Effects of differences in serum total homocysteine, folate, and vitamin B12on cognitive impairment in stroke patients

Abstract

BackgroundVascular cognitive impairment-no dementia (VCIND) refers to the early or mild cognitive impairment induced by cerebral vascular injury. Research shows that serum total homocysteine (tHcy) level is an independent risk factor for cerebral vascular disease and may be closely related to cognitive function.Current studies on the tHcy level in VCIND patients are limited, and the relationship of tHcy with cognitive function remains unclear. This study aims to investigate the tHcy levels in patients with VCIND and to determine their correlation with cognitive function, as well as to provide useful clues for preventing and treating VCIND.MethodsThe tHcy, folate, and vitamin B12 levels in 82 patients with VCIND were reviewed retrospectively and compared with those of 80 stroke patients without cognitive impairment and 69 healthy controls by using the Montreal Cognitive Assessment (MoCA) scale and the event-related potential P300 to evaluate cognitive function.ResultsThe tHcy levels in the VCIND group were higher than those in the other two groups, whereas the folate and Vitamin B12 levels in the VCIND group were lower than those of the other two groups. The tHcy levels in the stroke group were higher than those in the control group, and the folate and vitamin B12 levels in the stroke group were lower than those in the control group. The patients in the VCIND group with high tHcy exhibited lower MoCA scores and prolonged P300 latency than those in with normal tHcy. Correlation analysis showed that tHcy level is positively correlated with P300 latency period and negatively correlated with MoCA score.ConclusionThe tHcy levels were significantly higher and the vitamin B12 and folate levels were significantly lower in the patients with VCIND than those in the other groups. The high tHcy levels in the VCIND patients may be correlated with impaired cognitive function.

Folate and MMA predict cognitive impairment in elderly stroke survivors: A cross sectional study

“…These results indicate that low folate and high MMA are associated with cognitive impairment in elderly men and women, at 20 months after ischemic stroke, and suggest that folate and MMA could be useful biomarkers in identifying stroke surviving elderly individuals, at risk of developing long term cognitive impairment. This is consistent with previous research demonstrating that folate deficiency is associated with cognitive decline in non-stroke affected populations (Moretti et al, 2004;Ramos et al, 2005) and with research demonstrating that acute deficiencies in folate are associated with short term cognitive impairments in stroke survivors (Jiang et al, 2014). In the current study, half of the sample was seen to be clinically deficient in folate.…”

“…However in this cross sectional study, the authors did not report the possible predictive role of folate on cognitive outcomes. Furthermore, this study assessed cognitive impairment at 1 week, 1 month or 3 months following stroke, and thus did not investigate the significance of folate or MMA on longer-term cognitive outcomes (Jiang et al, 2014). Indeed, we have been unable to identify any studies investigating the association between folate, MMA and cognitive ability longer term after stroke.…”

“…Jiang et al (2014) reported that stroke survivors with cognitive impairments (n ¼82) had lower peripheral serum folate, compared to stroke survivors without cognitive impairment, as measured using the Montreal Cognitive Assessment scale. However in this cross sectional study, the authors did not report the possible predictive role of folate on cognitive outcomes.…”

Homocysteine, rather than age of onset, is a better predictor for cognitive function in older adults with bipolar disorder

“…15 One possible explanation for the negative findings may be due to the measures used to assess the vascular risk factors. In addition, biomarkers, such as serum levels of homocysteine, vitamin B12, folate, and triiodothyronine, that are potential risk factors for both cerebrovascular diseases and cognitive dysfunction [26][27][28] have rarely been examined in LOBD. In addition, biomarkers, such as serum levels of homocysteine, vitamin B12, folate, and triiodothyronine, that are potential risk factors for both cerebrovascular diseases and cognitive dysfunction [26][27][28] have rarely been examined in LOBD.…”

“…For example, the Framingham cardiovascular risk score model has been demonstrated as a valid tool to predict cognitive deficits in general population 24,25 but has not been used in studies of patients with LOBD. In addition, biomarkers, such as serum levels of homocysteine, vitamin B12, folate, and triiodothyronine, that are potential risk factors for both cerebrovascular diseases and cognitive dysfunction [26][27][28] have rarely been examined in LOBD.…”