The objective of this meta-analysis was to evaluate the effects of coenzyme Q10 (CoQ10) for the treatment of Parkinson’s disease (PD) patients in order to arrive at qualitative and quantitative conclusions about the efficacy of CoQ10. Databases searched included PubMed, Google scholar, CNKI, Wan-Fang, and the Cochrane Library from inception to March 2016. We only included sham-controlled, randomized clinical trials of CoQ10 intervention for motor dysfunction in patients with PD. Relevant measures were extracted independently by two investigators. Weighted mean differences (WMD) were calculated with random-effects models. Eight studies with a total of 899 patients were included. Random-effects analysis revealed a pooled WMD of 1.02, indicating no significant difference when CoQ10 treatment compared with placebo in terms of UPDRS part 3 (p = 0.54). Meanwhile, the effect size of UPDRS part 1, UPDRS part 2, and total UPDRS scores were similar in CoQ10 group with in placebo group (p > 0.05). Moreover, we found CoQ10 was well tolerated compared with placebo group. Subgroup analysis showed that the effect size of CoQ10 in monocentric studies was larger than in multicenter studies. Using the GRADE criteria, we characterized the quality of evidence presented in this meta-analysis as moderate to high level. The current meta-analysis provided evidence that CoQ10 was safe and well tolerated in participants with PD and no superior to placebo in terms of motor symptoms. According to these results, we cannot recommend CoQ10 for the routine treatment of PD right now.
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Klingelhoefer L, Reichmann H (2015) Pathogenesis of Parkinson disease-the gut-brain axis and environmental factors. Nat Rev Neurol 11(11):625–636
Dorsey ER, Constantinescu R, Thompson JP et al (2007) Projected number of people with Parkinson disease in the most populous nations, 2005 through 2030. Neurology 68(5):384–386
Przedborski S, Tieu K, Perier C et al (2004) MPTP as a mitochondrial neurotoxic model of Parkinson’s disease. J Bioenerg Biomembr 36(4):375–379
Schapira AH, Mann VM, Cooper JM et al (1990) Anatomic and disease specificity of NADH CoQ1 reductase (complex I) deficiency in Parkinson’s disease. J Neurochem 55(6):2142–2145
Burchell VS, Gandhi S, Deas E et al (2010) Targeting mitochondrial dysfunction in neurodegenerative disease: part I. Expert Opin Ther Targets 14(4):369–385
Shults CW (2005) Therapeutic role of coenzyme Q(10) in Parkinson’s disease. Pharmacol Ther 107(1):120–130
Spindler M, Beal MF, Henchcliffe C (2009) Coenzyme Q10 effects in neurodegenerative disease. Neuropsychiatric Dis Treat 5:597–610
Horvath TL, Diano S, Leranth C et al (2003) Coenzyme Q induces nigral mitochondrial uncoupling and prevents dopamine cell loss in a primate model of Parkinson’s disease. Endocrinology 144(7):2757–2760
Yoritaka A, Kawajiri S, Yamamoto Y et al (2015) Randomized, double-blind, placebo-controlled pilot trial of reduced coenzyme Q10 for Parkinson’s disease. Parkinsonism Relat Disord 21(8):911–916
Beal MF, Oakes D, Shoulson I et al (2003) A randomized clinical trial of high-dosage coenzyme Q10 in early Parkinson disease: no evidence of benefit. JAMA Neurol 71(5):543–552
Liu J, Wang L, Zhan SY et al (2011) Coenzyme Q10 for Parkinson’s disease. Cochrane Database Syst Rev (12):Cd008150. doi:10.1002/14651858
Negida A, Menshawy A, El Ashal G et al (2016) Coenzyme Q10 for patients with Parkinson’s disease: a systematic review and meta-analysis. CNS Neurol Disord: Drug Targets 15(1):45–53
Higgins JP, Altman DG, Gotzsche PC et al (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ (Clinical research ed) 343:d5928
Atkins D, Best D, Briss PA et al (2004) Grading quality of evidence and strength of recommendations. BMJ (Clinical research ed) 328(7454):1490
Guyatt GH, Oxman AD, Vist GE et al (2008) GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 336:924–926
Jie Z (2014) Clinical effects and safety of coenzyme Q10 in Parkinson disease. China Foreign Med Treat 23:79–80
Wang XY, Yang ZM, Zhang XJ, et al. (2014) Clinical observation of coenzyme Q10 in Parkinson disease. HeBei J TCM 36:151–153
Storch A, Jost WH, Vieregge P et al (2007) Randomized, double-blind, placebo-controlled trial on symptomatic effects of coenzyme Q(10) in Parkinson disease. Arch Neurol 64(7):938–944
NINDS NET-PD Investigators (2007) A randomized clinical trial of coenzyme Q10 and GPI-1485 in early Parkinson disease. Neurology 68(1):20–28
Muller T, Buttner T, Gholipour AF et al (2003) Coenzyme Q10 supplementation provides mild symptomatic benefit in patients with Parkinson’s disease. Neurosci Lett 341(3):201–204
Shults CW, Oakes D, Kieburtz K et al (2002) Effects of coenzyme Q10 in early Parkinson disease: evidence of slowing of the functional decline. Arch Neurol 59(10):1541–1550
Akushevich I, Kravchenko J, Ukraintseva S et al (2012) Age patterns of incidence of geriatric disease in the U.S. elderly population: medicare-based analysis. J Am Geriatr Soc 60(2):323–327
Choi H, Park HH, Koh SH et al (2012) Coenzyme Q10 protects against amyloid beta-induced neuronal cell death by inhibiting oxidative stress and activating the P13 K pathway. Neurotoxicology 33(1):85–90
Sikorska M, Lanthier P, Miller H et al (2012) Nanomicellar formulation of coenzyme Q10 (Ubisol-Q10) effectively blocks ongoing neurodegeneration in the mouse 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine model: potential use as an adjuvant treatment in Parkinson’s disease. Neurobiol Aging 35(10):2329–2346
Seet RC, Lim EC, Tan JJ et al (2014) Does high-dose coenzyme Q10 improve oxidative damage and clinical outcomes in Parkinson’s disease? Antioxid Redox Signal 21(2):211–217
Dias V, Junn E, Mouradian MM (2013) The role of oxidative stress in Parkinson’s disease. J Parkinson’s Dis 3(4):461–491
Thorlund K, Imberger G, Walsh M et al (2011) The number of patients and events required to limit the risk of overestimation of intervention effects in meta-analysis–a simulation study. PLoS One 6(10):e25491
Dias S, Sutton AJ, Welton NJ et al (2013) Evidence synthesis for decision making 3: heterogeneity–subgroups, meta-regression, bias, and bias-adjustment. Med Decis Mak 33(5):618–640
Guyatt GH, Oxman AD, Montori V et al (2011) GRADE guidelines: 5. Rating the quality of evidence–publication bias. J Clin Epidemiol 64(12):1277–1282
We gratefully acknowledge Prof Jie Chen from Wenzhou Medical University for his help in guiding and revising the manuscript.
The study was supported by the Projects of National Science Foundation of China (No. 81600977).
Conflict of interest
The authors declare that they have no conflict of interest.
Zhen-Guo Zhu and Miao-Xuan Sun have contributed equally to this work.
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Zhu, ZG., Sun, MX., Zhang, WL. et al. The efficacy and safety of coenzyme Q10 in Parkinson’s disease: a meta-analysis of randomized controlled trials. Neurol Sci 38, 215–224 (2017). https://doi.org/10.1007/s10072-016-2757-9
- Parkinson’s disease
- Coenzyme Q10