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Hyperhomocysteinemia in Alzheimer dementia patients and cognitive decline after 6 months follow-up period.
Acta Neurol Taiwan. 2010 Sep; 19(3):168-77.AN

Abstract

PURPOSE

White matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) are commonly found in Alzheimer's disease (AD) and may contribute to cognitive impairment. Plasma total homocysteine (tHcy) had also been linked with cognitive decline in AD. We examined the relationship among change of cognition, tHcy level, and WMHs on MRI in AD patients with a follow-up periods of 6 months.

METHODS

AD patients with normal creatinine level and initial clinical dementia rating (CDR) of 1 to 2 were enrolled. tHcy and biochemistry tests related to cerebral vascular risk factors were collected. WMHs were measured on MRI fluid attenuated inverse recovery sequence and classified into deep white matter hyperintensities (DWMHs) and periventricular white matter hyperintensities (PWMHs) by visual rating scale. Neuropsychological tests including cognitive ability screening instrument (CASI), mini-mental state examination (MMSE) converted from CASI scores and CDR were collected twice during the follow- up period of 6 months.

RESULTS

Ninety-two AD patients, 30 men and 62 women completed the study while the tHcy level was not significantly different between AD and age matched controls. tHcy level showed no correlation with CASI or MMSE score, at either the first or second examination. tHcy showed positive correlation with decline of CASI total score and abstract thinking (both p<0.01) but not in MMSE decline. There was no significant correlation between neuropsychiatric assessment and WMHs, but the decline of abstract thinking score was related to frontal PWMHs (R square=0.237, p=0.007).

CONCLUSION

tHcy might be associated with rapid cognitive decline in AD after a 6-month follow-up period and the effect might not be directly through WMHs. tHcy level correlated with greater WMHs in the trigone area although greater lesion load by MRI was in the occipital lobe.

Authors+Show Affiliations

Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20824536

Citation

Tu, Min-Chien, et al. "Hyperhomocysteinemia in Alzheimer Dementia Patients and Cognitive Decline After 6 Months Follow-up Period." Acta Neurologica Taiwanica, vol. 19, no. 3, 2010, pp. 168-77.
Tu MC, Huang CW, Chen NC, et al. Hyperhomocysteinemia in Alzheimer dementia patients and cognitive decline after 6 months follow-up period. Acta Neurol Taiwan. 2010;19(3):168-77.
Tu, M. C., Huang, C. W., Chen, N. C., Chang, W. N., Lui, C. C., Chen, C. F., Chen, C., Wang, Y. L., Lin, Y. T., & Chang, C. C. (2010). Hyperhomocysteinemia in Alzheimer dementia patients and cognitive decline after 6 months follow-up period. Acta Neurologica Taiwanica, 19(3), 168-77.
Tu MC, et al. Hyperhomocysteinemia in Alzheimer Dementia Patients and Cognitive Decline After 6 Months Follow-up Period. Acta Neurol Taiwan. 2010;19(3):168-77. PubMed PMID: 20824536.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hyperhomocysteinemia in Alzheimer dementia patients and cognitive decline after 6 months follow-up period. AU - Tu,Min-Chien, AU - Huang,Chi-Wei, AU - Chen,Nai-Ching, AU - Chang,Wen-Neng, AU - Lui,Chun-Chung, AU - Chen,Chih-Feng, AU - Chen,Ching, AU - Wang,Ya-Ling, AU - Lin,Yu-Ting, AU - Chang,Chiung-Chih, PY - 2009/12/24/received PY - 2010/01/18/revised PY - 2010/05/26/accepted PY - 2010/9/9/entrez PY - 2010/9/9/pubmed PY - 2011/3/9/medline SP - 168 EP - 77 JF - Acta neurologica Taiwanica JO - Acta Neurol Taiwan VL - 19 IS - 3 N2 - PURPOSE: White matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) are commonly found in Alzheimer's disease (AD) and may contribute to cognitive impairment. Plasma total homocysteine (tHcy) had also been linked with cognitive decline in AD. We examined the relationship among change of cognition, tHcy level, and WMHs on MRI in AD patients with a follow-up periods of 6 months. METHODS: AD patients with normal creatinine level and initial clinical dementia rating (CDR) of 1 to 2 were enrolled. tHcy and biochemistry tests related to cerebral vascular risk factors were collected. WMHs were measured on MRI fluid attenuated inverse recovery sequence and classified into deep white matter hyperintensities (DWMHs) and periventricular white matter hyperintensities (PWMHs) by visual rating scale. Neuropsychological tests including cognitive ability screening instrument (CASI), mini-mental state examination (MMSE) converted from CASI scores and CDR were collected twice during the follow- up period of 6 months. RESULTS: Ninety-two AD patients, 30 men and 62 women completed the study while the tHcy level was not significantly different between AD and age matched controls. tHcy level showed no correlation with CASI or MMSE score, at either the first or second examination. tHcy showed positive correlation with decline of CASI total score and abstract thinking (both p<0.01) but not in MMSE decline. There was no significant correlation between neuropsychiatric assessment and WMHs, but the decline of abstract thinking score was related to frontal PWMHs (R square=0.237, p=0.007). CONCLUSION: tHcy might be associated with rapid cognitive decline in AD after a 6-month follow-up period and the effect might not be directly through WMHs. tHcy level correlated with greater WMHs in the trigone area although greater lesion load by MRI was in the occipital lobe. SN - 1028-768X UR - https://www.unboundmedicine.com/medline/citation/20824536/Hyperhomocysteinemia_in_Alzheimer_dementia_patients_and_cognitive_decline_after_6_months_follow_up_period_ L2 - https://medlineplus.gov/alzheimersdisease.html DB - PRIME DP - Unbound Medicine ER -