Hyperhomocysteinemia: A Risk Factor for Cognitive Decline in mTBI Patients

Abstract

ObjectiveOur quest was to find an answer for “Why are some people able to recover 100% from a concussion/traumatic brain injury while others tend to have prolonged symptoms after their concussion/traumatic brain injury?”BackgroundThe prevalence of hyperhomocysteinemia in general is 5%–7% with increasing evidence showing higher prevalence of HHcy as age increases. The prevalence of vitamin D deficiency was 41.6% in the American population. The prevalence of vitamin B-12 deficiency is at least 40% in the patients of the Americas. With recent data, the prevalence of magnesium deficiency is around 10%–30% of the population. Hyperhomocysteinemia due MTHFR gene mutation B-12, B-6, magnesium, and folic acid deficiency is well established.Design/MethodsA retrospective study involving 45 patients was conducted in order to correlate the persistent symptoms concussion head injury/traumatic brain injury and their bio nutraceutical deficiency.ResultsThis data provides evidence that a patient's Homocysteine levels are significantly linearly related with their MoCA scores (t = −5.837, df = 34, p-value = 1.403e-06, [95% CI: −0.8406114 to −0.4936554]). In the mTBI group, for every 1 umol/L increase in Homocysteine levels, there is a 0.54217 decrease in MoCA scores. mTBI patients that had Homocysteine levels greater than 14 umol/L were 76% more likely to experience cognitive decline. The mean MoCA score of mTBI patients is significantly lower than the mean MoCA score of patients in the control group (t = −3.2898, df = 67, p-value = 0.0016, [95% CI: −6.710893 to −1.642642]). The mean Homocysteine levels of mTBI patients are significantly greater than the mean Homocysteine levels of patients in the control group (t = 2.2182, df = 85, p-value = 0.0292, [95% CI: 0.3039847 to 5.5603010]).ConclusionsmTBI patients should be routinely screened for serum homocysteine, vitamin D, B12, B6 and magnesium levels to know their risk for cognitive decline.