B Vitamins and Magnetic Resonance Imaging–Detected Ischemic Brain Lesions in Patients With Recent Transient Ischemic Attack or Stroke

• DOI: 10.1161/strokeaha.112.665703
• Publication Date: 2012-10-24T04:27:57Z
• Authors: Margherita Cavalieri; Reinhold Schmidt; Christopher Chen; Vincent Mok; Gabriel R. de Fre...; Swithin Song; Qilong Yi; Stefan Ropele; Anja Grazer; Nina Homayoon; Christian Enzinger; Katherine Loh; Ka Sing Lawrence ...; Adrian Wong; Yunyun Xiong; Hui Meng Chang; Meng Cheong Wong; Franz Fazekas; John W. Eikelboom; Graeme J. Hankey
• Keywords: Stroke; B vitamins

Elevated concentrations of homocysteine are associated with cerebral small vessel disease (CSVD). B-vitamin supplementation folate and vitamins B12 B6 reduces concentrations. In a substudy the VITAmins TO Prevent Stroke (VITATOPS) trial, we assessed hypothesis that addition once-daily supplements B would reduce progression CSVD-related brain lesions.A total 359 patients recent stroke or transient ischemic attack, who were randomly allocated to double-blind treatment placebo b vitamins, underwent MRI at randomization after 2 years supplementation. MR images analyzed blinded allocation. Outcomes related prespecified white matter hyperintensities incident lacunes. We also explored effect on incidence other abnormalities.After placebo, there was no significant difference in volume change (0.08 vs 0.13 cm3; P=0.419) lacunes (8.0% 5.9%, P=0.434; odds ratio=1.38). subanalysis evidence severe CSVD baseline, b-vitamin reduction (0.3 1.7 P=0.039).Daily for did not significantly lesions resulting from presumed all attack but may do so subgroup CSVD.http://vitatops.highway1.com.au/. Unique identifier: NCT00097669 ISRCTN74743444.