Vitamin B12 and Homocysteine Levels Predict Different Outcomes in Early Parkinson's Disease

ABSTRACT Background: In moderately advanced Parkinson's disease (PD), low serum vitamin B12 levels are common and are associated with neuropathy and cognitive impairment. However, little is known about B12 in early PD. Objective: To determine the prevalence of low vitamin B12 status in early PD...

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Bibliographic Details
Published in:Movement disorders 2018-05, Vol.33 (5), p.762-770
Main Authors: Christine, Chadwick W., Auinger, Peggy, Joslin, Amelia, Yelpaala, Yuora, Green, Ralph
Format: Article
Language:English
Subjects:
alpha-Tocopherol - therapeutic use
Antioxidants - therapeutic use
Antiparkinson Agents - therapeutic use
Cognition Disorders - etiology
Cognitive ability
cognitive impairment
cyanocobalamin
Dietary supplements
Double-Blind Method
Female
Follow-Up Studies
gait instability
Homocysteine
Homocysteine - blood
Humans
hyperhomocysteinemia
Male
Mental Status Schedule
Middle Aged
Morbidity
Movement disorders
Neurodegenerative diseases
Neuropathy
Parkinson Disease - blood
Parkinson Disease - complications
Parkinson Disease - drug therapy
Parkinson Disease - epidemiology
Parkinson's disease
Predictive Value of Tests
Selegiline - therapeutic use
Treatment Outcome
Vitamin B 12 - blood
Vitamin B12
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Summary:ABSTRACT Background: In moderately advanced Parkinson's disease (PD), low serum vitamin B12 levels are common and are associated with neuropathy and cognitive impairment. However, little is known about B12 in early PD. Objective: To determine the prevalence of low vitamin B12 status in early PD and whether it is associated with clinical progression. Methods: We measured vitamin B12 and other B12 status determinants (methylmalonic acid, homocysteine, and holotranscobalamin) in 680 baseline and 456 follow‐up serum samples collected from DATATOP participants with early, untreated PD. Borderline low B12 status was defined as serum B12 15 µmol/L. Outcomes included the UPDRS, ambulatory capacity score (sum of UPDRS items 13‐15, 29&30), and MMSE, calculated as annualized rates of change. Results: At baseline, 13% had borderline low B12 levels, 7% had elevated homocysteine, whereas 2% had both. Elevated homocysteine at baseline was associated with worse scores on the baseline MMSE. Analysis of study outcomes showed that compared with the other tertiles, participants in the low B12 tertile (
ISSN:0885-3185
1531-8257
DOI:10.1002/mds.27301