Hyperhomocysteinemia recurrence in levodopa-treated Parkinson's disease patients.
BACKGROUND
Patients with Parkinson's disease (PD) and chronically treated with L-DOPA exhibit, in a percentage of 10-30%, supra-physiological levels of plasma total homocysteinemia (tHcy). In this study, we have investigated, in a group of hyper-homocysteinemic PD patients, the time of hyper-tHcy recurrence after discontinuation of 1-month folate supplementation given to normalize plasma tHcy levels.


METHODS
Plasma tHcy, cobalamin and folate were assayed before and after 1-month folate supplementation (5 mg/day), and after 2 and 4 months after folate discontinuation in 29 PD patients (16M/13F, mean age 69.4 +/- 6.9 years) stabilized on a mean L-DOPA dose of 509.4 +/- 312.1 mg/day.


RESULTS
After folate supplementation, plasma tHcy levels fell within the normal range in all patients. At the 2-month control after folate discontinuation, plasma tHcy remained within physiological values in 25 out of 29 patients. Conversely, 4 months after folate discontinuation, all patients exhibited hyper-tHcy.


CONCLUSIONS
One-month intake of 5 mg/day folate normalizes plasma tHcy levels in all hyper-homocysteinemic PD patients. Following folate discontinuation, hyper-tHcy recurs in all patients within 4 months. Knowledge of this time interval is useful to optimize pulses of folate therapy in hyper-homocysteinemic patients with PD.
Belcastro
V
V
Neurology Clinic, University of Perugia, S. Maria della Misericordia Hospital, Perugia, Italy. vincenzobelcastro@libero.it
Pierguidi
L
L
Castrioto
A
A
Menichetti
C
C
Gorgone
G
G
Ientile
R
R
Pisani
F
F
Rossi
A
A
Calabresi
P
P
Tambasco
N
N
D000368:Aged; D003430:Cross-Sectional Studies; D015259:Dopamine Agents / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006710:Homocysteine / Q000096:biosynthesis / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000139:chemically induced* / Q000188:drug therapy* / Q000503:physiopathology; D007980:Levodopa / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy* / Q000235:genetics; D011446:Prospective Studies; D055502:Secondary Prevention; D016896:Treatment Outcome; D014805:Vitamin B 12 / Q000097:blood
D015259:Dopamine Agents; D006710:Homocysteine; D007980:Levodopa; D014805:Vitamin B 12