[The role of homocysteine levels in the pathogenesis of cognitive disorders in patients with chronic cerebral ischemia].

One hundred and twenty-one patients (mean age 64.13 +/- 8.43 years) with the diagnosis of chronic cerebral ischemia were examined. Somatic and neurological examinations, biochemical blood test, plasma homocysteine measurement, CKT/MRI were carried out. Neuropsychological tests (the MMSE, a battery of frontal dysfunction tests (BFDT), the Clock drawing test, the test of speech activity, the five words test, semantic and categorical associations, the Tailor Manifest Anxiety Scale) were administered: Patients were stratified into 3 groups: group 1 included 34 patients with confirmed cognitive disorders and mild hyperhomocysteinemia (> 15 mcmol/l); group 2 consisted of 51 patients with cognitive disorders and normal levels of homocysteine (< 15 mcmol/l) and group 3 consisted of 36 controls without cognitive disorders and with normal levels of homocysteine. In group 1, the performance of neuropsychological tests was significantly lower and neurological deficit was the most severe. We found reverse correlations between homocysteine levels and severity of cognitive disorders, which were most strong for the results of BFDT, the clock drawing test and the test of speech activity. Hyperhomocysteinemia was positively correlated with the worse values of neurological status and severity of chronic cerebral ischemia.