B Vitamin Supplementation Slows Cognitive Decline in Mild Cognitive Impairment Patients with Frontal Lobe Atrophy

作者全名："Gong, Xianmin; Shi, Lin; Wu, Yuanyuan; Luo, Yishan; Kwok, Timothy"

作者地址："[Gong, Xianmin] Chinese Univ Hong Kong, Big Data Decis Analyt Res Ctr, Hong Kong, Peoples R China; [Gong, Xianmin] Chinese Univ Hong Kong, Dept Psychol, Hong Kong, Peoples R China; [Shi, Lin] Chinese Univ Hong Kong, Dept Imaging & Intervent Radiol, Hong Kong, Peoples R China; [Wu, Yuanyuan] Chongqing Med Univ, Affiliated Hosp 2, Hlth Management Ctr, Chongqing, Peoples R China; [Luo, Yishan] Hong Kong Sci & Technol Pk, BrainNow Res Inst, Hong Kong, Peoples R China; [Kwok, Timothy] Chinese Univ Hong Kong, Dept Med & Therapeut, Hong Kong, Peoples R China; [Kwok, Timothy] Chinese Univ Hong Kong, Jockey Club Ctr Osteoporosis Care & Control, Hong Kong, Peoples R China"

通信作者："Kwok, T (通讯作者)，Chinese Univ Hong Kong, Shatin, Hong Kong, Peoples R China."

来源：JOURNAL OF ALZHEIMERS DISEASE

ESI学科分类：NEUROSCIENCE & BEHAVIOR

WOS号：WOS:000869690400028

JCR分区：Q2

影响因子：4

年份：2022

卷号：89

期号：4

开始页：1453

结束页：1461

文献类型：Article

关键词：B vitamins; brain atrophy; folate; homocysteine; mild cognitive impairment

摘要："Background: The effects of B vitamins on mild cognitive impairment (MCI) patients' cognition have been mixed, suggesting the existence of moderating factors. Objective: A post hoc analysis of a negative B vitamin trial was performed to examine the potential modulating effect of regional brain atrophy on the cognitive response to B vitamins in MCI patients. Methods: In the 24-month randomized trial, 279 MCI outpatients took 500 mu g methylcobalamin and 400 mu g folic acid once per day or placebo tablets once per day. Sixty-four aspirin users were excluded from analysis as aspirin use has been found to have significant negative interaction effects. Subjects were followed up at months 12 and 24. The primary cognitive outcome was clinical dementia rating scale sum of boxes (CDR SOB). In a subgroup of 83 subjects, MRI brain scans were performed at baseline to estimate regional brain atrophy ratios. Results: Among the trial subjects who had MRI data, B vitamin supplementation had no significant effect on CDR SOB, despite having significant homocysteine lowering effects. The atrophy ratio of the left frontal lobe significantly moderated the effect of B vitamin supplementation on CDR SOB, after adjusting for confounders, in that B vitamin supplementation was associated with lower CDR SOB scores (i.e., better cognitive function) at the 24th month among those patients with above median atrophy ratios, but not among those with lower atrophy ratios, in the left frontal lobe. Conclusion: B vitamins may be more effective in slowing down cognitive decline in MCI patients with atrophy in the left frontal lobe."

基金机构：General Research Fund of the Research Grants Council of Hong Kong [466612]

基金资助正文：This study received support from the General Research Fund of the Research Grants Council of Hong Kong (RGC Reference 466612) and a donation from Therese Pei Fong Chow Research Centre for Prevention of Dementia at The Chinese University of Hong Kong.