Vitamin B12-B6-Folate Treatment Improves Blood-Brain Barrier Function in Patients with Hyperhomocysteinaemia and Mild Cognitive Impairment

• Published in: Dementia and geriatric cognitive disorders Vol. 16; no. 3; pp. 145 - 150
• Main Authors: Lehmann, Martin, Regland, Björn, Blennow, Kaj, Gottfries, C.G.
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 2003
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Blood-Brain Barrier - drug effects; Cognition Disorders - complications; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Drug Therapy, Combination; Female; Folic Acid - administration & dosage; General and cellular metabolism. Vitamins; Humans; Hyperhomocysteinemia - complications; Hyperhomocysteinemia - drug therapy; Hyperhomocysteinemia - physiopathology; Male; Medical sciences; Middle Aged; Neurology; Original Research Article; Pharmacology. Drug treatments; Regression Analysis; Serum Albumin - cerebrospinal fluid; Serum Albumin - metabolism; Vitamin B 12 - administration & dosage; Vitamin B 6 - administration & dosage; Therapy; Blood-brain barrier; Mild cognitive impairment; Single-carbon metabolism; Homocysteine; Vitamin B12; Folate; Cognitive disorder; Blood brain barrier; Folic acid; Homocystein; Hyperhomocysteinemia; Quantitative analysis; Human; Thiol; Treatment efficiency; Etiopathogenesis; Exploration; Pyridoxine; Cyanocobalamin; Sulfur containing aminoacid; Concomitant disease; Treatment; Tau protein; Elderly; Dementia
• ISSN: 1420-8008; 1421-9824
• DOI: 10.1159/000071002

Thirty patients had mild cognitive impairment and increased homocysteine levels in serum. On average, they were supplemented orally with a high dose of a vitamin B 12 -B 6 -folate combination for 270 days. All patients had normal serum B 12 and folate levels at baseline. Cerebrospinal fluid levels of the tau protein (CSF-tau) and the albumin ratio were measured before and after treatment. The serum homocysteine levels were normalised after treatment. The albumin ratio significantly correlated with vascular risk factors. At baseline, the ratio was higher in the patients in comparison with age-matched controls. After treatment, the ratio was significantly reduced, which may indicate a tightening of the blood-brain barrier. The CSF-tau levels did not change significantly although there was a numeric decline. None of the patients progressed into dementia during the treatment period. When treated with a vitamin B 12 -B 6 -folate combination, patients with mild cognitive impairment and hyperhomocysteinaemia appear to improve their blood-brain barrier function. They may also stabilise their cognitive status. Further investigations are warranted on the role of blood-brain barrier dysfunction in the pathogenesis of dementia.