Impact of homocysteine on cortical perfusion and cognitive decline in mild Alzheimer's dementia

被引：35

作者：

Huang, C. -W. ^{[1
,2
,3
]}

Chang, W. -N. ^{[1
]}

Huang, S. -H. ^{[4
]}

Lui, C. -C. ^{[5
]}

Chen, N. -C. ^{[1
]}

Chang, Y. -T. ^{[1
]}

Lee, C. -C. ^{[5
]}

Chang, C. -C. ^{[1
,2
]}

Chang, A. Y. W. ^{[2
,3
]}

机构：

[1] Chang Gung Univ, Coll Med, Kaohsiung Chang Gung Mem Hosp, Dept Neurol, Kaohsiung, Taiwan

[2] Natl Sun Yat Sen Univ, Dept Biol Sci, Kaohsiung 80424, Taiwan

[3] Chang Gung Univ, Coll Med, Kaohsiung Chang Gung Mem Hosp, Ctr Translat Res Biomed Sci, Kaohsiung, Taiwan

[4] Chang Gung Univ, Coll Med, Kaohsiung Chang Gung Mem Hosp, Dept Nucl Med, Kaohsiung, Taiwan

[5] Chang Gung Univ, Coll Med, Kaohsiung Chang Gung Mem Hosp, Dept Radiol, Kaohsiung, Taiwan

来源：

EUROPEAN JOURNAL OF NEUROLOGY | 2013年 / 20卷 / 08期

关键词：

Alzheimer's disease; cortical perfusion; homocysteine; longitudinal decline; single photon emission computed tomography; WHITE-MATTER LESIONS; DISEASE; DIAGNOSIS; RISK;

D O I：

10.1111/ene.12159

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and purpose: Elevated plasma total homocysteine level (tHcy) is associated with increased risk of dementia via increased white matter changes or reduction in cortical volume. Whether tHcy has an independent impact on regional perfusion and if it can predict a more rapid cognitive decline in mild Alzheimer dementia (AD) warrants investigation. Methods: Eighty AD patients with a clinical dementia rating of 1 were enrolled. Their Cognitive Ability Screening Instrument (CASI) scores on enrolment and after 1 year of follow-up as well as their perfusion index (PI) from single photon emission computed tomography upon enrolment were analyzed. Results: In cross-sectional analysis, elevated tHcy was associated with lower frontal PI independent of cerebrovascular risk factors (beta = -0.35, P = 0.009). The CASI scores correlated with temporo-parietal PI (Pearson r range 0.3-0.39, P < 0.01) but not with tHcy or frontal PI. By longitudinal analysis, only tHcy level was related to a more rapid cognitive decline (odds ratio for executive function score 1.82; odds ratio for total CASI score 1.74). Conclusions: Cognitive performance in mild AD can be reflected by hypo-perfusion of the temporo-parietal region while frontal hypo-perfusion may be mediated by tHcy. tHcy level is an independent risk factor for rapid cognitive decline, especially in the executive function.

引用

页码：1191 / 1197

页数：7

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