Executive dysfunction in hyperhomocystinemia responds to homocysteine-lowering treatment.
An elevated serum homocysteine level is a risk factor for the development of cognitive impairment. Reported is a late-onset case of hyperhomocystinemia due to a vitamin B12 metabolic deficit (cobalamin C) with cognitive impairment, primarily in frontal/executive function. After homocysteine-lowering therapy, the patient's functional and neuropsychological status improved in conjunction with a decrease in leukoariosis on his MRI scan. These findings suggest that homocysteine-related cognitive impairment may be partially reversible.
Boxer
A L
AL
Memory and Aging Center, Department of Neurology, UCSF, San Francisco, CA 94143-1207, USA. adam.boxer@memory.ucsf.edu
Kramer
J H
JH
Johnston
K
K
Goldman
J
J
Finley
R
R
Miller
B L
BL
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001622:Betaine / Q000627:therapeutic use; D003072:Cognition Disorders / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism; D003221:Confusion / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005492:Folic Acid / Q000627:therapeutic use; D005625:Frontal Lobe / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D006710:Homocysteine / Q000037:antagonists & inhibitors / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D049292:Leukoaraiosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008764:Methylmalonic Acid / Q000097:blood / Q000378:metabolism; D012074:Remission Induction; D012640:Seizures / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000378:metabolism / Q000627:therapeutic use; D025101:Vitamin B 6 / Q000627:therapeutic use
D000925:Anticoagulants; D006710:Homocysteine; D001622:Betaine; D025101:Vitamin B 6; D008764:Methylmalonic Acid; D005492:Folic Acid; D014805:Vitamin B 12