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Hyperhomocysteinemia: A Risk Factor for Cognitive Decline in mTBI Patients.

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OBJECTIVE Our quest was to find an answer for "Why are some people able to recover 100% from a concussion/traumatic brain injury while others tend to have prolonged symptoms after… Click to show full abstract

OBJECTIVE Our quest was to find an answer for "Why are some people able to recover 100% from a concussion/traumatic brain injury while others tend to have prolonged symptoms after their concussion/traumatic brain injury?" BACKGROUND The prevalence of hyperhomocysteinemia in general is 5%-7% with increasing evidence showing higher prevalence of HHcy as age increases. The prevalence of vitamin D deficiency was 41.6% in the American population. The prevalence of vitamin B-12 deficiency is at least 40% in the patients of the Americas. With recent data, the prevalence of magnesium deficiency is around 10%-30% of the population. Hyperhomocysteinemia due MTHFR gene mutation B-12, B-6, magnesium, and folic acid deficiency is well established. DESIGN/METHODS A retrospective study involving 45 patients was conducted in order to correlate the persistent symptoms concussion head injury/traumatic brain injury and their bio nutraceutical deficiency. RESULTS This data provides evidence that a patient's Homocysteine levels are significantly linearly related with their MoCA scores (t = -5.837, df = 34, p-value = 1.403e-06, [95% CI: -0.8406114 to -0.4936554]). In the mTBI group, for every 1 umol/L increase in Homocysteine levels, there is a 0.54217 decrease in MoCA scores. mTBI patients that had Homocysteine levels greater than 14 umol/L were 76% more likely to experience cognitive decline. The mean MoCA score of mTBI patients is significantly lower than the mean MoCA score of patients in the control group (t = -3.2898, df = 67, p-value = 0.0016, [95% CI: -6.710893 to -1.642642]). The mean Homocysteine levels of mTBI patients are significantly greater than the mean Homocysteine levels of patients in the control group (t = 2.2182, df = 85, p-value = 0.0292, [95% CI: 0.3039847 to 5.5603010]). CONCLUSIONS mTBI patients should be routinely screened for serum homocysteine, vitamin D, B12, B6 and magnesium levels to know their risk for cognitive decline.

Keywords: homocysteine levels; prevalence; mtbi patients; deficiency; cognitive decline

Journal Title: Neurology
Year Published: 2020

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