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Clinical Manifestations.

Ifrah Zawar1, Shen Zm Zhu1, Jaideep Kapur1

  • 1University of Virginia, Charlottesville, VA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
PubMed
Summary
This summary is machine-generated.

Epilepsy in Alzheimer's disease (AD) and non-AD dementias shows distinct mesial temporal lobe atrophy patterns. These findings suggest epilepsy influences neurodegeneration in dementia, impacting specific brain regions.

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Area of Science:

  • Neuroimaging
  • Neurology
  • Dementia Research

Background:

  • Epilepsy is a common comorbidity in dementia, particularly in Alzheimer's disease (AD) and non-AD dementias.
  • Neuroimaging correlates of epilepsy in these dementia subtypes are not well understood.
  • This study investigates mesial temporal lobe morphology and volumes in individuals with and without epilepsy across different dementia types.

Purpose of the Study:

  • To explore the neuroimaging differences in mesial temporal lobe structures between dementia patients with and without epilepsy.
  • To identify specific morphological and volumetric patterns associated with epilepsy in Alzheimer's disease (AD+Epi) and non-AD dementias (nonAD+Epi).

Main Methods:

  • Utilized multicenter MRI data from 39 US Alzheimer's disease centers.
  • Classified participants into dementia with epilepsy, dementia without epilepsy, and healthy controls.
  • Employed FreeSurfer for hippocampal and amygdalar segmentation and ShapeWorks for detailed morphological analysis.
  • Used propensity score matching to control for age, sex, and dementia type.

Main Results:

  • Alzheimer's disease with epilepsy (AD+Epi) showed atrophy in hippocampal bodies and tails, sparing heads, with distinct deviations.
  • Non-AD dementias with epilepsy (nonAD+Epi) exhibited atrophy in the right hippocampal head, tail, and amygdala.
  • Dementia without epilepsy groups displayed uniform hippocampal and amygdalar atrophy; no significant volume differences were found except for smaller left hippocampi in AD-Epi compared to controls.

Conclusions:

  • Mesial temporal lobe morphology, specifically hippocampal body/tail atrophy in AD+Epi and right hippocampal head/tail/amygdalar atrophy in nonAD+Epi, serves as a neuroimaging correlate for epilepsy in dementia.
  • These region-specific patterns suggest epilepsy may modify the neurodegenerative process in dementia.
  • Further research is warranted to understand the role of epilepsy in altering dementia progression.