Association of Cognitive and Structural Correlates of Brain Aging and Incident Epilepsy. the Framingham Heart Study.

Details

• Alternative Title:
  Epilepsia, 2025, v. 66, no. 1: Association of Cognitive and Structural Correlates of Brain Aging and Incident Epilepsy. the Framingham Heart Study.
• Journal Article:
  Epilepsia
• Personal Author:
  Stefanidou, Maria ; Himali, Jayandra J. ; Bernal, Rebecca ; Satizabal, Claudia ; Devinsky, Orrin ; Romero, Jose R. ; Beiser, Alexa S. ; Seshadri, Sudha ; Friedman, Daniel
• Description:
  Late-onset epilepsy has the highest incidence among all age groups affected by epilepsy and often occurs in the absence of known clinical risk factors such as stroke and dementia. There is increasing evidence that brain changes contributing to epileptogenesis likely start years before disease onset, and we aim to relate cognitive and imaging correlates of subclinical brain injury to incident late-onset epilepsy in a large, community-based cohort.
  
  We studied Offspring Cohort of the Framingham Heart Study participants 45 years or older, who were free of prevalent stroke, dementia, or epilepsy, and had neuropsychological (NP) evaluation and brain magnetic resonance imaging (MRI). Cognitive measures included Visual Reproduction Delayed Recall, Logical Memory Delayed Recall, Similarities, Trail Making Test B minus A (TrTB-TrTA; attention and executive function), and a global measure of cognition derived from principal component analysis. MRI measures included total cerebral brain volume, cortical gray matter volume (CGMV), white matter hyperintensity volume (WMHV), and hippocampal volume. Incident epilepsy was identified through a review of administrative data and medical records. Cox proportional hazards regression models were used for the analyses. All analyses were adjusted for age, sex, and educational level (cognition only).
  
  Among participants who underwent NP testing (n = 2349, 45.81% male), 31 incident epilepsy cases were identified during follow-up. Better performance on the TrTB-TrTA was associated with a lower risk of developing epilepsy (hazard ratio HR .25, 95% confidence interval CI .08-.73; p = .011). In the subgroup of participants with MRI (n = 2056, 46.01% male), 27 developed epilepsy. Higher WMHV was associated with higher epilepsy risk (HR 1.5, 95%CI 1.01-2.20; p = .042), but higher CGMV (HR .73, 95% CI .57-.93; p = .001) was associated with lower incidence of epilepsy.
  
  Better performance on the (TrTB-TrTA), a measure of executive function and attention, and higher cortical volumes are associated with lower risk of developing epilepsy. Conversely, higher WMHV, a measure of occult vascular injury, increases the risk. Our study shows that non-invasive tests performed in mid-life may help identify people at risk for developing epilepsy later in life.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Male
  • Female
  • Epilepsy
  • Magnetic Resonance Imaging
  • Brain
  • Middle Aged
  • Aged
  • Aging
  • Neuropsychological Tests
  More +
• Keywords:
  • epilepsy
  • elderly
  • neuroepidemiology
  • cognitive testing
  • MRI brain
• Source:
  Epilepsia, 2025, v. 66, no. 1
• DOI:
  https://doi.org/10.1111/epi.18160
• ISSN:
  0013-9580 ; 1528-1167
• Pubmed ID:
  39555677
• Pubmed Central ID:
  PMC11875459
• Document Type:
  Text
• Funding:
  R01 NS017950/NS/NINDS NIH HHSUnited States/ ; R01 AG062531/AG/NIA NIH HHSUnited States/ ; P30 AG066546/AG/NIA NIH HHSUnited States/ ; Finding A Cure for Epilepsy and Seizures/ ; R01 NS123928/NS/NINDS NIH HHSUnited States/ ; R01 AG054076/AG/NIA NIH HHSUnited States/ ; U48 DP006396/DP/NCCDPHP CDC HHSUnited States/ ; R01 NS109367/NS/NINDS NIH HHSUnited States/ ; R01AG054076-02/National Institute of Aging/ ; U44 NS121562/NS/NINDS NIH HHSUnited States/
• Genre:
  Journal Article
• Pages in Document:
  160-169 (17 pdf pages)
• Volume:
  66
• Issue:
  1
• Download URL:
  https://stacks.cdc.gov/view/cdc/261919/cdc_261919_DS1.pdf
• File Type:
  [PDF - 588.47 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:099eefd6c2c1a7a332256a45f187081ca45c5c889d36787e635c46259f7e7497314875d35e521c2c6ab9307a6cd071dfbda32653356bc660c82dd3f1d1e18299