Interictal epileptiform discharges in Alzheimer's disease: prevalence, relevance, and controversies.

Interictal epileptiform discharges in Alzheimer's disease: prevalence, relevance, and controversies.
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DOI:
10.3389/fneur.2023.1261136
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发表时间:
2023
影响因子:
3.4
通讯作者:
--
中科院分区:
医学3区
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--
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阿尔茨海默病(AD)是最常见的痴呆症类型,仍然是一种无法治愈的进行性疾病,可用的疾病修改干预措施有限。在AD患者中,发作间期癫痫样放电(IED)在轻度认知障碍(MCI)或轻度痴呆的组合队列中被发现高达54%,是更具侵袭性的病程的标志。评估IED在AD中的作用的研究受到IED定义缺乏标准化或用于捕捉它们的不同神经生理学技术的限制。考虑到脑电和抗癫痫药物的可获得性,简易爆炸装置是一个有吸引力的治疗目标。关于何时治疗IEDS,治疗的最佳药物和剂量,以及治疗对病程的影响,仍然存在不确定性。这篇综述涵盖了AD中IED领域的知识状况,以及推动该领域向前发展所需的步骤。
Alzheimer’s disease (AD) is the most common type of dementia and remains an incurable, progressive disease with limited disease-modifying interventions available. In patients with AD, interictal epileptiform discharges (IEDs) have been identified in up to 54% of combined cohorts of mild cognitive impairment (MCI) or mild dementia and are a marker of a more aggressive disease course. Studies assessing the role of IEDs in AD are limited by the lack of standardization in the definition of IEDs or the different neurophysiologic techniques used to capture them. IEDs are an appealing treatment target given the availability of EEG and anti-seizure medications. There remains uncertainty regarding when to treat IEDs, the optimal drug and dose for treatment, and the impact of treatment on disease course. This review covers the state of knowledge of the field of IEDs in AD, and the steps needed to move the field forward.
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