Neuropsychiatric Disease and Treatment (Dec 2021)

Relationship Among Homocysteine, Inflammation and Cognitive Impairment in Patients with Acute Ischemic Stroke and Transient Ischemic Attack

  • Cui L,
  • Lu P,
  • Li S,
  • Pan Y,
  • Wang M,
  • Li Z,
  • Liao X,
  • Wang Y

Journal volume & issue
Vol. Volume 17
pp. 3607 – 3616

Abstract

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Lingyun Cui,1 Ping Lu,1 Shiyu Li,1 YueSong Pan,2 Mengxing Wang,2 Zixiao Li,1,2 Xiaoling Liao,1,2 Yongjun Wang1,2 1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of ChinaCorrespondence: Yongjun WangDepartment of Neurology, Beijing Tiantan Hospital, Capital Medical University, 119#Nan Si Huan Xi Lu, Beijing, 100070, People’s Republic of ChinaTel +86 10-59978351Email [email protected]: To investigate the associations among homocysteine (Hcy), inflammation and cognitive impairment in patients with acute ischemic stroke (AIS) and transient ischemic attack (TIA).Patients and Methods: Patients included were enrolled from a subgroup of China National Stroke Registry-III (CNSR-III). We used a Chinese version of Montreal Cognitive Assessment (MoCA) to screen for cognitive impairment. We used high-sensitivity C-reactive protein (hsCRP) level to reflect the inflammatory status, which was assessed at baseline together with Hcy concentration. The primary outcome was the incidence of post-stroke cognitive impairment (PSCI) at 3 months after AIS and TIA. Multivariable logistic regression analysis was used to evaluate the correlation between Hcy and hsCRP, and their effects on cognition.Results: We enrolled 1466 patients with a median age of 62 (54– 70) years old, including 895 (61.05%) patients with elevated Hcy levels, 466 (31.79%) with increased hsCRP concentrations, and 755 (51.50%) with PSCI. In the group of patients with hyperhomocysteinemia (HHcy), higher hsCRP levels were related to cognitive impairment, whether or not adjusted for multiple potential confounders (crude OR: 1.71,95% CI: 1.29– 2.27, p 0.05 for all).Conclusion: High inflammatory levels increase the risk of cognitive impairment in HHcy patients after AIS and TIA.Keywords: stroke, transient ischemic attack, inflammation, homocysteine, cognitive function

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