PT - JOURNAL ARTICLE AU - Antonio Costantini AU - Maria Immacolata Pala AU - Laura Compagnoni AU - Marco Colangeli TI - High-dose thiamine as initial treatment for Parkinson's disease AID - 10.1136/bcr-2013-009289 DP - 2013 Aug 28 TA - BMJ Case Reports PG - bcr2013009289 VI - 2013 4099 - http://casereports.bmj.com/content/2013/bcr-2013-009289.short 4100 - http://casereports.bmj.com/content/2013/bcr-2013-009289.full AB - Parkinson's disease (PD) is a systemic disease with motor and non-motor deficits. We recruited three patients with newly diagnosed PD. They were not under anti-Parkinson's therapy. Plasmatic thiamine was within healthy reference range. We performed the Unified Parkinson's Disease Rating Scale (UPDRS) and started a parenteral therapy with high doses of thiamine. The therapy led to a considerable improvement in the motor part of the UPDRS ranging from 31.3% to 77.3%. From this clinical observation, it is reasonable to infer that a focal, severe thiamine deficiency due to a dysfunction of thiamine metabolism could cause a selective neuronal damage in the centres that are typically hit in this disease. Injection of high doses of thiamine was effective in reversing the symptoms, suggesting that the abnormalities in thiamine-dependent processes could be overcome by diffusion-mediated transport at supranormal thiamine concentrations.