Martín-Fernández José Javier, Carles-Díes Rafael, Cañizares Francisco, Parra Soledad, Avilés Francisco, Villegas Irene, Morsi-Hassan Ossama, Fernández-Barreiro Andrés, Herrero M Trinidad
Servicio de Neurología, Hospital Universitario Virgen de la Arrixaca, El Palmar, Espana.
Rev Neurol. 2010;50(3):145-51.
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.
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.
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.
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).
Our study confirms presence of high levels of Hc in PD patients under treatment with levodopa, more evident in patients with cognitive impairment.
同型半胱氨酸（Hc）与血管疾病之间的关系已被知晓30多年。最近，Hc还与认知和运动障碍有关。在帕金森病（PD）中，左旋多巴的长期治疗可能会导致Hc水平升高，从而可能增加认知障碍的风险。
证实接受左旋多巴治疗的PD患者Hc水平更高，并确定Hc、叶酸和维生素B12水平之间的关系。此外，我们研究了这些变量与认知功能之间可能存在的联系。
纳入58例诊断为PD的患者（45例接受左旋多巴治疗）。测定Hc、维生素B12和叶酸的基础水平。45例患者接受了神经心理学评估。
服用左旋多巴的患者Hc水平显著更高，且与左旋多巴剂量或治疗持续时间无关。男性患者的Hc水平与维生素B12和叶酸水平呈负相关，但在女性患者中未发现这种相关性。未发现恩他卡朋可降低Hc水平。认知障碍患者（45例患者中有9例）的Hc水平显著更高。
我们的研究证实接受左旋多巴治疗的PD患者存在高水平的Hc，在认知障碍患者中更为明显。
