阿茲海默症中亞臨床癲癇樣放電的影響
阿茲海默症中亞臨床癲癇樣放電的影響
阿茲海默失智症佔所有失智症病例的 60%–70%。衰老是阿茲海默失智症和癲癇發作的潛在危險因素，阿茲海默失智症和癲癇發作的患病率隨著年齡的增長而增加。與沒有阿茲海默失智症的年齡匹配的對照組相比，阿茲海默失智症患者的癲癇發作風險更高。最近的一項分析結果表明，與一般人群相比，阿茲海默失智症患者的癲癇發作率更高。阿茲海默失智症患者癲癇發作的相對風險為 3.35。此外，發現沒有癲癇病史的阿茲海默失智症患者發作間期癲癇樣放電的發生率高於認知功能正常的健康對照組。在一項研究中，一些阿茲海默失智症患者在病程中經歷了亞臨床癲癇發作，並且高癲癇樣放電率與阿茲海默失智症患者認知能力下降的更快進展有關。
亞臨床癲癇樣放電定義為腦電圖上不伴有臨床癲癇表現的癲癇發作模式，是皮質過度興奮的生物標誌物。42.4% 的阿茲海默失智症患者在夜間腦電圖上出現亞臨床癲癇樣放電。亞臨床癲癇樣放電的累積發病率為21.41%，阿茲海默失智症患者的患病率為9.73%。患有亞臨床癲癇樣放電的阿茲海默失智症患者比沒有亞臨床癲癇樣放電 的患者表現出更早的認知能力下降。
應用與亮點：
1.亞臨床癲癇樣放電的患病率隨著阿茲海默失智症嚴重程度的增加而提升。
2.有亞臨床癲癇樣放電組患者的認知功能比沒有亞臨床癲癇樣放電的患者下降地更快。
【研究團隊】
團隊成員：葉威志、徐崇堯、李冠瑩、簡靖芳、黃玲鈞、楊淵韓
代表單位：高雄醫學大學神經科學研究中心及高醫附院和大同醫院神經科
團隊簡介：本團隊致力於研究阿茲海默氏症的相關危險因子及致病機轉
研究聯繫Email：endless@kmu.edu.tw
【論文資訊】
論文出處：Journal of Alzheimer's Disease, 2022 Sep 12. Online ahead of print.
全文下載：https://pubmed.ncbi.nlm.nih.gov/36120783/
Association between subclinical epileptiform discharge and severity of and cognitive decline in Alzheimer Dementia
Association between subclinical epileptiform discharge and severity of and cognitive decline in Alzheimer Dementia
Alzheimer's disease (AD) is the most common type of dementia. Aging is a risk factor for both AD and seizures. Subclinical epileptiform discharge (SED) has no evident clinical manifestation in patients with AD. Therefore, SED is liable to be overlooked in these patients since electroencephalography is not routinely performed in clinical settings. Previous studies about the association between SED and AD have yielded inconsistent results.
The current study aimed to evaluate the prevalence of SED and its effect on AD severity and clinical outcomes.Patients with AD from Kaohsiung Municipal Ta-tung Hospital were included in this study. International 10-20 system scalp electroencephalography for 13 minutes was performed to detect SED. Clinical outcomes of patients with and without SED were assessed by neuropsychological tests [Cognitive Abilities Screening Instrument (CASI), Mini-Mental State Examination (MMSE), and Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB)].
288 patients (mean age 80.5 years, 60.4% female) were enrolled in this study. Fifty-seven (19.8%) out of 288 patients with AD had SED. The prevalence of SED increased with the severity of cognitive impairment. Compared with patients without SED, those with SED showed significantly greater decline in CASI (-9.32 versus -3.52 points, p = 0.0001) and MMSE (-2.52 versus -1.12 points, p = 0.0042) scores in one year.
SED may play a significant role in AD progression and is a potential therapeutic target.
Application and Highlights:
1.The prevalence of subclinical epileptiform discharges increases with the severity of Alzheimer's disease.
2.The cognitive function of patients with subclinical epileptiform discharges declined faster than that of patients without subclinical epileptiform discharges.
Research Team Members:
Wei-Chih Yeh, Chung-Yao Hsu, Kuan-Ying Li, Ching-Fang Chien, Ling-Chun Huang, Yuan-Han Yang
Representative Department: Neuroscience Research Center, Kaohsiung Medical University . Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.
Introduction of Research Team:
The team has been committed to the risk factors and pathogenic mechanisms of Alzheimer's disease.
Contact Email: endless@kmu.edu.tw
Publication: Journal of Alzheimer's Disease, 2022 Sep 12. Online ahead of print.
Full-Text Article: https://pubmed.ncbi.nlm.nih.gov/36120783/
