Hyperhomocysteinemia and Its Treatment in Patients with Parkinson’s Disease

INTRODUCTION Homocysteine is process-product of methionine demethylation. It has proatherogenic, prothrombotic, prooxidative, proapoptotic, osteoporotic, neurotoxic, neuroinflamatory, and neurodegenerative effects. Hyperhomocysteinemia correlates with C667T MTHFR mutation, decrease of folic acid and vitamin B, as well as prolonged use of certain medications. MATERIALS AND METHODS We measured levels of homocysteine in thirty patients (15::15) with "de novo" Parkinson's disease, with average age 64.17 ± 13.19 (28-82) years (Department of Neurology, University Clinical Center Tuzla). Normal level of homocysteine for women was 3.36-20.44 micromole/l and 5.9-16 micromole/l for men. We followed the effects of medicament approach (folic acid) every six months for next five years. RESULTS 20% of patients with "de novo" Parkinson's disease exhibited hyperhomocysteinemia. An average level of homocysteine was 13.85 ± 5.82 micromole/l. Differences due to age and homocysteine levels, regardless of sex, were not concluded. For the next five years intake of folic acid (periodically, 1-2 months, 5 mg per day, orally) was effective to normalized levels of homocysteine in all. CONCLUSION Hyperhomocysteinemia is present in every fifth patient with "de novo" Parkinson's disease. Folic acid is medication of choice in treatment of hyperhomocysteinemia coexisting with Parkinson's disease.