Methylation capacity in children with severe cerebral palsy

Schoendorfer, Niikee C., Obeid, Rima, Moxon-Lester, Leith, Sharp, Nita, Vitetta, Luis, Boyd, Roslyn N. and Davies, Peter S. W. (2012) Methylation capacity in children with severe cerebral palsy. European Journal of Clinical Investigation, 42 7: 768-776. doi:10.1111/j.1365-2362.2011.02644.x

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Author Schoendorfer, Niikee C.
Obeid, Rima
Moxon-Lester, Leith
Sharp, Nita
Vitetta, Luis
Boyd, Roslyn N.
Davies, Peter S. W.
Title Methylation capacity in children with severe cerebral palsy
Journal name European Journal of Clinical Investigation   Check publisher's open access policy
ISSN 0014-2972
Publication date 2012
Sub-type Article (original research)
DOI 10.1111/j.1365-2362.2011.02644.x
Volume 42
Issue 7
Start page 768
End page 776
Total pages 9
Place of publication Oxford, United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2013
Language eng
Formatted abstract
Background  Methylation cycle and folate-mediated one-carbon metabolism maintenance is important for many physiological processes including neurotransmitter regulation, nerve myelination and DNA synthesis. These processes play an indispensible role in growth and development, as well as in cognitive function and neuromuscular stability, which are key issues in children with severe cerebral palsy (CP).

Methods  Blood samples were collected from children with severe CP (n = 24) and age-matched typically developing healthy controls (n = 24), as an exploratory study. The CP group was divided into orally (O) or enterally fed via percutaneous endoscopic gastrostomy (E). Concentrations of red cell folate (RCF), methylmalonic acid (MMA), mean cell volume (MCV), homocysteine (Hcy), cystathionine, choline, betaine and urate were assayed.

Results  Homocysteine was increased in both O mean (±SD) = 6·28 (±1·81 μM) and E = 6·03 (±1·28), vs. controls = 5·07 (±0·98) P = 0·02. Higher MMA was found in controls = 157 (±54) and O = 141 (±101), vs. E = 88(±21) P = 0·05. RCF was higher in E = 1422 (±70 nM) vs. O = 843 (±80) and controls = 820 (±43) P < 0·001. MCV z-scores were elevated in E = 3·1 (±1·8) and O = 1·1 (±1·1) compared with controls = −0·2 (±1·1) P < 0·001. Urate was significantly reduced in O = −0·64 (±1·38) and E = −0·87 (±0·71), vs. controls = 0·18 (±0·62) P = 0·006.

Conclusions  Raised MCV in the presence of elevated red cell folate, adequate B12 status and low plasma urate suggest potential methyltetrahydrofolate trapping and impaired purine synthesis. Well-documented malnutrition issues in O may explain differences between CP groups. These data support the hypothesis of possible dysregulation in methylation capacity and/or folate one-carbon metabolism, although more research is needed to elucidate a precise mechanism.
Keyword Cerebral palsy
One-carbon metabolism
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2013 Collection
School of Medicine Publications
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Created: Tue, 07 Feb 2012, 12:34:25 EST by Dr Luis Vitetta on behalf of Medicine - Princess Alexandra Hospital