Hyperhomocysteinemia in levodopa-treated patients with Parkinson's disease dementia.
Dementia is a frequent non-motor feature of Parkinson's disease (PD). Elevated plasma homocysteine (Hcy) levels have been associated with both cognitive impairment and dementia. Increased Hcy levels have been observed in levodopa-treated patients with PD. The objective of our study was to evaluate the association between plasma Hcy levels and dementia in PD. We performed a multicenter cross-sectional study on patients with PD with (PDD) and without (PDnD) dementia and age- and sex-matched healthy controls. We compared Hcy levels in patients with PDD and PDnD and healthy controls, and we performed logistic regression analysis to search for an association between the presence of dementia and increased Hcy levels in PD. Patients with PD (121), PDD (42), and PDnD (79), and age- and sex-matched controls (154) were enrolled. Hcy levels were higher in patients with PD compared to controls (17.5 micromol/L +/- 10.2 vs. 11 +/- 4.1; P < 0.00001). Among patients with PD, Hcy levels were higher in the PDD group compared to the PDnD group (20.7 micromol/L +/- 12.1 vs. 15.8 +/- 8.5; P = 0.002). In a multivariate logistic regression model, higher Hcy levels [Odds ratios comparing the top (>18.9 micromol/L) with the bottom tertile (<12.4 micromol/L): 3.68; 95% CI: 1.14-11.83] were significantly associated with dementia. These data support the association between elevated Hcy levels and the presence of dementia in PD.
Clinic of Nervous System Diseases, Medical and Neurological Sciences, Azienda Ospedaliero-Universitaria Ospedali Riuniti, University of Foggia, Italy.
Stefano
S
Zoccolella
Claudia
C
dell'Aquila
Giovanni
G
Abruzzese
Angelo
A
Antonini
Ubaldo
U
Bonuccelli
Margherita
M
Canesi
Silvano
S
Cristina
Roberta
R
Marchese
Claudio
C
Pacchetti
Roberto
R
Zagaglia
Giancarlo
G
Logroscino
Giovanni
G
Defazio
Paolo
P
Lamberti
Paolo
P
Livrea
D000368:Aged; D000704:Analysis of Variance; D000978:Antiparkinson Agents / Q000009:adverse effects*; D016022:Case-Control Studies; D002851:Chromatography, High Pressure Liquid / Q000379:methods; D003430:Cross-Sectional Studies; D003704:Dementia / Q000097:blood / Q000150:complications / Q000188:drug therapy; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000139:chemically induced*; D007980:Levodopa / Q000009:adverse effects* / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000097:blood / Q000150:complications / Q000188:drug therapy
D000978:Antiparkinson Agents; D006710:Homocysteine; D007980:Levodopa