title: Different impact of hyperhomocysteinemia on cerebral small vessel ischemia and cervico-cerebral atherosclerosis in non-stroke individuals.
abstract: BACKGROUND
  Our aim was to investigate the impact of plasma total homocysteine (tHcyt) levels on cervico-cerebral atherosclerosis and cerebral small vessel ischemia in non-stroke individuals.
  
  
  METHODS
  Demographic, laboratory, brain magnetic resonance imaging and magnetic resonance angiographic data were retrospectively analyzed in 682 non-stroke individuals. The association between plasma tHcyt and radiological indices of cervico-cerebral atherosclerosis (any presence of cervico-cerebral [aCC] atherosclerosis, extracranial [EC] atherosclerosis and intracranial [IC] atherosclerosis) and cerebral small vessel ischemia (silent brain infarct [SBI] and cerebral white matter hyperintensity [cWMH]) was analyzed after adjusting for cardiovascular risk factors.
  
  
  RESULTS
  There was no association between values for natural log-transformed tHcyt (log-Hcyt) and aCC atherosclerosis, EC atherosclerosis, or IC atherosclerosis. The log-Hcyt was independently associated with cWMH (OR: 3.07, 95% CI: 1.64-5.75) and SBI (OR: 2.91, 95% CI: 1.57-5.40) in multivariate analysis. Median plasma tHcyt level increased as the severity of cWMH increased.
  
  
  CONCLUSIONS
  Our results suggest that hyperhomocysteinemia plays a major role in the development of cerebral small vessel ischemia, but not in the development of atherosclerosis of major cerebral arteries.
authors.affiliation: Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
authors.forename: So-Young
authors.initials: SY
authors.lastname: Park
authors.forename: Se-A
authors.initials: SA
authors.lastname: An
authors.forename: Han-Bin
authors.initials: HB
authors.lastname: Lee
authors.forename: Yoon
authors.initials: Y
authors.lastname: Kim
authors.forename: Nam-Keun
authors.initials: NK
authors.lastname: Kim
authors.forename: Sang-Heum
authors.initials: SH
authors.lastname: Kim
authors.forename: Ok-Joon
authors.initials: OJ
authors.lastname: Kim
authors.forename: Seung-Hun
authors.initials: SH
authors.lastname: Oh
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D002533:Cerebral Angiography / Q000379:methods; D059345:Cerebral Small Vessel Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D016009:Chi-Square Distribution; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D002537:Intracranial Arteriosclerosis / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D056784:Leukoencephalopathies / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D016015:Logistic Models; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D006710:Homocysteine