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Review
. 2021 Aug;17(8):469-485.
doi: 10.1038/s41582-021-00505-9. Epub 2021 Jun 11.

Amyloid-β: a potential link between epilepsy and cognitive decline

Affiliations
Review

Amyloid-β: a potential link between epilepsy and cognitive decline

Michele Romoli et al. Nat Rev Neurol. 2021 Aug.

Abstract

People with epilepsy - in particular, late-onset epilepsy of unknown aetiology - have an elevated risk of dementia, and seizures have been detected in the early stages of Alzheimer disease (AD), supporting the concept of an epileptic AD prodrome. However, the relationship between epilepsy and cognitive decline remains controversial, with substantial uncertainties about whether epilepsy drives cognitive decline or vice versa, and whether shared pathways underlie both conditions. Here, we review evidence that amyloid-β (Aβ) forms part of a shared pathway between epilepsy and cognitive decline, particularly in the context of AD. People with epilepsy show an increased burden of Aβ pathology in the brain, and Aβ-mediated epileptogenic alterations have been demonstrated in experimental studies, with evidence suggesting that Aβ pathology might already be pro-epileptogenic at the soluble stage, long before plaque deposition. We discuss the hypothesis that Aβ mediates - or is at least a major determinant of - a continuum spanning epilepsy and cognitive decline. Serial cognitive testing and assessment of Aβ levels might be worthwhile to stratify the risk of developing dementia in people with late-onset epilepsy. If seizures are a clinical harbinger of dementia, people with late-onset epilepsy could be an ideal group in which to implement preventive or therapeutic strategies to slow cognitive decline.

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References

    1. The Lancet Neurology. Response to the growing dementia burden must be faster. Lancet Neurol. 17, 651 (2018). - PubMed - DOI
    1. Nichols, E. et al. Global, regional, and national burden of Alzheimer’s disease and other dementias, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 18, 88–106 (2019). - DOI
    1. Lozano, R. et al. Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 396, 1250–1284 (2020). - DOI
    1. Schneider, L. Alzheimer’s disease and other dementias: update on research. Lancet Neurol. 16, 4–5 (2017). - PubMed - DOI
    1. Braak, H. & Braak, E. Frequency of stages of Alzheimer-related lesions in different age categories. Neurobiol. Aging 18, 351–357 (1997). - PubMed - DOI

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