Effect of 12-Week BMI-Based Vitamin D3 Supplementation in Parkinson’s Disease with Deep Brain Stimulation on Physical Performance, Inflammation, and Vitamin D Metabolites

Abstract

Parkinson’s disease (PD) is the second most common neurodegenerative disease. To manage motor symptoms not controlled adequately with medication, deep brain stimulation (DBS) is used. PD patients often manifest vitamin D deficiency, which may be connected with a higher risk of falls. We administered a 12-week vitamin D3 supplementation based on BMI (with higher doses given to patients with higher BMI) to investigate its effects on physical performance and inflammation status in PD patients with DBS. Patients were randomly divided into two groups: treated with vitamin D3 (VitD, n = 13), and supplemented with vegetable oil as the placebo group (PL, n = 16). Patients underwent functional tests to assess their physical performance three times during this study. The serum 25(OH)D3 concentration increased to the recommended level of 30 ng/mL in the VitD group, and a significant elevation in vitamin D metabolites in this group was found. We observed significant improvement in the Up and Go and the 6 MWT in the VitD group. In inflammation status, we noticed a trend toward a decrease in the VitD group. To conclude, achieving the optimal serum 25(OH)D3 concentration is associated with better functional test performance and consequently may have a positive impact on reducing falling risk in PD.

Vitamin D supplementation in later life: a systematic review of efficacy and safety in movement disorders

“…The analysis incorporated five studies, which entailed a total of 369 participants, yielding mixed results. Some studies showed symptom improvement for PD by enhancing physical performance (Bytowska et al, 2023) or alleviating levodopa-induced dyskinesia (Suzuki et al, 2013), while others did not (Hiller et al, 2018) or only partially (Habibi et al, 2018). In the same way, vitamin D had no impact on relieving RLS symptoms (Wali et al, 2019).…”

“…Serum safety monitoring meticulously carried out in this trial did not reveal any obvious adverse signs associated with hypercalcemia. Bytowska et al (2023) did not disclose specific adverse event counts in their 12-week middle-range intervention study, which included 21 individuals in the treatment arm and 21 in the placebo arm, but did explain dropout causes. Six occurrences were linked to unexplained personal reasons relating to the continuing COVID scenario, and two to organizational issues such as transportation.…”

“…Variations in patient populations, including those recruited from the general public, specialized MD clinics, or specialized DBS clinics, as well as differences in primary outcomes such as dyskinesias, balance and falls, and disease severity, may impact the detection of potential effects of Vitamin D on different subtypes of MDs. Additionally, the relatively short duration of therapy (except for one study, they did not exceed 4 months) and the lack of more severe cases in the studies were cited as potential reasons for these varying results (Suzuki et al, 2013;Wali et al, 2019;Bytowska et al, 2023).…”

“…In a 2023 research byBytowska et al (2023) 29 PD patients receiving Deep Brain Stimulation (DBS) treatment at a neurosurgical university clinic were subjected to a 12-week Body Mass Index (BMI)based Vitamin D3 supplementation. The results indicated a remarkable increase in serum 25(OH)D3 concentration (p < 0.0006) within the Vitamin D group, along with notable improvements in physical performance, particularly in the Time Up and Go (TUG) (p < 0.005) and the six-minute walking (6 MWT) (p < 0.05) tests.…”

Targeting neuroendocrine abnormalities in Parkinson’s disease with exercise

“…Interestingly, the Fok/CC vitamin D receptor genotype has also previously been shown to be associated with less advanced cases of PD (Suzuki et al, 2012) and to have greater effects of vitamin D-dependent transcriptional activation as compared to the Fok/TT genotype. In another recent randomized placebocontrolled trial, Bytowoska et al investigated the effects of vitamin D ranging in dose from 2,500 to 4,800 international units per day (based on body mass index) in patients with PD who had previously undergone deep brain stimulation surgery (Bytowska et al, 2023). They reported significant improvements in tests of ambulatory function and a downward trend, though not significant, in inflammatory marker C-reactive protein, in the group that received vitamin D supplementation for 12 weeks.…”