vitamin-b-12 and Dysthymic-Disorder

Studies have found elevated plasma homocysteine (Hcy) levels in bipolar disorder (BD). We investigated serum Hcy levels in euthymic BD patients, and its relationship with cognitive and psychosocial functioning.. Sixty-five BD type I euthymic patients and 49 healthy controls were assessed using a neuropsychological test battery. Hcy levels were measured using an HPLC method with fluorescence detection.. The mean Hcy levels were 1.37 mg/L for BD patients and 1.30 mg/L for healthy controls (P=0.342), male patients showing higher Hcy levels as compared to females (P=0.009). Older patients, those with later illness onset, and patients taking more medications showed higher Hcy levels, but no significant correlation was found with psychosocial functioning. Patients with "elevated" Hcy levels performed significantly worse on all neurocognitive tests, and in patients we found significant associations between Hcy levels and number of perseverations on the SCT (r=0.248, P=0.047), and number of moves on the ToH (r=0.265, P=0.033); however, a linear regression model revealed that Hcy was not a significant predictor of neurocognitive test performance.. Our findings suggest that increased homocysteinemia may play a role in the pathophysiology of neurocognitive deficits in BD, with a higher impact among older patients, or who had a delayed onset of illness.

Topics: Adult; Age Factors; Bipolar Disorder; Cognition Disorders; Demography; Diagnostic and Statistical Manual of Mental Disorders; Dysthymic Disorder; Female; Folic Acid; Homocysteine; Humans; Male; Neuropsychological Tests; Severity of Illness Index; Sex Factors; Vitamin B 12

We have previously reported that homocysteine levels are elevated in euthymic bipolar patients with functional deterioration. The current study was designed to extend this finding by examining the relationship between neuropsychological functioning and homocysteine levels in euthymic bipolar patients.. Fifty-seven euthymic bipolar outpatients were assessed for serum levels of homocysteine, folic acid, and vitamin B-12 and administered a battery of neuropsychological tests.. We found that male bipolar subjects showed higher average homocysteine levels than a comparison group of normal subjects, that poorer functioning on a task of executive function (Wisconsin Card Sort) was related to higher homocysteine levels, and that folic acid or vitamin B-12 levels did not significantly affect neuropsychological functioning.. These results, while suggesting some relationship between higher homocysteine levels, bipolar illness, and impairment in cognitive function do not establish any causative effects.. The findings of this study confirm that in euthymic bipolar patients, higher homocysteine levels are associated with poorer performance in some neuropsychological tests. Treatment trials will be required before it will be known if the putative decrements in the executive function of bipolar patients can be reversed, or at least retarded, if homocysteine levels are reduced (as, for example, by dietary addition of B vitamin supplements).

Topics: Adolescent; Adult; Bipolar Disorder; Cognition; Cognition Disorders; Dysthymic Disorder; Female; Folic Acid; Homocysteine; Humans; Male; Middle Aged; Neuropsychological Tests; Severity of Illness Index; Vitamin B 12