The controversy concerning plasma homocysteine in Parkinson disease patients treated with levodopa alone or with entacapone: effects of vitamin status.

Theresa A Zesiewicz, Lynn Wecker, Kelly L Sullivan, Lisa R Merlin, Robert A Hauser

Journal: Clinical neuropharmacology 2006;29(3):106-11

PMID: 16772808

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Abstract

Levodopa treatment of Parkinson disease results in hyperhomocysteinemia (HHcy) as a consequence of levodopa methylation by catechol-O-methyltransferase (COMT). Although inhibition of COMT should theoretically prevent or reduce levodopa-induced HHcy, results from several prospective studies are conflicting. Our review of these studies suggests that the ability of COMT inhibition to reduce or prevent levodopa-induced HHcy in Parkinson disease patients may be attributed to differences in the vitamin status of the study participants. In patients with low or low-normal folate levels, levodopa administration is associated with a greater increase in homocysteine and concomitant entacapone administration is associated with a greater reduction in homocysteine.

Address: Parkinson's Disease and Movement Disorders Center, University of South Florida, Tampa, 33612, USA. [email protected]

DOI: 10.1097/01.WNF.0000220817.94102.95

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MeSH Terms: Catechol O-Methyltransferase, Catechol O-Methyltransferase Inhibitors, Catechols, Drug Therapy, Combination, Folic Acid, Homocysteine, Humans, Levodopa, Nitriles, Parkinson Disease, Randomized Controlled Trials as Topic, Vitamin B 12, Vitamins