The Effect of Creatine and Coenzyme Q10 Combination Therapy on Mild Cognitive Impairment in Parkinson's Disease

Abstract

Background: To investigate the effect of creatine and coenzyme Q10 (CoQ10) combination therapy on mild cognitive impairment (MCI) in Parkinson's disease (PD; PD-MCI) and its influences on plasma phospholipid (PL) levels in PD-MCI. Methods: The demographic data of 75 PD-MCI patients who enrolled in this collaborative PD study were collected. These patients were evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) III and the Montreal Cognitive Assessment (MoCA). These 75 PD-MCI patients were randomly treated with creatine monohydrate 5 g b.i.d. and CoQ10 100 mg t.i.d. orally or placebo. MoCA evaluation and PL level measurements were performed after 12 and 18 months of treatment. Results: After 12 and 18 months of treatment, the differences in the MoCA scores of the combination therapy and control groups were statistically significant (p < 0.05 at 12 months and p < 0.01 at 18 months), and the plasma PL levels of the combination therapy group were significantly lower than those of the control group (p < 0.01 at 12 months and p < 0.001 at 18 months). Conclusions: Combination therapy with creatine and CoQ10 could delay the decline of cognitive function in PD-MCI patients and could lower their plasma PL levels; therefore, this combination therapy may have a neuroprotective function.

Astragalus Polysaccharide Suppresses 6‐Hydroxydopamine‐Induced Neurotoxicity in Caenorhabditis elegans

“…Since PD is closely associated with oxidative stress, our results suggest an involvement of antioxidant activity in the neuroprotective effect of astragalan. This is supported by previous studies; for instance, a combination of antioxidant creatine and coenzyme Q10 can delay cognitive function decline and reduce plasma phospholipid level in PD patients [31]. …”

The effectiveness of creatine treatment for Parkinson’s disease: an updated meta-analysis of randomized controlled trials

“…Twenty-three of these articles were selected, and the full papers were analyzed to assess the efficacy and safety of creatine treatment in PD patients. Of these 23 papers, 17 were excluded and 1 was incomplete, although it may have satisfied the inclusion criteria [27], leaving 5 studies available for the final analysis [[18–22]; Fig. 1].…”

“…In one study, creatine was administered at a loading dose of 20 g/d for 6 days, followed by 2 g/d for 6 months and finally 4 g/d for 2 years [21]. Another study combined creatine (10 g/d) with coenzyme Q10 (300 mg/d) [18]. Patients in the other 3 studies all received 10 g/d of creatine [19, 20, 22].…”

“…Three of the five studies assessed disease progression using the Total, Mental, ADL, and Motor UPDRS scores. One study used the Total UPDRS scores only [20], and one study used the UPDRS Motor scores only [18]. Two studies provided data based on the Schwab & England scale [19, 22].…”

“…Previous studies have reported conflicting results regarding the effect of creatine as a treatment for PD, and it remains unclear whether creatine treatment can improve clinical outcomes when compared with a placebo [18–22]. Therefore, this meta-analysis was conducted to investigate the symptomatic efficacy of creatine versus placebo, analyzing outcomes assessed by the Unified Parkinson’s Disease Rating Scale (UPDRS) and the Schwab & England Activities of Daily Living Scale.…”