Data di Pubblicazione:
2017
Citazione:
Adult-Onset Epilepsy in Presymptomatic Alzheimer's Disease : a Retrospective Study / J.C. Difrancesco, L. Tremolizzo, V. Polonia, G. Giussani, E. Bianchi, C. Franchi, A. Nobili, I. Appollonio, E. Beghi, C. Ferrarese. - In: JOURNAL OF ALZHEIMER'S DISEASE. - ISSN 1387-2877. - 60:4(2017), pp. 1267-1274. [10.3233/JAD-170392]
Abstract:
Background: The prevalence of epilepsy with onset in adulthood increases with age, mainly due to the accumulation of brain damage. However, a significant proportion of patients experience seizures of unknown cause. Alzheimer's disease (AD) is associated with an increased risk of seizures. Seizure activity is interpreted as a secondary event related to hyperexcitability caused by amyloid-β aggregation. Objective: Since neurodegenerative processes begin several years before clinical symptoms, epilepsy could be more frequent in the presymptomatic stages of dementia. Methods: We retrospectively reviewed the prevalence of epilepsy of unknown origin with adult onset before cognitive decline in a large cohort of AD patients (EPS-AD) recruited based on clinical and neuropsychological data. Data of patients with epilepsy followed by AD were compared with two control groups: patients with AD without seizures (no EPS-AD) and a large reference population (RP). Results: In AD patients, the prevalence of epilepsy of unknown origin, with onset in the adulthood before cognitive decline is 17.1 times higher compared with the RP (95% CI: 10.3-28.3). In EPS-AD, seizures begin on average 4.6 years (median 2.0) before the onset of cognitive symptoms and cognitive decline starts 3.6 years earlier compared with noEPS-AD. Conclusions: Neurodegenerative processes of dementia could play a key role in the pathogenesis of epilepsy in a subgroup of individuals intended to develop cognitive decline. Adult-onset epilepsy of undefined cause could thus represent a risk factor for the ongoing neurodegenerative damage, even preceding by years the onset of clinical symptoms of dementia.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Alzheimer's disease; disease modifying therapies; epilepsy; neurodegeneration; prevalence; seizure; Clinical Psychology; Geriatrics and Gerontology; Psychiatry and Mental Health
Elenco autori:
J.C. Difrancesco, L. Tremolizzo, V. Polonia, G. Giussani, E. Bianchi, C. Franchi, A. Nobili, I. Appollonio, E. Beghi, C. Ferrarese
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