Homocysteine: A modifiable culprit of cognitive impairment for us to conquer?

Ji, Yifan; Lyu, Peiyuan; Jin, Wei; Li, Xiangyu; Li, Xiaosha; Dong, Yanhong

doi:10.1016/j.jns.2019.07.015

“…Homocysteine is not only a uremia toxin but also a biomarker of oxidative stress in patients with MHD. Many observational studies have suggested that elevated blood homocysteine levels are strongly associated with CI [20][21][22]. Moreover, previous studies have found that there are many mechanisms that cause elevated homocysteine levels in MHD patients including deficiency of vitamins B, especially thiamin and folate acid [23].…”

Section: Discussionmentioning

confidence: 99%

A pilot study of thiamin and folic acid in hemodialysis patients with cognitive impairment

Lu

¹

,

Fang

²

,

Zhou

³

et al. 2021

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Objective: This study aimed to explore the effectiveness of thiamin and folic acid supplementation on the improvement of the cognitive function in patients with maintenance hemodialysis. Method: In the present study, we randomly assigned patients undergoing hemodialysis who had the Montreal Cognitive Assessment (MoCA) score lower than 26 to treatment group (n ¼ 25, thiamin 90 mg/day combined with folic acid 30 mg/day) or control group (n ¼ 25, nonintervention). All subjects were followed up for 96 weeks. The primary outcome was the improvement of the MoCA score. The secondary outcomes included homocysteine level, survival and safety. Results: Patients in treatment group had an increase of the MoCA score from 21.95 ± 3.81 at baseline to 25.68 ± 1.96 at week 96 (p < 0.001, primary outcome), as compared with the MoCA score from 20.69 ± 3.40 to 19.62 ± 3.58 in control group. Thiamin combined with folic acid treatment also resulted in lower level of serum homocysteine in treatment group compare with control group at week 96 (p < 0.05, secondary outcome). 3 patients and 9 patients died during follow-up period in treatment and control group respectively (p ¼ 0.048). The proportion of adverse events in treatment group was significantly lower than that in control group. Conclusion: Hemodialysis patients with cognitive impairment treated with thiamin and folic acid had a significant improvement in MoCA score.

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“…Homocysteine is not only a uremia toxin but a biomarker of oxidative stress in patients with MHD. Many observational studies have suggested that elevated blood homocysteine levels are strongly associated with CI [21][22][23] . Moreover, previous studies have found that there are many mechanisms that cause elevated homocysteine levels in MHD patients including de ciency of vitamins B, especially thiamine and folate acid [24] .…”

Section: Discussionmentioning

confidence: 99%

A pilot study of thiamine and folic acid in hemodialysis patients with cognitive impairment

Lu

¹

,

Fang

²

,

Zhou

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: This study aimed to explore the effectiveness of thiamine and folic acid supplementation on the improvement of the cognitive function in patients with maintenance hemodialysis. Methods: In the present study, we randomly assigned patients undergoing hemodialysis who had the Montreal Cognitive Assessment (MoCA) score lower than 26 to treatment group (n=25, thiamine 90mg/day combined with folic acid 30mg/day) or control group (n=25, nonintervention). All subjects were followed up for 96 weeks. The primary outcome was the improvement of the MoCA score. The secondary outcomes included homocysteine level, survival and safety. Results: Patients in treatment group had an increase of the MoCA score from 21.95±3.81 at baseline to 25.68±1.96 at week 96 (P<0.001, primary outcome), as compared with the MoCA score from 20.69±3.40 to 19.62±3.58 in control group. Thiamine combined with folic acid treatment also resulted in lower level of serum homocysteine in treatment group compare with control group at week 96 (P<0.05, secondary outcome). 3 patients and 9 patients died during follow-up period in treatment and control group respectively (P=0.048). The proportion of adverse events in treatment group was significantly lower than that in control group. Conclusion: Hemodialysis patients with cognitive impairment treated with thiamine and folic acid had a significant improvement in MoCA score. Trial registration: Clinical trial registration number: ChiCTR-IPR-17012210.

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“…Homocysteine is not only a uremia toxin but a biomarker of oxidative stress in patients with MHD. Many observational studies have suggested that elevated blood homocysteine levels are strongly associated with CI [16] . Moreover, previous studies have found that there are many mechanisms that cause elevated homocysteine levels in MHD patients including de ciency of vitamins B, especially thiamine and folate acid [17] .…”

Section: Discussionmentioning

confidence: 99%

A pilot study of thiamine and folic acid in hemodialysis patients with cognitive impairment

Lu

¹

,

Fang

²

,

Zhou

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: This study aimed to explore the effectiveness of thiamine and folic acid supplementation on the improvement of the cognitive function in patients with maintenance hemodialysis. Methods: In the present study, we randomly assigned patients undergoing hemodialysis who had the Montreal Cognitive Assessment (MoCA) score lower than 26 to treatment group (n=25, thiamine 90mg/day combined with folic acid 30mg/day) or control group (n=25, nonintervention). All subjects were followed up for 96 weeks. The primary outcome was the improvement of the MoCA score. The secondary outcomes included homocysteine level, survival and safety. Results: Patients in treatment group had an increase of the MoCA score from 21.95±3.81 at baseline to 25.68±1.96 at week 96 (P<0.001, primary outcome), as compared with the MoCA score from 20.69±3.40 to 19.62±3.58 in control group. Thiamine combined with folic acid treatment also resulted in lower level of serum homocysteine in treatment group compare with control group at week 96 (P<0.05, secondary outcome). 3 patients and 9 patients died during follow-up period in treatment and control group respectively (P=0.048). The proportion of adverse events in treatment group was significantly lower than that in control group. Conclusion: Hemodialysis patients with cognitive impairment treated with thiamine and folic acid had a significant improvement in MoCA score. Trial registration: Clinical trial registration number: ChiCTR-IPR-17012210.

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Homocysteine: A modifiable culprit of cognitive impairment for us to conquer?

Cited by 14 publications

References 102 publications

A pilot study of thiamin and folic acid in hemodialysis patients with cognitive impairment

A pilot study of thiamin and folic acid in hemodialysis patients with cognitive impairment

A pilot study of thiamine and folic acid in hemodialysis patients with cognitive impairment

A pilot study of thiamine and folic acid in hemodialysis patients with cognitive impairment

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