Diagnosing cognitive disorders in older adults with epilepsy.

Published on Feb 1, 2021in Epilepsia5.866
· DOI :10.1111/EPI.16780
Anny Reyes10
Estimated H-index: 10
(UCSD: University of California, San Diego),
Erik Kaestner12
Estimated H-index: 12
(UCSD: University of California, San Diego)
+ 8 AuthorsAlzheimer’s Disease Neuroimaging Initiative33
Estimated H-index: 33
Objective To characterize the nature and prevalence of cognitive disorders in older adults with temporal lobe epilepsy (TLE) and compare their cognitive profiles to patients with amnestic mild cognitive impairment (ie, aMCI). Methods Seventy-one older patients with TLE, 77 aMCI, and 69 normal aging controls (NACs), all 55-80 years of age, completed neuropsychological measures of memory, language, executive function, and processing speed. An actuarial neuropsychological method designed to diagnose MCI was applied to individual patients to identify older adults with TLE who met diagnostic criteria for MCI (TLE-MCI). A linear classifier was performed to evaluate how well the diagnostic criteria differentiated patients with TLE-MCI from aMCI. In TLE, the contribution of epilepsy-related and vascular risk factors to cognitive impairment was evaluated using multiple regression. Results Forty-three TLE patients (60%) met criteria for TLE-MCI, demonstrating marked deficits in both memory and language. When patients were analyzed according to age at seizure onset, 63% of those with an early onset ( Significance Cognitive impairment is a common comorbidity in epilepsy and it presents in a substantial number of older adults with TLE. Although the underlying etiologies are unknown in many patients, the TLE-MCI phenotype may be secondary to an accumulation of epilepsy and vascular risk factors, signal the onset of a neurodegenerative disease, or represent a combination of factors.
#1Anny Reyes (UCSD: University of California, San Diego)H-Index: 10
#2Erik Kaestner (UCSD: University of California, San Diego)H-Index: 12
Last. Carrie R. McDonald (UCSD: University of California, San Diego)H-Index: 39
view all 9 authors...
OBJECTIVE: To identify cognitive phenotypes in temporal lobe epilepsy (TLE) and test their reproducibility in a large, multi-site cohort of patients using both data-driven and clinically driven approaches. METHOD: Four-hundred seven patients with TLE who underwent a comprehensive neuropsychological evaluation at one of four epilepsy centers were included. Scores on tests of verbal memory, naming, fluency, executive function, and psychomotor speed were converted into z-scores based on 151 healthy...
#1Elena Nardi Cesarini (University of Perugia)H-Index: 6
#2Claudio Babiloni (Sapienza University of Rome)H-Index: 86
Last. Cinzia Costa (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico)H-Index: 31
view all 15 authors...
.Introduction Despite epilepsy has been associated with cognitive decline, neuropsychological, neurobiological and neurophysiological features in patients with late-onset epilepsy of unknown etiology (LOEU) are poorly known. This cross-sectional study aimed at investigating neuropsychological profile, cerebrospinal fluid (CSF) biomarkers of Alzheimer’s disease (AD), and resting-state quantitative electroencephalographic (qEEG) cortical rhythms in LOEU patients with mild cognitive impairment (LOE...
#1Bruce P. Hermann (UW: University of Wisconsin-Madison)H-Index: 106
#2Lisa L. Conant (MCW: Medical College of Wisconsin)H-Index: 21
Last. Mary E. Meyerand (UW: University of Wisconsin-Madison)H-Index: 23
view all 28 authors...
Abstract This study explored the taxonomy of cognitive impairment within temporal lobe epilepsy and characterized the sociodemographic, clinical and neurobiological correlates of identified cognitive phenotypes. 111 temporal lobe epilepsy patients and 83 controls (mean ages 33 and 39, 57% and 61% female, respectively) from the Epilepsy Connectome Project underwent neuropsychological assessment, clinical interview, and high resolution 3T structural and resting-state functional MRI. A comprehensiv...
#1Claudio Liguori (University of Rome Tor Vergata)H-Index: 21
#2Cinzia Costa (University of Perugia)H-Index: 31
Last. Fabio Placidi (University of Rome Tor Vergata)H-Index: 32
view all 16 authors...
Abstract Introduction Epilepsy has a growing frequency, particularly in the elderly. Several triggers may cause late-onset epilepsy; however, more than 20% of epilepsies, manifesting in the elderly, has an unknown etiology. Although cognition is frequently altered in patients affected by epilepsy, there is a paucity of studies specifically evaluating cognition in patients affected by late-onset epilepsy. The aim of the present study was to assess the cognitive profile of patients affected by lat...
#1Kelsey M. Smith (Mayo Clinic)H-Index: 3
#2Melissa M. Blessing (Mayo Clinic)H-Index: 8
Last. Gregory D. Cascino (Mayo Clinic)H-Index: 73
view all 6 authors...
