Association between glymphatic system function and cognitive impairment in elderly patients with late-onset epilepsy.

IF 2.3 3区 医学 Q2 BEHAVIORAL SCIENCES Epilepsy & Behavior Pub Date : 2025-01-18 DOI:10.1016/j.yebeh.2024.110258
Long Wang, Jie Hu, Jia-Xuan Li, Zheng Tan, Fu-Yu Wang, Jun-Cang Wu
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Abstract

Purpose: Recent studies have shown that late-onset epilepsy (LOE) is accompanied with cognitive decline and increased risk of dementia, particularly Alzheimer's disease (AD). However, the pathophysiological mechanism underlying the cognitive decline in LOE remains unclear. The aim of current study was to evaluate the relationship between glymphatic system (GS) function and cognitive decline in LOE patients using the diffusion tensor imaging (DTI) analysis along the perivascular space (DTI-ALPS).

Methods: Medical records and neuro-imaging data were obtained from 21 LOE patients with cognitive decline, 14 LOE patients without cognitive decline, and 20 age- and sex-matched healthy controls (HCs). Plasma biomarkers including Aβ42 and Aβ40 were examined using single-molecule array (Simoa) assays. The DTI-ALPS parameter was calculated and correlated with the clinical characteristics of LOE, including age, seizure frequency, duration of epilepsy, Mini-Mental State Examination (MMSE), and Aβ42/40. Regression models were used to evaluate the influencing factors of DTI-ALPS index.

Results: LOE patients exhibited a decreased ALPS index and Aβ42/40 compared with the HCs. Post-hoc analysis indicated that the DTI-ALPS index and Aβ42/40 in LOE patients with cognitive decline was significantly lower in relative to LOE patients without cognitive decline and HCs. Spearman correlations showed a negative correlation between DTI-ALPS index and age, seizure frequency and disease duration while a positive correlations between the DTI-ALPS index and Aβ42/40 and MMSE scores in LOE patients. Linear regression analysis suggested that the DTI-ALPS index was independently related to age, Aβ42/40 and MMSE score after correcting for gender, education, and vascular risk factors.

Conclusion: Our findings using DTI-ALPS method found a positive correlation between cognitive decline and GS dysfunction in LOE patients, and may indicate a potential internal link between age-related LOEU and dementia formation. Therefore, the DTI-ALPS index may serve as a potential imaging marker for diagnosing and monitoring the GS function in LOE patients.

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老年迟发性癫痫患者淋巴系统功能与认知障碍的关系。
目的:最近的研究表明,迟发性癫痫(LOE)伴有认知能力下降和痴呆风险增加,特别是阿尔茨海默病(AD)。然而,LOE认知能力下降的病理生理机制尚不清楚。本研究的目的是利用沿血管周围间隙(DTI- alps)扩散张量成像(DTI)分析LOE患者淋巴系统(GS)功能与认知能力下降的关系。方法:获取21例认知能力下降的LOE患者、14例无认知能力下降的LOE患者和20例年龄和性别匹配的健康对照(hc)的医疗记录和神经影像学资料。采用单分子阵列(Simoa)检测血浆生物标志物a - β42和a - β40。计算DTI-ALPS参数,并与LOE的临床特征(包括年龄、发作频率、癫痫持续时间、迷你精神状态检查(MMSE)、Aβ42/40)相关。采用回归模型评价DTI-ALPS指数的影响因素。结果:与hcc患者相比,LOE患者的ALPS指数和a β42/40明显降低。事后分析显示,认知能力下降的LOE患者的DTI-ALPS指数和Aβ42/40明显低于无认知能力下降和hc的LOE患者。经Spearman相关分析,DTI-ALPS指数与LOE患者的年龄、发作频率、病程呈负相关,而DTI-ALPS指数与a β42/40、MMSE评分呈正相关。线性回归分析显示,校正性别、文化程度、血管危险因素后,DTI-ALPS指数与年龄、Aβ42/40、MMSE评分独立相关。结论:我们使用DTI-ALPS方法发现LOE患者认知能力下降与GS功能障碍呈正相关,可能提示年龄相关性LOEU与痴呆形成之间存在潜在的内在联系。因此,DTI-ALPS指数可作为LOE患者GS功能诊断和监测的潜在影像学指标。
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来源期刊
Epilepsy & Behavior
Epilepsy & Behavior 医学-行为科学
CiteScore
5.40
自引率
15.40%
发文量
385
审稿时长
43 days
期刊介绍: Epilepsy & Behavior is the fastest-growing international journal uniquely devoted to the rapid dissemination of the most current information available on the behavioral aspects of seizures and epilepsy. Epilepsy & Behavior presents original peer-reviewed articles based on laboratory and clinical research. Topics are drawn from a variety of fields, including clinical neurology, neurosurgery, neuropsychiatry, neuropsychology, neurophysiology, neuropharmacology, and neuroimaging. From September 2012 Epilepsy & Behavior stopped accepting Case Reports for publication in the journal. From this date authors who submit to Epilepsy & Behavior will be offered a transfer or asked to resubmit their Case Reports to its new sister journal, Epilepsy & Behavior Case Reports.
期刊最新文献
Epilepsy, compulsion and oxytocin: Insights from behavioral sequences, using neuroethology and complexity systems approaches. Knowledge, attitude and perception of epilepsy patients toward epilepsy surgery at Jordan University hospital. A multicenter Phase II randomized, placebo-controlled single-blind trial with the SV2A ligand seletracetam in photosensitive epilepsy patients. Association between glymphatic system function and cognitive impairment in elderly patients with late-onset epilepsy. Burden in caregivers of adults with epilepsy: A critical review.
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