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The Effect of NAD Supplementation on Brain Vascular Health in Aging

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ClinicalTrials.gov Identifier: NCT05483465
Recruitment Status : Recruiting
First Posted : August 2, 2022
Last Update Posted : May 13, 2024
Sponsor:
Collaborators:
University of Pennsylvania
Oklahoma Medical Research Foundation
Elysium Health
Information provided by (Responsible Party):
University of Oklahoma

Brief Summary:
Daily consumption of one of the forms of Vitamin B3, the Nicotinamide Riboside (NR), energizes the body and combats cellular aging. This study is designed to test whether NR can also improve brain health and memory.

Condition or disease Intervention/treatment Phase
Aging Drug: Nicotinamide riboside Drug: Placebo Phase 4

Detailed Description:
This study is designed to test the hypothesis that restoration of Nicotinamide Adenine Dinucleotide (NAD) levels with Nicotinamide Riboside (NR) in older adults will improve neurovascular coupling (NVC) responses and micro- and macrovascular endothelial function. This hypothesis will be tested by assessing the effects of treatment with oral NR (1g/day per os for 8 weeks) or placebo (8 weeks) in community dwelling older adults (60-85 years of age).

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 214 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: Randomized, double-blinded, placebo-controlled, parallel study design
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Masking Description: All data will be unmasked upon completion of the trial, or during performance of data review if requested by the data safety and monitoring board.
Primary Purpose: Other
Official Title: Effects of NAD Restoration on Neurovascular Coupling in Community Dwelling Older Adults
Actual Study Start Date : May 3, 2023
Estimated Primary Completion Date : June 2027
Estimated Study Completion Date : December 2027

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: NR
Treatment with oral NR (1g/day per os for 8 weeks)
Drug: Nicotinamide riboside
Oral NR, 1g/day per os for 8 weeks
Other Name: NR

Placebo Comparator: Control
Visually identical placebo (daily, per os, for 8 weeks)
Drug: Placebo
Visually identical pill to NR, daily per os for 8 weeks
Other Name: Sugar pill




Primary Outcome Measures :
  1. Change in neurovascular coupling using functional near infrared spectroscopy (fNIRS) [ Time Frame: 8 weeks ]
    Functional near infrared spectroscopy (fNIRS) will be performed during the cognitive n-back task. fNIRS approach generates data that represent a relative change in oxygenated and deoxygenated hemoglobin measured over the cortical brain tissues. Neurovascular coupling will be evaluated as a change in oxy- and deoxy-hemoglobin between before and after treatment. Units of measure - beta. Reported as a %change from baseline, before and after treatment.

  2. Change in neurovascular coupling using transcranial Doppler [ Time Frame: 8 weeks ]
    Transcranial Doppler sonography will be used to measure the change in the blood flow velocities during the cognitive n-back task between before and after treatment. Units of measure - % change between the n-back tasks. Reported as a %change from baseline, before and after treatment.

  3. Change in neurovascular coupling using the dynamic retinal vessel analysis [ Time Frame: 8 weeks ]
    Flicker light-induced dilation of the retinal vessels (percentage increase over baseline diameter) will be measured in the right or left eye of each study participant using the Dynamic Vessel Analyzer (DVA, IMEDOS Systems, Jena, Germany). Units of measure mm, reported as a %change from baseline, before and after treatment.

  4. Change in neuronal activity [ Time Frame: 8 weeks ]
    EEG signal will be collected to generate spectral data. These data will be used for comparison of EEG activity between before and after treatment. Units of measure - power spectral density. Reported as a %change from baseline, before and after treatment.


Secondary Outcome Measures :
  1. Change in microvascular endothelial function [ Time Frame: 8 weeks ]
    Changes in microvascular endothelial function will be assessed using laser speckle contrast imaging (LSCI) in the hand using the flow mediated dilation approach. The change in skin perfusion is calculated and reported as a %change from baseline, between before and after treatment. Units of measure - perfusion index (arbitrary units). Reported as a %change from baseline, before and after treatment.

  2. Change in macrovascular endothelial function [ Time Frame: 8 weeks ]
    Changes in macrovascular endothelial function will be assessed using sonography during flow mediated dilation approach. The change in brachial artery diameter (mm) is calculated and reported as a %change from baseline, between before and after treatment.

  3. Change in deep tissue oxygen saturation [ Time Frame: 8 weeks ]
    Transcutaneous deep tissue oxygen saturation will be measured using the inSpectra near infrared device. The data are calculated and reported as a %change from baseline, between before and after treatment.

  4. Change in arterial stiffness [ Time Frame: 8 weeks ]
    The arterial stiffness will be measured using the pulse wave analysis approach (SphygmoCor, Atcor medical, Itasca IL, or similar). Analysis generates the augmentation index which will be used for comparison before and after treatment.

  5. Change in ECG [ Time Frame: 8 weeks ]
    ECG will be recorded for heart rate variability analysis. The values of high frequency domain, low frequency domain, their ratio, as well as total power will be calculated and used for comparison before and after treatment.

  6. Change in Glycocalyx - perfused boundary region [ Time Frame: 8 weeks ]
    Video recordings of the sublingual vasculature will be performed using the high definition video camera GlycoCheck (Microvascular health solutions). Data collected will include perfused boundary region (um), and will be used for comparison before and after treatment.

  7. Change in capillary density [ Time Frame: 8 weeks ]
    Video recordings of the sublingual vasculature will be performed using the high definition video camera GlycoCheck (Microvascular health solutions). Data collected will include capillary density (mm/mm^2), and will be used for comparison before and after treatment.

