Incidence and impact of subclinical epileptiform activity in Alzheimer's disease.
Incidence and impact of subclinical epileptiform activity in Alzheimer's disease.
复制标题
DOI：
10.1002/ana.24794
复制
发表时间：
2016-12
影响因子：
11.2
通讯作者：
Nagarajan, Srikantan S.
中科院分区：
文献类型：
--
作者：
Vossel, Keith A.;Ranasinghe, Kamalini G.;Beagle, Alexander J.;Mizuiri, Danielle;Honma, Susanne M.;Dowling, Anne F.;Darwish, Sonja M.;Van Berlo, Victoria;Barnes, Deborah E.;Mantle, Mary;Karydas, Anna M.;Coppola, Giovanni;Roberson, Erik D.;Miller, Bruce L.;Garcia, Paul A.;Kirsch, Heidi E.;Mucke, Lennart;Nagarajan, Srikantan S.
癫痫发作在阿尔茨海默病（AD）患者中更常见，并可加速认知能力下降。然而，AD亚临床癫痫样活动的发生率及其后果尚不清楚。受动物研究结果的启发，我们假设AD亚临床癫痫样活动的发生率高于预期，并对认知产生有害影响。我们前瞻性地招募了33名符合AD标准但无癫痫发作史的患者（平均年龄62岁）和19名年龄匹配的认知正常对照。亚临床癫痫样活动的评估，盲诊断，通过夜间长期视频脑电图和一个小时的休息脑磁图检查，同时脑电图。患者还进行了全面的临床和认知评估，平均3.3年的纵向评估。在42.4%的AD患者和10.5%的对照组中检测到亚临床癫痫样活动（p = 0.02）。在监测时，有癫痫样活动的AD患者与无癫痫样活动的AD患者在临床上没有差异。然而，具有亚临床癫痫样活动的患者显示出更快的整体认知下降，由简易精神状态检查确定（癫痫样活动患者为3.9分/年，无癫痫样活动患者为1.6分/年，p = 0.006）和执行功能（p = 0.01）。扩展监测检测亚临床癫痫样活动在很大比例的AD患者。具有这种网络过度兴奋指标的患者面临认知能力加速下降的风险，并且可能会从抗癫痫治疗中受益。这些数据要求在AD患者评估和即将进行的临床试验中进行更敏感和全面的神经生理学评估。
Seizures are more frequent in patients with Alzheimer’s disease (AD) and can hasten cognitive decline. However, the incidence of subclinical epileptiform activity in AD and its consequences are unknown. Motivated by results from animal studies, we hypothesized higher than expected rates of subclinical epileptiform activity in AD with deleterious effects on cognition. We prospectively enrolled 33 patients (mean age 62 years) who met criteria for AD, but had no history of seizures, and 19 age-matched, cognitively normal controls. Subclinical epileptiform activity was assessed, blinded to diagnosis, by overnight long-term video-electroencephalography and a one-hour resting magnetoencephalography exam with simultaneous EEG. Patients also had comprehensive clinical and cognitive evaluations, assessed longitudinally over an average period of 3.3 years. Subclinical epileptiform activity was detected in 42.4% of AD patients and 10.5% of controls (p = 0.02). At the time of monitoring, AD patients with epileptiform activity did not differ clinically from those without such activity. However, patients with subclinical epileptiform activity showed faster declines in global cognition, determined by the Mini-Mental State Examination (3.9 points/year in patients with epileptiform activity vs. 1.6 points/year in patients without, p = 0.006), and in executive function (p = 0.01). Extended monitoring detects subclinical epileptiform activity in a substantial proportion of patients with AD. Patients with this indicator of network hyperexcitability are at risk for accelerated cognitive decline and might benefit from antiepileptic therapies. These data call for more sensitive and comprehensive neurophysiological assessments in AD patient evaluations and impending clinical trials.
登录
查看更多内容
影响因子：
29
作者：
Donohue, Michael C.;Sperling, Reisa A.;Salmon, David P.;Rentz, Dorene M.;Raman, Rema;Thomas, Ronald G.;Weiner, Michael;Aisen, Paul S.
通讯作者：
Aisen, Paul S.
DOI：
10.1016/j.jalz.2011.03.005
发表时间：
2011-05
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
--
作者：
McKhann GM;Knopman DS;Chertkow H;Hyman BT;Jack CR Jr;Kawas CH;Klunk WE;Koroshetz WJ;Manly JJ;Mayeux R;Mohs RC;Morris JC;Rossor MN;Scheltens P;Carrillo MC;Thies B;Weintraub S;Phelps CH
通讯作者：
Phelps CH
DOI：
10.1073/pnas.0812697106
发表时间：
2009-02-10
影响因子：
11.1
作者：
Agosta, Federica;Vossel, Keith A.;Gorno-Tempini, Maria Luisa
通讯作者：
Gorno-Tempini, Maria Luisa
影响因子：
16.2
作者：
Bakker A;Krauss GL;Albert MS;Speck CL;Jones LR;Stark CE;Yassa MA;Bassett SS;Shelton AL;Gallagher M
通讯作者：
Gallagher M
影响因子：
4.2
作者：
Bakker, Arnold;Albert, Marilyn S.;Krauss, Gregory;Speck, Caroline L.;Gallagher, Michela
通讯作者：
Gallagher, Michela