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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1527896
This article is part of the Research Topic Advances in the Understanding, Diagnosis, and Management of Intracranial and Extracranial Arterial Dissections View all articles

Ischemic stroke in young Asians caused by spontaneous cervical artery dissection may be due to slightly increased homocysteine

Provisionally accepted
Zijun Lin Zijun Lin 1,2Shuhan Huang Shuhan Huang 1*Wei Li Wei Li 2*
  • 1 First Affiliated Hospital of Chongqing Medical University, Chongqing, China
  • 2 Army Medical Center of PLA, Chongqing, China

The final, formatted version of the article will be published soon.

    Background: Spontaneous cervical artery dissection (sCAD) is a nonatherosclerotic vascular disease among young and middle-aged individuals of unknown etiology that is recognized as a cause of ischemic stroke. Total plasma homocysteine (tHcy) is associated with an increased risk of sCAD, but the precise mechanism and level of tHcy remain unclear.Methods: Fasting tHcy levels were determined in 296 patients with a first ischemic stroke due to sCAD (n = 159) and in age/gender-matched hospital-based controls (n = 137) within 24 h after the onset of symptoms.The mean age of sCAD patients with ischemic stroke and controls was 45.6 years; 61.0% of the cases and controls were male. The prevalence rates of hypertension, diabetes mellitus and hyperlipidemia in sCAD patients were significantly increased. Fasting tHcy levels in sCAD patients were significantly higher (12.81±5.24 µmol/l, 95 % CI: 11.7913.89) than those in controls (10.21±3.33µmol/l, 95 % CI: 9.9211.89, P<0.001). Compared with the lowest homocysteine quartile, the quartile between 12.1 and 14.54 µmol/L was significantly associated with sCAD, with an adjusted odds ratio of 4.7. The adjusted odds ratio was 5.02 (95% CI: 1.9113.39, P=0.001) for every 1 µmol/L increase in log homocysteine according to the logistic regression model. Although sCAD occurred more often in winter than in the other seasons (p = 0.02), tHcy levels in sCAD were not significantly different in terms of seasonal variation (P>0.05).Our results suggest that mildly increased tHcy may be a predisposing risk factor for ischemic stroke in young Asians caused by sCAD and that the relationship between them is significant; however, the precise mechanism requires further study. This result also supports the screening of fasting tHcy in young Asian adults for early intervention and control of tHcy levels, which plays an important role in early clinical prediction and intervention of sCAD.

    Keywords: spontaneous cervical artery dissection, Homocysteine, Stroke, Risk factors, ischemic stroke, Asian young adults

    Received: 14 Nov 2024; Accepted: 03 Feb 2025.

    Copyright: © 2025 Lin, Huang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Shuhan Huang, First Affiliated Hospital of Chongqing Medical University, Chongqing, China
    Wei Li, Army Medical Center of PLA, Chongqing, China

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