title: Advances in clinical determinants and neurological manifestations of B vitamin deficiency in adults.
abstract: B vitamin deficiency is a leading cause of neurological impairment and disability throughout the world. Multiple B vitamin deficiencies often coexist, and thus an understanding of the complex relationships between the different biochemical pathways regulated in the brain by these vitamins may facilitate prompter diagnosis and improved treatment. Particular populations at risk for multiple B vitamin deficiencies include the elderly, people with alcoholism, patients with heart failure, patients with recent obesity surgery, and vegetarians/vegans. Recently, new clinical settings that predispose individuals to B vitamin deficiency have been highlighted. Moreover, other data indicate a possible pathogenetic role of subclinical chronic B vitamin deficiency in neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis. In light of these findings, this review examines the clinical manifestations of B vitamin deficiency and the effect of B vitamin deficiency on the adult nervous system. The interrelationships of multiple B vitamin deficiencies are emphasized, along with the clinical phenotypes related to B vitamin deficiencies. Recent advances in the clinical determinants and diagnostic clues of B vitamin deficiency, as well as the suggested therapies for B vitamin disorders, are described.
authors.affiliation: G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA. gpsechi@uniss.it.
authors.forename: GianPietro
authors.initials: G
authors.lastname: Sechi
authors.affiliation: G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Elia
authors.initials: E
authors.lastname: Sechi
authors.affiliation: G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Chiara
authors.initials: C
authors.lastname: Fois
authors.affiliation: G.P. Sechi, E. Sechi, and C. Fois are with the Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. N. Kumar is with the Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Kumar
mesh_terms: D000328:Adult; D000544:Alzheimer Disease / Q000209:etiology / Q000378:metabolism; D000690:Amyotrophic Lateral Sclerosis / Q000209:etiology / Q000378:metabolism; D002490:Central Nervous System / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D009422:Nervous System Diseases / Q000209:etiology* / Q000378:metabolism; D010300:Parkinson Disease / Q000209:etiology / Q000378:metabolism; D014803:Vitamin B Complex / Q000378:metabolism*; D014804:Vitamin B Deficiency / Q000150:complications* / Q000378:metabolism
chemical_list: D014803:Vitamin B Complex
keywords: B vitamins; adults; deficiency; nervous system.