Objective To evaluate the presence of tau deposition and pathologic features of chronic traumatic encephalopathy (CTE) in young adult patients treated with focal cortical resections for drug‐resistant epilepsy.
#1Marian GalovicH-Index: 12
#2Victor Q. H. van Dooren (UCL: University College London)H-Index: 1
Last. Matthias J. Koepp (UCL: University College London)H-Index: 74
view all 12 authors...
Importance It is controversial whether epilepsy is a static or progressive disease. Evidence of progressive gray matter loss in epilepsy would support early diagnosis, rapid treatment, and early referral for surgical interventions. Objective To demonstrate progressive cortical thinning in patients with focal epilepsy distinct from cortical thinning associated with normal aging. Design, Setting, and Participants A case-control neuroimaging study was conducted from August 3, 2004, to January 26, 2...
#1Kathleen H. Elverman (MCW: Medical College of Wisconsin)H-Index: 1
#2Zachary J. Resch (RFUMS: Rosalind Franklin University of Medicine and Science)H-Index: 7
Last. Sara J. Swanson (MCW: Medical College of Wisconsin)H-Index: 25
view all 6 authors...
Abstract Neuropsychological assessment is critical for understanding the impact of seizures on cognition and informing treatment decisions. While focus is often placed on examining groups based on seizure type/epilepsy syndrome, an alternate approach emphasizes empirically derived groups based solely on cognitive performance. This approach has been used to identify cognitive phenotypes in temporal lobe epilepsy (TLE). The current study sought to replicate prior work by Hermann and colleagues (20...
#1Emily C. Edmonds (UCSD: University of California, San Diego)H-Index: 21
#2Carrie R. McDonald (UCSD: University of California, San Diego)H-Index: 39
Last. Mark W. Bondi (UCSD: University of California, San Diego)H-Index: 73
view all 10 authors...
Abstract Introduction The Alzheimer's Disease Neuroimaging Initiative (ADNI) separates "early" and "late" mild cognitive impairment (MCI) based on a single memory test. We compared ADNI's MCI classifications to our neuropsychological approach, which more broadly assesses cognitive abilities. Methods Three hundred thirty-six ADNI-2 participants were classified as "early" or "late" MCI. Cluster analysis was performed on neuropsychological test data, and participants were reclassified based on clus...
#1Anny ReyesH-Index: 10
#2Erik KaestnerH-Index: 12
Last. Carrie R. McDonaldH-Index: 39
view all 8 authors...
Objective To identify distinct cognitive phenotypes in temporal lobe epilepsy (TLE) and evaluate patterns of white matter (WM) network alterations associated with each phenotype. Methods Seventy patients with TLE were characterized into 4 distinct cognitive phenotypes based on patterns of impairment in language and verbal memory measures (language and memory impaired, memory impaired only, language impaired only, no impairment). Diffusion tensor imaging was obtained in all patients and in 46 hea...
#1Arjune Sen (John Radcliffe Hospital)H-Index: 18
#2Valentina Capelli (John Radcliffe Hospital)H-Index: 2
Last. Masud Husain (University of Oxford)H-Index: 89
view all 3 authors...
: With advances in healthcare and an ageing population, the number of older adults with epilepsy is set to rise substantially across the world. In developed countries the highest incidence of epilepsy is already in people over 65 and, as life expectancy increases, individuals who developed epilepsy at a young age are also living longer. Recent findings show that older persons with epilepsy are more likely to suffer from cognitive dysfunction and that there might be an important bidirectional rel...
Cited By3
#1Emily C. Edmonds (Veterans Health Administration)H-Index: 21
#2Denis S. Smirnov (UCSD: University of California, San Diego)H-Index: 4
Last. Mark W. Bondi (Veterans Health Administration)H-Index: 73
view all 9 authors...
Background and Objectives null Given prior work demonstrating that mild cognitive impairment (MCI) can be empirically differentiated into meaningful cognitive subtypes, we applied actuarial methods to comprehensive neuropsychological data from the University of California San Diego Alzheimer9s Disease Research Center (ADRC) in order to identify cognitive subgroups within ADRC participants without dementia and to examine cognitive, biomarker, and neuropathologic trajectories. null Methods null Cl...
A Nationwide, Retrospective, Data-Linkage, Cohort Study of Epilepsy and Incident Dementia Schnier C, Duncan S, Wilkinson T, Mbizvo GK, Chin RFM. Neurology. 2020;95(12):e1686-e1693. doi:10.1212/WNL....
#7Alberto Fernández (National University of Cordoba)H-Index: 55
This paper addresses the absence of an international diagnostic taxonomy for cognitive disorders in patients with epilepsy. Initiated through the 2020 Memorandum of Understanding between the International League Against Epilepsy and the International Neuropsychological Society, neuropsychological representatives from both organizations met to address the problem and consequences of the absence of an international diagnostic taxonomy for cognitive disorders in epilepsy, overview potential solutio...
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