Periventricular White Matter Lucencies Relate to Low Vitamin B12 Levels in Patients With Small Vessel Stroke

Pieters, B. M. A.; Staals, Julie; Knottnerus, Iris L.H.; Rouhl, Rob P.W.; Menheere, P. P. C. A.; Kessels, Alfons; Lodder, J.

doi:10.1161/strokeaha.108.523431

Cited by 42 publications

(59 citation statements)

References 21 publications

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“…Although diabetes mellitus (Padovani1 et al, 1997;Anan et al, 2009), dyslipoproteinemia (Park et al, 2007;Anan et al, 2009), smoking (Park et al, 2007;van Dijk et al, 2008), low vitamin B12 level (de Lau et al, 2009;Pieters et al, 2009), and hyperhomocysteinemia (Hassan et al, 2004;Wright et al, 2005) are also risk factors of LA, these explain only a proportion of the occurrence and progression of LA. Yet both the heterogeneity of histopathologic correlates and the difference of clinical consequences between different LA types implied that they are highly heritable and genetics were implicated in the occurrence and progression of LA (De Groot et al, 2002;Prins et al, 2004;Bracco et al, 2005;de Leeuw et al, 2006;Choi et al, 2009).…”

Section: Genetics Of Lamentioning

confidence: 99%

Genetic associations of leukoaraiosis indicate pathophysiological mechanisms in white matter lesions etiology

Lin¹,

Huang

Tzeng

2015

Reviews in the Neurosciences

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AbstractLeukoaraiosis (LA), also called white matter lesions (WMLs) and white matter hyperintensities (WMHs), is a frequent neuroimaging finding commonly seen on magnetic resonance imaging brain scans of elderly people with prevalence ranging from 50% to 100%. Although it remains asymptomatic, LA is not considered to be benign, and it is showed to be related to a host of poor clinical outcomes and increases the risk of disability, dementia, depression, stroke, and the overall morbidity and mortality. Pathologically, LA is characterized by loss of myelin and axons, patchy demyelination, and denudation of ependyma in regions of WMH. Age and hypertension are the most importantly established risk factors for LA. However, the precise pathogenic mechanisms remain unclear. Together with the previous findings, our recent genetic results strongly supported that LA is associated with immune response and neuroinflammation. Therefore, we confidently hypothesized that LA was not only a common neuroimaging phenomenon in the elderly but also an emerging neuroinflammatory disorder in the central nervous system. This article focusing on neuroimaging classification, genetics basis, and putative molecular mechanism introduced the basic knowledge and current status of LA and put forward some of our research ideas and results from our molecular genetics research, which may pave the way for deciphering the putative pathogenic mechanism, risk factor, epigenetic index, and its application in diagnostic agents or drug target for prevention and treatment. Thus, it could provide clinicians and researchers with a specific and modern overview of LA to enable the understanding of recent progress and future directions in this illness.

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Section: Genetics Of Lamentioning

confidence: 99%

Genetic associations of leukoaraiosis indicate pathophysiological mechanisms in white matter lesions etiology

Lin¹,

Huang

Tzeng

2015

Reviews in the Neurosciences

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“…Several studies have reported an association between low vitamin B12 levels and white matter disease, especially with periventricular lesions 55 56. However, even though there is some evidence that low vitamin B12 levels and hyperhomocysteinaemia, which may be caused by lack of vitamin B12, are associated with leukoaraiosis,57 58 there are no data showing that treatment with vitamin B12 or lowering homocysteine levels improves white matter disease or slows its progression.…”

Section: Risk Factorsmentioning

confidence: 99%

Age-related cerebral white matter disease (leukoaraiosis): a review

Grueter

Schulz

2011

Postgraduate Medical Journal

160

140

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With the availability of improved brain imaging techniques, the high prevalence and clinical importance of cerebral small vessel disease have been increasingly recognised in recent years. As age is one of the most important risk factors for this condition, its prevalence is set to rise further as populations age. This may lead to an increase in the clinical consequences of white matter disease, namely cognitive decline, decreased mobility and increased stroke risk. Given the impact this will have on individuals and on healthcare systems, knowledge of the risk factors for small vessel disease, its prevention and its treatment is becoming more important. Although a lot of data are now available on the epidemiology, risk factors, clinical consequences and prognosis of leukoaraiosis, some of this information is conflicting. In this review, we summarise the current literature on cerebral small vessel disease, with an emphasis on its clinical aspects.

