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Detection of subclinical epileptiform discharges in Alzheimer's disease using long-term outpatient EEG monitoring

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

DOI

  • Christian Sandøe Musaeus, Københavns Universitet
    • ,
  • Kristian Steen Frederiksen, Københavns Universitet
    • ,
  • Birgitte Bo Andersen, Københavns Universitet
    • ,
  • Peter Høgh, Sjællands Universitetshospital, Københavns Universitet
    • ,
  • Preben Kidmose
  • Martin Fabricius, Københavns Universitet
    • ,
  • Melita Cacic Hribljan, Københavns Universitet
    • ,
  • Martin Christian Hemmsen, T & W Engineering
    • ,
  • Mike Lind Rank, T & W Engineering
    • ,
  • Gunhild Waldemar, Københavns Universitet
    • ,
  • Troels Wesenberg Kjær, Københavns Universitet

Background: In patients with Alzheimer's disease (AD) without clinical seizures, up to half have epileptiform discharges on long-term in-patient electroencephalography (EEG) recordings. Long-term in-patient monitoring is obtrusive, and expensive as compared to outpatient monitoring. No studies have so far investigated if long-term outpatient EEG monitoring is able to identify epileptiform discharges in AD. Our aim is to investigate if epileptiform discharges as measured with ear-EEG are more common in patients with AD compared to healthy elderly controls (HC). Methods: In this longitudinal observational study, 24 patients with mild to moderate AD and 15 age-matched HC were included in the analysis. Patients with AD underwent up to three ear-EEG recordings, each lasting up to two days, within 6 months. Results: The first recording was defined as the baseline recording. At baseline, epileptiform discharges were detected in 75.0% of patients with AD and in 46.7% of HC (p-value = 0.073). The spike frequency (spikes or sharp waves/24 h) was significantly higher in patients with AD as compared to HC with a risk ratio of 2.90 (CI: 1.77–5.01, p < 0.001). Most patients with AD (91.7%) showed epileptiform discharges when combining all ear-EEG recordings. Conclusions: Long-term ear-EEG monitoring detects epileptiform discharges in most patients with AD with a three-fold increased spike frequency compared to HC, which most likely originates from the temporal lobes. Since most patients showed epileptiform discharges with multiple recordings, elevated spike frequency should be considered a marker of hyperexcitability in AD.

OriginalsprogEngelsk
Artikelnummer106149
TidsskriftNeurobiology of Disease
Vol/bind183
ISSN0969-9961
DOI
StatusUdgivet - jul. 2023

Bibliografisk note

Funding Information:
The study was funded by the Alzheimer Research Foundation (grant numer: 181003), Toyota Foundation (KJ/BG-9171 F), Axel Juul Muusfeldts Foundation (2016–527), Ellen Mørchs foundation (J.nr. 32491419), Rigshospitalet Research Foundation and T&W Engineering. None of the funding parties had a role in the collection, analysis, and interpretation of data or in the writing of the manuscript or whether to publish the results of the study.

Funding Information:
The study was funded by the Alzheimer Research Foundation (grant numer: 181003 ), Toyota Foundation ( KJ/BG-9171 F ), Axel Juul Muusfeldts Foundation ( 2016–527 ), Ellen Mørchs foundation (J.nr. 32491419 ), Rigshospitalet Research Foundation and T&W Engineering . None of the funding parties had a role in the collection, analysis, and interpretation of data or in the writing of the manuscript or whether to publish the results of the study.

Publisher Copyright:
© 2023

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