{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T20:20:07Z","timestamp":1789417207973,"version":"build-2803163510"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2002,3]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:bold>\n                  <jats:italic>Background and Purpose<\/jats:italic>\n                <\/jats:bold>\n                \u2014\n              <\/jats:italic>\n            <\/jats:bold>\n            The role of mild hyperhomocysteinemia as a risk factor for cerebral ischemia may depend on stroke subtype. To test this hypothesis, we undertook a prospective case-control study of a group of patients with spontaneous cervical artery dissection (sCAD), a group of patients with atherothrombotic stroke (non-CAD), and a group of control subjects.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:bold>\n                  <jats:italic>Methods<\/jats:italic>\n                <\/jats:bold>\n                \u2014\n              <\/jats:italic>\n            <\/jats:bold>\n            Fasting total plasma homocysteine (tHcy) concentration, C677T\n            <jats:italic>MTHFR<\/jats:italic>\n            genotype, and 844ins68bp\n            <jats:italic>CBS<\/jats:italic>\n            genotype were determined in 25 patients with sCAD, 31 patients &lt;45 years of age with non-CAD ischemic stroke, and 36 control subjects. Biochemical data in the patient groups were obtained within the first 72 hours of stroke onset.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:bold>\n                  <jats:italic>Results<\/jats:italic>\n                <\/jats:bold>\n                \u2014\n              <\/jats:italic>\n            <\/jats:bold>\n            Median tHcy levels were significantly higher in patients with sCAD (13.2 \u03bcmol\/L; range, 7 to 32.8 \u03bcmol\/L) compared with control subjects (8.9 \u03bcmol\/L; range, 5 to 17.3 \u03bcmol\/L; 95% CI, 1.05 to 1.52;\n            <jats:italic>P<\/jats:italic>\n            =0.006). Cases with tHcy concentration above the cutoff level of 12 \u03bcmol\/L were significantly more represented in the group of patients with sCAD compared with control subjects (64% versus 13.9%; 95% CI, 2.25 to 44.23;\n            <jats:italic>P<\/jats:italic>\n            =0.003); a significant association between the\n            <jats:italic>MTHFR TT<\/jats:italic>\n            genotype and sCAD was also observed (36% versus 11.1%; 95% CI, 1.10 to 19.23;\n            <jats:italic>P<\/jats:italic>\n            =0.045). No significant difference in tHcy levels and in the prevalence of thermolabile\n            <jats:italic>MTHFR<\/jats:italic>\n            was found between patients with non-CAD ischemic stroke and control subjects and between patients with sCAD and non-CAD ischemic stroke. The distribution of the 844ins68bp\n            <jats:italic>CBS<\/jats:italic>\n            genotype and the prevalence of subjects carrying both the\n            <jats:italic>TT MTHFR<\/jats:italic>\n            and 844ins68bp\n            <jats:italic>CBS<\/jats:italic>\n            genotypes were not significantly different among the 3 groups.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:bold>\n                  <jats:italic>Conclusions<\/jats:italic>\n                <\/jats:bold>\n                \u2014\n              <\/jats:italic>\n            <\/jats:bold>\n            Our results are consistent with the hypothesis that increased plasma homocysteine levels and the\n            <jats:italic>TT MTHFR<\/jats:italic>\n            genotype may represent risk factors for sCAD. In contrast, their role in atherothrombotic strokes remains a contentious issue.\n          <\/jats:p>","DOI":"10.1161\/hs0302.103625","type":"journal-article","created":{"date-parts":[[2002,7,28]],"date-time":"2002-07-28T23:16:47Z","timestamp":1027898207000},"page":"664-669","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":138,"title":["Plasma Homocysteine Concentration, C677T\n            <i>MTHFR<\/i>\n            Genotype, and 844ins68bp\n            <i>CBS<\/i>\n            Genotype in Young Adults With Spontaneous Cervical Artery Dissection and Atherothrombotic Stroke"],"prefix":"10.1161","volume":"33","author":[{"given":"Alessandro","family":"Pezzini","sequence":"first","affiliation":[{"name":"From Clinica Neurologica (A.P., E. Del Z., L.A.V., M.M., A.P.); III Laboratorio di Analisi, Biotecnologie (S.A., R.N., P.B., A.A.); Clinica Cardiologica (D.A.); and Dipartimento di Radiologia, Neuroradiologia (R.G.), Universita\u0300 degli Studi di Brescia, Brescia, Italia, and Istituto di Statistica Medica e Biometria, Universita\u0300 degli Studi di Pavia (M.G.), Pavia, Italia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Del Zotto","sequence":"additional","affiliation":[{"name":"From Clinica Neurologica (A.P., E. Del Z., L.A.V., M.M., A.P.); III Laboratorio di Analisi, Biotecnologie (S.A., R.N., P.B., A.A.); Clinica Cardiologica (D.A.); and Dipartimento di Radiologia, Neuroradiologia (R.G.), Universita\u0300 degli Studi di Brescia, Brescia, Italia, and Istituto di Statistica Medica e Biometria, Universita\u0300 degli Studi di Pavia (M.G.), Pavia, Italia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvana","family":"Archetti","sequence":"additional","affiliation":[{"name":"From Clinica Neurologica (A.P., E. Del Z., L.A.V., M.M., A.P.); III Laboratorio di Analisi, Biotecnologie (S.A., R.N., P.B., A.A.); Clinica Cardiologica (D.A.); and Dipartimento di Radiologia, Neuroradiologia (R.G.), Universita\u0300 degli Studi di Brescia, Brescia, Italia, and Istituto di Statistica Medica e Biometria, Universita\u0300 degli Studi di Pavia (M.G.), Pavia, Italia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Negrini","sequence":"additional","affiliation":[{"name":"From Clinica Neurologica (A.P., E. Del Z., L.A.V., M.M., A.P.); III Laboratorio di Analisi, Biotecnologie (S.A., R.N., P.B., A.A.); Clinica Cardiologica (D.A.); and Dipartimento di Radiologia, Neuroradiologia (R.G.), Universita\u0300 degli Studi di Brescia, Brescia, Italia, and Istituto di Statistica Medica e Biometria, Universita\u0300 degli Studi di Pavia (M.G.), Pavia, Italia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Bani","sequence":"additional","affiliation":[{"name":"From Clinica Neurologica (A.P., E. Del Z., L.A.V., M.M., A.P.); III Laboratorio di Analisi, Biotecnologie (S.A., R.N., P.B., A.A.); Clinica Cardiologica (D.A.); and Dipartimento di Radiologia, Neuroradiologia (R.G.), Universita\u0300 degli Studi di Brescia, Brescia, Italia, and Istituto di Statistica Medica e Biometria, Universita\u0300 degli Studi di Pavia (M.G.), Pavia, Italia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Albertini","sequence":"additional","affiliation":[{"name":"From Clinica Neurologica (A.P., E. Del Z., L.A.V., M.M., A.P.); III Laboratorio di Analisi, Biotecnologie (S.A., R.N., P.B., A.A.); Clinica Cardiologica (D.A.); and Dipartimento di Radiologia, Neuroradiologia (R.G.), Universita\u0300 degli Studi di Brescia, Brescia, Italia, and Istituto di Statistica Medica e Biometria, Universita\u0300 degli Studi di Pavia (M.G.), Pavia, Italia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Grassi","sequence":"additional","affiliation":[{"name":"From Clinica Neurologica (A.P., E. Del Z., L.A.V., M.M., A.P.); III Laboratorio di Analisi, Biotecnologie (S.A., R.N., P.B., A.A.); Clinica Cardiologica (D.A.); and Dipartimento di Radiologia, Neuroradiologia (R.G.), Universita\u0300 degli Studi di Brescia, Brescia, Italia, and Istituto di Statistica Medica e Biometria, Universita\u0300 degli Studi di Pavia (M.G.), Pavia, Italia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deodato","family":"Assanelli","sequence":"additional","affiliation":[{"name":"From Clinica Neurologica (A.P., E. Del Z., L.A.V., M.M., A.P.); III Laboratorio di Analisi, Biotecnologie (S.A., R.N., P.B., A.A.); Clinica Cardiologica (D.A.); and Dipartimento di Radiologia, Neuroradiologia (R.G.), Universita\u0300 degli Studi di Brescia, Brescia, Italia, and Istituto di Statistica Medica e Biometria, Universita\u0300 degli Studi di Pavia (M.G.), Pavia, Italia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Gasparotti","sequence":"additional","affiliation":[{"name":"From Clinica Neurologica (A.P., E. 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Del Z., L.A.V., M.M., A.P.); III Laboratorio di Analisi, Biotecnologie (S.A., R.N., P.B., A.A.); Clinica Cardiologica (D.A.); and Dipartimento di Radiologia, Neuroradiologia (R.G.), Universita\u0300 degli Studi di Brescia, Brescia, Italia, and Istituto di Statistica Medica e Biometria, Universita\u0300 degli Studi di Pavia (M.G.), Pavia, Italia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Magoni","sequence":"additional","affiliation":[{"name":"From Clinica Neurologica (A.P., E. 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