Homocysteine & Brain Aging

Ian Goddard igoddard at erols.mom
Wed May 29 13:21:21 EST 2002


Abstracts of the two new studies cited here:
http://my.webmd.com/content/article/1626.51332
(Follow these links for additional information)

http://www.neurology.org/cgi/content/abstract/58/10/1539

Neurology 2002;58:1539-1541 - American Academy of Neurology 

Relationship between plasma homocysteine levels and
brain atrophy in healthy elderly individuals 

[authors and affiliations cut for brevity, see URL above]

The authors examined the association of total plasma homocysteine 
(Hcy) levels with measures of atrophy and white matter disease on 
MRI scans in 36 healthy elderly individuals. Hcy had a significant 
positive relationship with lateral ventricle-brain ratios in the 
anterior (r = 0.49) and middle (r = 0.43) ventricular regions as 
measures of central atrophy, but not with cortical atrophy or 
white matter hyperintensities. In a logistic regression analysis, 
elevated Hcy was a significant determinant of increased anterior 
ventricle-brain ratio (0.34) after controlling for age, folate, 
B12, creatinine, and white matter disease (OR = 2.3; CI, 1.03-5.09). 

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http://www.neurology.org/cgi/content/abstract/58/10/1471

Neurology 2002;58:1471-1475 - American Academy of Neurology 

Homocysteine, vitamin B6, and vascular disease in AD patients 

[authors and affiliations cut for brevity, see URL above]

Background: Cerebrovascular disease is a cause of dementia 
and is associated with elevated plasma levels of homocysteine. 
Patients with AD tend to have unexplained elevations of 
homocysteine concentrations vs healthy control subjects. 
Vitamin B6 status, a potential determinant of plasma 
homocysteine, has not been characterized in patients with AD. 

Objective: To investigate plasma homocysteine, vitamin B6 status, 
and the occurrence of vascular disease in patients with AD. 

Methods: Forty-three patients with AD and 37 control subjects 
without AD were studied for homocysteine, B vitamin status
(folate, vitamin B12, pyridoxal-5'-phosphate [PLP]), kidney 
function (creatinine), and thyroid function (thyroid-stimulating
hormone, thyroxin). In addition, the presence of vascular disease 
was assessed by reviewing both medical histories and brain imaging 
data provided by CT and MRI. 

Results: The OR for elevated plasma homocysteine (>12 µmol/L) 
was only 2.2 (not significant) for subjects with AD. In contrast, 
the OR was 10.0 (p = 0.03) for subjects with vascular disease 
(n = 26). The OR for low plasma PLP (<25 nmol/L) was 12.3 
(p = 0.01) for patients with AD. No significant relationship was
observed between vascular disease and PLP level or between plasma 
homocysteine and PLP concentrations. 

Conclusions: Elevated plasma homocysteine in patients with AD 
appears related to vascular disease and not AD pathology. In 
addition, low vitamin B6 status is prevalent in patients with AD. 
It remains to be determined if elevated plasma homocysteine or 
low vitamin B6 status directly influences AD pathogenesis or
progression. 

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