TY - JOUR
T1 - Hyperhomocysteinemia in patients with epilepsy
T2 - Does it play a role in the pathogenesis of brain atrophy? A preliminary report
AU - Gorgone, Gaetano
AU - Caccamo, Daniela
AU - Pisani, Laura Rosa
AU - Currò, Monica
AU - Parisi, Giulia
AU - Oteri, Giancarla
AU - Ientile, Riccardo
AU - Rossini, Paolo Maria
AU - Pisani, Francesco
PY - 2009/1
Y1 - 2009/1
N2 - Purpose: Brain atrophy (BA) is observed in 20-50% of patients with epilepsy. Hyper-total-homocysteinemia (hyper-tHcy), which occurs in 10-40% of patients, is considered to be a risk factor for cardiovascular diseases and BA. The present study was aimed at investigating the possible association of hyper-tHcy with BA in a population of patients with epilepsy. Methods: Fifty-eight patients (33 M/25 F, 43.5 ± 13.1 years of age) chronically treated with antiepileptic drugs (AEDs) and 60 controls matched for age and sex were enrolled. All participants underwent determination of plasma tHcy, folate, vitamin B12, and C677T methylene-tetrahydrofolate-reductase (MTHFR) polymorphism genotyping, and brain magnetic resonance imaging (MRI). Results: Patients exhibited significantly higher tHcy and lower folate levels than controls; hyper-tHcy was significantly associated with the variables group (patients vs. controls), MTHFR genotype, and their interaction terms. BA was observed in 30.1% of patients and was significantly associated with hyper-tHcy (β = 0.45, p = 0.003) and polytherapy (β = 0.31, p <0.001). Discussion: Our investigation suggests that hyper-tHcy plays a role in the development of BA in patients with epilepsy. Although the real origin of this phenomenon is not yet fully elucidated, experimental data support the hypothesis of a link of the neuronal Hcy-mediated damage with oxidative stress and excitotoxicity.
AB - Purpose: Brain atrophy (BA) is observed in 20-50% of patients with epilepsy. Hyper-total-homocysteinemia (hyper-tHcy), which occurs in 10-40% of patients, is considered to be a risk factor for cardiovascular diseases and BA. The present study was aimed at investigating the possible association of hyper-tHcy with BA in a population of patients with epilepsy. Methods: Fifty-eight patients (33 M/25 F, 43.5 ± 13.1 years of age) chronically treated with antiepileptic drugs (AEDs) and 60 controls matched for age and sex were enrolled. All participants underwent determination of plasma tHcy, folate, vitamin B12, and C677T methylene-tetrahydrofolate-reductase (MTHFR) polymorphism genotyping, and brain magnetic resonance imaging (MRI). Results: Patients exhibited significantly higher tHcy and lower folate levels than controls; hyper-tHcy was significantly associated with the variables group (patients vs. controls), MTHFR genotype, and their interaction terms. BA was observed in 30.1% of patients and was significantly associated with hyper-tHcy (β = 0.45, p = 0.003) and polytherapy (β = 0.31, p <0.001). Discussion: Our investigation suggests that hyper-tHcy plays a role in the development of BA in patients with epilepsy. Although the real origin of this phenomenon is not yet fully elucidated, experimental data support the hypothesis of a link of the neuronal Hcy-mediated damage with oxidative stress and excitotoxicity.
KW - Brain atrophy
KW - C677T MTHFR polymorphism
KW - Enzyme-inducing antiepileptic drugs
KW - Hyper-total-homocysteinemia
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U2 - 10.1111/j.1528-1167.2008.01967.x
DO - 10.1111/j.1528-1167.2008.01967.x
M3 - Article
C2 - 19125845
AN - SCOPUS:58149286300
VL - 50
SP - 33
EP - 36
JO - Epilepsia
JF - Epilepsia
SN - 0013-9580
IS - SUPPL. 1
ER -