Ikegaya Naoki, Nakamura Honoka, Takayama Yutaro, Miyake Yohei, Hayashi Takahiro, Sonoda Masaki, Sato Mitsuru, Tateishi Kensuke, Suenaga Jun, Takaishi Masao, Kitazawa Yu, Kunii Misako, Abe Hiroki, Miyazaki Tomoyuki, Arai Tetsuaki, Iwasaki Manabu, Abe Takayuki, Yamamoto Tetsuya
YCU Epilepsy Center Yokohama City University Hospital Yokohama Japan.
Department of Neurosurgery Yokohama City University Graduate School of Medicine Yokohama Japan.
Alzheimers Dement (N Y). 2024 Sep 10;10(3):e70001. doi: 10.1002/trc2.70001. eCollection 2024 Jul-Sep.
The use of anti-epileptic drugs (AEDs) in degenerative dementia (DD) remains uncertain. We aimed to evaluate the association of early AED administration with subsequent DD occurrence.
Using a large nationwide database, we enrolled patients newly diagnosed with epilepsy from 2014 to 2019 ( = 104,225), and using propensity score matching, we divided them into treatment (those prescribed AEDs in 2014) and control groups. The primary outcome was subsequent DD occurrence in 2019.
Overall, 4489 pairs of patients (2156 women) were matched. The odds ratio (treatment/control) for DD occurrence was 0.533 (95% confidence interval: 0.459-0.617). The DD proportions significantly differed between the treatment (340/4489 = 0.076) and control (577/4489 = 0.129) groups.
Among patients newly diagnosed with epilepsy, compared to non-use, early AED use was associated with a lower occurrence of subsequent DD. Further investigations into and optimization of early intervention for epilepsy in DD are warranted.
Anti-epileptic drug (AED) use before epilepsy diagnosis was linked with a lower subsequent degenerative dementia (DD) occurrence.Identifying the epileptic phenotype was crucial for justifying early AED use in DD.AED use with an epilepsy diagnosis did not pose an additional risk of DD.The potential contribution of combination drug therapy to the strategy was noted.
抗癫痫药物（AEDs）在退行性痴呆（DD）中的应用仍不明确。我们旨在评估早期使用AEDs与随后发生DD之间的关联。
利用一个大型全国性数据库，我们纳入了2014年至2019年新诊断为癫痫的患者（n = 104,225），并使用倾向评分匹配法将他们分为治疗组（2014年开具AEDs的患者）和对照组。主要结局是2019年随后发生的DD。
总体而言，匹配了4489对患者（2156名女性）。DD发生的比值比（治疗组/对照组）为0.533（95%置信区间：0.459 - 0.617）。治疗组（340/4489 = 0.076）和对照组（577/4489 = 0.129）之间的DD比例存在显著差异。
在新诊断为癫痫的患者中，与未使用AEDs相比，早期使用AEDs与随后发生DD的发生率较低相关。有必要对DD中癫痫的早期干预进行进一步研究和优化。
癫痫诊断前使用抗癫痫药物（AED）与随后较低的退行性痴呆（DD）发生率相关。识别癫痫表型对于证明在DD中早期使用AED的合理性至关重要。癫痫诊断时使用AED不会带来额外的DD风险。注意到联合药物治疗对该策略的潜在贡献。
