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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.


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1437-4331
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The role of hyperhomocysteinemia and B-vitamin deficiency in neurological and psychiatric diseases

Rima Obeid1 / Andrew McCaddon2 / Wolfgang Herrmann3

1Department of Clinical Chemistry and Laboratory Medicine, Faculty of Medicine, University Hospital of Saarland, Homburg/Saar, Germany

2Cardiff School of Medicine, Gardden Road Surgery, Rhosllanerchrugog, Wrexham, UK

3Department of Clinical Chemistry and Laboratory Medicine, Faculty of Medicine, University Hospital of Saarland, Homburg/Saar, Germany

Corresponding author: Prof. Dr. Wolfgang Herrmann, Department of Clinical Chemistry and Laboratory Medicine, University Hospital of the Saarland, Kirrberger Straße, Gebäude 57, 66421 Homburg, Germany Phone: +49-6841-1630700, Fax: +49-6841-1630703,

Citation Information: Clinical Chemical Laboratory Medicine. Volume 45, Issue 12, Pages 1590–1606, ISSN (Online) 14374331, ISSN (Print) 14346621, DOI: https://doi.org/10.1515/CCLM.2007.356, December 2007

Publication History

Received:
2007-08-10
Accepted:
2007-10-25
Published Online:
2007-12-08

Abstract

Hyperhomocysteinemia (HHcy) is related to central nervous system diseases. Epidemiological studies show a positive, dose-dependent relationship between plasma total homocysteine (tHcy) concentration and neurodegenerative disease risk. tHcy is a marker of B-vitamin (folate, B12, B6) status. Hypomethylation, caused by low B-vitamin status and HHcy, is linked to key pathomechanisms of dementia; B-vitamin supplementation could potentially reduce neurological damage. In retrospective studies, the association between tHcy and cognition is impressive; there is also evidence that tHcy-lowering treatment could be effective in primary and secondary stroke prevention. Increased tHcy and low serum folate occur in patients with Parkinson's disease, especially those receiving L-dopa. There is also an association between HHcy and multiple sclerosis, and between B-vitamin status and depression. Studies also confirm a causal role for tHcy in epilepsy, and certain anti-epileptics enhance HHcy. B-vitamin status should be optimized by ensuring sufficient intake in patients with neuropsychiatric diseases. HHcy occurs commonly in the elderly and can contribute to age-related neurodegeneration. Treatment with folic acid, B12 and B6 lowers tHcy. For secondary and primary prevention from several neuropsychiatric disorders, it seems prudent to actively identify deficient subjects and ensure sufficient vitamin intake.

Clin Chem Lab Med 2007;45:1590–606.

Keywords: brain atrophy; depression; epilepsy; homocysteine; neurodegeneration; vitamin B group

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