Plasma homocysteine levels and Parkinson disease: disease progression, carotid intima-media thickness and neuropsychiatric complications.
OBJECTIVE
To determine whether plasma homocysteine (Hcy) levels are associated with clinical characteristics, neuropsychological and psychiatric manifestations and cardiovascular comorbidity in patients with Parkinson disease (PD).


BACKGROUND
Elevated Hcy levels are linked to atherosclerosis, vascular disease, depression, and dementia. Patients with PD treated with L-dopa have been shown to have elevated Hcy levels.


METHODS
Idiopathic PD patients were evaluated using the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr stage, Parkinson Psychosis Rating Scale, Beck Depression Inventory, Frontal Assessment Battery, Mini-Mental Status Examination, and several tests for frontal type cognitive functions. Fasting blood samples were collected for the measurement of Hcy, and carotid B-mode ultrasound was performed to measure intima-media thickness of the common carotid arteries.


RESULTS
Seventy-two consecutive PD patients (46 men; average age, 68.7 +/- 11.6 years; average disease duration, 7.0 +/- 4.7 years) were recruited. All but 10 patients were treated with L-dopa. The average level of Hcy was 16.4 +/- 7.8 micromol/L, and 38.9% of the patients had Hcy level above the reference range (>15.0 micromol/L). The Hcy levels were associated with PD duration as they were with L-dopa treatment duration but were not associated with the parameters of disease severity or with L-dopa dose. The Hcy levels were associated neither with the common carotid intima-media thickness nor with cardiovascular morbidity. No association was found between Hcy and the neuropsychiatric features of PD such as depression, cognitive performance, or psychosis.


CONCLUSIONS
Hyperhomocystinemia is common in L-dopa-treatedPD patients but was not associated with neuropsychological complications (depression, dementia, and cognitive decline associated with frontal lobe functioning or psychosis), enhanced disease severity, or vascular comorbidity.
Hassin-Baer
Sharon
S
Department of Neurology and Parkinson's Disease and Movement Disorders Clinic, Chaim Sheba Medical Center, Tel Hashomer, Israel. shassin@post.tau.ac.il
Cohen
Oren
O
Vakil
Eli
E
Sela
Ben-Ami
BA
Nitsan
Zeev
Z
Schwartz
Roseline
R
Chapman
Joab
J
Tanne
David
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000097:blood / Q000150:complications / Q000473:pathology; D011618:Psychotic Disorders / Q000209:etiology*; D017539:Tunica Intima / Q000187:drug effects / Q000473:pathology*; D017540:Tunica Media / Q000187:drug effects / Q000473:pathology*
D000978:Antiparkinson Agents; D006710:Homocysteine; D007980:Levodopa