INTERVENTION EFFECT OF FOLIC ACID AND VITAMIN B12 ON VASCULAR COGNITIVE IMPAIRMENT COMPLICATED WITH HYPERHOMOCYSTEINEMIA / EFEKAT INTERVENCIJE FOLNOM KISELINOM I VITAMINOM B12 NA VASKULARNI KOGNITIVNI POREMEĆAJ KOMPLIKOVAN HIPERHOMOCISTEINEMIJOM

Summary Background: Hyperhomocysteinemia (HHcy) may be corre- lated with cognitive function. Although intervention with folic acid and VitB12 can decrease the homocysteine (Hey) level, its effect on cognitive function remains uncertain. This prospective study aimed to explore the effects of folic acid and VitB/! 2 on the ^су an<^ cognitive function in patients with vascular cognitive impairment-no dementia (VCIND) complicated with HHcy. Methods: A total of 120 patients with VCIND complicated fcy HHcy were randomly selected. They were divided into inter- vention and control groups. The intervention group was given 5 mg of folic acid per day and 500 цд of VitB^ thrice per day apart from conventional therapy. Folic acid, V'itBl2, and Hey were determined and Montreal cognitive assess- ment (MoCA) and event-related potential P300 determination were performed before and after treatment. Results: Before treatment, no significant differences in the folic acid, VitB^, Hey, MoCA, and P300 parameters were observed between the groups. After treatment, the folic acid and VitBl2 levels increased and the Hey level decreased in the intervention group compared with that before treatment and in the control group. At 24 weeks, the MoCA score and P300 outcomes in the intervention group improved com- pared with those before treatment and in the control group. Conclusions: Folic acid and VitB^ effectively decrease the Hey level in VCIND patients and improve their cognitive functions. Kratak sadržaj Uvod: Hiperhomocisteinemija (HHcy) nekada koreliše sa kognitivnom funkcijom. lako se nivo homocisteina (Hey) snižava posle intervencije folnom kiselinom ivitaminom B12, njihov efekat na kognitivnu funkciju ostaje nejasan. Cilj ove prospektivne studije bio je da se istraži uticaj folne kiseline i vitamina B^ na nivo homocisteina i kognitivnu funkciju kod pacijenata sa vaskulamim kognitivnim poremećajem bez demencije (eng. vascular cognitive impairment - no deme- tia, VCIND) komplikovanim hiperhomocisteinemijom. Metode: Nasumično je izabrano ukupno 120 pacijenata sa vaskulamim kognitivnim poremećajem bez demencije kom- plikovanim hiperhomocisteinemijom. Oni su podeljeni u in- tervencionu i kontrolnu grupu. Intervenciona grupa je pri- mala 5 mg folne kiseline jednom dnevno i 500 цд vitamina B>|2 tri puta dnevno, uz uobičajenu terapiju. Odredeni su nivoi folne kiseline, vitamina B12 i homocisteina a pre i posle tretmana su urađeni kognitivni testcvi Montreal Cognitive Assessment (MoCA) i P300 kognitivni potencijal. Rezultati: Pre tretmana, izmedu grupa nisu uočene značajne razlike u n'rvoima folne kiseline, vitamina B12, homocisteina, n'rti u parametrima MoCA i P300. Posle tretmana, nivoi folne kiseline i vitamina B12 su porasli, dok se nivo homocisteina u intervencionoj grupi snizio u poredenju sa n'rvoom pre tret- mana i u kontrolnoj grupi. Posle 24 nedelje, u intervencionoj grupi su se popravili rezultati MoCA i P300, u poredenju sa onima pre tretmana i u kontrolnoj grupi. ZakJjučak: Folna kiselina i vitamin B12 efikasno snižavaju nivo homocisteina kod pacijenata sa vaskulamim kognitiv- nim poremećajem bez demencije i poboljšavaju njihove kog- nitivne funkcije.