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Hyperhomocysteinemia and vitamin score: correlations with silent brain ischemic lesions and brain atrophy
Zeev Polyak1, Felicia Stern, Yitshal N Berner
1Department of Geriatrics, Kaplan Medical Center, 76100 Rehovot, Israel.
Insights
Elevated homocysteine (tHcy) and low vitamin status are linked to brain issues like ischemia and atrophy in older adults. Monitoring tHcy and vitamin levels is crucial for evaluating brain health.
Area of Science:
- Neurology
- Biochemistry
- Geriatrics
Background:
- Elevated fasting plasma total homocysteine (tHcy) and suboptimal vitamin status are associated with atherosclerotic conditions.
- Silent brain ischemic lesions and brain atrophy are common in the elderly and are influenced by tHcy and vitamin levels.
Purpose of the Study:
- To investigate the relationship between tHcy, vitamin status (pyridoxal phosphate (PLP), vitamin B12, folic acid), and cognitive/functional capacities in elderly outpatients with and without brain impairment.
Main Methods:
- Brain computed tomography (CT) was used to categorize 56 outpatients into three groups: minor brain ischemia, brain atrophy, and control.
- Measurements included brain CT, plasma tHcy, plasma PLP, vitamin B12, folic acid, and cognitive and functional assessments.
Main Results:
- Subjects with minor brain ischemic lesions (n=21) exhibited higher tHcy and lower vitamin scores and cognitive function compared to controls (n=24).
- Individuals with brain atrophy (n=11) showed lower plasma PLP and reduced cognitive function.
Conclusions:
- Findings suggest a significant association between elevated tHcy, reduced vitamin status, and the presence of brain impairments like ischemia and atrophy.
- Monitoring tHcy levels, assessing vitamin status, and evaluating brain impairment are recommended for elderly individuals.
Abstract:
Elevated fasting plasma total homocysteine concentration (tHcy) and lower vitamin status are associated with atherosclerotic states. Silent brain ischemic lesions and brain atrophy, prevailing in the elderly, are affected by tHcy and vitamin status. The study was performed on 56 outpatients who had undergone brain computed tomography (CT) before the onset of the study. According to brain CT evaluation, three groups were set: minor brain ischemia, brain atrophy and control. Brain CT, tHcy, plasma pyridoxal phosphate (PLP), vitamin B(12), folic acid and cognitive and functional capacities were measured or evaluated in all of the subjects. Plasma vitamin score for three vitamins was calculated. In subjects with minor brain ischemic lesions (n = 21), tHcy was higher by 5.6 microM, whereas vitamin score and cognitive function were lower than in controls (n = 24). In subjects with brain atrophy (n = 11), plasma PLP and cognitive function were lower. Particular attention should be paid to tHcy monitoring, vitamin status assessment and brain impairment evaluation.