N-acetylcysteine for Parkinson's disease: a translational systematic review of mechanistic and early clinical data.
N-acetylcysteine for Parkinson's disease: a translational systematic review of mechanistic and early clinical data.
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Original abstract
BACKGROUND: Parkinson's disease (PD) involves progressive motor and non-motor decline, linked to oxidative stress and glutathione depletion. N-acetylcysteine (NAC), a glutathione precursor and antioxidant, is a potential disease-modifying therapy. OBJECTIVE: To evaluate preclinical and clinical evidence on NAC in PD, focusing on motor and non-motor outcomes, dopaminergic function, and oxidative stress biomarkers. METHODS: A PRISMA-compliant review of MEDLINE and Embase (May 2025) identified prospective studies in animal models or adults with PD. Outcomes included Unified Parkinson's Disease Rating Scale (UPDRS), dopamine transporter (DAT) imaging, glutathione levels, and safety. RESULTS: Twelve studies met criteria. Preclinical models showed consistent neuroprotection. Intravenous NAC raised brain glutathione levels; high-dose oral NAC reached CSF. Two open-label trials (n = 65), reported ~ 13% improvement in UPDRS scores and 4-9% dopamine transporter signal increases over three months. No serious adverse events were attributed to NAC. CONCLUSIONS: Larger randomized controlled trials are needed to test efficacy and disease-modifying potential.