Details

Autor(en) / Beteiligte

• 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.

Titel

Impact of homocysteine on cortical perfusion and cognitive decline in mild Alzheimer's dementia

Ist Teil von

• European journal of neurology, 2013-08, Vol.20 (8), p.1191-1197

Ort / Verlag

England: Blackwell Publishing Ltd

Erscheinungsjahr

2013

Quelle

Wiley Online Library Journals Frontfile Complete

Beschreibungen/Notizen

• Background and purpose Elevated plasma total homocysteine level (tHcy) is associated with increased risk of dementia via increased white matter changes or reduction in cortical volume. Whether tHcy 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 tHcy 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 tHcy or frontal PI. By longitudinal analysis, only tHcy 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 tHcy. tHcy level is an independent risk factor for rapid cognitive decline, especially in the executive function.