Rehabilitation, Villa Immacolata Clinic , Viterbo, Italy .1 Department of Neurological Rehabilitation, Villa Immacolata Clinic , Viterbo, Italy .5 University Studies Abroad Consortium , Viterbo, Italy .6 Unit of Neurology, IRCCS San Martino University Hospital IST , Genoa, Italy .

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26505466

Citation

Costantini, Antonio, et al. "Long-Term Treatment With High-Dose Thiamine in Parkinson Disease: an Open-Label Pilot Study." Journal of Alternative and Complementary Medicine (New York, N.Y.), vol. 21, no. 12, 2015, pp. 740-7.
Costantini A, Pala MI, Grossi E, et al. Long-Term Treatment with High-Dose Thiamine in Parkinson Disease: An Open-Label Pilot Study. J Altern Complement Med. 2015;21(12):740-7.
Costantini, A., Pala, M. I., Grossi, E., Mondonico, S., Cardelli, L. E., Jenner, C., Proietti, S., Colangeli, M., & Fancellu, R. (2015). Long-Term Treatment with High-Dose Thiamine in Parkinson Disease: An Open-Label Pilot Study. Journal of Alternative and Complementary Medicine (New York, N.Y.), 21(12), 740-7. https://doi.org/10.1089/acm.2014.0353
Costantini A, et al. Long-Term Treatment With High-Dose Thiamine in Parkinson Disease: an Open-Label Pilot Study. J Altern Complement Med. 2015;21(12):740-7. PubMed PMID: 26505466.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-Term Treatment with High-Dose Thiamine in Parkinson Disease: An Open-Label Pilot Study. AU - Costantini,Antonio, AU - Pala,Maria Immacolata, AU - Grossi,Enzo, AU - Mondonico,Stella, AU - Cardelli,Luisa Ercoli, AU - Jenner,Carina, AU - Proietti,Sabrina, AU - Colangeli,Marco, AU - Fancellu,Roberto, Y1 - 2015/10/27/ PY - 2015/10/28/entrez PY - 2015/10/28/pubmed PY - 2016/9/24/medline SP - 740 EP - 7 JF - Journal of alternative and complementary medicine (New York, N.Y.) JO - J Altern Complement Med VL - 21 IS - 12 N2 - OBJECTIVES: To investigate the potential clinical, restorative, and neuroprotective effects of long-term treatment with thiamine in Parkinson disease (PD). DESIGN: Observational open-label pilot study. SETTING: Outpatient neurologic rehabilitation clinic. PATIENTS AND METHODS: Starting in June 2012, we have recruited 50 patients with PD (33 men and 17 women; mean age, 70.4 ± 12.9 years; mean disease duration, 7.3 ± 6.7 years). All the patients were assessed at baseline with the Unified Parkinson's Disease Rating Scale (UPDRS) and the Fatigue Severity Scale (FSS) and began treatment with 100 mg of thiamine administered intramuscularly twice a week, without any change to personal therapy. All the patients were re-evaluated after 1 month and then every 3 months during treatment. RESULTS: Thiamine treatment led to significant improvement of motor and nonmotor symptoms: mean UPDRS scores (parts I-IV) improved from 38.55 ± 15.24 to 18.16 ± 15.08 (p = 2.4 × 10(-14), t test for paired data) within 3 months and remained stable over time; motor UPDRS part III score improved from 22.01 ± 8.57 to 9.92 ± 8.66 (p = 3.1 × 10(-22)). Some patients with a milder phenotype had complete clinical recovery. FSS scores, in six patients who had fatigue, improved from 53.00 ± 8.17 to 23.60 ± 7.77 (p < 0.0001, t test for paired data). Follow-up duration ranged from 95 to 831 days (mean, 291.6 ± 207.2 days). CONCLUSIONS: Administration of parenteral high-dose thiamine was effective in reversing PD motor and nonmotor symptoms. The clinical improvement was stable over time in all the patients. From our clinical evidence, we hypothesize that a dysfunction of thiamine-dependent metabolic processes could cause selective neural damage in the centers typically affected by this disease and might be a fundamental molecular event provoking neurodegeneration. Thiamine could have both restorative and neuroprotective action in PD. SN - 1557-7708 UR - https://www.unboundmedicine.com/medline/citation/26505466/Long_Term_Treatment_with_High_Dose_Thiamine_in_Parkinson_Disease:_An_Open_Label_Pilot_Study_ L2 - https://www.liebertpub.com/doi/10.1089/acm.2014.0353?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -