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Published on: February 27, 2018
Hyperhomocysteinemia and Vitamin B Deficiency as Potential Aggravating Factors in Huntington's Disease: A Prospective
Salomé Puisieux1,2, Elise Pourié2, Céline Bonnet2,3
1Department of Neurology, University Hospital of Nancy, Nancy, France.
Insights
Elevated homocysteine levels are common in Huntington's disease (HD) patients and linked to faster motor progression. This suggests hyperhomocysteinemia may influence HD
Area of Science:
- Neurology
- Metabolic Medicine
- Genetics
Background:
- Elevated homocysteine levels are suspected in Huntington's disease (HD) but their clinical significance is not confirmed.
- Understanding the role of homocysteine and vitamin B in HD pathogenesis is crucial for potential therapeutic strategies.
Purpose of the Study:
- To evaluate vitamin B and homocysteine levels in Huntington's disease patients.
- To investigate the association between hyperhomocysteinemia, vitamin B deficiency, and motor symptom progression in HD.
Main Methods:
- A monocentric case-control study involving 77 HD patients and 87 controls.
- Clinical assessment using the Unified Huntington Disease Rating Scale-Motor and biochemical evaluation of vitamin B and homocysteine levels.
- Statistical analysis included Fisher's exact test, Wilcoxon test, and Student's t-test (P < 0.05 significance).
Main Results:
- HD patients (symptomatic and premanifest) exhibited significantly higher homocysteine levels compared to controls.
- Hyperhomocysteinemia was identified in approximately 48% of HD patients.
- A significant association was found between hyperhomocysteinemia and accelerated motor progression (P < 0.001).
Conclusions:
- Hyperhomocysteinemia is prevalent in Huntington's disease and may contribute to disease variability.
- Findings suggest a connection between altered one-carbon metabolism and HD.
- Further research is warranted to explore the therapeutic potential of targeting hyperhomocysteinemia in HD management.
Background:
Although not confirmed, some studies have suggested that elevated homocysteine levels are common in patients with Huntington's disease (HD). Its clinical relevance remains unclear.
Objectives:
We aimed to assess vitamin B and homocysteine levels in HD patients and explore the relationships among hyperhomocysteinemia, vitamin B deficiency, and motor symptom progression.
Methods:
In this monocentric case-control study, 77 HD patients were prospectively included between January 2020 and June 2023 at Nancy University Hospital. As controls, biological data were obtained retrospectively from 87 individuals referred to the Metabolic Medicine Department between January 2017 and February 2025. HD patients underwent clinical (Unified Huntington Disease Rating Scale-Motor) and biochemical (vitamin B and homocysteine levels) evaluations. Fisher's exact test, Wilcoxon test, or Student's t-test were used, with P < 0.05 considered significant.
Results:
HD patients-both symptomatic and premanifest-had significantly higher homocysteine levels than did controls. Hyperhomocysteinemia was found in 36 patients (≈48%) and was associated with faster motor progression (P < 0.001).
Conclusions:
Hyperhomocysteinemia appears to be frequent in HD patients and may represent a risk factor contributing to phenotypic variability. These findings support a potential link between altered one-carbon metabolism and HD. Further longitudinal and mechanistic studies are needed to clarify the clinical and pathophysiological relevance of homocysteine metabolism in HD and to determine whether targeting hyperhomocysteinemia could have therapeutic implications. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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