---
title: Recent Phase 1 Trial Explores Role of NR to Support Neuronal Health During Aging
description: Nicotinamide riboside raised cerebral NAD+ levels and lowered inflammatory markers in a phase 1 trial of 30 people with Parkinson's disease.
image: https://www.casi.org/hubfs/casi/archive/friblog_4.jpg
---

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Science Update

# Recent Phase 1 Trial Explores Role of NR to Support Neuronal Health During Aging

CA Cory Ambrose, ND, MAT Aug 18, 2022

![Recent Phase 1 Trial Explores Role of NR to Support Neuronal Health During Aging](https://www.casi.org/hs-fs/hubfs/casi/archive/friblog_4.jpg?width=960)

Parkinson’s Disease (PD) is a [progressive neurodegenerative disorder](https://www.dynamed.com/condition/parkinson-disease) associated with brain changes, deficits in motor function, nonmotor symptoms, and cognitive decline. [Age](https://www.dynamed.com/condition/parkinson-disease), family history, and environmental factors are major risk factors for PD. Inflammation, [mitochondrial dysfunction](https://pubmed.ncbi.nlm.nih.gov/35235774/), and oxidative damage have been linked to PD. In recent research, the molecule nicotinamide adenine dinucleotide (NAD+) has been shown to exhibit potential [neuroprotective effects](https://pubmed.ncbi.nlm.nih.gov/35235774/) and support healthy aging.  

NAD+ is found in every living cell and plays a role in more than 500 reactions in the body, including gene expression, stress response, and [DNA repair](https://pubmed.ncbi.nlm.nih.gov/32486488/). Deficiencies of NAD+ have been linked to certain [age-related diseases](https://pubmed.ncbi.nlm.nih.gov/32486488/). [Nicotinamide riboside](https://pubmed.ncbi.nlm.nih.gov/29211728/) (NR) is a variation of vitamin B3 (niacin) that functions as a building block for NAD+. 

A recently published [double-blind phase 1 clinical trial](https://pubmed.ncbi.nlm.nih.gov/35235774/) by Brakedal and colleagues explored the efficacy of supplementation with NR on parameters related to PD. The study involved 30 participants who were recently diagnosed with PD and were treatment-naive. Participants received either 1,000 mg of NR daily or a placebo for 30 days. NR was shown to increase levels of [cerebral NAD+](https://pubmed.ncbi.nlm.nih.gov/35235774/) through phosphorus magnetic resonance spectroscopy measurements and biomarkers from cerebrospinal fluid. [Cerebral metabolism](https://pubmed.ncbi.nlm.nih.gov/35235774/) was also shown to be influenced by NR and was reported to be related to increases in brain NAD+ levels.  

In the central nervous system, decreased levels of certain [pro-inflammatory cytokines](https://pubmed.ncbi.nlm.nih.gov/35235774/), including interleukin (IL)-1β and IL-12 were observed in the NR group. NR was also reported to help support [biochemical processes](https://pubmed.ncbi.nlm.nih.gov/35235774/) relating to the function of mitochondria, lysosomes, and proteasomes. The authors report that NR may also attenuate epigenomic dysregulation associated with PD through the regulation of [histone acetylation](https://pubmed.ncbi.nlm.nih.gov/35235774/).  

In the study by [Brakedal and colleagues](https://pubmed.ncbi.nlm.nih.gov/35235774/), NR was also shown to significantly influence the expression of over 50 genes, including KLF2 in muscle tissue. KLF2 is linked to the induction of nuclear factor erythroid 2-related factor 2 (Nrf2). Nrf2 is associated with supporting [antioxidative status](https://pubmed.ncbi.nlm.nih.gov/35235774/). NR was also associated with the upregulation of genes associated with a cellular response to oxidative stress, [mitochondrial respiration](https://pubmed.ncbi.nlm.nih.gov/35235774/), and protein degradation. 

[Study strengths](https://pubmed.ncbi.nlm.nih.gov/35235774/) include patient retention, treatment adherence, and all adverse events, which were reported to be unrelated to NR. Study limitations include a relatively small sample size and short time of observation. Further studies need to be conducted before clinical conclusions can be determined.  

NR has been shown to support healthy NAD+ levels, mitochondrial function, and healthy aging. It may also support a healthy response to neuroinflammation and [neuronal DNA damage](https://pubmed.ncbi.nlm.nih.gov/35235774/) and may help support healthy aging. 

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### Cory Ambrose, ND, MAT

Clinical Application

## Clinical Considerations in Practice

 In clinical practice, practitioners considering the topics discussed above may also weigh nutrient form, delivery and formulation, alongside individual patient variability.

### Practitioner Formulation Example

![CellGuard-NR™](https://cdn.sanity.io/images/lemtscrs/production-www/4d6912c04b3ecf34c5db4dacf07a8c0b9f518024-2000x2000.png?w=128&h=128&fit=max&auto=format)

CellGuard-NR™

Nicotinamide riboside, resveratrol and pterostilbene · Capsules

[Explore Formulations →](https://www.designsforhealth.com/products/cellguard-nr)

## Continue your research

#### [Research & Education Beyond Standard Labs: How Functional Testing Enhances Clinical Insight Apr 29, 2026](https://www.casi.org/articles/functional-testing-clinical-insight)

#### [Research & Education Ubiquinone vs. Ubiquinol: Does the Form of CoQ10 Matter – Or Is Delivery the Real Key? Mar 17, 2026](https://www.casi.org/articles/ubiquinone-ubiquinol-coq10-delivery)

#### [Research & Education Your CoQ10 Supplements May be Missing a Key Ingredient: Geranylgeraniol (GG) Feb 10, 2026](https://www.casi.org/articles/coq10-supplements-key-ingredient-geranylgeraniol)

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