Neurology Clinic, University of Perugia, S. Maria della Misericordia Hospital, Perugia, Italy.
Eur J Neurol. 2010 May;17(5):661-5. doi: 10.1111/j.1468-1331.2009.02894.x. Epub 2009 Dec 27.
Patients with Parkinson's disease (PD) and chronically treated with L-DOPA exhibit, in a percentage of 10-30%, supra-physiological levels of plasma total homocysteinemia (tHcy). In this study, we have investigated, in a group of hyper-homocysteinemic PD patients, the time of hyper-tHcy recurrence after discontinuation of 1-month folate supplementation given to normalize plasma tHcy levels.
Plasma tHcy, cobalamin and folate were assayed before and after 1-month folate supplementation (5 mg/day), and after 2 and 4 months after folate discontinuation in 29 PD patients (16M/13F, mean age 69.4 +/- 6.9 years) stabilized on a mean L-DOPA dose of 509.4 +/- 312.1 mg/day.
After folate supplementation, plasma tHcy levels fell within the normal range in all patients. At the 2-month control after folate discontinuation, plasma tHcy remained within physiological values in 25 out of 29 patients. Conversely, 4 months after folate discontinuation, all patients exhibited hyper-tHcy.
One-month intake of 5 mg/day folate normalizes plasma tHcy levels in all hyper-homocysteinemic PD patients. Following folate discontinuation, hyper-tHcy recurs in all patients within 4 months. Knowledge of this time interval is useful to optimize pulses of folate therapy in hyper-homocysteinemic patients with PD.
患有帕金森病（PD）且长期接受左旋多巴治疗的患者中，有 10-30%存在血浆总同型半胱氨酸水平（tHcy）超生理水平。在这项研究中，我们研究了一组高同型半胱氨酸血症的 PD 患者，在停止为期 1 个月的叶酸补充以将血浆 tHcy 水平正常化后，高 tHcy 复发的时间。
在 29 名 PD 患者（16 名男性/13 名女性，平均年龄 69.4 +/- 6.9 岁）中，在开始为期 1 个月的叶酸补充（5mg/天）之前和之后，以及在停止叶酸补充后的 2 个月和 4 个月，测定血浆 tHcy、钴胺素和叶酸水平。这些患者的 L-多巴剂量平均为 509.4 +/- 312.1mg/天。
在叶酸补充后，所有患者的血浆 tHcy 水平均降至正常范围。在停止叶酸后的 2 个月复查时，29 名患者中有 25 名的血浆 tHcy 仍处于生理范围内。相反，在停止叶酸 4 个月后，所有患者均出现高 tHcy。
每天摄入 5mg 叶酸可使所有高同型半胱氨酸血症的 PD 患者的血浆 tHcy 水平正常化。停止叶酸补充后，所有患者在 4 个月内均出现高 tHcy。了解这段时间间隔有助于优化高同型半胱氨酸血症 PD 患者的叶酸治疗脉冲。
