Investıgatıon of The Effect of Serum Homocysteıne Level on Cognıtıve Functıons in Multıple Sclerosıs Patıents

Yıl 2022, Cilt: 8 Sayı: 2, 297 - 304, 31.05.2022

Tuba Gül M.kazım Onar

https://doi.org/10.19127/mbsjohs.1070107

Öz

Objective: In this study, we aimed to investigate whether serum homocysteine level was higher in patients with MS, and evaluate the effect of this situation on cognitive functions. In addition, we aimed to determine whether high blood homocysteine level is associated with socio-demographic and clinical features and determine the affected cognitive functions with neuropsychological tests.
Methods: We looked at changes in the levels of vitamin B12 and folic acid associated with high levels of serum homocysteine levels. Cognitive performance, and laboratory values of 60 cases with Relapsing-remitting MS (RRMS) patient, and 30 healthy volunteers were compared. The frontal lobe activities, information processing speed, flexibility, and the ability of the calculation, as well as cognitive functions of attention and visuospatial perception and construction of complex skills were also evaluated. For these purposes, Paced Auditory Serial Addition Test (PASAT), Line Orientation Test (LOT) and Stroop Test were used.
Results: Test performance for all of the test steps were found to be defective in MS group more than the control group subjects. In addition, all steps of the test performance were found to be impaired in both patients and healthy subjects with high levels of homocysteine(p<0.001).
Conclusion: In this study visual memory processes, visual-spatial functions, construction skills, planning, programming and executive functions were found to be significantly deteriorated and the reaction time prolonged in RRMS patients with high levels of homocysteine compared with healthy control group

Anahtar Kelimeler

Multiple sclerosis, cognitive impairment, serum homocysteine levels

Kaynakça

• 1. Lassmann H, Brück W, Lucchinetti CF. The immunopathology of multipl sclerosis: an overview. Brain Pathol 2007; 17(2):210-8.
• 2. Trapp BD, Stys PK. Virtual hypoxia and chronic necrosis of demiyelinated axons in multipl sclerosis. Lancet Neurol 2009; 8(3):280-91.
• 3. Mattson MP, Kruman II, Duan W. Folic acid and homocysteine in age-related disease. Ageing Res Rev 2002; 1: 95-111.
• 4. Chiaravalloti ND, Deluca J. Cognitive impairment in multiple sclerosis. Lancet Neurol 2008; 7(12):1139-1151.
• 5. Siegert RJ, Abernethy DA. Depression in multiple sclerosis: a review. J Neurol Neurosurg Psychiatry 2005 Apr;76(4):469-75.
• 6. Engel C, Greim B, Zettl UK. Diagnostics of cognitive dysfunctions in multiple sclerosis. J. Neurol. 2007; 254: II/30–II/34.
• 7. Brattstrom L, Wilcken DE. Homocysteine and cardiovascular disease: cause or effect? Am J Clin Nutr 2000;72: 315–23.
• 8. Durga J, Verhoef P, Bots ML, Schouten E. Homocysteine, and carotid intima-media thickness: a critical appraisal of the evidence. Atherosclerosis 2004;176:1–19.
• 9. Di Minno G, Davi G, Margaglione M. Abnormally High Thromboxane Biosynthesis in Homozygous Homocystinuria. J Clin Invest 1993; 92: 1400-1406.
• 10. Tsai JC, Peralla MA, Yarkizumi M. Promotion of vascular smooth muscle cell growth by homocysteine a link to atherosclerosis. Proc Natl Acad Sci USA.1994; 91: 6369-6373.
• 11. White AR, Huang X, Jobling MF, et al. Homocysteine potentiates copper and amyloid beta peptide-mediated toxicity in primary neuronal cultures: possible risk factors in the Alzheimer’s-type neurodegenerative pathways. J Neurochem 2001; 76: 1509-20.
• 12. Vural A, Tuncer Kurne A, Karabudak R. Immüpatholegenesis of Multiple Sclerosis Part 1: Are all the plaques the same? Ankara University Faculty of Medicine Journal. 2016;69(2):1-6.
• 13. Teunissen CE, van Boxtel MP, Jolles J, de Vente J, Vreeling F, et al. Homocysteine in relation to cognitive performance in pathological and non-pathological conditions. Clin Chem Lab Med 2005; 43(10):1089-95.
• 14. Aksungar FB, Topkaya AE, Yildiz Z, Sahin S, Turk U. Coagulation status and biochemical and inflammatory markers in multiple sclerosis. J Clin Neurosci 2008; 15: 393–397.
• 15. Vrethem M, Mattsson E, Hebelka H, et al. Increased plasma homocysteine levels without signs of vitamin B12 deficiency in patients with multiple sclerosis assessed by blood and cerebospinal fluid homocyteine and methylmalonic acid. Mult Scler 2003; 9: 239–45.
• 16. Baig SM, Qureshi G. Homocysteine and vitamin B12 in multiple sclerosis. Biogenic Amines 1995; 11: 479–85.
• 17. Olaso‐Gonzalez, Gloria, Et Al. Impact Of Supplementation With Vitamins B6, B12, And/Or Folic Acid On The Reduction Of Homocysteine Levels İn Patients With Mild Cognitive İmpairment: A Systematic Review. Iubmb Life 2022; 74.1: 74-84.