[Homocysteine and cognitive impairment in Parkinson's disease]. / Homocisteína y deterioro cognitivo en la enfermedad de Parkinson.

INTRODUCTION: The relationship between homocysteine (Hc) and vascular diseases has been known for more than 30 years. Lately, Hc has also been related to cognitive and motor impairment. In Parkinson's disease (PD), chronic treatment with levodopa could induce higher levels of Hc, and thus may increase risk of cognitive impairment. AIMS: To confirm that PD patients treated with levodopa have higher levels of Hc and to establish a relationship between Hc, folic acid and vitamin B12 levels. Also, we studied a possible link between those variables and cognitive function. PATIENTS AND METHODS: 58 patients with diagnosis of PD were included (45 under treatment with levodopa). Basal levels of Hc, vitamin B12 and folic acid were determined. Forty five patients underwent neuropsychological evaluation. RESULTS: Hc levels were significantly higher in patients taking levodopa and were not related to levodopa dosage or treatment duration. There was a negative correlation between Hc levels and those of vitamin B12 and folic acid in men but we found no such correlation in women. Entacapone was not found to reduce Hc levels. Hc levels were significantly higher in patients with cognitive impairment (9 out of 45 patients). CONCLUSIONS: Our study confirms presence of high levels of Hc in PD patients under treatment with levodopa, more evident in patients with cognitive impairment.

Homocisteína y deterioro cognitivo en la enfermedad de Parkinson / Homocysteine and cognitive impairment in Parkinson’s disease

Introducción. La relación entre homocisteína (Hc) y enfermedades vasculares se conoce desde hace más de 30 años. En los últimos años se ha relacionado también con deterioro cognitivo y motor. En la enfermedad de Parkinson (EP), el tratamiento crónico con levodopa puede inducir un incremento en los niveles de Hc, implicando un riesgo añadido para el deterioro cognitivo. Objetivos. Confirmar la elevación de los niveles de Hc en pacientes con EP tratados con levodopa, su relación con los niveles de vitamina B12 y folato, y si podía existir una relación entre dichas variables y la función cognitiva. Pacientes y métodos. Se incluyeron 58 pacientes diagnosticados de EP (45 en tratamiento con levodopa), se determinaron los niveles basales de Hc, vitamina B12 y folato, y se realizó una evaluación neuropsicológica en 45 de los pacientes. Resultados. El nivel de Hc estaba significativamente más elevado en los pacientes en tratamiento con levodopa, sin relación con la dosis ni el tiempo en tratamiento. Existía una correlación negativa entre los valores de Hc y vitamina B12 y folato en los hombres, que no se observó en las mujeres. Tomar entacapona no redujo los niveles de Hc. El nivel de Hc estaba significativamente más elevado en los pacientes con deterioro cognitivo (9 de los 45 evaluados).Conclusiones. Nuestro estudio confirma la elevación de los niveles de Hc en pacientes con EP en tratamiento con levodopa, y de forma más evidente en los pacientes con deterioro cognitivo (AU)

Introduction. The relationship between homocysteine (Hc) and vascular diseases has been known for more than 30 years. Lately, Hc has also been related to cognitive and motor impairment. In Parkinson’s disease (PD), chronic treatment with levodopa could induce higher levels of Hc, and thus may increase risk of cognitive impairment. Aims. To confirm that PD patients treated with levodopa have higher levels of Hc and to establish a relationship between Hc, folic acid and vitamin B12 levels. Also, we studied a possible link between those variables and cognitive function. Patients and methods. 58 patients with diagnosis of PD were included (45 under treatment with levodopa). Basal levels of Hc, vitamin B12 and folic acid were determined. Forty five patients underwent neuropsychological evaluation. Results. Hc levels were significantly higher in patients taking levodopa and were not related to levodopa dosage or treatment duration. There was a negative correlation between Hc levels and those of vitamin B12 and folic acid in men but we found no such correlation in women. Entacapone was not found to reduce Hc levels. Hc levels were significantly higher in patients with cognitive impairment (9 out of 45 patients). Conclusions. Our study confirms presence of high levels of Hc in PD patients under treatment with levodopa, more evidentin patients with cognitive impairment (AU)