Treatment of cobalamin deficiency in dementia, evaluated clinically and with cerebral blood flow measurements

Nilsson, Karin; Warkentin, Siegbert; Hultberg, Björn; Fäldt, R.; Gustafson, Lars

doi:10.1007/bf03339837

Cited by 20 publications

(34 citation statements)

References 30 publications

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“…This observation is in line with previous studies showing an association of circulating homocysteine in healthy aged subjects [12] and of homocysteine lowering treatment in vitamin B12 deficient patients [34] with both global and regional CBF. Although the associations of homocysteine with cerebrovascular disease, brain aging and neurodegenerative disease are well established, the exact mechanisms are not clear.…”

Section: Discussionsupporting

confidence: 93%

Sub-Clinical Cognitive Decline and Resting Cerebral Blood Flow in Middle Aged Men

et al. 2017

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BackgroundAlthough dementia is associated with both global and regional cerebral blood flow (CBF) changes, little is known about cerebral perfusion in the early pre-clinical stages of cognitive decline preceding overt cognitive dysfunction. The aim of this study was to investigate the association of early sub-clinical cognitive decline with CBF.Materials and MethodsThe study participants were recruited from a cohort of Danish men born in 1953. Based on a regression model we selected men who performed better (Group A, n = 94) and poorer (Group B, n = 95) on cognitive testing at age 57 than expected from testing at age 20. Participants underwent supplementary cognitive testing, blood sampling and MRI including measurements of regional and global CBF.ResultsRegional CBF was lower in group B than in group A in the posterior cingulate gyrus and the precuneus. The associations were attenuated when corrected for global atrophy, but remained significant in regions of interest based analysis adjusting for regional gray matter volume and vascular risk factors. No influence of group on global CBF was observed.ConclusionsWe conclude that early sub-clinical cognitive decline is associated with reduced perfusion in the precuneus and posterior cingulate gyrus independently of regional atrophy and vascular risk factors, but cannot be statistically separated from an association with global atrophy.

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Section: Discussionsupporting

confidence: 93%

Sub-Clinical Cognitive Decline and Resting Cerebral Blood Flow in Middle Aged Men

et al. 2017

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“…Un estudio prospectivo en pacientes con delirio que además tenían déficit de vitamina B12 identificó una mejoría en el minimental en más del 50 % de los casos y además se observaron cambios en el flujo cerebral después del suplemento vitamínico (58).…”

Section: Psicosis Delirio Y Otros Trastornos Psiquiátricosunclassified

Déficit de vitamina B12 en la práctica psiquiátrica

Vargas-Upegui

Noreña-Rengifo

2017

iatreia

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RESUMENEs común la solicitud de los niveles de vitamina B12 en pacientes evaluados por psiquiatría y específicamente en las unidades de pacientes agudos, pero, a pesar de la creciente literatura disponible sobre la correlación entre esta hipovitaminosis y los síntomas neuropsiquiátricos, aún existen muchas dudas sobre los grupos poblacionales de riesgo que se deben tamizar, el tipo de examen que se debe solicitar, la forma de hacer el tratamiento y la utilidad real de la reposición vitamínica en la resolución de los síntomas afectivos, cognitivos o psicóticos. Este artículo es una revisión narrativa de la literatura disponible con el objetivo de poder evaluar de forma crítica los interrogantes teóricos y prácticos más relevantes para el psiquiatra actual, con énfasis en la evidencia sobre la correlación entre niveles bajos de vitamina B12 y déficit cognitivo, depresión y algunos trastornos psicóticos.

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“…A relationship between low/normal Hcy levels and a possible protective effect on dementia conversion has not been reported, although our fi ndings support that relationship in MCI patients. However, Hcy-lowering intervention studies have in some small studies and in individual patients been successful in reversing dementia, thus arguing in favor of such a relationship [25][26][27] . Further longitudinal cohort as well as intervention studies are required using large sample sizes and the sensitive vitamin B 12 /folate defi ciency marker Hcy.…”

Section: Discussionmentioning

confidence: 99%

“…In our analyses we excluded all patients having known supplementation with Hcy-lowering agents such as vitamin B 12 and/or folate, thereby neither confi rming nor ruling out the possible protective effects of these vitamins. However, there are some prospective intervention studies with vitamin B 12 and folate on overt dementia patients that have shown benefi cial effects [25][26][27] .…”

Section: Discussionmentioning

confidence: 99%

The Relation between Homocysteine Levels and Development of Alzheimer’s Disease in Mild Cognitive Impairment Patients

Annerbo

Wahlund

Lökk

2005

Dement Geriatr Cogn Disord

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The aim of this study was to investigate over a 3-year period the connection between homocysteine (Hcy) levels and development of Alzheimer’s disease (AD) in patients with mild cognitive impairment (MCI). Hcy was analyzed in 68 men, mean age 65 years, and 68 women, mean age 64 years. Age, sex, cobalamin, folate, creatinine, and thyroid profiles as well as results of Mini-Mental State Examination at the first visit to the memory investigation unit of a geriatric department were recorded from patient journals collected between 1992 and 1999. The total numbers of persons who converted to AD within a period of 3 years from initial investigation with baseline Hcy sampling was 12 of 46 (26%) males, and 18 of 50 women (36%). The total percentage of men and women converting to AD was 31%. Thirty-three percent of men with Hcy levels >20 µmol/l converted to AD. The corresponding figure for men with Hcy levels 20–17 µmol/l was 50%, whereas none of the 18 men with Hcy levels <17 µmol/l converted to AD. These differences were statistically significant. There was also a statistically significant difference between the percentage of women with Hcy levels >16 µmol/l who converted to AD (45%) as compared to those with Hcy levels <16 µmol/l who converted (21%). These findings are inconsistent with the results of other studies showing a positive correlation with hyperhomocysteinemia and occurrence of AD. However, our findings tentatively suggest a possible protective effect of low/normal Hcy levels on dementia conversion in MCI patients.

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Treatment of cobalamin deficiency in dementia, evaluated clinically and with cerebral blood flow measurements

Cited by 20 publications

References 30 publications

Sub-Clinical Cognitive Decline and Resting Cerebral Blood Flow in Middle Aged Men

Sub-Clinical Cognitive Decline and Resting Cerebral Blood Flow in Middle Aged Men

Déficit de vitamina B12 en la práctica psiquiátrica

The Relation between Homocysteine Levels and Development of Alzheimer’s Disease in Mild Cognitive Impairment Patients

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