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High plasma homocysteine levels have been observed in Parkinson's disease (PD) patients treated with levodopa. In this study, we investigated the effects of C677T and A1298C MTHFR polymorphisms, in association with L-DOPA daily dose and vitamin status, on hyperhomocysteinemia development in PD patients. Plasma homocysteine and folate/vitamin B12 levels were assayed in 49 L-DOPA-treated PD patients, and compared with those of 86 healthy subjects. Genotyping for MTHFR polymorphisms was carried out by DG-DGGE. Homocysteine levels were significantly higher in patients than in controls (16.3 +/- 5.7 vs. 11.7 +/- 2.7 micromol/l, P < 0.01). No significant differences were found between patients and controls with regard to folate/vitamin B12 levels, and MTHFR allele distribution. The TT+AA genotype was significantly more frequent in PD patients than in controls (32.5% vs. 17.4%, P < 0.05), but not associated with an increased risk for PD (OR = 2.3, CI = 1.0-5.2). Further, patients carrier of this genotype exhibited a mild hyperhomocysteinemia (22.1 +/- 4.9 micromol/l), while a protective effect was observed in patients having the CC+AA genotype (11.2 +/- 1.6 micromol/l; OR = 0.19, CI = 0.06-0.59). Interestingly, homocysteine levels were also moderately increased in patients with CT heterozygous genotype, in the context of either AA or AC (14.5 +/- 3.6 micromol/l), in comparison to subjects with the CC + AA genotype. Finally, we did not find any significant association of combined C677T and A1298C MTHFR polymorphisms with an increased risk for hyperhomocysteinemia in PD patients. A better understanding of the role of homocysteine and MTHFR genotypes in PD is needed to reveal novel approaches for disease management.

We define as early seizure (ES) those occurring within 7 days after stroke and late seizures those developing beyond 1 week after stroke. Seizures are well known to occur at the onset of intracerebral hemorrhage and serve as a clinical marker. Onset seizures may be focal or generalized, are usually brief and are associated with loss of consciousness in the setting of hemorrhage. A similar concept of immediate seizure occurs in traumatic brain injury. Predictive factors of ES can be classified of general and neurologic origin. An important question is whether ES per se worsen prognosis and outcome. The viability of the penumbral region in animal models of focal ischemia is influenced by the peri-infarct depolarization waves. If this also is true in humans, seizures in the immediate poststroke period might worsen outcome. Recently, hypercholesterolemia has been associated with better functional outcome at 1 month after a first-ever stroke, and multivariate analysis studies have shown that mean cholesterol values were lower in patients with ES compared with controls.

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