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BMC Neurology
Published in: BMC Neurology 1/2017

Open Access 01-12-2017 | Research article

Effects of Homocysteine on white matter diffusion parameters in Alzheimer’s disease

Authors: Chen-Chang Lee, Shih-Wei Hsu, Chi-Wei Huang, Wen-Neng Chang, Sz-Fan Chen, Ming-Kung Wu, Chiung-Chih Chang, Lain-Chyr Hwang, Po-Chou Chen

Published in: BMC Neurology | Issue 1/2017

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Abstract

Background

The clinical features of Alzheimer’s disease (AD) are related to brain network degeneration, and hyperhomocysteinemia is related to greater white matter hyperintensities. We investigated the changes in four diffusion tensor imaging parameters in the white matter of patients with early stage AD, examined their associations with homocysteine level, and tested the clinical significance of the diffusion tensor imaging parameters and homocysteine level in correlation analysis with cognitive test scores.

Methods

We enrolled 132 patients with AD and analyzed white matter (WM) macrostructural changes using diffusion tensor neuroimaging parameters including fractional anisotropy (FA), mean diffusion (MD), axial diffusivity (axial-D) and radial diffusivity (RD). Two neuroimaging post-processing analyses were performed to provide complementary data. First, we calculated 11 major bundle microstructural integrities using a WM parcellation algorithm, and correlated them with serum homocysteine levels to explore whether the fiber bundles were affected by homocysteine. Second, we used tract-based spatial statistics to explore the anatomical regions associated with homocysteine levels. Changes in cognitive test scores caused by homocysteine served as the major outcome factor.

Results

The results suggested that homocysteine levels did not have a direct impact on cross-sectional cognitive test scores, but that they were inversely correlated with renal function, B12 and folate levels. Topographies showing independent correlations with homocysteine in FA and MD were more diffusely located compared to the posterior brain regions in axial-D and RD. In the association bundle analysis, homocysteine levels were significantly correlated with the four diffusion parameters even after correcting for confounders, however no association between homocysteine and WM to predict cognitive outcomes was established.

Conclusions

In our patients with AD, homocysteine levels were associated with renal dysfunction and decreased levels of vitamin B12 and folate, all of which require clinical attention as they may have been associated with impaired WM microstructural integrity and modulated cognitive performance in cross-sectional observations.
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Metadata
Title
Effects of Homocysteine on white matter diffusion parameters in Alzheimer’s disease
Authors
Chen-Chang Lee
Shih-Wei Hsu
Chi-Wei Huang
Wen-Neng Chang
Sz-Fan Chen
Ming-Kung Wu
Chiung-Chih Chang
Lain-Chyr Hwang
Po-Chou Chen
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2017
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-017-0970-7

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