Objective: To explore the associations of serum homocysteine (Hcy), folic acid (FA) and vitamin B12 (VitB12) levels with the severity of Parkinson’s disease (PD), as well as motor and non-motor symptoms in PD patients.

Background: PD is the second most common neurodegenerative disease, mainly including motor symptoms and non-motor symptoms. Hcy participates the occurrence of PD by regulating the levels of oxidative stress, resulting in aggravation of symptoms in patients. In addition, FA and VitB12 are important helper factors in the process of Hcy metabolism, and the deficiency of them will lead to hyperhomocysteinemia.

Method: A total of 312 patients with PD were enrolled and analyzed in current study. The PD patients were systematically assessed and statistically analyzed for serum Hcy, FA and VitB12 with the PD-related motor and non-motor indicators using Spearman rank correlation.

Results: Increased serum Hcy level was positively correlated with the severity of PD (H&Y stages) (r=0.167, P=0.003) and more severe motor symptoms (UPDRS-II: r=0.235, P<0.001; UPDRS- Ⅲ: r=0.119, P=0.039). Meanwhile, higher Hcy were associated with more severe motor symptoms (UPDRS-IV: r=0.201, P=0.002) and higher doses of dopamine equivalent daily dose (LEDD) (r=0.299, P<0.001). Besides, FA and VitB12 levels were negatively correlated with UPDRS-III scores (FA: r=-0.127, P=0.050; VitB12: r=-0.135, P=0.037), and lower VitB12 were associated with more severe motor symptoms (r=-0.158, P=0.021) and higher LEDD (r=-0.145, P=0.024). Elevated serum Hcy was also associated with non-motor symptoms. Detailly, higher Hcy levels were associated with non-motor symptom burden (UPDRS-I: r=0.236, P<0.001), quality of life (PDQ-39: r=0.206, P<0.001), anxiety (HAMA: r=0.001) 0.145, P=0.013), sleep quality (PDSS: r=-0.152, P=0.008), and autonomic dysfunction (SCOPA-AUT: r=0.323, P<0.001). Reduced FA levels were related to more severe autonomic dysfunction (r=-0.170, P=0.009).

Conclusion: Hcy can be used as a non-invasive biomarker in PD prevention, diagnosis, treatment and prognosis monitoring. The elevation of serum Hcy was associated with PD severity, motor symptoms, and non-motor symptoms, as well as the deficiencies of FA and VitB12 were linked to PD severity. Adequate supplementation of FA and VitB12 can reduce the level of Hcy, which may improve PD symptoms, and postpone PD progression.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-correlation-analyses-of-parkinsons-disease-with-serum-homocysteine-folic-acid-and-vitamin-b12/