The impact of long-term antiseizure treatment on cognitive decline in late-onset epileptic prodromal Alzheimer's disease: an exploratory study.

Background: The well-documented bidirectional relationship between Alzheimer's disease (AD) and epilepsy suggests that seizures are not merely a complication of AD but may also contribute to disease progression. Emerging evidence indicates that antiseizure medications (ASMs) could potentially slow t...

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Publicado en:Frontiers in Aging Neuroscience pp. 1 - 12
Autores principales: Cretin, Benjamin, Philippi, Nathalie, Bousiges, Olivier, Dibitonto, Laure, Blanc, Frederic
Formato: research tables/charts Journal Article
Publicado: Frontiers Media S.A. 2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2026
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      pub: Frontiers Media S.A.
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        10.3389/fnagi.2026.1786247
        195995281
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        atl: The impact of long-term antiseizure treatment on cognitive decline in late-onset epileptic prodromal Alzheimer's disease: an exploratory study.
      aug:
        au:
          Cretin, Benjamin
          Philippi, Nathalie
          Bousiges, Olivier
          Dibitonto, Laure
          Blanc, Frederic
        affil: Unité de Neuropsychologie, Service de Neurologie et Hôpital de Jour de Gériatrie, Pôle de Gériatrie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
      sug:
        subj:
          Alzheimer's Disease Drug Therapy
          Epilepsy Drug Therapy
          Anticonvulsants Therapeutic Use
          Cognition Drug Effects
          Long Term Care
          Treatment Outcomes
          Human
          Male
          Female
          Aged
          Retrospective Design
          Record Review
          Prospective Studies
          Exploratory Research
          Scales
          Cognition Disorders Prevention and Control
          Activities of Daily Living
          Matched-Pair Analysis
          Cox Proportional Hazards Model
          Electroencephalography
          Magnetic Resonance Imaging
          France
          Data Analysis Software
          Power Analysis
          Descriptive Statistics
          Chi Square Test
          T-Tests
          Univariate Statistics
          Multiple Regression
          Kaplan-Meier Estimator
          Log-Rank Test
          P-Value
          Post Hoc Analysis
          Aged: 65+ years
          Male
          Female
      ab: Background: The well-documented bidirectional relationship between Alzheimer's disease (AD) and epilepsy suggests that seizures are not merely a complication of AD but may also contribute to disease progression. Emerging evidence indicates that antiseizure medications (ASMs) could potentially slow the disease course and act as disease-modifying agents if initiated early. Objectives: We investigated the long-term cognitive and functional effects of ASMs when introduced at the prodromal stage of AD. Methods: Twenty-two sporadic epileptic prodromal AD patients (epADs) and 21 matched subjects without epilepsy (nepADs) were followed for a median of 7 years. Baseline cognition, daily functioning, clinical/paraclinical features, and pharmacological profiles were compared. Annual assessments included cognition, pharmacological burden, and functional impairment. Results: At the final follow-up, epADs evidenced more preserved cognition than nepADs, reflecting a significantly slower annual rate of cognitive decline (−1.2 ± 0.9 vs. −2.7 ± 2.4 points/year on the MMSE score, respectively; p = 0.01). They were also less likely to require neuroleptics (9.1% vs. 47.6%, p < 0.01) or memantine (0% vs. 28.6%, p < 0.01). However, epADs and nepADs had the same proportion of Alzheimer's dementia at the final follow-up visit (90.9% vs. 90.5%, p = 0.96). Despite being significant, these results had low statistical power due to our small sample size and should be considered exploratory. Conclusion: Our findings support the idea that early ASM treatment may attenuate cognitive decline in sporadic prodromal AD patients with comorbid epilepsy. However, these benefits were not accompanied by a lower dementia rate at the final follow-up visit, suggesting that ASMs alone are insufficient for sustained disease modification. Combinatorial therapeutic strategies may be needed to achieve long-term neuroprotection in AD.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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