ABSTRACT
BACKGROUND AND AIMS: Leukoaraiosis (LA), one of the most frequent causes of an age-associated cognitive decline, can be associated with a poor quality of life, leading overall to far-reaching public health problems. Chronic hypoxia of the white matter of the brain may be a factor triggering this entity. LA may develop as a consequence of chronically insufficient cellular energy production and the accumulation of free radicals. METHODS: In this context, after hypothesizing that the number of healthy mitochondria can be crucial in this complex process, a case-control LA study was carried out in which we analyzed the numbers of deleted and non-deleted mitochondria (the common D-loop deletion) per white blood cell. A total of 234 patients with LA and 123 MRI alteration-free subjects served as a control group. RESULTS: Interestingly, it emerged that the ratio of deleted relative to non-deleted mitochondria is strongly associated with the risk of LA. The calculated K ratio in the LA group was significantly lower than the K ratio in the controls (LA: K 0.37 95% CI 0.05; controls: K 0.48, 95% CI 0.076, p < 0.001). CONCLUSIONS: Our study suggests that the ratio of the dmDNA and mDNA can be of great importance in the pathogenesis of LA.
Subject(s)
DNA, Mitochondrial/genetics , Leukoaraiosis/pathology , Mitochondria/genetics , Mitochondria/pathology , Aged , Brain/pathology , Cognition Disorders/etiology , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Quality of LifeABSTRACT
The authors present a case report and review the literature on Hashimoto encephalopathy. The onset of the disease may be marked by focal and then progressively generalized seizures or other neurological symptoms, but a cognitive decline or various psychiatric symptoms may also emerge. High levels of anti-thyroid peroxidase antibodies and/or anti-thyroglobulin antibodies are present in the serum. Corticosteroid treatment usually results in an improvement of symptoms. The syndrome is frequently overlooked and, therefore, the authors strongly recommend testing serum thyroid autoantibodies in cases with encephalopathy of unknown origin independently on the presence of thyroid disease in the patient or family history. The importance of long-term immunosuppressive treatment should also be stressed.
Subject(s)
Autoantibodies/blood , Brain Diseases/diagnosis , Brain Diseases/drug therapy , Hashimoto Disease/diagnosis , Hashimoto Disease/drug therapy , Thyroid Gland/immunology , Adrenal Cortex Hormones/administration & dosage , Adult , Anticonvulsants/administration & dosage , Antipsychotic Agents/administration & dosage , Brain Diseases/complications , Brain Diseases/immunology , Clonazepam/administration & dosage , Cognition Disorders/etiology , Drug Therapy, Combination , Encephalitis , Female , Hashimoto Disease/complications , Hashimoto Disease/immunology , Humans , Lamotrigine , Methylprednisolone/administration & dosage , Patient Discharge , Patient Readmission , Seizures/etiology , Suicide , Thyroxine/administration & dosage , Triazines/administration & dosageABSTRACT
Vascular demyelinization of the white matter of the brain is referred to as leukoaraiosis (LA). This very frequent entity is associated with a cognitive decline, thereby resulting in a deteriorating quality of life. Besides poorly controlled hypertension and aging, its development is reported to be associated with an elevated serum homocysteine level. Although the methylenetetrahydrofolate reductase (MTHFR) C677T genetic variant is associated with an elevated serum homocysteine level, it has not been proved to be an independent risk factor for LA. The aim of the present study was to examine whether the MTHFR A1298C genetic variant, which is also believed to be unfavorable, is associated with the presence of LA. The clinical and genetic data on 198 LA patients and 235 neuroimaging alteration-free controls were analyzed. The presence of the A1298C or the 1298CC variant was calculated to be a risk factor for LA, as compared with the absence of both of them. The clustering of the heterozygous A1298C and C677T variants was proved to involve the risk of LA. Our results suggest that the MTHFR A1298C variant confers an independent genetic risk of LA, and this pathological role may be amplified by the MTHFR C677T variant.
