Neurology Department, Centro Hospitalário e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal.
Neurology Department, Centro Hospitalário e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal.
Epilepsy Behav. 2019 Sep;98(Pt A):207-209. doi: 10.1016/j.yebeh.2019.06.033. Epub 2019 Aug 2.
Neurofibrillary tangles and tau protein, the neuropathological hallmarks of Alzheimer's disease (AD), have been identified in patients with epilepsy. Tau protein was also associated with the modulation of neuronal excitability in animal models of AD.
We evaluated in 292 patients with AD the association between the risk of seizure development and AD cerebrospinal fluid (CSF) biomarkers, demographic characteristics, baseline Mini-Mental State Examination (MMSE) score, comorbidities, and apolipoprotein E status.
The development of seizures was associated with younger age at dementia's onset, lower baseline MMSE, and higher CSF total tau protein levels, but only MMSE (hazard ratio [HR] = 0.935; 95% confidence interval [CI] = [0.903, 0.968]; p < 0.001) and CSF tau (HR = 1.001; 95%CI = [1.001, 1.002]; p = 0.001) were independent predictors on multivariate analysis.
While CSF tau and lower baseline MMSE association with seizure development could in part be explained by a greater degree of cortical damage, the role of tau in the modulation of neuronal excitability may also play a role and should be further investigated.
神经原纤维缠结和 tau 蛋白是阿尔茨海默病（AD）的神经病理学标志，已在癫痫患者中被发现。tau 蛋白也与 AD 动物模型中神经元兴奋性的调节有关。
我们评估了 292 名 AD 患者，评估了癫痫发作发展的风险与 AD 脑脊液（CSF）生物标志物、人口统计学特征、基线简易精神状态检查（MMSE）评分、合并症和载脂蛋白 E 状态之间的关联。
癫痫发作的发生与痴呆发病时年龄较小、基线 MMSE 评分较低以及 CSF 总 tau 蛋白水平较高有关，但只有 MMSE（风险比[HR] = 0.935；95%置信区间[CI] = [0.903, 0.968]；p < 0.001）和 CSF tau（HR = 1.001；95%CI = [1.001, 1.002]；p = 0.001）是多变量分析的独立预测因素。
虽然 CSF tau 和较低的基线 MMSE 与癫痫发作的发展有关，这在一定程度上可以解释为皮质损伤程度更大，但 tau 在调节神经元兴奋性中的作用也可能发挥作用，应进一步研究。
