Late-onset epilepsy and the risk of dementia: a systematic review and meta-analysis

Huang, Lei; Fu, Chi Yung; Li, Jie; Peng, Shijun

doi:10.1007/s40520-022-02118-8

Cited by 10 publications

(6 citation statements)

References 40 publications

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“…From a clinical point of view, it is highly important that recent studies have implied that epileptic events, in particular those occurring during sleep [ 29 , 30 , 31 ], may promote neurodegeneration [ 32 , 33 , 34 , 35 ]. The hypothesis states that detecting this pathological electrical brain activity early on and then initiating treatment with antiseizure medication might slow down the neurodegenerative processes and cognitive decline.…”

Section: Discussionmentioning

confidence: 99%

Ultra-Long-Term-EEG Monitoring (ULTEEM) Systems: Towards User-Friendly Out-of-Hospital Recordings of Electrical Brain Signals in Epilepsy

Yilmaz,

Seiler,

Chételat

et al. 2024

Sensors

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Epilepsy is characterized by the occurrence of epileptic events, ranging from brief bursts of interictal epileptiform brain activity to their most dramatic manifestation as clinically overt bilateral tonic–clonic seizures. Epileptic events are often modulated in a patient-specific way, for example by sleep. But they also reveal temporal patterns not only on ultra- and circadian, but also on multidien scales. Thus, to accurately track the dynamics of epilepsy and to thereby enable and improve personalized diagnostics and therapies, user-friendly systems for long-term out-of-hospital recordings of electrical brain signals are needed. Here, we present two wearable devices, namely ULTEEM and ULTEEMNite, to address this unmet need. We demonstrate how the usability concerns of the patients and the signal quality requirements of the clinicians have been incorporated in the design. Upon testbench verification of the devices, ULTEEM was successfully benchmarked against a reference EEG device in a pilot clinical study. ULTEEMNite was shown to record typical macro- and micro-sleep EEG characteristics in a proof-of-concept study. We conclude by discussing how these devices can be further improved and become particularly useful for a better understanding of the relationships between sleep, epilepsy, and neurodegeneration.

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Section: Discussionmentioning

confidence: 99%

Ultra-Long-Term-EEG Monitoring (ULTEEM) Systems: Towards User-Friendly Out-of-Hospital Recordings of Electrical Brain Signals in Epilepsy

Yilmaz,

Seiler,

Chételat

et al. 2024

Sensors

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“…Therefore, it is important to highlight the epilepsy-dementia and dementia-epilepsy relationship. A meta-analysis study reported that late-onset epilepsy in elderly people is related to a higher risk of developing Alzheimer's disease and vascular dementia [170].…”

Section: Risk Factors and Comorbidities Related To Epilepsy And Aed T...mentioning

confidence: 99%

Pathophysiology to Risk Factor and Therapeutics to Treatment Strategies on Epilepsy

Boleti,

Cardoso,

Frihling

et al. 2024

Brain Sciences

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Epilepsy represents a condition in which abnormal neuronal discharges or the hyperexcitability of neurons occur with synchronicity, presenting a significant public health challenge. Prognostic factors, such as etiology, electroencephalogram (EEG) abnormalities, the type and number of seizures before treatment, as well as the initial unsatisfactory effects of medications, are important considerations. Although there are several third-generation antiepileptic drugs currently available, their multiple side effects can negatively affect patient quality of life. The inheritance and etiology of epilepsy are complex, involving multiple underlying genetic and epigenetic mechanisms. Different neurotransmitters play crucial roles in maintaining the normal physiology of different neurons. Dysregulations in neurotransmission, due to abnormal transmitter levels or changes in their receptors, can result in seizures. In this review, we address the roles played by various neurotransmitters and their receptors in the pathophysiology of epilepsy. Furthermore, we extensively explore the neurological mechanisms involved in the development and progression of epilepsy, along with its risk factors. Furthermore, we highlight the new therapeutic targets, along with pharmacological and non-pharmacological strategies currently employed in the treatment of epileptic syndromes, including drug interventions employed in clinical trials related to epilepsy.

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“…Existing publications rarely compare risk of cognitive decline in LOEU patients with late-onset epilepsy of known etiology or patients with early-onset epilepsy. Patients with late-onset epilepsy in general demonstrate increased risk of developing dementia ( 45 ) potentially related to increased risk of developing vascular dementia in patients with cerebrovascular disease as a cause of epilepsy ( 46 ). Epilepsy itself is associated with increased risk of dementia and amyloid pathology ( 47 ), even when first diagnosed in early life.…”

Section: Epidemiological Evidence Of An Association Between Loeu and Admentioning

confidence: 99%

Clinical, imaging, and biomarker evidence of amyloid- and tau-related neurodegeneration in late-onset epilepsy of unknown etiology

Hickman,

Stern,

Silverman

et al. 2023

Front. Neurol.

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Accumulating evidence suggests amyloid and tau-related neurodegeneration may play a role in development of late-onset epilepsy of unknown etiology (LOEU). In this article, we review recent evidence that epilepsy may be an initial manifestation of an amyloidopathy or tauopathy that precedes development of Alzheimer’s disease (AD). Patients with LOEU demonstrate an increased risk of cognitive decline, and patients with AD have increased prevalence of preceding epilepsy. Moreover, investigations of LOEU that use CSF biomarkers and imaging techniques have identified preclinical neurodegeneration with evidence of amyloid and tau deposition. Overall, findings to date suggest a relationship between acquired, non-lesional late-onset epilepsy and amyloid and tau-related neurodegeneration, which supports that preclinical or prodromal AD is a distinct etiology of late-onset epilepsy. We propose criteria for assessing elevated risk of developing dementia in patients with late-onset epilepsy utilizing clinical features, available imaging techniques, and biomarker measurements. Further research is needed to validate these criteria and assess optimal treatment strategies for patients with probable epileptic preclinical AD and epileptic prodromal AD.

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Late-onset epilepsy and the risk of dementia: a systematic review and meta-analysis

Cited by 10 publications

References 40 publications

Ultra-Long-Term-EEG Monitoring (ULTEEM) Systems: Towards User-Friendly Out-of-Hospital Recordings of Electrical Brain Signals in Epilepsy

Ultra-Long-Term-EEG Monitoring (ULTEEM) Systems: Towards User-Friendly Out-of-Hospital Recordings of Electrical Brain Signals in Epilepsy

Pathophysiology to Risk Factor and Therapeutics to Treatment Strategies on Epilepsy

Clinical, imaging, and biomarker evidence of amyloid- and tau-related neurodegeneration in late-onset epilepsy of unknown etiology

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