Association of plasma homocysteine concentration with cerebral white matter hyperintensity on magnetic resonance images in stroke patients

Tseng, Yu-Lung; Chang, Yung‐Yee; Liu, Jiashou; Su, Chen-San; Lai, Shung-Lon; Lan, Min‐Yu

doi:10.1016/j.jns.2009.03.030

Cited by 36 publications

(28 citation statements)

References 35 publications

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“…This observation is in contrast to reports by other groups who have described a greater number of infarcts and more WMH burden with higher homocysteine concentrations. [27][28][29] Absence of an association in our study may be due to the few subjects. The observation of effect modification by APOE4 on the association of cystathionine and TBV is consistent with evidence that the genotype and low B vitamin status confers greater vulnerability to cognitive deficits.…”

Section: Resultscontrasting

confidence: 57%

Vitamin B12, cognition, and brain MRI measures: A cross-sectional examination

2011

Neurology

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Objective: To investigate the interrelations of serum vitamin B12 markers with brain volumes, cerebral infarcts, and performance in different cognitive domains in a biracial population sample cross-sectionally. Methods:In 121 community-dwelling participants of the Chicago Health and Aging Project, serum markers of vitamin B12 status were related to summary measures of neuropsychological tests of 5 cognitive domains and brain MRI measures obtained on average 4.6 years later among 121 older adults. Results:Concentrations of all vitamin B12-related markers, but not serum vitamin B12 itself, were associated with global cognitive function and with total brain volume. Methylmalonate levels were associated with poorer episodic memory and perceptual speed, and cystathionine and 2-methylcitrate with poorer episodic and semantic memory. Homocysteine concentrations were associated with decreased total brain volume. The homocysteine-global cognition effect was modified and no longer statistically significant with adjustment for white matter volume or cerebral infarcts. The methylmalonate-global cognition effect was modified and no longer significant with adjustment for total brain volume. Conclusions:Methylmalonate, a specific marker of B12 deficiency, may affect cognition by reducing total brain volume whereas the effect of homocysteine (nonspecific to vitamin B12 deficiency) on cognitive performance may be mediated through increased white matter hyperintensity and cerebral infarcts. Vitamin B12 status may affect the brain through multiple mechanisms. Neurology White matter hyperintensity volume (WMHV), cerebral infarcts, and total brain volume (TBV) have been related to performance in multiple cognitive domains 1-4 but few reports exist in which both cognitive performance and structural brain abnormalities are examined in the context of vitamin B12 status. 5,6 To date, no study has investigated these relations with vitamin B12 status among nonwhites or in populations with folic acid fortification policies such as in the United States.In our ongoing study of the risk factors for cognitive disorders in a biracial community, the Chicago Health and Aging Project (CHAP), we reported that brain MRI measures were associated with cognitive performance, especially perceptual speed in both blacks and whites. Moreover, we found that serum vitamin B12 and methylmalonic acid (MMA) concentrations were associated with 6-year cognitive decline.7 However, neither performance in specific cognitive domains nor brain MRI measures were examined in relation to vitamin B12-related markers in these reports. Thus, our primary objective in this study was to examine the relations of circulating levels of

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Section: Resultscontrasting

confidence: 57%

Vitamin B12, cognition, and brain MRI measures: A cross-sectional examination

2011

Neurology

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“…Homocysteine is a risk factor for WMI in stroke subjects (Tseng et al, 2009). Cloonan et al demonstrated a positive correlation between WMI load and homocysteine (β=0.11, p=0.003) as well as hemoglobin A1c levels (β=0.1, p=0.008), both of which are associated with endothelial dysfunction via oxidative stress (Cloonan et al, 2015).…”

Section: Management and Treatmentmentioning

confidence: 99%

White matter injury in ischemic stroke

Wang

Liu

Hong

et al. 2016

Progress in Neurobiology

227

206

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Stroke is one of the major causes of disability and mortality worldwide. It is well known that ischemic stroke can cause gray matter injury. However, stroke also elicits profound white matter injury, a risk factor for higher stroke incidence and poor neurological outcomes. The majority of damage caused by stroke is located in subcortical regions and, remarkably, white matter occupies nearly half of the average infarct volume. Indeed, white matter is exquisitely vulnerable to ischemia and is often injured more severely than gray matter. Clinical symptoms related to white matter injury include cognitive dysfunction, emotional disorders, sensorimotor impairments, as well as urinary incontinence and pain, all of which are closely associated with destruction and remodeling of white matter connectivity. White matter injury can be noninvasively detected by MRI, which provides a three-dimensional assessment of its morphology, metabolism, and function. There is an urgent need for novel white matter therapies, as currently available strategies are limited to preclinical animal studies. Optimal protection against ischemic stroke will need to encompass the fortification of both gray and white matter. In this review, we discuss white matter injury after ischemic stroke, focusing on clinical features and tools, such as imaging, manifestation, and potential treatments. We also briefly discuss the pathophysiology of WMI and future research directions.

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“…Perini et al study found that the hyperhomocysteinemia in acute stoke stage was associated with higher risk of small artery disease subtype of stroke [159]. Many studies had indicated that hyperhomocysteinemia was an independent predictor for WMC independent of smoking, hypertension, or age [160–172]. …”

Section: Chemical Biomarkersmentioning

confidence: 99%

Age-Related White Matter Changes

Xiong

Mok

2011

Journal of Aging Research

110

100

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Age-related white matter changes (WMC) are considered manifestation of arteriolosclerotic small vessel disease and are related to age and vascular risk factors. Most recent studies have shown that WMC are associated with a host of poor outcomes, including cognitive impairment, dementia, urinary incontinence, gait disturbances, depression, and increased risk of stroke and death. Although the clinical relevance of WMC has been extensively studied, to date, only very few clinical trials have evaluated potential symptomatic or preventive treatments for WMC. In this paper, we reviewed the current understanding in the pathophysiology, epidemiology, clinical importance, chemical biomarkers, and treatments of age-related WMC.

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Association of plasma homocysteine concentration with cerebral white matter hyperintensity on magnetic resonance images in stroke patients

Cited by 36 publications

References 35 publications

Vitamin B12, cognition, and brain MRI measures: A cross-sectional examination

Vitamin B12, cognition, and brain MRI measures: A cross-sectional examination

White matter injury in ischemic stroke

Age-Related White Matter Changes

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