This article is more than 5 years old. Information may no longer be current.

Epileptic activity associated with earlier cognitive decline in Alzheimer's disease

People with epilepsy also affected by Alzheimer’s disease or amnestic mild cognitive impairment experienced cognitive decline earlier than those without epilepsy, according to recent study results.

“Epileptic activity associated with Alzheimer’s disease deserves increased attention because it has a harmful impact on these patients, can easily go unrecognized and untreated, and may reflect pathogenic processes that also contribute to other aspects of the illness,” researchers wrote.

The retrospective, observational study conducted from 2007 to 2012 included 54 people with a diagnosis of amnestic mild cognitive impairment with epilepsy (n=12), Alzheimer’s disease plus epilepsy (35), and Alzheimer’s disease plus subclinical epileptiform activity (7).

Researchers found participants with amnestic mild cognitive impairment and epilepsy had symptoms of cognitive decline 6.8 years earlier than those without epilepsy (64.3 vs. 71.1 years, respectively; P=.02). Similarly, participants with Alzheimer’s disease and epilepsy had symptoms of cognitive decline 5.5 years earlier than those without epilepsy (64.8 vs. 70.3 years, respectively; P=.001). Participants with Alzheimer’s disease and subclinical epileptiform activity also showed earlier symptoms of cognitive decline (58.9 years).

Seizure onset in participants with amnestic mild cognitive impairment and Alzheimer’s disease was nonuniform (P<.001) and clustered near the onset of cognitive decline. Forty-seven percent of epilepsies were complex partial seizures and 55% were nonconvulsive.

 

Keith A. Vossel

“These findings are important because they suggest epileptic activity as a new target for therapy in Alzheimer’s disease,” Keith A. Vossel, MD, MSc, assistant professor at the University of California, San Francisco, Memory and Aging Center, said in an interview. “By treating seizures we may be counteracting some of the symptoms and, possibly, even some of the disease-promoting mechanisms at work in this condition.”

Disclosure: See the study for a full list of relevant disclosures.