Serum Total Homocysteine and Its Biomarkers "Vitamin B12 and Folic Acid" In Patients with Multiple Sclerosis: The Relation to Disease Course, Severity and Cognitive Impairment

[摘要] Background: Several recent studies have investigated the link between hyperhomocysteinemia and the risk of dementia. However, the association between hyperhomocysteinemia and multiple sclerosis (MS) and its cognitive impairment is still investigational. Objective: is to examine the possible association between increased plasma total homocysteine level and multiple sclerosis not only the disease course and severity but also its association with cognitive impairment. Methods: 42 M.S. patients were enrolled in this study with 40 healthy control subjects. All subjects underwent full history with complete general and neurological examination and cerebral MRI. Physical disability was rated using expanded disability status scale (EDSS) score). Specialized neuropsychological scales tests were done. The measurements of serum total homocysteine and its biological determinants vit B12 and folic acid were obtained by chemilumenscence immunoassay. Results: The course of M.S. was relapsing remittent in 66.3%, secondary progressive in 23.8% and primary progressive in 9.9%. Cognitive impairment was present in 38.1%. Hyperhomocysteinemia was found in M.S. patients than in controls (P<0.001), in progressive type as well as with more severe physical disability (P<0.001), and in moderate cognitive impairment than mild cognitive impairment (P<0.001). Cognitive impairment was significantly higher in patients with progressive course than relapsing remitting type (P<0.001) and in severe physical disability (P<0.001). Conclusion: This study confirm the possible association between increased plasma total homocysteine level and multiple sclerosis not only the disease course and severity but also its association with cognitive impairment. (Egypt J Neurol Psychiat Neurosurg. 2010; 47(1): 169-174)

[学科分类] 精神健康和精神病学