A Longitudinal Study of Epileptic Seizures in Alzheimer's Disease

Abstract

The prevalence of epileptic seizures is increased in patients in the clinical stages of Alzheimer's disease (AD) when compared to age-matched cognitively normal populations. In previously reported work from the Presentation of Epileptic Seizures in Dementia (PrESIDe) study, we identified a clinical suspicion of epilepsy in between 12.75 and 28.43% of patients with AD recruited from a memory clinic. EEGs were not performed in this study. Patients with epilepsy performed similarly to patients without epilepsy on cognitive testing at the time of recruitment but were more impaired on two measures of everyday functioning [Cambridge Behavioral Inventory—Revised and Clinical Dementia Rating (CBI-R and CDR)]. On repeated testing in this 12-month follow-up study, patients in whom a suspicion of epilepsy was identified performed significantly worse on cognitive function testing (p = 0.028) in addition to maintaining a difference on the informant questionnaires (CBI-R p < 0.001, CDR p = 0.020). These findings suggest that seizures in this population could be a marker of a more rapid decline and worse prognosis.

Ablating Tau Reduces Hyperexcitability and Moderates Electroencephalographic Slowing in Transgenic Mice Expressing A53T Human α-Synuclein

“…Aberrant network excitability has come to the forefront as a significant contributor to cognitive decline in neurodegenerative disorders. Rates of seizures in dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) are estimated to be ten-fold higher than in age-matched controls, and seizures in AD are associated with faster cognitive decline (1)(2)(3). Extended neurophysiological monitoring has revealed that ∼40% of AD patients exhibit epileptiform activity even in the absence of seizures, and this subclinical phenomenon could accelerate disease progression (4).…”

Abnormalities of Cortical Sources of Resting State Delta Electroencephalographic Rhythms Are Related to Epileptiform Activity in Patients With Amnesic Mild Cognitive Impairment Not Due to Alzheimer's Disease

“…In the baseline recordings, the ADD patients with and without the suspect of epilepsy showed quite similar cognitive performances (76). However, those performances worsened more in the ADD patients with than without the suspicion of epilepsy at 1-year follow-up (76).…”

“…In those studies, proper regression and mixed linear models may test the significance and direction of those relationships between the magnitude of rsEEG delta rhythms and EEA. A fruitful example of a similar methodological approach is the PrESIDe study (76). In the PrESIDe study, a significant number of ADD patients (13-28%) were suspected of suffering from a sort of silent epilepsy (76).…”

“…A fruitful example of a similar methodological approach is the PrESIDe study (76). In the PrESIDe study, a significant number of ADD patients (13-28%) were suspected of suffering from a sort of silent epilepsy (76). In the baseline recordings, the ADD patients with and without the suspect of epilepsy showed quite similar cognitive performances (76).…”

“…In the PrESIDe study, a significant number of ADD patients (13-28%) were suspected of suffering from a sort of silent epilepsy (76). In the baseline recordings, the ADD patients with and without the suspect of epilepsy showed quite similar cognitive performances (76). However, those performances worsened more in the ADD patients with than without the suspicion of epilepsy at 1-year follow-up (76).…”