Subclinical epileptiform discharges in Alzheimer’s disease are associated with increased hippocampal blood flow
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Subclinical epileptiform discharges in Alzheimer’s disease are associated with increased hippocampal blood flow. / Musaeus, Christian Sandøe; Kjaer, Troels Wesenberg; Lindberg, Ulrich; Vestergaard, Mark B.; Bo, Henrik; Larsson, Wiberg; Press, Daniel Zvi; Andersen, Birgitte Bo; Høgh, Peter; Kidmose, Preben; Hemmsen, Martin Christian; Rank, Mike Lind; Hasselbalch, Steen Gregers; Waldemar, Gunhild; Frederiksen, Kristian Steen.
I: Alzheimer's Research and Therapy, Bind 16, Nr. 1, 80, 2024.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Subclinical epileptiform discharges in Alzheimer’s disease are associated with increased hippocampal blood flow
AU - Musaeus, Christian Sandøe
AU - Kjaer, Troels Wesenberg
AU - Lindberg, Ulrich
AU - Vestergaard, Mark B.
AU - Bo, Henrik
AU - Larsson, Wiberg
AU - Press, Daniel Zvi
AU - Andersen, Birgitte Bo
AU - Høgh, Peter
AU - Kidmose, Preben
AU - Hemmsen, Martin Christian
AU - Rank, Mike Lind
AU - Hasselbalch, Steen Gregers
AU - Waldemar, Gunhild
AU - Frederiksen, Kristian Steen
N1 - Publisher Copyright: © The Author(s) 2024.
PY - 2024
Y1 - 2024
N2 - Background: In epilepsy, the ictal phase leads to cerebral hyperperfusion while hypoperfusion is present in the interictal phases. Patients with Alzheimer’s disease (AD) have an increased prevalence of epileptiform discharges and a study using intracranial electrodes have shown that these are very frequent in the hippocampus. However, it is not known whether there is an association between hippocampal hyperexcitability and regional cerebral blood flow (rCBF). The objective of the study was to investigate the association between rCBF in hippocampus and epileptiform discharges as measured with ear-EEG in patients with Alzheimer’s disease. Our hypothesis was that increased spike frequency may be associated with increased rCBF in hippocampus. Methods: A total of 24 patients with AD, and 15 HC were included in the analysis. Using linear regression, we investigated the association between rCBF as measured with arterial spin-labelling MRI (ASL-MRI) in the hippocampus and the number of spikes/sharp waves per 24 h as assessed by ear-EEG. Results: No significant difference in hippocampal rCBF was found between AD and HC (p-value = 0.367). A significant linear association between spike frequency and normalized rCBF in the hippocampus was found for patients with AD (estimate: 0.109, t-value = 4.03, p-value < 0.001). Changes in areas that typically show group differences (temporal-parietal cortex) were found in patients with AD, compared to HC. Conclusions: Increased spike frequency was accompanied by a hemodynamic response of increased blood flow in the hippocampus in patients with AD. This phenomenon has also been shown in patients with epilepsy and supports the hypothesis of hyperexcitability in patients with AD. The lack of a significant difference in hippocampal rCBF may be due to an increased frequency of epileptiform discharges in patients with AD. Trial registration: The study is registered at clinicaltrials.gov (NCT04436341).
AB - Background: In epilepsy, the ictal phase leads to cerebral hyperperfusion while hypoperfusion is present in the interictal phases. Patients with Alzheimer’s disease (AD) have an increased prevalence of epileptiform discharges and a study using intracranial electrodes have shown that these are very frequent in the hippocampus. However, it is not known whether there is an association between hippocampal hyperexcitability and regional cerebral blood flow (rCBF). The objective of the study was to investigate the association between rCBF in hippocampus and epileptiform discharges as measured with ear-EEG in patients with Alzheimer’s disease. Our hypothesis was that increased spike frequency may be associated with increased rCBF in hippocampus. Methods: A total of 24 patients with AD, and 15 HC were included in the analysis. Using linear regression, we investigated the association between rCBF as measured with arterial spin-labelling MRI (ASL-MRI) in the hippocampus and the number of spikes/sharp waves per 24 h as assessed by ear-EEG. Results: No significant difference in hippocampal rCBF was found between AD and HC (p-value = 0.367). A significant linear association between spike frequency and normalized rCBF in the hippocampus was found for patients with AD (estimate: 0.109, t-value = 4.03, p-value < 0.001). Changes in areas that typically show group differences (temporal-parietal cortex) were found in patients with AD, compared to HC. Conclusions: Increased spike frequency was accompanied by a hemodynamic response of increased blood flow in the hippocampus in patients with AD. This phenomenon has also been shown in patients with epilepsy and supports the hypothesis of hyperexcitability in patients with AD. The lack of a significant difference in hippocampal rCBF may be due to an increased frequency of epileptiform discharges in patients with AD. Trial registration: The study is registered at clinicaltrials.gov (NCT04436341).
KW - Alzheimer’s disease
KW - EEG
KW - Epileptiform discharges
KW - Hyperperfusion
KW - Spike frequency
U2 - 10.1186/s13195-024-01432-9
DO - 10.1186/s13195-024-01432-9
M3 - Journal article
C2 - 38610005
AN - SCOPUS:85190261106
VL - 16
JO - Alzheimer's Research and Therapy
JF - Alzheimer's Research and Therapy
SN - 1758-9193
IS - 1
M1 - 80
ER -
ID: 389509874