The correct answer: B and C
Results from a randomized controlled trial found that cognitive scores and dyskinesia were worse while daytime sleepiness was improved in patients with PD randomized to six months of 200 mg caffeine twice daily, compared to placebo.2 When the trial was extended to 18 months, combined results for all time points continued to suggest worsening of cognition (difference in MoCA score: 0.66, 95% CI 0.01, 1.32), and worsening of dyskinesia (difference in MDS-UPDRS part IV, 0.25, 95% CI 0.05, 0.45). Improvement in daytime sleepiness was equivocal (difference in SCOPA scores: -0.42, 95% CI -1.09, 0.25).
1. Noyce AJ, Bestwick JP, Silveira-Moriyama L, et al. Meta-analysis of early nonmotor features and risk factors for Parkinson disease. Ann Neurol. 2012;72:893-901.
2. Postuma RB, Anang J, Pelletier A, et al. Caffeine as symptomatic treatment for Parkinson disease (Café-PD): A randomized trial. Neurology. 2017;89:1795-1803.
3. Postuma RB, Anang AE, Munhoz RP, et al. Caffeine for treatment of Parkinson disease: a randomized controlled trial. Neurology. 2012;79:651-658.