Researchers at Seoul National University Boramea Hospital have discovered that a substance called total homocysteine (tHcy) can increase the risk of cerebrovascular disease, which can cause cerebral infarction.

From left, Professors Nam Ki-woong, Park Jin-ho and Kwon Hyung-min

Total homocysteine is one of the proteins produced when people digest food. Excessive accumulation of the protein can significantly increase the risk of dementia caused by cardiovascular disease and brain tissue damage.

Cerebral infarction is a disease in which there is a block in the supply of blood to the brain due to blocked blood vessels. As the illness stops the supply of oxygen and nutrients to the brain cells, symptoms such as paralysis, sensory abnormality, and speech disorder can occur.

Most cases of cerebral infarction also accompany small blood vessel diseases such as white matter hyperintensities and cerebral microbleeds, which makes it essential to prevent the disease in advance as it is difficult to cure once the symptoms appear.

The team, led by Professors Nam Ki-woong and Kwon Hyung-min of the neurology department at the hospital, analyzed 1,578 brain MRIs and blood test results from 2006 to 2013 at Seoul National University Hospital's Health Checkup Center. Professor Park Jin-ho of the family medicine department at Seoul National University Hospital also participated in the study.

Afterward, the researchers divided the participants into two groups based on the tHcy concentration of 9.60 μmol/L and investigated whether the risk of small-vessel diseases such as WMH and CMB was higher in correlation with tHcy.

As a result, the ratio of small-vessel disease was high in the group of 9.60 μmol/L or more, while 14 percent of the group had more than 25 enlarged perivascular spaces. The results confirmed the tHcy is a significant contributor to the risk of small-vessel diseases.

The study also found a significant risk in the tHcy concentration ranging from 5 μmol/L to 15, which were previously considered to be within the normal range, and confirmed that tHcy is a common factor in various forms of small vessel disease.

“This study was the first in the world to identify that tHcy is involved in the development of generalized small vessel disease that can lead to subsequent cerebral infarction and dementia,” Professor Kwon said. “As tHcy accumulates when people eat protein-rich foods such as meat, it is necessary to consume foods rich in vitamin B, such as green vegetables such as spinach and fish, to maintain normal levels.”

Neurology published the results of the study.

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