PMID- 36402110
OWN - NLM
STAT- MEDLINE
DCOM- 20221130
LR  - 20221130
IS  - 1532-2688 (Electronic)
IS  - 1059-1311 (Linking)
VI  - 103
DP  - 2022 Dec
TI  - Effects of three-months folate supplementation on early vascular abnormalities in 
      hyperhomocysteinemic patients with epilepsy.
PG  - 120-125
LID - S1059-1311(22)00262-X [pii]
LID - 10.1016/j.seizure.2022.11.009 [doi]
AB  - BACKGROUND: Epilepsy has been associated with an increased risk of cardiovascular 
      events. Anti-seizure medication (ASM) may contribute to vascular risk by several 
      mechanisms, including increased homocysteine levels. This study aims to assess 
      the global vascular burden in hyperhomocysteinemic people with epilepsy (PWE) on 
      long-term ASM before and after folic acid supplementation and in subgroups of PWE 
      treated with single enzyme-inducing or single non-enzyme inducing ASM. METHODS: 
      One hundred and seventy-four hyperhomocysteinemic (HHcy) PWE who met the 
      inclusion criteria were enrolled. Carotid Doppler ultrasonography, FMD and 
      ultrasound assessment of the brachial artery properties at the baseline and after 
      90 days of folic acid supplementation were performed. The vascular biomarkers 
      MMP-9 and TIMP-1 were also detected. RESULTS: After folic acid supplementation, 
      in HHcy patients homocysteine levels reduced from 26.8 +/- 10.5 to 
      20.2 +/- 5.3 mumol/L, carotid Intima-Media-Thickness reduced from 0.83+0.06 mm to 
      0.79+/-0.05 mm, and FMD, distensibility coefficient and beta-stiffness improved 
      (p < 0.05). Moreover, MMP-9 and TIMP-1 reduced after supplementation (p < 0.05). 
      PWE treated with a single enzyme-inducing ASM showed an impairment of vascular 
      parameters compared to patients treated with non-enzyme inducing ASM. 
      CONCLUSIONS: The results highlight the importance of assessing homocysteine 
      levels and estimating the cardiovascular risk of PWE, preferring non-enzyme 
      inducing ASM in high cardiovascular-risk patients. An adequate correction of 
      homocysteine levels with folate supplementation should be considered to improve 
      the cardiovascular profile.
CI  - Published by Elsevier Ltd.
FAU - De Luca, Mariarosaria
AU  - De Luca M
AD  - Department of Translational Medical Sciences, University Federico II, Via 
      Pansini, 5, Naples 80131, Italy.
FAU - Valvano, Antonio
AU  - Valvano A
AD  - Department of Internal Medicine, Cuggiono Hospital, Milan, Italy.
FAU - Striano, Pasquale
AU  - Striano P
AD  - Pediatric Neurology and Muscular Diseases Unit, IRCCS Istituto Giannina Gaslini, 
      Genova, and Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics 
      and Child Health, University of Genova, Italy.
FAU - Bosso, Giorgio
AU  - Bosso G
AD  - Santa Maria delle Grazie Hospital, Via Domitiana, Pozzuoli, Italy.
FAU - Pirone, Daniela
AU  - Pirone D
AD  - Department of Neuroscience, Reproductive Sciences and Dentistry, University 
      Federico II, Naples, Italy.
FAU - Trinchillo, Assunta
AU  - Trinchillo A
AD  - Department of Neuroscience, Reproductive Sciences and Dentistry, University 
      Federico II, Naples, Italy.
FAU - Bilo, Leonilda
AU  - Bilo L
AD  - Department of Neuroscience, Reproductive Sciences and Dentistry, University 
      Federico II, Naples, Italy.
FAU - Oliviero, Ugo
AU  - Oliviero U
AD  - Department of Translational Medical Sciences, University Federico II, Via 
      Pansini, 5, Naples 80131, Italy. Electronic address: ugo.oliviero@unina.it.
LA  - eng
PT  - Journal Article
DEP - 20221114
PL  - England
TA  - Seizure
JT  - Seizure
JID - 9306979
RN  - 0 (Tissue Inhibitor of Metalloproteinase-1)
RN  - EC 3.4.24.35 (Matrix Metalloproteinase 9)
RN  - 0LVT1QZ0BA (Homocysteine)
RN  - 935E97BOY8 (Folic Acid)
SB  - IM
MH  - Humans
MH  - *Tissue Inhibitor of Metalloproteinase-1
MH  - Matrix Metalloproteinase 9
MH  - *Epilepsy/complications/drug therapy
MH  - Dietary Supplements
MH  - Homocysteine
MH  - Folic Acid/therapeutic use
OTO - NOTNLM
OT  - Carotid ultrasound
OT  - Epilepsy
OT  - FMD
OT  - Homocysteine
OT  - Matrix metalloproteases
COIS- Declaration of Competing Interest The authors declare that they have no conflict 
      of interest/competing interests.
EDAT- 2022/11/20 06:00
MHDA- 2022/12/01 06:00
CRDT- 2022/11/19 18:31
PHST- 2022/09/08 00:00 [received]
PHST- 2022/11/02 00:00 [revised]
PHST- 2022/11/13 00:00 [accepted]
PHST- 2022/11/20 06:00 [pubmed]
PHST- 2022/12/01 06:00 [medline]
PHST- 2022/11/19 18:31 [entrez]
AID - S1059-1311(22)00262-X [pii]
AID - 10.1016/j.seizure.2022.11.009 [doi]
PST - ppublish
SO  - Seizure. 2022 Dec;103:120-125. doi: 10.1016/j.seizure.2022.11.009. Epub 2022 Nov 
      14.