Atrophy and cognitive profiles in older adults with temporal lobe epilepsy are similar to mild cognitive impairment.

Published on Feb 12, 2021in Brain13.501
· DOI :10.1093/BRAIN/AWAA397
Erik Kaestner12
Estimated H-index: 12
(UCSD: University of California, San Diego),
Anny Reyes10
Estimated H-index: 10
(UCSD: University of California, San Diego)
+ 12 AuthorsAlzheimer’s Disease Neuroimaging Initiative33
Estimated H-index: 33
Epilepsy incidence and prevalence peaks in older adults yet systematic studies of brain ageing and cognition in older adults with epilepsy remain limited. Here, we characterize patterns of cortical atrophy and cognitive impairment in 73 older adults with temporal lobe epilepsy (>55 years) and compare these patterns to those observed in 70 healthy controls and 79 patients with amnestic mild cognitive impairment, the prodromal stage of Alzheimer's disease. Patients with temporal lobe epilepsy were recruited from four tertiary epilepsy surgical centres; amnestic mild cognitive impairment and control subjects were obtained from the Alzheimer's Disease Neuroimaging Initiative database. Whole brain and region of interest analyses were conducted between patient groups and controls, as well as between temporal lobe epilepsy patients with early-onset (age of onset 50 years) seizures. Older adults with temporal lobe epilepsy demonstrated a similar pattern and magnitude of medial temporal lobe atrophy to amnestic mild cognitive impairment. Region of interest analyses revealed pronounced medial temporal lobe thinning in both patient groups in bilateral entorhinal, temporal pole, and fusiform regions (all P < 0.05). Patients with temporal lobe epilepsy demonstrated thinner left entorhinal cortex compared to amnestic mild cognitive impairment (P = 0.02). Patients with late-onset temporal lobe epilepsy had a more consistent pattern of cortical thinning than patients with early-onset epilepsy, demonstrating decreased cortical thickness extending into the bilateral fusiform (both P < 0.01). Both temporal lobe epilepsy and amnestic mild cognitive impairment groups showed significant memory and language impairment relative to healthy control subjects. However, despite similar performances in language and memory encoding, patients with amnestic mild cognitive impairment demonstrated poorer delayed memory performances relative to both early and late-onset temporal lobe epilepsy. Medial temporal lobe atrophy and cognitive impairment overlap between older adults with temporal lobe epilepsy and amnestic mild cognitive impairment highlights the risks of growing old with epilepsy. Concerns regarding accelerated ageing and Alzheimer's disease co-morbidity in older adults with temporal lobe epilepsy suggests an urgent need for translational research aimed at identifying common mechanisms and/or targeting symptoms shared across a broad neurological disease spectrum.
📖 Papers frequently viewed together
#1Joaquim RaduaH-Index: 63
#2Eduard VietaH-Index: 141
Last. Julian A Pineda-ZapataH-Index: 6
view all 111 authors...
Abstract A common limitation of neuroimaging studies is their small sample sizes. To overcome this hurdle, the Enhancing Neuro Imaging Genetics through Meta-Analysis (ENIGMA) Consortium combines neuroimaging data from many institutions worldwide. However, this introduces heterogeneity due to different scanning devices and sequences. ENIGMA projects commonly address this heterogeneity with random-effects meta-analysis or mixed-effects mega-analysis. Here we tested whether the batch adjustment met...
#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...
#1Gyujoon Hwang (UW: University of Wisconsin-Madison)H-Index: 6
#2Bruce P. Hermann (UW: University of Wisconsin-Madison)H-Index: 106
Last. Mary E. Meyerand (UW: University of Wisconsin-Madison)H-Index: 23
view all 23 authors...
Abstract The association of epilepsy with structural brain changes and cognitive abnormalities in midlife has raised concern regarding the possibility of future accelerated brain and cognitive aging and increased risk of later life neurocognitive disorders. To address this issue we examined age-related processes in both structural and functional neuroimaging among individuals with temporal lobe epilepsy (TLE, N = 104) who were participants in the Epilepsy Connectome Project (ECP). Support vector...
