Functional imaging in late-onset epilepsy: A focused review

Area of Science:

• Neurology
• Neuroimaging
• Geriatrics

Background:

• Late-onset epilepsy (LOE) affects 25% of new-onset epilepsy cases in individuals over 65.
• LOE is projected to increase due to global population aging, posing a significant healthcare challenge.
• Neurodegenerative disorders are implicated in 10-20% of LOE cases, with over 20% having unknown causes.

Purpose of the Study:

• To review the utility of functional neuroimaging techniques in diagnosing late-onset epilepsy.
• To assess the potential of FDG-PET and novel biomarkers like amyloid and tau PET in identifying neurodegenerative causes of LOE.

Main Methods:

• A literature search was performed to identify studies utilizing functional neuroimaging in late-onset epilepsy populations.
• Boolean searching and snowballing techniques were employed to gather relevant articles.

Main Results:

• Five studies met the inclusion criteria.
• Significant heterogeneity was observed across studies regarding LOE definitions, analytical methods, and interpretation pipelines.

Conclusions:

• Preliminary evidence suggests FDG-PET and amyloid PET are feasible for LOE diagnosis.
• Methodological inconsistencies in current literature prevent definitive conclusions.
• Standardized guidelines for epilepsy-specific analysis and interpretation of amyloid and tau PET are needed for future research.