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Effects of vitamin B12, folate, and entacapone on homocysteine levels in levodopa-treated Parkinson's disease patients: A randomized controlled study.
J Clin Neurosci. 2021 Jun; 88:226-231.JC

Abstract

INTRODUCTION

Previous studies have suggested a significant increase in plasma homocysteine (Hcy) levels in levodopa-treated Parkinson's disease (PD) patients, and vitamin B12 and folate supplementation may decrease Hcy levels. However, the effects of catechol-O-methyltransferase inhibitors on levodopa-induced increase in Hcy levels were conflicting. The aim of this study was to evaluate whether Hcy levels are increased in levodopa-treated PD patients and to evaluate the effects of vitamin B12 and folate or entacapone on Hcy levels in levodopa-treated PD patients.

METHODS

We analyzed and compared plasma Hcy levels in 20 levodopa-naïve PD patients and 42 levodopa-treated PD patients, followed by randomized assignment of 42 levodopa-treated patients to treatment groups with either vitamin B12 and folate, entacapone, or no medication.

RESULTS

Plasma Hcy levels in levodopa-treated PD patients were higher than those in the control group, but the difference was not statistical significant (15.25 ± 6.70 and 13.13 ± 4.68, P = 0.216). Patients treated with vitamin B12 and folate had a significant decrease in plasma Hcy levels (P < 0.001). In the entacapone group, Hcy levels were mildly decreased, but the change did not reach statistical significance.

CONCLUSION

Levodopa-treated PD patients had higher plasma Hcy than levodopa-naive PD patients. Unlike entacapone, combination supplementation with vitamin B12 and folate was associated with significantly decreased plasma Hcy. We suggest that plasma Hcy levels should be monitored during levodopa treatment, and supplementation with inexpensive vitamin B12 and folate is beneficial for levodopa-treated patients.

Authors+Show Affiliations

King Prajadhipok Memorial Hospital (Prapokklao Hospital), Thailand. Electronic address: chumpolan@gmail.com.King Prajadhipok Memorial Hospital (Prapokklao Hospital), Thailand.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

33992189

Citation

Anamnart, Chumpol, and Ram Kitjarak. "Effects of Vitamin B12, Folate, and Entacapone On Homocysteine Levels in Levodopa-treated Parkinson's Disease Patients: a Randomized Controlled Study." Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, vol. 88, 2021, pp. 226-231.
Anamnart C, Kitjarak R. Effects of vitamin B12, folate, and entacapone on homocysteine levels in levodopa-treated Parkinson's disease patients: A randomized controlled study. J Clin Neurosci. 2021;88:226-231.
Anamnart, C., & Kitjarak, R. (2021). Effects of vitamin B12, folate, and entacapone on homocysteine levels in levodopa-treated Parkinson's disease patients: A randomized controlled study. Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia, 88, 226-231. https://doi.org/10.1016/j.jocn.2021.03.047
Anamnart C, Kitjarak R. Effects of Vitamin B12, Folate, and Entacapone On Homocysteine Levels in Levodopa-treated Parkinson's Disease Patients: a Randomized Controlled Study. J Clin Neurosci. 2021;88:226-231. PubMed PMID: 33992189.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of vitamin B12, folate, and entacapone on homocysteine levels in levodopa-treated Parkinson's disease patients: A randomized controlled study. AU - Anamnart,Chumpol, AU - Kitjarak,Ram, Y1 - 2021/04/20/ PY - 2021/02/22/received PY - 2021/03/28/revised PY - 2021/03/30/accepted PY - 2021/5/16/entrez PY - 2021/5/17/pubmed PY - 2021/6/23/medline KW - Folate KW - Hyperhomocysteinemia KW - Levodopa KW - Parkinson’s disease KW - Vitamin B12 SP - 226 EP - 231 JF - Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia JO - J Clin Neurosci VL - 88 N2 - INTRODUCTION: Previous studies have suggested a significant increase in plasma homocysteine (Hcy) levels in levodopa-treated Parkinson's disease (PD) patients, and vitamin B12 and folate supplementation may decrease Hcy levels. However, the effects of catechol-O-methyltransferase inhibitors on levodopa-induced increase in Hcy levels were conflicting. The aim of this study was to evaluate whether Hcy levels are increased in levodopa-treated PD patients and to evaluate the effects of vitamin B12 and folate or entacapone on Hcy levels in levodopa-treated PD patients. METHODS: We analyzed and compared plasma Hcy levels in 20 levodopa-naïve PD patients and 42 levodopa-treated PD patients, followed by randomized assignment of 42 levodopa-treated patients to treatment groups with either vitamin B12 and folate, entacapone, or no medication. RESULTS: Plasma Hcy levels in levodopa-treated PD patients were higher than those in the control group, but the difference was not statistical significant (15.25 ± 6.70 and 13.13 ± 4.68, P = 0.216). Patients treated with vitamin B12 and folate had a significant decrease in plasma Hcy levels (P < 0.001). In the entacapone group, Hcy levels were mildly decreased, but the change did not reach statistical significance. CONCLUSION: Levodopa-treated PD patients had higher plasma Hcy than levodopa-naive PD patients. Unlike entacapone, combination supplementation with vitamin B12 and folate was associated with significantly decreased plasma Hcy. We suggest that plasma Hcy levels should be monitored during levodopa treatment, and supplementation with inexpensive vitamin B12 and folate is beneficial for levodopa-treated patients. SN - 1532-2653 UR - https://www.unboundmedicine.com/medline/citation/33992189/Effects_of_vitamin_B12_folate_and_entacapone_on_homocysteine_levels_in_levodopa_treated_Parkinson's_disease_patients:_A_randomized_controlled_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0967-5868(21)00176-4 DB - PRIME DP - Unbound Medicine ER -