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- Title
Impact of homocysteine on cortical perfusion and cognitive decline in mild Alzheimer's dementia.
- Authors
Huang, C.‐W.; Chang, W.‐N.; Huang, S.‐H.; Lui, C.‐C.; Chen, N.‐C.; Chang, Y.‐T.; Lee, C.‐C.; Chang, C.‐C.; Chang, A. Y. W.
- Abstract
Background and purpose Elevated plasma total homocysteine level (t Hcy) is associated with increased risk of dementia via increased white matter changes or reduction in cortical volume. Whether t Hcy has an independent impact on regional perfusion and if it can predict a more rapid cognitive decline in mild Alzheimer dementia (AD) warrants investigation. Methods Eighty AD patients with a clinical dementia rating of 1 were enrolled. Their Cognitive Ability Screening Instrument ( CASI) scores on enrolment and after 1 year of follow-up as well as their perfusion index ( PI) from single photon emission computed tomography upon enrolment were analyzed. Results In cross-sectional analysis, elevated t Hcy was associated with lower frontal PI independent of cerebrovascular risk factors ( β = −0.35, P = 0.009). The CASI scores correlated with temporo-parietal PI (Pearson r range 0.3-0.39, P < 0.01) but not with t Hcy or frontal PI. By longitudinal analysis, only t Hcy level was related to a more rapid cognitive decline (odds ratio for executive function score 1.82; odds ratio for total CASI score 1.74). Conclusions Cognitive performance in mild AD can be reflected by hypo-perfusion of the temporo-parietal region while frontal hypo-perfusion may be mediated by t Hcy. t Hcy level is an independent risk factor for rapid cognitive decline, especially in the executive function.
- Subjects
HOMOCYSTEINE; SULFUR amino acids; NEUROBEHAVIORAL disorders; HUNTINGTON disease; PHOTON emission
- Publication
European Journal of Neurology, 2013, Vol 20, Issue 8, p1191
- ISSN
1351-5101
- Publication type
Article
- DOI
10.1111/ene.12159