The Effects of Vitamin D and Bone Loss in Parkinson's Disease

Parkinson's disease is the second most common neurodegenerative disorder after Alzheimer's disease affecting approximately 1% of the population older than 50 years. There is a worldwide increase in disease prevalence due to the increasing age of human populations. The disease is characterized by tremor, stiffness of the limbs and trunk, impaired balance and coordination, and slowing of movements, leading to immobility and frequent falls. Patients also sometimes develop other symptoms, including difficulty swallowing, disturbed sleep, and emotional problems. Parkinson's disease results from the loss of dopaminergic neurons in the substantia nigra region of the brain. The cause and mechanism of continued neuron cell death in the substantia nigra is currently unknown.

Epidemiological studies suggest an association between Parkinson's disease and osteoporosis, vitamin D inadequacy and altered bone and mineral metabolism. Accumulating evidence indicates that patients with Parkinson's disease are at a higher risk for fractures compared to healthy subjects. This could be attributed to several contributing factors including increased rate of falls, vitamin D deficiency, reduced body mass index and reduced bone mineral density.

Inclusion criteria

• Subject must be >18 yrs of age
• Subject must have a diagnosis of Parkinson's disease (Hoehn and Yahr stages I-III), confirmed by the study physician designated to complete patient staging
• Subject must sign the informed consent documentation according to MMC's IRB guidelines
• Subject must be willing and able to complete all study requirements at the designated time intervals
• Subject must agree to be randomized
• If subject has been taking a separate Vitamin D supplement other than a multivitamin within the last 6 months, the subject must be willing to discontinue Vitamin D supplement for 3 months before entering the study
• Subject must have a vitamin D level greater than 10 ng/mL
• Subjects must have a serum calcium level within the range of 8.4-10 mg/dl.
• Females subjects of child bearing potential must have a negative urine pregnancy test or have undergone a sterilization procedure

Exclusion criteria

• Subjects < 18 years old
• Parkinson's disease patients with Hoehn and Yahr stages IV-V.
• Subjects not willing and able to complete all study requirements at the designated time intervals
• Subjects who do not agree to be randomized
• Subjects receiving treatment with bisphosphonates (more that 3 months), parathyroid hormones (PTH) or PTH derivatives, e.g. Teriparatide or Fluoride, in the last 6 months.
• Subjects with an allergy to the investigational product.
• Subjects who have a vitamin D level less than 10 ng/mL
• Subjects who do not have a serum calcium level within the range of 8.4-10 mg/dl.
• Subjects who are pregnant, verified by a urine pregnancy test*