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Homocysteine, vitamin B metabolites, dopamine-substituting compounds, and symptomatology in Parkinson’s disease : clinical and therapeutic considerations

Phokaewvarangkul, Onanong ; Bhidayasiri, Roongroj ; Garcia-Ruiz, Pedro ; Odin, Per LU orcid ; Riederer, Peter and Müller, Thomas (2023) In Journal of Neural Transmission 130(11). p.1451-1462
Abstract

Emerging studies suggest a correlation between elevated plasma homocysteine (hcy) levels and the risk of atherosclerosis, vascular disorders, and neurodegenerative diseases, including Parkinson's disease (PD). This narrative review delves into the intricate relationships between Hcy, vitamin B metabolites, dopamine-substituting compounds, and various symptoms of PD. Patients undergoing a long-term L-dopa/dopa-decarboxylase inhibitor (DDI) regimen, especially without a concurrent catechol-O-methyl transferase (COMT) inhibitor or methyl group-donating vitamin supplementation, such as vitamins B6 and B12, exhibit an elevation in Hcy and a decline in vitamin B metabolites. These altered concentrations appear to be associated with heightened... (More)

Emerging studies suggest a correlation between elevated plasma homocysteine (hcy) levels and the risk of atherosclerosis, vascular disorders, and neurodegenerative diseases, including Parkinson's disease (PD). This narrative review delves into the intricate relationships between Hcy, vitamin B metabolites, dopamine-substituting compounds, and various symptoms of PD. Patients undergoing a long-term L-dopa/dopa-decarboxylase inhibitor (DDI) regimen, especially without a concurrent catechol-O-methyl transferase (COMT) inhibitor or methyl group-donating vitamin supplementation, such as vitamins B6 and B12, exhibit an elevation in Hcy and a decline in vitamin B metabolites. These altered concentrations appear to be associated with heightened risks of developing non-motor symptoms, including peripheral neuropathy and cognitive disturbances. The review underscores the impact of levodopa metabolism via COMT on homocysteine levels. In light of these findings, we advocate for the supplementation of methyl group-donating vitamins, notably B6 and B12, in patients undergoing a high-dose L-dopa/DDI regimen, particularly those treated with L-dopa/carbidopa intestinal gel (LCIG) infusion.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Homocysteine, Levodopa, Neuropathy, Parkinson’s disease, Vitamin B metabolites
in
Journal of Neural Transmission
volume
130
issue
11
pages
1451 - 1462
publisher
Springer
external identifiers
  • pmid:37603058
  • scopus:85168449679
ISSN
0300-9564
DOI
10.1007/s00702-023-02684-9
language
English
LU publication?
yes
id
fc16d740-c74c-436f-9cd4-a0d7668130b1
date added to LUP
2023-11-13 14:29:39
date last changed
2024-04-25 06:45:24
@article{fc16d740-c74c-436f-9cd4-a0d7668130b1,
  abstract     = {{<p>Emerging studies suggest a correlation between elevated plasma homocysteine (hcy) levels and the risk of atherosclerosis, vascular disorders, and neurodegenerative diseases, including Parkinson's disease (PD). This narrative review delves into the intricate relationships between Hcy, vitamin B metabolites, dopamine-substituting compounds, and various symptoms of PD. Patients undergoing a long-term L-dopa/dopa-decarboxylase inhibitor (DDI) regimen, especially without a concurrent catechol-O-methyl transferase (COMT) inhibitor or methyl group-donating vitamin supplementation, such as vitamins B6 and B12, exhibit an elevation in Hcy and a decline in vitamin B metabolites. These altered concentrations appear to be associated with heightened risks of developing non-motor symptoms, including peripheral neuropathy and cognitive disturbances. The review underscores the impact of levodopa metabolism via COMT on homocysteine levels. In light of these findings, we advocate for the supplementation of methyl group-donating vitamins, notably B6 and B12, in patients undergoing a high-dose L-dopa/DDI regimen, particularly those treated with L-dopa/carbidopa intestinal gel (LCIG) infusion.</p>}},
  author       = {{Phokaewvarangkul, Onanong and Bhidayasiri, Roongroj and Garcia-Ruiz, Pedro and Odin, Per and Riederer, Peter and Müller, Thomas}},
  issn         = {{0300-9564}},
  keywords     = {{Homocysteine; Levodopa; Neuropathy; Parkinson’s disease; Vitamin B metabolites}},
  language     = {{eng}},
  number       = {{11}},
  pages        = {{1451--1462}},
  publisher    = {{Springer}},
  series       = {{Journal of Neural Transmission}},
  title        = {{Homocysteine, vitamin B metabolites, dopamine-substituting compounds, and symptomatology in Parkinson’s disease : clinical and therapeutic considerations}},
  url          = {{http://dx.doi.org/10.1007/s00702-023-02684-9}},
  doi          = {{10.1007/s00702-023-02684-9}},
  volume       = {{130}},
  year         = {{2023}},
}