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April 08, 2003; 60 (7) Articles

Effect of l-dopa on plasma homocysteine in PD patients

Relationship to B-vitamin status

J. W. Miller, J. Selhub, M. R. Nadeau, C. A. Thomas, R. G. Feldman, P. A. Wolf
First published April 8, 2003, DOI: https://doi.org/10.1212/01.WNL.0000055899.24594.8E
J. W. Miller
PhD
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J. Selhub
PhD
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M. R. Nadeau
BS
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C. A. Thomas
RN MS
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R. G. Feldman
MD
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P. A. Wolf
MD
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Citation
Effect of l-dopa on plasma homocysteine in PD patients
Relationship to B-vitamin status
J. W. Miller, J. Selhub, M. R. Nadeau, C. A. Thomas, R. G. Feldman, P. A. Wolf
Neurology Apr 2003, 60 (7) 1125-1129; DOI: 10.1212/01.WNL.0000055899.24594.8E

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Abstract

Background: The antiparkinsonian drug l-dopa causes increased cellular synthesis of homocysteine and consequent hyperhomocysteinemia in rats. This effect of l-dopa on plasma homocysteine is accentuated under conditions of impaired homocysteine metabolism such as folate deficiency.

Objective: To investigate the effect of l-dopa administration and B-vitamin status on plasma homocysteine concentrations in humans with PD.

Methods: Plasma homocysteine, folate, vitamin B12, and pyridoxal-5′-phosphate (PLP) concentrations were determined in 40 individuals diagnosed with idiopathic PD who were being treated as outpatients at the Boston University Medical Center Neurology Clinic. Twenty of the patients were on l-dopa therapy (treatment group) and 20 were l-dopa-naive (control group).

Results: The mean plasma homocysteine concentration was higher in the treatment group than in the controls (p = 0.018). Plasma homocysteine was correlated with plasma folate, vitamin B12, and PLP concentrations in the treatment group (p ≤ 0.007) but not in the controls.

Conclusion: l-Dopa can cause hyperhomocysteinemia in PD patients, the extent of which is influenced by B-vitamin status. The B-vitamin requirements necessary to maintain normal plasma homocysteine concentrations are higher in l-dopa-treated patients than in those not on l-dopa therapy. B-Vitamin supplements may be warranted for PD patients on l-dopa therapy.

  • Received September 19, 2002.
  • Accepted December 28, 2002.
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Letters: Rapid online correspondence

  • Reply to Both Letters to the Editor
    • Joshua W Miller, UC Davis Medical Center, Department of Medical Pathology 4645 Second Avenue Research III, Room 3200A Sacramento, CA 95817jwmiller@ucdavis.edu
    Submitted August 11, 2003
  • Effect of L-dopa on plasma homocysteine in PD patients: Relationship to B-vitamin status
    • Alessandro DiRocco, Albert Einstein College of Medicine and Beth Israel Medical Center, PACC-10 Union Square East #2-R New York, NY 10003adirocco@aecom.yu.edu
    • Peter Werner
    Submitted August 11, 2003
  • Effect of L-dopa on plasma homocysteine in PD patients: Relationship to B-vitamin status
    • Katharina Schroecksnadel, Institute of Medical Chemistry and Biochemistry University of Innsbruck, Fritz-Pregl-Streasse 3 Innsbruck, A-6020 AustriaDietmar.Fuchs@uibk.ac.at
    • Friedrich Leblhuber and Dietmar Fuchs
    Submitted August 11, 2003
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