Abstract
An elevated serum homocysteine level is a risk factor for the development of cognitive impairment. Reported is a late-onset case of hyperhomocystinemia due to a vitamin B12 metabolic deficit (cobalamin C) with cognitive impairment, primarily in frontal/executive function. After homocysteine-lowering therapy, the patient's functional and neuropsychological status improved in conjunction with a decrease in leukoariosis on his MRI scan. These findings suggest that homocysteine-related cognitive impairment may be partially reversible.
Publication types
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Case Reports
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Research Support, N.I.H., Extramural
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Research Support, U.S. Gov't, P.H.S.
MeSH terms
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Adult
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Anticoagulants / therapeutic use
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Betaine / therapeutic use
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Cognition Disorders / drug therapy
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Cognition Disorders / etiology*
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Cognition Disorders / metabolism
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Confusion / drug therapy
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Confusion / etiology*
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Confusion / metabolism
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Disease Progression
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Drug Therapy, Combination
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Folic Acid / therapeutic use
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Frontal Lobe / metabolism
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Frontal Lobe / pathology
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Frontal Lobe / physiopathology
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Homocysteine / antagonists & inhibitors
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Homocysteine / blood*
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Humans
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Hyperhomocysteinemia / complications*
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Hyperhomocysteinemia / drug therapy
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Hyperhomocysteinemia / physiopathology
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Leukoaraiosis / diagnosis
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Leukoaraiosis / drug therapy
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Leukoaraiosis / etiology*
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Magnetic Resonance Imaging
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Male
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Methylmalonic Acid / blood
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Methylmalonic Acid / metabolism
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Remission Induction
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Seizures / drug therapy
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Seizures / etiology*
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Seizures / metabolism
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Treatment Outcome
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Vitamin B 12 / metabolism
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Vitamin B 12 / therapeutic use
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Vitamin B 6 / therapeutic use
Substances
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Anticoagulants
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Homocysteine
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Betaine
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Vitamin B 6
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Methylmalonic Acid
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Folic Acid
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Vitamin B 12