Permoda-Osip Agnieszka, Kisielewski Jacek, Dorszewska Jolanta, Rybakowski Janusz
Klinika Psychiatrii Dorosłych UM w Poznaniu.
Pracownia Neurobiologii Katedry Neurologii UM w Poznaniu.
Psychiatr Pol. 2014 Nov-Dec;48(6):1117-26. doi: 10.12740/PP/31394.
The aim of the study was to evaluate a relationship between concentrations of hoocysteine (HCY), vitamin B12 and folic acid and disturbances of cognitive functions during acute episode of bipolar depression.
116 patients were studied (93 women, 23 men), aged 20-78 (mean 51±13) years during acute episode of bipolar depression. Depression was evaluated by the 17-item Hamilton's Depression Rating Scale (HDRS). The following tests measuring cognitive functions were applied: Trail Making Test, Wisconsin Card Sorting Test, Stroop Test and Wechsler Adult Intelligence Scale-Revised. In all patients, the measurements of serum homocysteine, vitamin B12 and folic acid were carried out.
Hyperhomocystemia (HCY>15μM/l) was detected in 41 patients (35%), more frequently in men (52%) than in women (31%). Patients with hyperhomocysteinemia achieved worse results in sub-tests of WAIS-R (verbal understanding and perceptional organization). In men, negative correlation was found between HCY concentration and number of errors in Stroop Test, and WCST (total errors and non-perseverative errors). In women with bipolar disorder, type II, negative correlation between HCY concentration and time of Stroop Test, and between vitamin B12 concentration and number of errors in Stroop Test, were demonstrated. In the whole group and in men, there was positive correlation between higher folic acid concentration and the number of errors in Stroop Test.
The results obtained show higher HCY concentration in considerable proportion of patients with bipolar depression, especially in men. They also confirm a connect between high homocysteine concentration and worse performance in some neuropsychological tests. Such relationship was more marked in men.
本研究旨在评估双相抑郁急性发作期同型半胱氨酸（HCY）、维生素B12和叶酸浓度与认知功能障碍之间的关系。
对116例年龄在20 - 78岁（平均51±13岁）的双相抑郁急性发作期患者进行研究（93例女性，23例男性）。采用17项汉密尔顿抑郁量表（HDRS）评估抑郁程度。应用以下认知功能测试：连线测验、威斯康星卡片分类测验、斯特鲁普测验和韦氏成人智力量表修订版。对所有患者进行血清同型半胱氨酸、维生素B12和叶酸的检测。
41例患者（35%）检测出高同型半胱氨酸血症（HCY>15μM/l），男性（52%）比女性（31%）更常见。高同型半胱氨酸血症患者在韦氏成人智力量表修订版的子测试（言语理解和知觉组织）中成绩较差。在男性中，HCY浓度与斯特鲁普测验错误数以及威斯康星卡片分类测验（总错误数和非持续性错误数）之间呈负相关。在Ⅱ型双相情感障碍女性患者中，HCY浓度与斯特鲁普测验时间之间以及维生素B12浓度与斯特鲁普测验错误数之间呈负相关。在整个研究组和男性中，较高的叶酸浓度与斯特鲁普测验错误数之间呈正相关。
研究结果表明，相当比例的双相抑郁患者，尤其是男性，HCY浓度较高。研究还证实高同型半胱氨酸浓度与某些神经心理学测试中较差的表现之间存在关联。这种关系在男性中更为明显。