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“…Homocysteine, Folate, and Vitamin B12: In 124 patients with lacunar stroke, almost one third had B12 levels below the reference range, more than 15 times the proportion expected, and B12 was correlated with periventricular leukoaraiosis but not with deep white-matter lesions. 31 However, additional data from the Rotterdam Scan Study that included measures of B12 biologic activity and homocysteine found the same association, with only a limited contribution from homocysteine. 32 The Three-City study failed to identify any correlation between B12 and cognition but did find a correlation with low folate and with high homocysteine, although only when folate levels were low.…”

Section: Table 2 Key Results About Other Cardiovascular Risk Factorsmentioning

confidence: 84%

“…Эти дополнительные данные представлены в таблице 2 [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34].…”

Section: церебральная амилоидная ангиопатия сосудистая дисфункция и unclassified

“…Гомоцистеин, фолаты и витамин B 12 : Среди 124 пациентов с лакунарными инсультами, более чем в 30% случаев содержание витамина B 12 было ниже нормального значения более чем в 15 раз. Содержание витамина B 12 коррелировало с перивентрикулярным лейкоареозом, но не с поражением белого вещества [31]. Однако дополнительные данные исследования Rotterdam Scan Study, в котором проводили определение биологической активности B 12 и гомоцистеина, представили подобные взаимосвязи только при ограниченном влиянии уровня гомоцистеина [32].…”

Section: нейровизуализация гистопатология и генетика: в центре внимаunclassified

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Advances in Vascular Cognitive Impairment

Gorelick

Bowler

2010

Stroke

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A dvances in our understanding of vascular cognitive impairment (VCI) have springboarded from further elucidation of the role of vascular risk factors, surgical procedures, medications, and neuroimaging studies that are related to this condition. The main focus of this VCI review will highlight the relation of diabetes mellitus and hippocampal dysfunction in VCI; coronary artery bypass surgery and cognitive decline; the role of cerebral amyloid angiopathy (CAA) in vascular dysfunction; and a discussion of other cardiovascular risk factors, treatment, and neuroimaging findings related to disease progression; and histopathologic and genetic correlates. Diabetes Mellitus, Hippocampal Function, Cerebral Blood Volume, Glucose, and InfarctsDiabetes increases the risk of both VCI and Alzheimer disease and may do so by the effects of insulin resistance, hyperglycemia-related increases in advanced glycation end products, and via oxidative stress, inflammation, and macrovascular or microvascular injury. 1 Insulin is transported into the central nervous system through the blood-brain barrier by a saturable receptor-mediated process, and insulin receptors are located in astrocytes and neuronal synapses and are highly concentrated in the olfactory bulb, cerebral cortex, hippocampus, hypothalamus, amygdala, and septum. 1 Of these structures, the hippocampus has been a focus of interest in relation to metabolic dysfunction and cognitive impairment in persons with diabetes.Wu et al 2 have shown that in community-based, nondemented elderly who underwent magnetic resonance imaging (MRI) and high-resolution functional mapping of the hippocampus, both diabetes and brain infarcts were associated with hippocampal dysfunction but with separate hippocampal subregions suggestive of distinct underlying mechanisms. Specifically, blood glucose levels were inversely and selectively correlated with dentate gyrus cerebral blood volume, and blood glucose levels were selectively and inversely correlated with total recall on the Selective Reminding Test, whereas CA1 dysfunction was linked to the occurrence of cerebral infarcts, an area known to be differentially vulnerable to transient hypoperfusion. Therefore, these findings clarify how blood glucose levels and brain infarcts in later life may differentially target hippocampal formation and suggest possible mechanisms for prevention of late-life memory decline.Diabetes is nonetheless associated with a variety of types of cerebral damage. In the SMART study of MRI segmentation data in 1043 individuals, of whom 151 had type 2 diabetes, diabetes mellitus was associated with global atrophy, subcortical atrophy, leukoaraiosis, and lacunar infarcts (but not large infarcts) after correction for other common vascular risk factors. 3 In the Adult Changes in Thought Study, a longitudinal, population-based study of aging and cognitive decline, 2 different patterns of cerebral injury at brain necropsy were noted in patients with dementia: Individuals without diabetes had a greater amyloid-B peptide load an...

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Periventricular White Matter Lucencies Relate to Low Vitamin B12 Levels in Patients With Small Vessel Stroke

Abstract: More severe periventricular white matter lesions in lacunar stroke patients relate to lower vitamin B12 levels. A possible causal relationship should now be studied prospectively.

Cited by 42 publications

References 21 publications

Genetic associations of leukoaraiosis indicate pathophysiological mechanisms in white matter lesions etiology

Genetic associations of leukoaraiosis indicate pathophysiological mechanisms in white matter lesions etiology

Age-related cerebral white matter disease (leukoaraiosis): a review

Advances in Vascular Cognitive Impairment

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