TY - JOUR

T1 - Subclinical Epileptiform Activity in Dementia with Lewy Bodies

AU - Musaeus, Christian Sandøe

AU - Kjær, Troels Wesenberg

AU - Hribljan, Melita Cacic

AU - Andersen, Birgitte Bo

AU - Høgh, Peter

AU - Kidmose, Preben

AU - Fabricius, Martin

AU - Hemmsen, Martin Christian

AU - Rank, Mike Lind

AU - Waldemar, Gunhild

AU - Frederiksen, Kristian Steen

N1 - Publisher Copyright: © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

PY - 2023

Y1 - 2023

N2 - Background: Patients with dementia with Lewy bodies (DLB) have a higher probability of seizures than in normal aging and in other types of neurodegenerative disorders. Depositions of α-synuclein, a pathological hallmark of DLB, can induce network excitability, which can escalate into seizure activity. Indicator of seizures are epileptiform discharges as observed using electroencephalography (EEG). However, no studies have so far investigated the occurrence of interictal epileptiform discharges (IED) in patients with DLB. Objectives: To investigate if IED as measured with ear-EEG occurs with a higher frequency in patients with DLB compared to healthy controls (HC). Methods: In this longitudinal observational exploratory study, 10 patients with DLB and 15 HC were included in the analysis. Patients with DLB underwent up to three ear-EEG recordings, each lasting up to 2 days, over a period of 6 months. Results: At baseline, IED were detected in 80% of patients with DLB and in 46.7% of HC. The spike frequency (spikes or sharp waves/24 hours) was significantly higher in patients with DLB as compared to HC with a risk ratio of 2.52 (CI, 1.42–4.61; P-value = 0.001). Most IED occurred at night. Conclusions: Long-term outpatient ear-EEG monitoring detects IED in most patients with DLB with an increased spike frequency compared to HC. This study extends the spectrum of neurodegenerative disorders in which epileptiform discharges occurs at an elevated frequency. It is possible that epileptiform discharges are, therefore, a consequence of neurodegeneration.

AB - Background: Patients with dementia with Lewy bodies (DLB) have a higher probability of seizures than in normal aging and in other types of neurodegenerative disorders. Depositions of α-synuclein, a pathological hallmark of DLB, can induce network excitability, which can escalate into seizure activity. Indicator of seizures are epileptiform discharges as observed using electroencephalography (EEG). However, no studies have so far investigated the occurrence of interictal epileptiform discharges (IED) in patients with DLB. Objectives: To investigate if IED as measured with ear-EEG occurs with a higher frequency in patients with DLB compared to healthy controls (HC). Methods: In this longitudinal observational exploratory study, 10 patients with DLB and 15 HC were included in the analysis. Patients with DLB underwent up to three ear-EEG recordings, each lasting up to 2 days, over a period of 6 months. Results: At baseline, IED were detected in 80% of patients with DLB and in 46.7% of HC. The spike frequency (spikes or sharp waves/24 hours) was significantly higher in patients with DLB as compared to HC with a risk ratio of 2.52 (CI, 1.42–4.61; P-value = 0.001). Most IED occurred at night. Conclusions: Long-term outpatient ear-EEG monitoring detects IED in most patients with DLB with an increased spike frequency compared to HC. This study extends the spectrum of neurodegenerative disorders in which epileptiform discharges occurs at an elevated frequency. It is possible that epileptiform discharges are, therefore, a consequence of neurodegeneration.

KW - EEG

KW - fluctuations

KW - interictal epileptiform discharges

KW - Lewy body dementia

KW - long-term EEG monitoring

U2 - 10.1002/mds.29531

DO - 10.1002/mds.29531

M3 - Journal article

C2 - 37431847

AN - SCOPUS:85165047009

VL - 38

SP - 1861

EP - 1870

JO - Movement Disorders

JF - Movement Disorders

SN - 0885-3185

IS - 10

ER -