Simvastatin as a Neuroprotective Treatment for Moderate Parkinson's Disease

Exclusion Criteria

• •Diagnosis or suspicion of other cause for parkinsonism
• •Known abnormality on CT or MRI brain imaging considered to be causing symptoms or signs of neurological dysfunction, or considered likely to compromise compliance with study protocol
• •Concurrent dementia defined by MoCA score \<21
• •Concurrent severe depression defined by MADRS score \>31
• •Prior intracerebral surgical intervention for PD including deep brain stimulation, lesional surgery, growth factor administration, gene therapy or cell transplantation
• •Already actively participating in a research study that might conflict with this trial
• •Prior or current use of statins as a lipid lowering therapy
• •Intolerance to statins
• •Untreated hypothyroidism
• •End stage renal disease (creatinine clearance \<30 mL/min) or history of severe cardiac disease (angina, myocardial infarction or cardiac surgery in preceding two years)
• •eGFR \<30 mL/min
• •History of alcoholism or liver impairment
• •Creatine kinase (CK) \>1.1 x upper limit of normal (ULN)
• •Aspartate transaminase (AST) or alanine transaminase (ALT) \>1.1 x ULN
• •Females who are pregnant or breast feeding or of child-bearing potential and unwilling to use appropriate contraception methods whilst on trial treatment
• •Currently taking any medication contraindicated with simvastatin use (Appendix 2)
• •Any requirement for statin use
• •Regular participation in endurance or high-impact sports
• •Unable to abstain from consumption of grapefruit-based products