Banote Rakesh Kumar, Håkansson Samuel, Zetterberg Henrik, Zelano Johan
Department of Neurology, Sahlgrenska University Hospital, Gothenburg 41345, Sweden.
Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg, Sweden.
Brain Commun. 2022 Aug 17;4(4):fcac210. doi: 10.1093/braincomms/fcac210. eCollection 2022.
Alzheimer's disease is the most common neurodegenerative dementia. A subset of Alzheimer's disease patients develop epilepsy. The risk is higher in young-onset Alzheimer's disease, but pathophysiological mechanisms remain elusive. The purpose of this study was to assess biomarkers reflecting neurodegeneration in Alzheimer's disease patients with and without epilepsy. By cross-referencing the largest national laboratory database with Swedish National Patient Register, we could identify CSF biomarker results from 17901 Alzheimer's disease patients, and compare levels of neurofilament light, glial fibrillary acidic protein, total tau, phosphorylated tau and amyloid beta 42 in patients with ( = 851) and without epilepsy. The concentrations of total tau and phosphorylated tau were higher in Alzheimer's disease patients with epilepsy than Alzheimer's disease patients without epilepsy and amyloid beta 42 levels were significantly lower in Alzheimer's disease patients with epilepsy. No differences in the levels of neurofilament light and glial fibrillary acidic protein were observed. Our study suggests that epilepsy is more common in Alzheimer's disease patients with more pronounced Alzheimer's pathology, as determined by the CSF biomarkers. Further studies are needed to investigate the biomarker potential of these CSF markers as predictors of epilepsy course or as indicators of epileptogenesis in Alzheimer's disease.
阿尔茨海默病是最常见的神经退行性痴呆。一部分阿尔茨海默病患者会发生癫痫。早发型阿尔茨海默病患者的风险更高，但病理生理机制仍不清楚。本研究的目的是评估反映有癫痫和无癫痫的阿尔茨海默病患者神经退行性变的生物标志物。通过将最大的国家实验室数据库与瑞典国家患者登记册进行交叉对照，我们能够识别17901名阿尔茨海默病患者的脑脊液生物标志物结果，并比较有癫痫（n = 851）和无癫痫患者的神经丝轻链、胶质纤维酸性蛋白、总tau蛋白、磷酸化tau蛋白和淀粉样β蛋白42的水平。有癫痫的阿尔茨海默病患者的总tau蛋白和磷酸化tau蛋白浓度高于无癫痫的阿尔茨海默病患者，且有癫痫的阿尔茨海默病患者的淀粉样β蛋白42水平显著降低。未观察到神经丝轻链和胶质纤维酸性蛋白水平的差异。我们的研究表明，根据脑脊液生物标志物确定，癫痫在阿尔茨海默病病理更明显的患者中更常见。需要进一步研究来调查这些脑脊液标志物作为癫痫病程预测指标或阿尔茨海默病癫痫发生指标的生物标志物潜力。
