title: Hyperhomocysteinemia in patients with epilepsy: does it play a role in the pathogenesis of brain atrophy? A preliminary report.
abstract: OBJECTIVE
  Brain atrophy (BA) is observed in 20-50% of patients with epilepsy. Hyper-total-homocysteinemia (hyper-tHcy), which occurs in 10-40% of patients, is considered to be a risk factor for cardiovascular diseases and BA. The present study was aimed at investigating the possible association of hyper-tHcy with BA in a population of patients with epilepsy.
  
  
  METHODS
  Fifty-eight patients (33 M/25 F, 43.5 +/- 13.1 years of age) chronically treated with antiepileptic drugs (AEDs) and 60 controls matched for age and sex were enrolled. All participants underwent determination of plasma tHcy, folate, vitamin B(12), and C677T methylene-tetrahydrofolate-reductase (MTHFR) polymorphism genotyping, and brain magnetic resonance imaging (MRI).
  
  
  RESULTS
  Patients exhibited significantly higher tHcy and lower folate levels than controls; hyper-tHcy was significantly associated with the variables group (patients vs. controls), MTHFR genotype, and their interaction terms. BA was observed in 30.1% of patients and was significantly associated with hyper-tHcy (beta = 0.45, p = 0.003) and polytherapy (beta = 0.31, p < 0.001).
  
  
  CONCLUSIONS
  Our investigation suggests that hyper-tHcy plays a role in the development of BA in patients with epilepsy. Although the real origin of this phenomenon is not yet fully elucidated, experimental data support the hypothesis of a link of the neuronal Hcy-mediated damage with oxidative stress and excitotoxicity.
authors.affiliation: Associazione Fatebenefratelli per la Ricerca AFaR, Dipartimento di Neuroscienze, Ospedale San Giovanni Calibita Fatebenefratelli, Isola Tiberina, Rome, Italy. gaegorg@tin.it
authors.forename: Gaetano
authors.initials: G
authors.lastname: Gorgone
authors.forename: Daniela
authors.initials: D
authors.lastname: Caccamo
authors.forename: Laura Rosa
authors.initials: LR
authors.lastname: Pisani
authors.forename: Monica
authors.initials: M
authors.lastname: Currò
authors.forename: Giulia
authors.initials: G
authors.lastname: Parisi
authors.forename: Giancarla
authors.initials: G
authors.lastname: Oteri
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ientile
authors.forename: Paolo Maria
authors.initials: PM
authors.lastname: Rossini
authors.forename: Francesco
authors.initials: F
authors.lastname: Pisani
mesh_terms: D000293:Adolescent; D000328:Adult; D001284:Atrophy / Q000209:etiology; D001921:Brain / Q000473:pathology*; D004827:Epilepsy / Q000097:blood / Q000150:complications* / Q000473:pathology*; D005260:Female; D006710:Homocysteine / Q000009:adverse effects / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000150:complications* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology
chemical_list: D006710:Homocysteine