#1Nastasija Lezaic (UdeM: Université de Montréal)H-Index: 2
#2Josée Roussy (Laval University)H-Index: 1
Last. Mark R. KeezerH-Index: 17
view all 5 authors...
Abstract Elderly individuals (aged at least 60 or 65 years) represent a rapidly growing segment of the population. The incidence and prevalence of epilepsy is higher in this age group than in any other. Diagnosing epilepsy in the elderly can be challenging because the causes and clinical manifestations of seizures often differ as compared with younger individuals. Particular differential diagnoses, such as syncope and amyloid spells, are commonly encountered in the elderly population. A diagnosi...
#1Nikhila Veluri (American University of Integrative Sciences)H-Index: 1
Cognitive functioning is imperative in our daily lives. It allows us to understand, process, and react appropriately to different situations. Aging has been linked to cognitive decline. The degree and rate of cognitive decline are crucial as they differentiate normal aging from dementia or memory loss secondary to medical conditions. A 63-year-old Caucasian woman with a 50-year history of temporal lobe epilepsy experienced memory difficulties in recent years. She was admitted voluntarily to the ...
#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...
#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...
#1Rani A. Sarkis (Brigham and Women's Hospital)H-Index: 17
#2Kim C. Willment (Brigham and Women's Hospital)H-Index: 6
Last. Gad A. Marshall (Brigham and Women's Hospital)H-Index: 46
view all 4 authors...
Abstract With the aging of the US population, the incidence of epilepsy will increase, with 25 to 50% of new cases with no identifiable etiology diagnosed as late-onset unexplained epilepsy (LOUE). In the current targeted review, we discuss the possible role of cerebral small vessel ischemic disease, accumulation of amyloidβ and hyperphosphorylated tau, and sleep apnea as potential pathophysiologic mechanisms explaining LOUE. We highlight the impact of these processes on cognition and avenues fo...
#1Ettore BeghiH-Index: 99
#2Giorgia GiussaniH-Index: 35
Last. Fares AlahdabH-Index: 53
view all 109 authors...
Summary Background Seizures and their consequences contribute to the burden of epilepsy because they can cause health loss (premature mortality and residual disability). Data on the burden of epilepsy are needed for health-care planning and resource allocation. The aim of this study was to quantify health loss due to epilepsy by age, sex, year, and location using data from the Global Burden of Diseases, Injuries, and Risk Factors Study. Methods We assessed the burden of epilepsy in 195 countries...
#1Cinzia CostaH-Index: 31
#2Michele RomoliH-Index: 17
Last. Paolo CalabresiH-Index: 114
view all 12 authors...
Abstract Although amyloid pathology plays a role in epilepsy, little is known about the relationship between beta amyloid and progression to Alzheimer's disease (AD) among patients with late-onset epilepsy of unknown origin (LOEU). This multicenter, observational, prospective study enrolled 40 consecutive nondemented adults diagnosed with LOEU, together with 43 age- and sex-matched healthy controls. All patients completed neuropsychological tests, core CSF AD biomarkers assessment (Aβ1-42, total...
Cited By2
#1Michele Romoli (University of Perugia)H-Index: 17
#2Arjune Sen (John Radcliffe Hospital)H-Index: 18
Last. Cinzia Costa (University of Perugia)H-Index: 31
view all 5 authors...
People with epilepsy — in particular, late-onset epilepsy of unknown aetiology — have an elevated risk of dementia, and seizures have been detected in the early stages of Alzheimer disease (AD), supporting the concept of an epileptic AD prodrome. However, the relationship between epilepsy and cognitive decline remains controversial, with substantial uncertainties about whether epilepsy drives cognitive decline or vice versa, and whether shared pathways underlie both conditions. Here, we review e...
#1Arjune Sen (NIHR: National Institute for Health Research)H-Index: 18
#2Michele Romoli (University of Perugia)H-Index: 17
This website uses cookies.
We use cookies to improve your online experience. By continuing to use our website we assume you agree to the placement of these cookies.
To learn more, you can find in our Privacy Policy.