Abstract

Patients with dementia present epilepsy more frequently than the general population. Seizures are more common in patients with Alzheimer’s disease (AD), dementia with Lewy bodies (LBD), frontotemporal dementia (FTD) and progressive supranuclear palsy (PSP) than in other dementias. Missense mutations in the microtubule associated protein tau (MAPT) gene have been found to cause familial FTD and PSP, while the P301S mutation in MAPT has been associated with early-onset fast progressive dementia and the presence of seizures. Brains of patients with AD, LBD, FTD and PSP show hyperphosphorylated tau aggregates, amyloid-β plaques and neuropil threads. Increasing evidence suggests the existence of overlapping mechanisms related to the generation of network hyperexcitability and cognitive decline. Neuronal overexpression of tau with various mutations found in FTD with parkinsonism-linked to chromosome 17 (FTDP-17) in mice produces epileptic activity. On the other hand, the use of certain antiepileptic drugs in animal models with AD prevents cognitive impairment. Further efforts should be made to search for plausible common targets for both conditions. Moreover, attempts should also be made to evaluate the use of drugs targeting tau and amyloid-β as suitable pharmacological interventions in epileptic disorders. The diagnosis of dementia and epilepsy in early stages of those diseases may be helpful for the initiation of treatments that could prevent the generation of epileptic activity and cognitive deterioration.

Highlights

  • Epileptic seizures are more common in patients with dementia than in the general elderly population [1,2]

  • Epileptic seizures are more common in patients with dementia than in the general elderly population and their appearance has been associated with the progression of cognitive impairment

  • Both abnormally phosphorylated tau and amyloid-β overexpression in mouse models produce aberrant excitatory activity, amyloid-β excitotoxicity depends on the presence of tau

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Summary

Epilepsy in Dementia

Epileptic seizures are more common in patients with dementia than in the general elderly population [1,2]. An increase in age-related seizures due to vascular disease or other morbidities has been observed [2] This fact contradicts with the increased risk of seizures in early-onset AD, which could be related to the existence of risk factors associated with the altered expression of genes that regulate the activity of neural networks in young patients with AD [26,27,28,29,30,31,32]. Typical familial forms of AD are due to autosomal dominant mutations present in the amyloid precursor protein (APP) gene, the precursor to the amyloid- β peptide, in the presenilin 1 (PSEN1) or 2 (PSEN2) genes, or to duplications of APP These mutations give rise to early-onset forms of the disease [36,37] (Alzheimer Disease & Frontotemporal Dementia Mutation Database, Available online: http://www.molgen.ua.ac.be/ADMutations). The information on epidemiologic data from patients with dementia suffering epilepsy and from cases of epileptic patients that develop dementia is, so far, insufficient [48,49]

AD and Seizures
Seizures in FTDP-17 and Other Dementias
FTDP-17 and Seizures
Seizures in PSP
Seizures in DLB
Epilepsy in DS
Animal Models
Findings
Conclusions
Full Text
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