  8. Change in red blood cell velocity [ Time Frame: 8 weeks ]
    Video recordings of the sublingual vasculature will be performed using the high definition video camera GlycoCheck (Microvascular health solutions). Data collected will include red blood cell velocity (um/sec), and will be used for comparison before and after treatment.

  9. Change in Attention [ Time Frame: 8 weeks ]
    The allocation of one's limited capacities to deal with an abundance of environmental stimulation will be measured in a combined "Flanker Inhibitory Control and Attention Test".Units of measure - score (from 0 to 10, bigger number is better). Reported as a %change from baseline, before and after treatment.

  10. Change in Episodic Memory [ Time Frame: 8 weeks ]
    Cognitive processes involved in the acquisition, storage and retrieval of new information, will be measured using the "Picture Sequence Memory Test". Unit of measure - overall score (bigger number is better). Reported as a %change from baseline, before and after treatment.

  11. Change in Working Memory [ Time Frame: 8 weeks ]
    The ability to store information until the amount of information to be stored exceeds one's capacity to hold that information will be measured using the "List Sorting Working Memory Test". Unit of measure - overall score (bigger number is better). Reported as a %change from baseline, before and after treatment.

  12. Change in Language [ Time Frame: 8 weeks ]
    Picture Vocabulary Test measures receptive vocabulary administered in a computer-adaptive test (CAT) format. Respondents select the picture that most closely matches the meaning of the word, before and after treatment. Unit of measure - overall score (bigger number is better). Reported as a %change from baseline, before and after treatment.

  13. Change in Executive Function [ Time Frame: 8 weeks ]
    The capacity to plan, organize and monitor the executive of behaviors that are strategically directed in a goal-oriented manner will be measured using the "Dimensional Change Card Sort Test". Units of measure - score (from 0 to 10, bigger number is better). Reported as a %change from baseline, before and after treatment.

  14. Change in Processing Speed [ Time Frame: 8 weeks ]
    Pattern Comparison Processing Speed Test assesses the amount of information that can be processed within a certain unit of time. Items are simple so as to purely measure processing speed. Units of measure - score (from 0 to 130, bigger number is better). Reported as a %change from baseline, before and after treatment.

  15. Blood collection [ Time Frame: 8 weeks ]
    Blood samples will be collected to measure concentration of NAD metabolites for comparison before and after treatment. Blood samples will also be used in in vitro assays to measure the effect of treatment on endothelial function.



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Ages Eligible for Study:   60 Years to 85 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Age ≥60 and ≤85 years of age
  • Adequate hearing and visual acuity to participate in the examinations
  • Ability to read and write in English
  • Competence to provide informed consent.
  • Mini-Mental State Exam score ≥24

Exclusion Criteria:

  • Vision or hearing impairment that would impair the ability to complete study assessments
  • Active CNS disease including multiple sclerosis, uncontrolled seizures, active brain cancer
  • Cerebrovascular accident other than TIA within 60 days prior to Visit 0
  • Major psychiatric disease, including major depression not currently controlled on medications, alcohol or drug abuse
  • Abnormal kidney function (creatinine >2mg/dL or EGFR <30mL/min) by most recent labs within 6 months prior to Visit 0
  • Elevated liver enzymes (AST and/or ALT above x2 upper limit of normal) by most recent labs within 6 months prior to Visit 0
  • Treatment with other NAD enhancers (Nicotinamide riboside or nicotinamide mononucleotide) within 4 weeks prior to randomization.
  • Any other medical condition which, in the opinion of investigator, would render the patient inappropriate or too unstable to complete the study protocol

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05483465


Contacts
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Contact: Andriy Yabluchanskiy, MD, PhD 405-271-7622 andriy-yabluchanskiy@ouhsc.edu

Locations
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United States, Oklahoma
University of Oklahoma Health Sciences Center Recruiting
Oklahoma City, Oklahoma, United States, 73117
Contact: Andriy Yabluchanskiy, MD, PhD    405-271-8130    andriy-yabluchanskiy@ouhsc.edu   
Contact: Peter Mukli, MD, PhD    405-271-8000 ext 47097    peter-mukli@ouhsc.edu   
Sponsors and Collaborators
University of Oklahoma
University of Pennsylvania
Oklahoma Medical Research Foundation
Elysium Health
Investigators
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Principal Investigator: Andriy Yabluchanskiy, MD, PhD University of Oklahoma
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Responsible Party: University of Oklahoma
ClinicalTrials.gov Identifier: NCT05483465    
Other Study ID Numbers: 14782
First Posted: August 2, 2022    Key Record Dates
Last Update Posted: May 13, 2024
Last Verified: May 2024
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Plan Description: The results may be uploaded to scientific online repositories such as PhysioNet (or other) as requested by the journal when data is submitted for publication. In that case, all data will be de-identified and labeled by group+number (for example Placebo1, Placebo2, NR1, NR2, these IDs will be different from study IDs stored on the servers at the OUHSC) and supported by subjects' age, sex, comorbidities and treatments data.

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: No
Keywords provided by University of Oklahoma:
NAD
NR
nicotinamide riboside
neurovascular coupling
endothelial function
cognitive function
Additional relevant MeSH terms:
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Niacinamide
Niacin
Nicotinic Acids
Vitamin B Complex
Vitamins
Micronutrients
Physiological Effects of Drugs
Hypolipidemic Agents
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Lipid Regulating Agents
Vasodilator Agents