Hypertrophy of IMC of carotid artery in Parkinson's disease is associated with L-DOPA, homocysteine, and MTHFR genotype.
In recent years, an intense interest has developed in the association between Parkinson's disease (PD) and hyperhomocysteinemia. Homocysteine (Hcy) is a neuronal excitotoxic amino acid, and is well known as a risk factor for vascular diseases. Some reports suggest that the administration of L-DOPA may promote hyperhomocysteinemia and idiopathic atherosclerosis. In this study, we report that a mild hypertrophy of the intima-media complex (IMC) of the carotid artery, which has been established as a marker for systemic atherosclerosis, is observed in PD patients compared with normal subjects. PD patients that were treated with L-DOPA for long durations showed a hypertrophic IMC, while the patients that were not treated with L-DOPA did not show any hypertrophic changes in the IMC. These hypertrophic changes were observed primarily in patients with a Hoehn-Yahr stage of 3-5. PD patients with hypertrophic IMC of the carotid artery also exhibited elevated plasma levels of Hcy associated with the C677T genotype of 5,10-methylenetetrahydrofolate reductase (MTHFR). Moreover, a prolonged duration of treatment with L-DOPA in patients with MTHFR T/T genotype enhanced the hypertrophy of IMC, compared with patients with the C/C or C/T genotype. These results suggest that hyperhomocysteinemia promoted by the C677T genotype of MTHFR and prolonged treatment with L-DOPA enhances atherosclerosis in PD patients and affects their general condition.
Nakaso
Kazuhiro
K
Division of Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago, Japan. kazuhiro@grape.med.tottori-u.ac.jp
Yasui
Kenichi
K
Kowa
Hisanori
H
Kusumi
Masayoshi
M
Ueda
Keigo
K
Yoshimoto
Yuko
Y
Takeshima
Takao
T
Sasaki
Kiyohiro
K
Nakashima
Kenji
K
D000368:Aged; D000704:Analysis of Variance; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D006984:Hypertrophy; D007980:Levodopa / Q000009:adverse effects*; D008297:Male; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D008875:Middle Aged; D000587:Oxidoreductases Acting on CH-NH Group Donors / Q000235:genetics*; D010300:Parkinson Disease / Q000097:blood / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology*; D018709:Statistics, Nonparametric; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography
D006710:Homocysteine; D007980:Levodopa; D000587:Oxidoreductases Acting on CH-NH Group Donors; D042965:Methylenetetrahydrofolate Reductase (NADPH2)