Elevated Plasma Level of Homocysteine is an Independent Risk Factor for Peripheral Neuropathy

Luo, Jin; Sivaraaman, Kartik; Nouh, A.; Dun, Nae J.

doi:10.9734/bjmmr/2014/5206

Cited by 13 publications

(17 citation statements)

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“…[40] The current study provided evidence that the large fiber dysfunction occurs in central conduction, involving the somatosensory pathway. The findings combining our previous [16,18] and current observations suggest that, in addition to B12 deficiency, eHcy may be a potential risk factor in interfering with peripheral and central conduction of the somatosensory pathway. In other words, it is possible that the mechanism by which B12 deficiency causes central and peripheral nervous system dysfunction maybe partly via eHcy.…”

Section: P100-p-l P100-p-r P100-g-l P100-g-rsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

“…[16,18] We have recently reported that eHcy is an independent risk factor for the development of peripheral neuropathy. [16] The estimated incidence of the isolated eHcy-induced neuropathy was as low as 1.81% of peripheral neuropathy (our unpublished data). The electrophysiologic features of the isolated eHcy-induced peripheral neuropathy are a mild, large fiber sensorimotor neuropathy with mixed neurophysiologic features of mild demyelination and distal axonal degeneration, although the involvement of small diameter fibers cannot be dismissed.…”

Section: Discussionmentioning

confidence: 99%

“…Neurophysiology laboratory databank of evoked potentials and the charts of subjects with a clinical diagnosis of eHcy-induced neuropathy [16] seen in the Neuromuscular Clinic were initially retrospectively reviewed. The symptoms and signs of neuropathy included the presentation of numbness and tingling in the distal limbs with a decreased sensation in a glove-and/or stocking-like pattern.…”

Section: Methodsmentioning

confidence: 99%

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Central somatosensory conduction slowing in adults with isolated elevated plasma level of homocysteine

Luo¹,

Bumanlag²,

Ansari³

et al. 2015

Neuroimmunol Neuroinflammation

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Aim: Elevated plasma level of homocysteine (eHcy) is a recognized risk factor for dementia. However, whether the central conduction is affected in patients with an isolated eHcy is unknown. In this study, we addressed whether central conduction is altered in adults with eHcy. Methods: Evoked potential studies including somatosensory (SSEP), visual (VEP) and brainstem auditory evoked potentials (BAEP), were performed to evaluate central conduction in patients with isolated eHcy. Results: Nine SSEP, 7 VEP, and 6 BAEP were studied in 9 patients with eHcy (age: 63.3 ± 7.5 years old, mean ± standard deviation, male/female: 4/5). SSEP with median nerve stimulation was delayed in peak latency of N9 (5/9/55.6%, abnormal/total subjects/percentage), N13 (7/9/77.8%), N20 (6/9/66.7%), and/or interpeak latency of N9-N13 (5/9/55.6%), N13-N20 (5/9/55.6%), and N9-N20 (4/9/44.4%). There was one delayed P100 latency (1/7/14.3%) in 7 VEP. BAEP was within normal limits in all the 6 subjects tested. Conclusion: Our pilot study provided neurophysiologic evidence of central conduction slowness in patients with eHcy, which may be due to a large diameter fiber dysfunction within the somatosensory, but not the visual and auditory, white matter pathway. The central conduction slowing in eHcy may be relevant to the pathophysiologic background for slowing the central processing.

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Section: P100-p-l P100-p-r P100-g-l P100-g-rsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Central somatosensory conduction slowing in adults with isolated elevated plasma level of homocysteine

Luo¹,

Bumanlag²,

Ansari³

et al. 2015

Neuroimmunol Neuroinflammation

View full text Add to dashboard Cite

show abstract

“…The clinical diagnosis of PN was made based on the clinical information, which was defined as the clinical findings from history, clinical manifestation, and neurologic examination, such as presentation of symptoms of numbness and tingling with or without weakness in distal limbs, and signs of sensory deficits such as light touch, temperature or vibration sensations, and decrease or absence of ankle reflex [5].…”

Section: Methodsmentioning

confidence: 99%

Sampling an Intrinsic Foot Muscle Improves Electrodiagnostic Sensitivity for Peripheral Neuropathy

Luo¹

2016

J Neurol Exp Neurosci

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Routinely performed electrodiagnostic study may be normal in some subjects with mild peripheral neuropathy such as acral dysesthesia and/or weakness and, therefore, fails to confirm the diagnosis at the early stage. Aiming to improve electrodiagnostic sensitivity, we studied critical muscle sampling in electromyography. Subjects with clinical diagnosis of peripheral neuropathy and with normal conventional electrodiagnostic findings were initially recorded.An additional muscle sampling on the first dorsal interosseous pedis was performed. Based on the observation whether there was an absence or presence of abnormal electromyography findings in the muscle of first dorsal interosseous pedis, they were divided into normal group-A or abnormal Group-B. Relationships between the frequency of the abnormal electrodiagnostic study and comorbidities were analyzed. Group-A with 63 subjects (age 45.0 ± 13.0 years old, Male/Female = 16/47) while Group-B with 73 subjects (age 54.2 ± 13.5, M/F = 29/43) were identified based on whether there was the absence or presence of fibrillation potentials and positive sharp waves, an indicator of active denervation process, in the muscle of first dorsal interosseous pedis.More than half of the cohort had abnormal findings, which was increased in frequencies in diabetes, distal weakness, elderly and male populations. Sampling the first dorsal interosseous pedis improves the electrodiagnostic sensitivity for peripheral neuropathy.

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Causes of neuropathy in patients referred as “idiopathic neuropathy”

Luo

Dun

2016

Muscle Nerve

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Elevated Plasma Level of Homocysteine is an Independent Risk Factor for Peripheral Neuropathy

Cited by 13 publications

References 0 publications

Central somatosensory conduction slowing in adults with isolated elevated plasma level of homocysteine

Central somatosensory conduction slowing in adults with isolated elevated plasma level of homocysteine

Sampling an Intrinsic Foot Muscle Improves Electrodiagnostic Sensitivity for Peripheral Neuropathy

Causes of neuropathy in patients referred as “idiopathic neuropathy”

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