Parkinson's disease is a progressive condition that harms nerve cells of the brain (neurodegeneration). Current treatments for Parkinson's disease (including levodopa and deep brain stimulation) improve certain symptoms but are not thought to improve the underlying neurodegenerative disease process (they are not a "cure"). The cause of Parkinson's disease is unknown. However, some evidence suggests that tiny structures in the investigators cells called "mitochondria" might be involved. Mitochondria are the powerhouses that produce fuel for the investigators cells. Failure of these 'powerhouses' to supply the energy needs of certain nerve cells might lead to Parkinson's disease. Preliminary evidence suggests that a food called 'ketones' might be able to enhance the function of mitochondria and improve Parkinson's disease symptoms and possibly even the neurodegenerative process. In this study, the investigators would like to investigate this possibility by giving patients with Parkinson's disease dietary supplements of 'ketone esters' in a drink. The investigators will then assess if this improves symptoms of Parkinson's disease. The study design is a prospective, double blinded, randomised, controlled trial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
20
Ketone drink - milligram per kilogram dose, consumed three times daily (at meal times)
Placebo drink - containing carbohydrates, matched in calories to ketone, consumed three times daily
John Radcliffe Hospital
Oxford, Oxfordshire, United Kingdom
RECRUITINGUnified Parkinson's Disease rating Scale, part III (motor)
Difference between ketone versus placebo scores
Time frame: 5 days
Timed motor tasks as per CAPSIT
Hand/Arm movements, 7m walk, 9 hole peg test
Time frame: 5 days
Computerised reaction time and cogntive tests
CANTAB * SRT and CRT (Task: MOT "Motor screening" practice then RTI "Reaction time") * Spatial working memory (Task: SSP "spatial span") * Set shifting and visual discrimination (Task: BLC "big circle little circle" practice then IED "intra-extra dimensional shift) * Continuous performance task (alertness) (Task: RVP - "Rapid visual processing")
Time frame: 5 days
Unified Parkinson's disease rating scale, parts I, II, IV
Difference between ketone versus placebo scores
Time frame: 5 days
Dopaminergic medication requirements (expressed as levodopa dose equivalent, mg/day)
Difference between ketone versus placebo doses
Time frame: 5 days
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