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| ID | Type | Description | Link |
|---|---|---|---|
| 2016-A00563-48 | Other Identifier | ID-RCB |
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Beyond 60 years, the prevalence of epilepsy is estimated at approximately 1% and increases with age. In these patients, the etiology of epilepsy is unknown in 25% of cases, even up to 55% after 65 years. Although new-onset epilepsy in the elderly is associated with a vascular disease in 50% of cases, the hypothesis of an ongoing neurodegenerative process, including an Alzheimer's disease (AD), is also common. However, investigators do not have any marker that might help to identify the patients who develop epilepsy after 60 years and who might be, despite a normal cognitive functioning, already engaged in the pathophysiological process of AD.
A number of data suggest a link between the pathophysiological process of AD and epileptogenesis:
(i) a third of patients with epilepsy develops MA, (ii) the occurrence of epilepsy in AD is an aggravating factor for cognition, (iii) in animal models of AD, the relationship between neuronal hyperexcitability and amyloid deposits is bidirectional, the amyloid protein has a pro-seizure effect and the presence of epilepsy increases the amyloid deposits, (iv) in these models, the administration of an antiepileptic drug protects from deterioration of cognition, (v) the close relationship between amyloid and neuronal hyperexcitability might be mediated by the inflammatory processes associated with AD, and particularly the microglial activation which role in epileptogenesis has been shown elsewhere.
Investigators hypothesize that in a subgroup of patients who develop epilepsy after 60 years, the occurrence of epilepsy might reflect the presence of an ongoing amyloid pathology. Our goal is to identify through biomarkers of AD in the cerebrospinal fluid of patients who develop an epilepsy after 60 years with normal MRI and normal cognition those at high risk of later developing clinically defined AD.
Identifying patients with amyloid pathology which would be expressed through epilepsy before the onset of cognitive dysfunction might help to adapt both the management of seizures and of the cognitive dysfunction.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Presence of biomarkers of AD in cerebrospinal fluid | Other | Patients older than 60 years, with normal brain MRI and with normal cognitive functioning who demonstrate a profile of CSF biomarkers of AD suggestive of biological AD |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| profile of CSF biomarkers of AD | Biological | dosage of biomarker of AD |
|
| Measure | Description | Time Frame |
|---|---|---|
| The primary endpoint was the number of patients in a population of subjects older than 60 years with new-onset epilepsy but without cognitive impairment whose profile of the CSF biomarkers of the AD is suggestive of an AD. | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| changes in episodic verbal memory at 2 years | Evolution of RL/RI-16 score between inclusion and 2 years of follow-up | 2 years |
| changes in visual recognition memory at 2 years | Evolution of DMS 48 score between inclusion and 2 years of follow-up |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Aurélie RICHARD-MORNAS, Doctor | Hospices Civils de Lyon | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospices Civils de Lyon | Bron | 69500 | France | |||
| CHU Gabriel- Montpied |
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| ID | Term |
|---|---|
| D004827 | Epilepsy |
| ID | Term |
|---|---|
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| 2 years |
| Evolution of DO 80 score | Evolution of semantic memory at 2 years: Evolution of DO 80 score between inclusion and 2 years follow-up | 2 years |
| Evolution of categorical influences | Evolution of semantic memory at 2 years: Evolution of categorical influences between inclusion and 2 years follow-up | 2 years |
| Evolution of TOP 10 score | Evolution of semantic memory at 2 years: Evolution of TOP 10 score between inclusion and 2 years follow-up | 2 years |
| Changes in monthly frequency of seizures at 2 years | Evolution of monthly frequency of seizures between inclusion and 2 years of follow-up | 2 years |
| Clermont-Ferrand |
| France |
| CHU des Alpes | Grenoble | France |
| CHU Hôpital Nord | Saint-Etienne | France |