HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Correspondence: Submit a response Correspondence: View responses Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Miller, J. W. Articles by Wolf, P. A. Search for Related Content PubMed PubMed Citation Articles by Miller, J. W. Articles by Wolf, P. A. Related Collections Nutritional Parkinson's disease/Parkinsonism

Effect of L-dopa on plasma homocysteine in PD patients

Relationship to B-vitamin status

From the Vitamin Bioavailability Lab (Drs. Miller and Selhub, M.R. Nadeau), Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, and Department of Neurology (Drs. Feldman and Wolf, C.A. Thomas), Boston University School of Medicine, Boston, MA.

Address correspondence and reprint requests to Joshua W. Miller, PhD, Department of Medical Pathology, UC Davis Medical Center, 4645 Second Ave., Research Building III, Rm. 3200A, Sacramento, CA 95817; e-mail: jwmiller{at}ucdavis.edu

Background: The antiparkinsonian drug L-dopa causes increased cellular synthesis of homocysteine and consequent hyperhomocysteinemia in rats. This effect of L-dopa on plasma homocysteine is accentuated under conditions of impaired homocysteine metabolism such as folate deficiency.

Objective: To investigate the effect of L-dopa administration and B-vitamin status on plasma homocysteine concentrations in humans with PD.

Methods: Plasma homocysteine, folate, vitamin B₁₂, and pyridoxal-5'-phosphate (PLP) concentrations were determined in 40 individuals diagnosed with idiopathic PD who were being treated as outpatients at the Boston University Medical Center Neurology Clinic. Twenty of the patients were on L-dopa therapy (treatment group) and 20 were L-dopa-naive (control group).

Results: The mean plasma homocysteine concentration was higher in the treatment group than in the controls (p = 0.018). Plasma homocysteine was correlated with plasma folate, vitamin B₁₂, and PLP concentrations in the treatment group (p 0.007) but not in the controls.

Conclusion: L-Dopa can cause hyperhomocysteinemia in PD patients, the extent of which is influenced by B-vitamin status. The B-vitamin requirements necessary to maintain normal plasma homocysteine concentrations are higher in L-dopa-treated patients than in those not on L-dopa therapy. B-Vitamin supplements may be warranted for PD patients on L-dopa therapy.

This article has been cited by other articles:

				M. Folstein, T. Liu, I. Peter, J. Buel, L. Arsenault, T. Scott, and W. W. Qiu The Homocysteine Hypothesis of Depression Am J Psychiatry, June 1, 2007; 164(6): 861 - 867. [Abstract] [Full Text] [PDF]

				M. C. Irizarry, M. E. Gurol, S. Raju, R. Diaz-Arrastia, J. J. Locascio, M. Tennis, B. T. Hyman, J. H. Growdon, S. M. Greenberg, and T. Bottiglieri Association of homocysteine with plasma amyloid {beta} protein in aging and neurodegenerative disease Neurology, November 8, 2005; 65(9): 1402 - 1408. [Abstract] [Full Text] [PDF]

				O. Midttun, S. Hustad, E. Solheim, J. Schneede, and P. M. Ueland Multianalyte Quantification of Vitamin B6 and B2 Species in the Nanomolar Range in Human Plasma by Liquid Chromatography-Tandem Mass Spectrometry Clin. Chem., July 1, 2005; 51(7): 1206 - 1216. [Abstract] [Full Text] [PDF]

				C. Lewerin, M. Matousek, G. Steen, B. Johansson, B. Steen, and H. Nilsson-Ehle Significant correlations of plasma homocysteine and serum methylmalonic acid with movement and cognitive performance in elderly subjects but no improvement from short-term vitamin therapy: a placebo-controlled randomized study Am. J. Clinical Nutrition, May 1, 2005; 81(5): 1155 - 1162. [Abstract] [Full Text] [PDF]

				R. B. Postuma and A. E. Lang Homocysteine and levodopa: Should Parkinson disease patients receive preventative therapy? Neurology, September 14, 2004; 63(5): 886 - 891. [Abstract] [Full Text] [PDF]

				H. Chen, S. M. Zhang, M. A. Schwarzschild, M. A. Hernan, G. Logroscino, W. C. Willett, and A. Ascherio Folate Intake and Risk of Parkinson's Disease Am. J. Epidemiol., August 15, 2004; 160(4): 368 - 375. [Abstract] [Full Text] [PDF]

				P. O'Suilleabhain and R. Diaz-Arrastia Levodopa Elevates Homocysteine: Is This a Problem? Arch Neurol, May 1, 2004; 61(5): 633 - 634. [Full Text] [PDF]

				T. Muller, K. Renger, and W. Kuhn Levodopa-Associated Increase of Homocysteine Levels and Sural Axonal Neurodegeneration Arch Neurol, May 1, 2004; 61(5): 657 - 660. [Abstract] [Full Text] [PDF]

				A. Di Rocco, P. Werner, K. Schroecksnadel, F. Leblhuber, D. Fuchs, and J. W. Miller Effect of L-dopa on plasma homocysteine in PD patients: Relationship to B-vitamin status Neurology, February 24, 2004; 62(4): 676 - 677. [Full Text] [PDF]

				H. Refsum, A. D. Smith, P. M. Ueland, E. Nexo, R. Clarke, J. McPartlin, C. Johnston, F. Engbaek, J. Schneede, C. McPartlin, et al. Facts and Recommendations about Total Homocysteine Determinations: An Expert Opinion Clin. Chem., January 1, 2004; 50(1): 3 - 32. [Abstract] [Full Text] [PDF]

Correspondence: