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Homocysteine, cerebrovascular disease and brain atrophy

Perminder Sachdev1

  • 1School of Psychiatry, University of New South Wales, Neuropsychiatric Institute, the Prince of Wales Hospital, Barker Street, Randwick, Sydney NSW 2031, Australia. p.sachdev@unsw.edu.au

Journal of the Neurological Sciences
|November 13, 2004
PubMed

Insights

High homocysteine (Hcy) levels are linked to increased stroke risk, brain atrophy, and cognitive decline, including Alzheimer

Area of Science:

  • Neurology
  • Vascular Biology
  • Gerontology

Background:

  • Homocysteine (Hcy) is a known risk factor for cerebrovascular disease (CVD).
  • Emerging evidence links Hcy to brain atrophy, cognitive impairment, and potentially Alzheimer disease (AD).

Purpose of the Study:

  • To investigate the impact of elevated homocysteine levels on brain structure and cognitive function through two distinct studies.

Main Methods:

  • Sydney Stroke Study: Assessed Hcy levels in stroke patients (N=131) and healthy controls (N=81) correlating with stroke incidence and cognitive function.
  • PATH Through Life Study: Examined Hcy levels in community-dwelling older adults (N=385, aged 60-64) and their association with brain imaging markers and cognitive performance.

Main Results:

  • Higher Hcy levels correlated with increased stroke occurrences and impaired cognitive functions (frontal-executive, attention) in the Sydney Stroke Study.
  • In healthy controls, Hcy was associated with greater subcortical atrophy.
  • The PATH Through Life Study found Hcy linked to increased white matter hyperintensities, and deficits in verbal memory and fine motor speed.

Conclusions:

  • Elevated homocysteine levels contribute to both micro- and macrovascular disease, brain atrophy, and subsequent cognitive impairment.
  • Early intervention to manage high Hcy levels is recommended to mitigate long-term neurological consequences.

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