Abstract Details

Title Association of Vitamin B12 and Homocysteine with Parkinson's Disease Progression in Contemporary Trials

Topic Movement Disorders

Presentation(s) P9 - Poster Session 9 (8:00 AM-9:00 AM)

Poster/Presentation
Number 3-013

Objective To measure blood levels of vitamin B12 and homocysteine (tHcy) in contemporary clinical trial cohorts and to correlate with Parkinson’s disease (PD) progression.

Background Our analysis of baseline serum in the DATATOP study showed geometric mean levels of B12 of 369pg/ml and 9.5µM for tHcy. We found associations of low B12 with greater worsening of ambulatory capacity and of elevated tHcy(>15µM) with greater declines in the MMSE. Since DATATOP was performed in the late 1980’s, before mandatory folic acid fortification in the US, dietary changes may have altered these levels

Design/Methods We obtained baseline blood samples from 3 clinical trials of early PD (SURE-PD, STEADY-PDIII, and SURE-PD3), which recruited between 2009-17, and measured B12 and tHcy. We then tested for associations of analyte levels with annualized changes in clinical rating scales

Results The geometric mean B12 levels for SURE-PD, STEADY-PDIII, and SURE-PD3 were 484, 524, and 618pg/ml and for tHcy were 7.4, 10.0 and 9.7µM, respectively. B12 deficiency(≤212pg/ml) was rare, ranging between 1.1-3.7%, while tHcy>15 µM was 5% in STEADY-PDIII and SURE-PD3. Supplement use containing B12 ranged from 41-61%, and those taking supplements had 100-200pg/ml higher levels. Compared to those with tHcy≤15µM, subjects combined from STEADY-PDIII and SURE-PD3 with tHcy>15 µM had more rapid declines in MoCA scores (0.7 vs 0.2 points/year, p=0.02). No association was found for low B12 levels and ambulatory capacity.

Conclusions Compared with DATATOP, in these recent trials, B12 levels were substantially higher, likely due to increased supplement intake, while tHcy levels were similar. Like DATATOP, there was greater cognitive decline in those with tHcy>15µM. While an association of low B12 with greater worsening of ambulatory capacity was not found in this study, the smaller number of subjects with low B12 levels reduced the power to replicate this finding. Further study of tHcy with PD cognitive impairment is warranted.

Authors/Disclosures
Chadwick W. Christine, MD, FAAN PRESENTER	The institution of Dr. Christine has received research support from Michael J Fox Foundation for Parkinson's Research. The institution of Dr. Christine has received research support from Aspen Neurosciences. The institution of Dr. Christine has received research support from ASK BIo. The institution of Dr. Christine has received research support from Bayer.
Peggy Auinger (University of Rochester)	Ms. Auinger has nothing to disclose.
Esther Rodriguez-Forti	Esther Rodriguez-Forti has nothing to disclose.
Lyvin Tat (ÚC Davis Medical Center)	Lyvin Tat has nothing to disclose.
Noemi Cannizzaro (UC Davis)	No disclosure on file
David Oakes (University of Rochester)	No disclosure on file
Ralph Green (UCDavis)	Dr. Green has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for WiiTi. Dr. Green has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Abbott.

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