Objective: To investigate the effect of exogenous ketone ester supplementation on motor and non-motor symptoms in Parkinson’s Disease (PD).

Background: Animal research and human pilot studies suggest that increasing blood ketone concentrations may reduce neuroinflammation and increase metabolic efficiency, which may impact motor and non-motor symptoms in Parkinson’s Disease. Exogenous ketone ester supplementation has been suggested as an uncomplicated alternative to achieving ketosis versus a high-fat, low-carbohydrate diet.

Method: Participants with PD were recruited for this prospective, open label, pilot study to consume 25 grams of D-betahydroxybutyrate 4 times per day for 4 weeks. On days 1 and 29, participants underwent neurological evaluation, including the Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), Non-Motor Symptom Scale (NMSS), King’s Pain Scale (KPS), the Parkinson’s Disease Questionnaire-39 (PDQ-39), Parkinson’s Sleep Scale (PSS), and the Montreal Cognitive Assessment (MoCA). Scores from day 29 were compared to day 1 using a paired t-test or a Wilcoxon Signed Rank Test (WSRT).

Results: 10 participants participated in this study; only participants who completed assessments at day 1 and 29 were included in the questionnaire assessments (n=8). Additionally, only participants who were in the clinical “OFF” state were included in the MDS-UPDRS analysis (n=7). No significant safety concerns were identified. Part 1 scores decreased from 23.3± 5.4 to 10.3± 7.0 (mean± SD; p<0.001). A WSRT indicated that the UPDRS Part II median day 29 scores (8) were significantly lower than the median day 1 scores (21; p<0.05). Part 3 (Motor) scores were significantly lower on day 29 (24.3± 11.9 vs 43.4± 11.1; p<0.05). NMSS total scores decreased significantly from 113.3± 33.4 to 48.5± 33.2 (p<0.005). KPS scores were significantly lower on day 29 (19.3± 21.3) compared to day 1 (35.9± 16; p<0.001). Total PDQ-39 scores decreased from 90.4± 23.2 to 75.6± 21.1; p<0.05) with improvements in the mobility, activities of daily living, communication, and bodily discomfort domains. No differences were found for PSS or MoCA scores.

Conclusion: Our data provides preliminary, short term evidence of potential benefit in PD symptoms with ketone supplementation. Additional studies are needed to further explore the effects of exogenous ketone ester supplementation in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-ketone-ester-supplementation-on-motor-and-non-motor-symptoms-in-parkinsons-disease/