Hyperhomocysteinemia in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL)

Kelly D. Flemming, Tu T. Nguyen, Haitham S. Abu-Lebdeh, Joseph E. Parisi, David O. Wiebers, Jorean D. Sicks, W. Michael Ofallon, George W. Petty

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Objective: To determine whether patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) had evidence of increased homocysteine levels compared with non-CADASIL patients with ischemic stroke or transient ischemic attack. Patients and Methods: We compared fasting plasma homocysteine levels and levels 6 hours after oral loading with methionine, 100 mg/kg, in non-CADASIL patients with ischemic stroke or transient ischemic attack and in patients with CADASIL. Prechallenge, postchallenge, and change in homocysteine levels between the 2 groups were compared with use of the Wilcoxon rank sum test. Results: CADASIL and non-CADASIL groups were similar in age (mean, 48.8 vs 46.5 years, respectively; 2-tailed t test, P=.56) and sex (men, 86% vs 59%; Fisher exact test, P=.12). The 59 patients in the CADASIL group had higher median plasma homocysteine levels compared with the 14 patients in the non-CADASIL group, both in the fasting state (12.0 vs 9.0 μ mol/L; P=.03) and after methionine challenge (51.0 vs 34.0 μmol/L; P=.007). Median difference between homocysteine levels before and after methionine challenge was greater in the CADASIL group than in the non-CADASIL group (34.5 vs 24.0 μmol/ L; P=.02). Conclusion: Our findings raise the possibility that increased homocysteine levels or abnormalities of homocysteine metabolism may have a role in the pathogenesis of CADASIL.

Original languageEnglish (US)
Pages (from-to)1213-1218
Number of pages6
JournalMayo Clinic proceedings
Volume76
Issue number12
DOIs
StatePublished - Jan 1 2001

Keywords

  • CADASIL = cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy
  • GOM = granular osmophilic material
  • TIA = transient ischemic attack

ASJC Scopus subject areas

  • Medicine(all)

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    Flemming, K. D., Nguyen, T. T., Abu-Lebdeh, H. S., Parisi, J. E., Wiebers, D. O., Sicks, J. D., Ofallon, W. M., & Petty, G. W. (2001). Hyperhomocysteinemia in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Mayo Clinic proceedings, 76(12), 1213-1218. https://doi.org/10.4065/76.12.1213