Epilepsy in Neurodegenerative Dementias: A Clinical, Epidemiological, and EEG Study

Article type: Research Article

Authors: Arnaldi, Dario^{a; b; *} | Donniaquio, Andrea^a | Mattioli, Pietro^a | Massa, Federico^a | Grazzini, Matteo^a | Meli, Riccardo^a | Filippi, Laura^a | Grisanti, Stefano^a | Famà, Francesco^{a; b} | Terzaghi, Michele^{c; d} | Girtler, Nicola^{a; b} | Brugnolo, Andrea^{a; b} | Doglione, Elisa^a | Pardini, Matteo^{a; b} | Villani, Flavio^b | Nobili, Flavio^{a; b}

Affiliations: [a] Department of Neuroscience (DINOGMI), Clinical Neurology, University of Genoa, Genoa, Italy | [b] IRCCS Ospedale Policlinico San Martino, Genoa, Italy | [c] Unit of Sleep Medicine and Epilepsy, IRCCS Mondino Foundation, Pavia, Italy | [d] Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy

Correspondence: [*] Correspondence to: Dario Arnaldi, Clinical Neurology, Department of Neuroscience (DINOGMI), Largo P. Daneo 3, Genoa, 16132, Italy. Tel.: +39 010 5552397; Fax: +39 010 5556893; E-mail: dario.arnaldi@gmail.com.

Abstract: Background:Seizures are common in patients with dementia but precise epidemiologic data of epilepsy in neurodegenerative dementia is lacking. Objective:The first aim of the study was to investigate prevalence and clinical characteristics of epilepsy in a large cohort of patients with neurodegenerative dementias. Subsequently, we explored clinical, neuropsychological, and quantitative electroencephalogram (qEEG) data of Alzheimer’s disease (AD) patients with epilepsy (AD-EPI) as compared to AD patients without epilepsy (AD-CTR). Methods:We retrospectively evaluated consecutive patients with a diagnosis of a neurodegenerative dementia and a clinically diagnosed epilepsy that required antiepileptic drugs (AED). All patients underwent baseline comprehensive neuropsychological assessment. A follow-up of at least one year was requested to confirm the dementia diagnosis. In AD patients, qEEG power band analysis was performed. AD-CTR and AD-EPI patients were matched for age, Mini-Mental State Examination score, and gender. Results:Thirty-eight out of 2,054 neurodegenerative dementia patients had epilepsy requiring AED. The prevalence of epilepsy was 1.82% for AD, 1.28% for the behavioral variant of frontotemporal dementia (bvFTD), 2.47% for dementia with Lewy bodies (DLB), and 12% for primary progressive aphasia. Epilepsy were more drug-responsive in AD than in non-AD dementias. Finally, no significant differences were found in neuropsychological and qEEG data between AD-EPI and AD-CTR patients. Conclusion:In our cohort, AD, FTD, and DLB dementias have similar prevalence of epilepsy, even if AD patients were more responsive to AED. Moreover, AD-EPI patients did not have significant clinical, neuropsychological qEEG differences compared with AD-CTR patients.

Keywords: Alzheimer’s disease, dementia, EEG, epilepsy, seizure

DOI: 10.3233/JAD-191315

Journal: Journal of Alzheimer's Disease, vol. 74, no. 3, pp. 865-874, 2020