Witt Juri-Alexander, Andernach Johanna, Becker Albert, Helmstaedter Christoph
Department of Epileptology, University Hospital Bonn (UKB), 53127 Bonn, Germany.
Section for Translational Epilepsy Research, Institute of Neuropathology, Medical Faculty, University of Bonn, 53127 Bonn, Germany.
J Clin Med. 2025 Jan 15;14(2):514. doi: 10.3390/jcm14020514.
In light of the growing interest in the bidirectional relationship between epilepsy and dementia, this review aims to provide an overview of the role of hyperphosphorylated tau (pTau) in cognition in human epilepsy. A literature search identified five relevant studies. All of them examined pTau burden in surgical biopsy specimens from patients with temporal lobe epilepsy. The prevalence of pTau reported across the five studies, encompassing a total of 142 patients, ranged from 3.5% to 95%. Findings also varied regarding the location of pTau in the hippocampus and/or temporal cortex. Two of five studies (40%) demonstrated an inverse relationship between pTau burden and cognitive performance, one study with regard to executive functions and the other with regard to naming and verbal short-term memory. The only longitudinal study found a significant link between pTau and cognitive decline in verbal learning and memory, and in part also in naming, from the pre- to the postoperative assessment and from three to 12 months postoperatively. Given the heterogeneity of the study cohorts and the neuropsychological and neuropathological methodologies and findings, no clear picture emerges regarding the association between pTau and cognition in temporal lobe epilepsy. Added to this is the multifactorial etiology of cognitive impairment in epilepsy, including the active epilepsy, the underlying and sometimes dynamic pathology, and anti-seizure medication. Some of these factors may affect pTau expression. Further research should aim to investigate pTau longitudinally and noninvasively on a whole-brain level, using targeted neuropsychological outcome measures and controlling for age and other factors potentially influencing cognitive trajectories in epilepsy.
鉴于对癫痫与痴呆之间双向关系的兴趣日益浓厚，本综述旨在概述高磷酸化tau蛋白（pTau）在人类癫痫认知中的作用。文献检索确定了五项相关研究。所有研究均检测了颞叶癫痫患者手术活检标本中的pTau负荷。五项研究共纳入142例患者，报告的pTau患病率在3.5%至95%之间。关于pTau在海马体和/或颞叶皮质中的位置，研究结果也各不相同。五项研究中的两项（40%）表明pTau负荷与认知表现呈负相关，一项研究涉及执行功能，另一项研究涉及命名和言语短期记忆。唯一的纵向研究发现，从术前到术后评估以及术后3至12个月，pTau与言语学习和记忆以及部分命名方面的认知衰退之间存在显著关联。鉴于研究队列的异质性以及神经心理学和神经病理学方法及结果，关于颞叶癫痫中pTau与认知之间的关联尚无清晰的图景。此外，癫痫认知障碍的病因是多因素的，包括活动性癫痫、潜在的且有时是动态变化的病理状况以及抗癫痫药物。其中一些因素可能会影响pTau的表达。未来的研究应旨在使用有针对性的神经心理学结果测量方法，在全脑水平上对pTau进行纵向和非侵入性研究，并控制年龄和其他可能影响癫痫认知轨迹的因素。
