This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (75)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Epilepsy  • Alert me on articles by topic  Social Bookmarking   What's this?

Ramon Diaz-Arrastia, MD, PhD

Arch Neurol. 2000;57:1422-1427.

Over the last 10 years, there has been an explosion of interest in homocysteine, a sulfur-containing amino acid that occupies a central location in the metabolic pathways of thiol compounds. This interest is primarily because of the realization that hyperhomocysteinemia is an important risk factor for vascular disease, including stroke, independent of long-recognized factors such as hyperlipidemia, hypertension, diabetes mellitus, and smoking. Since elevated homocysteine levels can often be normalized by supplementing the diet with folic acid (folate), pyridoxine hydrochloride (vitamin B₆), and cyanocobalamin (vitamin B₁₂), these observations raise the exciting possibility that this inexpensive and well-tolerated therapy may be effective in decreasing the incidence of vascular disease. In addition to its association with cerebrovascular disease, homocysteine may play a role in neurodegenerative disorders, even if only as a marker of functional vitamin B₁₂ deficiency. Homocysteine is also important to neurologists since most anticonvulsants raise homocysteine levels, an effect that may explain the teratogenic effects of these drugs. Practical knowledge concerning some details of homocysteine metabolism, the diagnosis of hyperhomocysteinemia, and the use of polyvitamin therapy to lower homocysteine levels will be increasingly important in the treatment of patients with neurologic disease.

From the Department of Neurology, University of Texas Southwestern Medical Center, Dallas.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Archives of Neurology Reader's Choice: Continuing Medical Education
Arch Neurol. 2000;57(10):1535-1537.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Role of micronutrients in the periconceptional period
Cetin et al.
Hum Reprod Update 2009;0:dmp025v1-dmp025.
ABSTRACT | FULL TEXT  

Homocysteine Levels in Epileptic Children Receiving Antiepileptic Drugs
Kurul et al.
J Child Neurol 2007;22:1389-1392.
ABSTRACT  

Dietary folate, vitamin B12, and vitamin B6 and the risk of Parkinson disease.
de Lau et al.
Neurology 2006;67:315-318.
ABSTRACT | FULL TEXT  

Folate Intake and Risk of Stroke Among Women
Al-Delaimy et al.
Stroke 2004;35:1259-1263.
ABSTRACT | FULL TEXT  

Levodopa Elevates Homocysteine: Is This a Problem?
O'Suilleabhain and Diaz-Arrastia
Arch Neurol 2004;61:633-634.
FULL TEXT  

Epilepsy and Women's Health: Family Planning, Bone Health, Menopause, and Menstrual-Related Seizures
Liporace and D'Abreu
Mayo Clin Proc. 2003;78:497-506.
ABSTRACT  

Elevated Plasma Homocysteine Levels in Patients Treated With Levodopa: Association With Vascular Disease
Rogers et al.
Arch Neurol 2003;60:59-64.
ABSTRACT | FULL TEXT  

Fibrillin-2 Defects Impair Elastic Fiber Assembly in a Homocysteinemic Chick Model
Hill et al.
J. Nutr. 2002;132:2143-2150.
ABSTRACT | FULL TEXT  

Relationship between plasma homocysteine levels and brain atrophy in healthy elderly individuals
Sachdev et al.
Neurology 2002;58:1539-1541.
ABSTRACT | FULL TEXT  

Plasma Homocysteine Levels, Cerebrovascular Risk Factors, and Cerebral White Matter Changes (Leukoaraiosis) in Patients With Alzheimer Disease
Hogervorst et al.
Arch Neurol 2002;59:787-793.
ABSTRACT | FULL TEXT  

Stroke Prevention Therapy Beyond Antithrombotics: Unifying Mechanisms in Ischemic Stroke Pathogenesis and Implications for Therapy: An Invited Review
Gorelick
Stroke 2002;33:862-875.
ABSTRACT | FULL TEXT  

Limits of the Genetic Revolution
Scheuerle
Arch Pediatr Adolesc Med 2001;155:1204-1209.
ABSTRACT | FULL TEXT  

Vitamin B12 and folate in relation to the development of Alzheimer's disease
Wang et al.
Neurology 2001;56:1188-1194.
ABSTRACT | FULL TEXT