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Hyperhomocysteinemia is associated with volumetric white matter change in patients with small vessel disease

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Abstract

Background

Hyperhomocysteinemia is associated with cerebral small vessel disease (SVD). We examined the relationship between homocysteine and 1) volumetric measure of white matter change (WMC), 2) silent brain infarcts, 3) cerebral atrophy on MRI and 4) cognition on a consecutive cohort of patients with stroke associated with SVD.

Subjects and methods

Fifty–seven patients consecutively admitted to the Acute Stroke Unit in a university hospital due to stroke associated with SVD were recruited and assessed three months after the stroke. Non–fasting homocysteine was obtained. Using MRI, the number of infarcts, volume of WMC and cerebral atrophy were measured. General cognitive functions were assessed using the Mini Mental State Examination and Alzheimer's disease Assessment Scale. Mattis Dementia Rating Scale – Initiation/Perseveration subset was used to assess executive cognitive functions.

Results

Hyperhomocysteinemia (≥ 14.88 μmol/L) significantly accounted for the volume of WMC on MRI in a multivariate stepwise regression model (adjusted R2=0.058, p <0.05) after adjustment for age and folate level. Patients in the highest quartile of WMC volume had significantly higher levels of homocysteine than those in lowest quartile (p <0.001). No significant relationship was found between homocysteine and silent brain infarcts, cerebral atrophy and performance on psychometric tests.

Conclusion

Hyperhomocysteinemia is associated with volumetric measure of WMC among patients with SVD. The role of homocysteine in the development of silent brain infarcts and cerebral atrophy as previously reported cannot be ascertained in this study. No direct relationship was found between homocysteine and cognitive functions.

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Authors and Affiliations

  1. Dept. of Radiology and Organ Imaging, Chinese University of Hong Kong, Hong Kong HKSAR

    W. W. M. Lam MD

  2. Dept. of Medicine and Therapeutics Chinese, University of Hong Kong, 9/F Clinical Sciences Building, Prince of Wales Hospital Shatin, New Territories, Hong Kong

    A. Wong BSc, V. Mok MD, Y. H. Fan MD, K. S. Liang MD &  K. S. Wong

Authors
  1. A. Wong BSc
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  2. V. Mok MD
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  3. Y. H. Fan MD
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  4. W. W. M. Lam MD
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  5. K. S. Liang MD
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  6. K. S. Wong
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Corresponding author

Correspondence to K. S. Wong.

Additional information

This study was supported by the Neurology research fund of Division of Neurology, Department of Medicine and Therapeutics, Chinese University of Hong Kong.

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Wong, A., Mok, V., Fan, Y.H. et al. Hyperhomocysteinemia is associated with volumetric white matter change in patients with small vessel disease. J Neurol 253, 441–447 (2006). https://doi.org/10.1007/s00415-005-0022-x

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  • DOI: https://doi.org/10.1007/s00415-005-0022-x

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