Simvastatin as a Neuroprotective Treatment for Moderate Parkinson's Disease

Inclusion criteria

• Diagnosis of idiopathic PD
• Modified Hoehn and Yahr stage ≤ 3.0 in the ON medication state
• Age 40-90 years
• On dopaminergic treatment with wearing-off phenomenon
• Able to comply with study protocol and willing to attend necessary study visits

Exclusion criteria

• Diagnosis or suspicion of other cause for parkinsonism
• Known abnormality on CT or MRI brain imaging considered to be causing symptoms or signs of neurological dysfunction, or considered likely to compromise compliance with study protocol
• Concurrent dementia defined by MoCA score <21
• Concurrent severe depression defined by MADRS score >31
• Prior intracerebral surgical intervention for PD including deep brain stimulation, lesional surgery, growth factor administration, gene therapy or cell transplantation
• Already actively participating in a research study that might conflict with this trial
• Prior or current use of statins as a lipid lowering therapy
• Intolerance to statins
• Untreated hypothyroidism
• End stage renal disease (creatinine clearance <30 mL/min) or history of severe cardiac disease (angina, myocardial infarction or cardiac surgery in preceding two years)
• eGFR <30 mL/min
• History of alcoholism or liver impairment
• Creatine kinase (CK) >1.1 x upper limit of normal (ULN)
• Aspartate transaminase (AST) or alanine transaminase (ALT) >1.1 x ULN
• Females who are pregnant or breast feeding or of child-bearing potential and unwilling to use appropriate contraception methods whilst on trial treatment
• Currently taking any medication contraindicated with simvastatin use (Appendix 2)
• Any requirement for statin use
• Regular participation in endurance or high-impact sports
• Unable to abstain from consumption of grapefruit-based products