The Clinical Application of Homocysteine by Seema Bhargava

Author:Seema Bhargava
Language: eng
Format: epub
Publisher: Springer Singapore, Singapore

5.7 Peripheral Neuropathy

Since homocysteine affects the nervous system through a variety of mechanisms, several scientists performed experiments to elucidate its role in peripheral neuropathy.

Bruce and Young (2008), in their community-based study on 483 adults, established through multivariate logistic regression that, after correction for age, sex, low socio-economic status, low education, HbA1c and smoking, homocysteine was an independent risk factor for peripheral neuropathy. Also, it was found that it exacerbates existing peripheral neuropathy per se as well as diabetic peripheral neuropathy.

Similarly, Jianbo et al. (2011) demonstrated that plasma concentration of total homocysteine was associated with diabetic neuropathy independent of the traditional risk factors.

Luo et al. (2013) demonstrated the presence of elevated plasma homocysteine in the absence of any other identifiable aetiology in a group of patients with peripheral neuropathy. They termed this condition IHIN (isolated homocysteine-induced neuropathy). Electrophysiological studies suggested large fibre neuropathy with demyelination and axonal denervation.

Shandal and Luo (2016) demonstrated that sensory deficits were the predominant components of IHIN.

Further studies are required to better understand this entity and improve its management.

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