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Modest increase in plasma homocysteine follows levodopa initiation in Parkinson's disease.
Mov Disord. 2004 Dec; 19(12):1403-8.MD

Abstract

Levodopa, typically ingested chronically at high daily doses, is predictably methylated by means of a series of reactions using B vitamins, which convert methionine to homocysteine. Elevated total plasma homocysteine (tHcy), a risk factor for dementia, has been found in PD patients using levodopa. We prospectively measured the effects on plasma tHcy and B vitamins of levodopa initiation, and measured the effects of dose changes and of treatment with dopamine agonists and entacapone. We collected paired plasma samples, at baseline and again after several months treatment, from patients initiating levodopa (n = 30), from patients whose levodopa dose was doubled (n = 15), halved or stopped (n = 14), from patients starting or stopping entacapone (n = 15) and from patients initiating or doubling dopamine agonist monotherapy (n = 16). Vitamin B12, folate, and tHcy concentrations were measured. Baseline tHcy concentration of 8.7 (2.8) micromol/L increased to 10.1 (3.1) micromol/L (P = 0.004) an average of 94 (range 36 to 200) days after initiation of 604 (240 to 1050) mg/day of L-dopa. Average concentration of vitamin B12 fell from 380 to 291 pmol/ L (P = 0.01). Patients who doubled their daily levodopa dose experienced tHcy elevations from 9.5 to 11.1 micromol/L (P = 0.05). Levodopa reduction, agonist treatment, and entacapone treatment did not have significant effects. Levodopa elevates tHcy and lowers vitamin B12 concentration to modest degrees. The clinical implications, if any, have not yet been determined.

Authors+Show Affiliations

Department of Neurology, University of Texas Southwestern Medical School, Dallas, Texas, USA. padraig.osilleabhain@utsouthwestern.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15390053

Citation

O'Suilleabhain, Padraig E., et al. "Modest Increase in Plasma Homocysteine Follows Levodopa Initiation in Parkinson's Disease." Movement Disorders : Official Journal of the Movement Disorder Society, vol. 19, no. 12, 2004, pp. 1403-8.
O'Suilleabhain PE, Bottiglieri T, Dewey RB, et al. Modest increase in plasma homocysteine follows levodopa initiation in Parkinson's disease. Mov Disord. 2004;19(12):1403-8.
O'Suilleabhain, P. E., Bottiglieri, T., Dewey, R. B., Sharma, S., & Diaz-Arrastia, R. (2004). Modest increase in plasma homocysteine follows levodopa initiation in Parkinson's disease. Movement Disorders : Official Journal of the Movement Disorder Society, 19(12), 1403-8.
O'Suilleabhain PE, et al. Modest Increase in Plasma Homocysteine Follows Levodopa Initiation in Parkinson's Disease. Mov Disord. 2004;19(12):1403-8. PubMed PMID: 15390053.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Modest increase in plasma homocysteine follows levodopa initiation in Parkinson's disease. AU - O'Suilleabhain,Padraig E, AU - Bottiglieri,Teodoro, AU - Dewey,Richard B,Jr AU - Sharma,Shailja, AU - Diaz-Arrastia,Ramon, PY - 2004/9/25/pubmed PY - 2005/4/9/medline PY - 2004/9/25/entrez SP - 1403 EP - 8 JF - Movement disorders : official journal of the Movement Disorder Society JO - Mov Disord VL - 19 IS - 12 N2 - Levodopa, typically ingested chronically at high daily doses, is predictably methylated by means of a series of reactions using B vitamins, which convert methionine to homocysteine. Elevated total plasma homocysteine (tHcy), a risk factor for dementia, has been found in PD patients using levodopa. We prospectively measured the effects on plasma tHcy and B vitamins of levodopa initiation, and measured the effects of dose changes and of treatment with dopamine agonists and entacapone. We collected paired plasma samples, at baseline and again after several months treatment, from patients initiating levodopa (n = 30), from patients whose levodopa dose was doubled (n = 15), halved or stopped (n = 14), from patients starting or stopping entacapone (n = 15) and from patients initiating or doubling dopamine agonist monotherapy (n = 16). Vitamin B12, folate, and tHcy concentrations were measured. Baseline tHcy concentration of 8.7 (2.8) micromol/L increased to 10.1 (3.1) micromol/L (P = 0.004) an average of 94 (range 36 to 200) days after initiation of 604 (240 to 1050) mg/day of L-dopa. Average concentration of vitamin B12 fell from 380 to 291 pmol/ L (P = 0.01). Patients who doubled their daily levodopa dose experienced tHcy elevations from 9.5 to 11.1 micromol/L (P = 0.05). Levodopa reduction, agonist treatment, and entacapone treatment did not have significant effects. Levodopa elevates tHcy and lowers vitamin B12 concentration to modest degrees. The clinical implications, if any, have not yet been determined. SN - 0885-3185 UR - https://www.unboundmedicine.com/medline/citation/15390053/Modest_increase_in_plasma_homocysteine_follows_levodopa_initiation_in_Parkinson's_disease_ L2 - https://doi.org/10.1002/mds.20253 DB - PRIME DP - Unbound Medicine ER -