A. DavidSmith, Professor of Pharmacology, University of Oxforddavid.smith@pharm.ox.ac.uk
Submitted June 27, 2002
Sachdev et al. [1] report findings of a relationship between measures of brain atrophy and plasma levels of total homocysteine in 36 patients.
The power of their study was probably too low to detect a relationship between homocysteine and white matter hyperintensities. Two recent studies have now shown such a relationship [2, 3].
In a prospective study on patients with AD, it was
shown that elevated homocysteine levels at baseline were related to a more rapid atrophy of the medial temporal lobe in the following 3 years [4].
In a cohort of normal elderly, the thickness of the medial
temporal lobe is inversely related to the level of plasma homocysteine [5].
In the same cohort, the level of homocysteine was inversely
related to performance on a cognitive test [6].
Together with other findings, recently reviewed [7], the new results are consistent with elevated
homocysteine levels being a risk factor for atrophy of certain brain regions that leads to cognitive decline and to dementia.
References
[1] Sachdev PS, Valenzuela M, Wang XL,Looi JCL, Brodaty H.
Relationship between plasma homocysteine levels and brain atrophy in healthy elderly individuals
Neurology 2002; 58: 1539-1541.
[2] Vermeer SE, van Dijk E, et al. Homocysteine, silent brain infarcts, and white matter
lesions: The Rotterdam Scan Study. Ann Neurol 2002, 51: 285-289.
[3] Hogervorst E, Ribeiro HM, et al. Plasma homocysteine levels, cerebrovascular risk factors, and cerebral white matter changes (leukoaraiosis) in patients with Alzheimer disease. Arch Neurol 2002, 59:787-793.
[4] Clarke R, Smith AD, et al. Folate, vitamin B12, and serum total homocysteine levels in confirmed Alzheimer disease. Arch Neurol 1998, 55: 1449-1455.
[5] Williams JH,Pereira EAC, et al. Hippocampal width relates to
plasma homocysteine in community-dwelling older people. Age Ageing 2002. In press.
[6] Budge M, Johnston C, et al. Plasma total homocysteine and cognitive performance in a volunteer elderly population. Ann NY Acad Sci 2000, 903: 407-410.
[7] Smith AD. Homocysteine, B vitamins, and cognitive deficit in the elderly. Am J Clin Nutr 2002 75: 785-786.
Sachdev et al. [1] report findings of a relationship between measures of brain atrophy and plasma levels of total homocysteine in 36 patients.
The power of their study was probably too low to detect a relationship between homocysteine and white matter hyperintensities. Two recent studies have now shown such a relationship [2, 3].
In a prospective study on patients with AD, it was shown that elevated homocysteine levels at baseline were related to a more rapid atrophy of the medial temporal lobe in the following 3 years [4].
In a cohort of normal elderly, the thickness of the medial temporal lobe is inversely related to the level of plasma homocysteine [5].
In the same cohort, the level of homocysteine was inversely related to performance on a cognitive test [6].
Together with other findings, recently reviewed [7], the new results are consistent with elevated homocysteine levels being a risk factor for atrophy of certain brain regions that leads to cognitive decline and to dementia.
References
[1] Sachdev PS, Valenzuela M, Wang XL,Looi JCL, Brodaty H. Relationship between plasma homocysteine levels and brain atrophy in healthy elderly individuals Neurology 2002; 58: 1539-1541.
[2] Vermeer SE, van Dijk E, et al. Homocysteine, silent brain infarcts, and white matter lesions: The Rotterdam Scan Study. Ann Neurol 2002, 51: 285-289.
[3] Hogervorst E, Ribeiro HM, et al. Plasma homocysteine levels, cerebrovascular risk factors, and cerebral white matter changes (leukoaraiosis) in patients with Alzheimer disease. Arch Neurol 2002, 59:787-793.
[4] Clarke R, Smith AD, et al. Folate, vitamin B12, and serum total homocysteine levels in confirmed Alzheimer disease. Arch Neurol 1998, 55: 1449-1455.
[5] Williams JH,Pereira EAC, et al. Hippocampal width relates to plasma homocysteine in community-dwelling older people. Age Ageing 2002. In press.
[6] Budge M, Johnston C, et al. Plasma total homocysteine and cognitive performance in a volunteer elderly population. Ann NY Acad Sci 2000, 903: 407-410.
[7] Smith AD. Homocysteine, B vitamins, and cognitive deficit in the elderly. Am J Clin Nutr 2002 75: 785-786.