Cognitive and spatial patterns of amyloid-β burden in Alzheimer's disease with epilepsy

BackgroundThe risk of unprovoked seizures in patients with Alzheimer's disease (AD) is three-fold higher than the general population. However, no studies to date have reported on amyloid-β (Aβ) deposition in patients with Alzheimer's disease with epilepsy (ADEP).ObjectiveThe aim of this study was to collect clinical and positron emission tomography (PET)/magnetic resonance imaging (MRI) data from ADEP patients to compare and present the clinical characteristics and Aβ deposition patterns in this patient population.MethodsFifteen patients with ADEP, thirty-five patients with AD, twenty-three with late-onset epilepsy (LOEP), and twelve healthy controls were recruited. PET/MRI detected intracranial Aβ deposition, and differences in the brain regions distribution were compared between groups at the region of interest and voxel levels. Demographic data and medical history were further collected, while clinical and cognitive assessments were performed.ResultsIn ADEP patients, the first seizure occurred in the early stages of AD, with focal-onset motor seizures accompanied by impaired consciousness being the predominant seizure type. Diagnosis and initiation of antiseizure medication (ASMs) were significantly delayed compared to LOEP patients. Additionally, the ADEP group showed less Aβ deposition in the middle cingulate gyrus than the AD group and had higher Mini-Mental State Exam and Montreal Cognitive Assessment scores.ConclusionsThis study reveals the clinical features and brain imaging differences between AD patients with and without EP, preliminarily confirming that the spatial deposition pattern of Aβ may be related to epilepsy and ASMs.