Amyloid deposition in adults with drug‐resistant temporal lobe epilepsy.

Bibliographic Details
Title: Amyloid deposition in adults with drug‐resistant temporal lobe epilepsy.
Authors: Fonseca, Elena, Lallana, Sofía, Ortega, Gemma, Cano, Amanda, Sarria‐Estrada, Silvana, Pareto, Deborah, Quintana, Manuel, Lorenzo‐Bosquet, Carles, López‐Maza, Samuel, Gifreu, Ariadna, Campos‐Fernández, Daniel, Abraira, Laura, Santamarina, Estevo, Orellana, Adelina, Montrreal, Laura, Puerta, Raquel, Aguilera, Núria, Ramis, Maribel, de Rojas, Itziar, Ruiz, Agustín
Source: Epilepsia (Series 4); Dec2024, Vol. 65 Issue 12, p3664-3675, 12p
Subject Terms: TEMPORAL lobe epilepsy, POSITRON emission tomography, CINGULATE cortex, TAU proteins, PEOPLE with epilepsy
Abstract: Objective: Pathological amyloid‐β (Aβ) accumulation and hyperphosphorylated tau proteins have been described in resected temporal lobe specimens of epilepsy patients. We aimed to determine cerebrospinal fluid (CSF) Aβ1‐42 and p181‐tau levels and cerebral Aβ deposits on positron emission tomography (Aβ PET) and correlate these findings with cognitive performance in adults with drug‐resistant temporal lobe epilepsy (TLE). Methods: In this cross‐sectional study, we enrolled individuals with drug‐resistant TLE who were 25–55 years old. Each participant underwent 18F‐flutemetamol PET, determination of CSF Aβ1‐42, p181‐tau, and total tau, and a comprehensive neuropsychological assessment. We evaluated normalized standard uptake value ratios (SUVRs) for different brain regions on Aβ PET. Results: Thirty patients (mean age = 41.9 ± SD 8.1 years, 57% men) were included. The median disease duration was 9.5 (interquartile range = 4–24) years. Twenty‐six patients (87%) had a clinically significant cognitive impairment on neuropsychological evaluation, 18 (69%) of the amnesic type. On Aβ PET, high uptake was observed in both mesial temporal regions (ipsilateral: SUVR z‐score =.90, 95% confidence interval [CI] =.60–1.20; contralateral: SUVR z‐score =.92, 95% CI =.57–1.27; p <.001), which was higher when compared to SUVR z‐scores in all the remaining regions (p <.001) and in the ipsilateral anterior cingulate (SUVR z‐score =.27, 95% CI =.04–.49, p =.020). No significant deposition was observed in other regions. Seven patients (23%) had low Aβ1‐42 levels, and two (7%) had elevated p181‐tau levels in CSF. Higher p181‐tau levels correlated with poorer verbal fluency (R = −.427, p =.044). Significance: Our findings reveal a considerable Aβ deposition in mesial temporal regions and ipsilateral anterior cingulate among adults with drug‐resistant TLE. Additionally, abnormal CSF Aβ1‐42 levels were observed in a significant proportion of patients, and p181‐tau levels were associated with verbal fluency. These results suggest that markers of neuronal damage can be observed in adults with TLE, warranting further investigation. [ABSTRACT FROM AUTHOR]
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Database: Complementary Index
More Details
ISSN:00139580
DOI:10.1111/epi.18142
Published in:Epilepsia (Series 4)
Language:English