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Adjunctive Antioxidant Therapy in Neurologic Wilson’s Disease Improves the Outcomes

  • Jayantee KalitaEmail author
  • Vijay Kumar
  • Usha K Misra
  • Vasudev Parashar
  • Abhay Ranjan
Article
  • 31 Downloads

Abstract

Oxidative stress has been reported in Wilson’s disease with neurological manifestation (WDNM), but there is a paucity of studies on the role of adjunctive antioxidant therapy. This study aims to evaluate the efficacy of adjunctive vitamin C and E treatment in reducing oxidative stress and improving clinical outcomes. Forty-nine patients with WDNM were included and their clinical details were noted. Glutathione (GSH), total antioxidant capacity (TAC), and malondialdehyde (MDA) were measured using spectrophotometer at baseline and follow-up. All patients received zinc with or without chelating therapy, and 32 of them prescribed vitamin C (500 mg/day) and E (400 mg/day). Clinical outcomes at 6, 12, and 24 months were categorized as improved, static, or worsened based on improvement in Burke-Fahn-Marsden (BFM) score (>10%) and/or severity grade (> 1). Baseline parameters were similar between two groups; except BFM score was higher in the antioxidant group. At follow-up, the antioxidant group had higher GSH, TAC, and lower MDA levels compared with baseline. Patients on antioxidant treatment experienced improvement more frequently at 6 (53.1% vs. 29.4%), 12 (62.5% vs. 29.4%), and 24 months (68.8% vs. 35.3%) compared with those without antioxidant treatment. In WDNM, adjunctive vitamin C and E treatment reduce oxidative stress and improve clinical outcome.

Keywords

Wilson’s disease  Oxidative stress  Copper  Vitamin C and E 

Notes

Funding

None

Compliance with Ethical Standards

Conflict of Interest

On behalf of all the authors, the corresponding author states that there are no conflicts of interest.

Ethics Approval

The research has been approved by the Institutional Ethics Committee, SGPGIMS, Lucknow (Ethic No. A-03: PGI/IMP/IEC/56/19.08.2011).

Abbreviations

BFM Burke-Fahn-MarsdenCNS Central nervous systemCu CopperGSH GlutathioneLPO Lipid peroxidation MRI Magnetic resonance imagingMDA MalondialdehydeWD Wilson’s diseaseTAC Total antioxidant capacity

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of NeurologySanjay Gandhi Post Graduate Medical SciencesLucknowIndia
  2. 2.Department of BiotechnologyYeungnam UniversityGyeongsanRepublic of Korea

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