Novel therapy of hyperhomocysteinemia in mild cognitive impairment, Alzheimer’s disease, and other dementing disorders

摘要: Studies have produced conflicting results assessing hyperhomocysteinemia (HYH) treatment with B vitamins in patients normal cognition, Alzheimer’s disease and related disorders (ADRD). This study examined the effect of HYH management L-methylfolate (LMF), methylcobalamin (MeCbl; B12), N-acetyl-cysteine (CFLN: Cerefolin®/Cerefolin-NAC®) on cognitive decline. Prospective, case-control subjects followed longitudinally. Outpatient clinic for disorders. 116 ADRD (34 HYH, 82 No-HYH) met inclusion exclusion criteria to participate. No participant took vitamins. received CFLN, No-HYH did not. Cognitive outcome measures included MCI Screen (memory), CERAD Drawings (constructional praxis), Ishihara Number Naming (object recognition), Trails A (executive function), F-A-S test (verbal fluency). Dependent or predictor demographics, functional severity, CFLN no duration, diagnosis, memantine cholinesterase inhibitor treatment. Linear mixed effects models covariate adjustment were used evaluate rate change outcomes. The duration treatment, compared an equivalent without significantly slowed decline learning memory, constructional praxis, visual-spatial executive function (Trails B). more milder baseline severity. increased as severity decreased. analytical model showed that must exceed some minimum period at least one year slow After adjustment, HYH+CFLN No-HYH+No-CFLN. Longer magnitude homocysteine reduction from all significant predictors. There are a number factors could account disagreement other clinical trials vitamin HYH. Moreover, is chemically distinct commonly both LMF MeCbl fully reduced bioactive forms; CLFN also contains glutathione precursor, N-acetyl-cysteine. findings can, therefore, only partly CFLN. These warrant further evaluation randomized, placebo-controlled trial.