Can Exercise plus NAD+ Precursor Move the Needle in Friedreich’s Ataxia?

Patients with the neurodegenerative disorder Friedreich’s ataxia often have low cardiopulmonary fitness, which is strongly associated with worse disease severity and impaired day-to-day function. Although exercise has long been recommended, rigorous randomized, controlled trial data supporting its use have been sparse. In this single-center randomized trial, investigators tested whether 12 weeks of individualized aerobic and resistance exercise, supplementation with the NAD+ precursor nicotinamide riboside, or both interventions combined could improve cardiopulmonary fitness compared with weekly clinical phone calls alone in 66 patients, 10 to 40 years of age, with Friedreich’s ataxia. The primary end point was peak oxygen consumptio…