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impairment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Objective<\/jats:title>\n                <jats:p>To study the correlation between homocysteine levels and cognitive impairment in patients with PD.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a case\u2013control study that included 246 patients with PD, of whom 32 were cognitively impaired. The levels of homocysteine, folate, and vitamin B12 were measured in peripheral blood. Multivariate logistic regression analysis was applied to determine differences in homocysteine levels between PD patients with and without cognitive impairment. A meta-analysis was performed to clarify the role of Hcy levels in PD with cognitive decline. Five polymorphisms in genes involved in Hcy metabolism, including <jats:italic>MTHFR<\/jats:italic> rs1801133 and rs1801131, <jats:italic>COMT<\/jats:italic> rs4680, <jats:italic>MTRR<\/jats:italic> rs1801394, and <jats:italic>TCN2<\/jats:italic> rs1801198, were genotyped.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Our case\u2013control study showed that homocysteine levels were associated with cognitive impairment in PD after adjusting for possible confounding factors such as levodopa equivalent daily dose. The results of our meta-analysis further supported the positive association between homocysteine levels and cognition in PD. We found that the <jats:italic>MTHFR<\/jats:italic> rs1801133 TT genotype led to higher homocysteine levels in PD patients, whereas the <jats:italic>MTHFR<\/jats:italic> rs1801131 CC genotype resulted in higher folate levels. However, the polymorphisms studied were not associated with cognitive impairment in PD.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Increased homocysteine levels were a risk factor for cognitive decline in PD. However, no association was found between polymorphisms in genes involved in homocysteine metabolism and cognitive impairment in PD. Large-scale studies of ethnically diverse populations are required to definitively assess the relationship between <jats:italic>MTHFR<\/jats:italic> and cognitive impairment in PD.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00415-022-11361-y","type":"journal-article","created":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T05:02:41Z","timestamp":1664341361000},"page":"477-485","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Homocysteine levels, genetic background, and cognitive impairment in Parkinson\u2019s disease"],"prefix":"10.1007","volume":"270","author":[{"given":"Mar\u00eda Teresa","family":"Peri\u00f1\u00e1n","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Mac\u00edas-Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Jes\u00fas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Francisco","family":"Mart\u00edn-Rodr\u00edguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Mu\u00f1oz-Delgado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Valle","family":"Jimenez-Jaraba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dolores","family":"Buiza-Rueda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Bonilla-Toribio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid Daniela","family":"Adarmes-G\u00f3mez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"G\u00f3mez-Garre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Mir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,9,28]]},"reference":[{"key":"11361_CR1","doi-asserted-by":"publisher","first-page":"S119","DOI":"10.1016\/j.parkreldis.2015.09.004","volume":"22","author":"RF Pfeiffer","year":"2016","unstructured":"Pfeiffer RF (2016) Non-motor symptoms in Parkinson\u2019s disease. 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Mac\u00edas-Garc\u00eda D: has received honoraria from Abbvie and Zambon. Jes\u00fas S: has received honoraria from Abbvie, Bial, Merz, UCB, Italfarmaco and Zambon. Mart\u00edn-Rodriguez JF: none. Mu\u00f1oz-Delgado L: has received honoraria from Teva. Jim\u00e9nez-Jaraba MV: none. Buiza-Rueda D: none. Bonilla-Toribio M: none. Adarmes-G\u00f3mez AD: has received honoraria from Abbvie and Italfarmaco. Gom\u00e9z-Garre P: none. Mir P: has received honoraria from Abbott, Allergan, Abbvie. Bial, Britannia, Italfarmaco, Merz, UCB, Teva and Zambon. The authors have no conflict of interest to report.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}