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Chu SF, Liao KH, Wei L. Increasing Risk of Dementia Among Patients with Subsequent Epilepsy Within 2 Years Post-Traumatic Brain Injury: A Population-Based Case-Control Study. J Multidiscip Healthc 2024; 17:1447-1457. [PMID: 38577293 PMCID: PMC10992670 DOI: 10.2147/jmdh.s452086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/13/2024] [Indexed: 04/06/2024] Open
Abstract
Background Although the association between neurodegenerative diseases, such as dementia, and traumatic brain injury (TBI) has long been known, the association between dementia and TBI with epilepsy has been controversial. Aim This data-driven population-based study is designed to investigate the association between dementia and epilepsy after TBI within a 2-year period. Methods This case-control cohort study was conducted using the Longitudinal Health Insurance Database 2000 (LHID2000). We included 784 individuals ambulatory or hospitalized for TBI with epilepsy from 2001 to 2011, compared with 2992 patients with TBI without epilepsy who were matched for characteristics including sex, age, and healthcare resource use index date. Every participant was followed up for 5 years to ascertain any dementia development. Data were stratified and analyzed using the Cox proportional hazards regression. Results Through the 5-year follow-up period, 39 patients (5.21%) with TBI with epilepsy and 55 (1.53%) with TBI without epilepsy developed dementia. TBI with epilepsy was independently associated with a >3.03 times risk of dementia after correcting for age, sex, and comorbidities. Conclusion These findings suggest an increased risk of dementia in patients with TBI with epilepsy. Our research recommends that individuals with TBI and epilepsy be monitored more intensively.
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Affiliation(s)
- Shu-Fen Chu
- College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai, People’s Republic of China
| | - Kuo-Hsing Liao
- Division of Neurosurgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Division of Critical Medicine, Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Neurotraumatology and Intensive Care, Taipei Neuroscience Institute, Taipei Medical University, Taipei, Taiwan
- Division of Neurosurgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Li Wei
- Division of Neurosurgery, Department of Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan
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Couper RG, Antaya TC, Wilk P, Gofton T, Debicki DB, Burneo JG. Incidence of First-Episode Status Epilepticus and Risk Factors in Ontario, Canada. Can J Neurol Sci 2024:1-9. [PMID: 38312043 DOI: 10.1017/cjn.2024.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
BACKGROUND Status epilepticus (SE) is a neurological emergency characterized by prolonged seizures. However, the incidence of first-episode SE is unclear, as estimates vary greatly among studies. Additionally, SE risk factors have been insufficiently explored. Therefore, the objectives of this study were to estimate the incidence of first-episode SE in Ontario, Canada, and estimate the associations between potential sociodemographic and health-related risk factors and first-episode SE. METHODS We conducted a population-based retrospective cohort study using linked health administrative datasets. We included individuals who completed Canada's 2006 Census long-form questionnaire, lived in Ontario, were between 18 and 105, and had no history of SE. A Cox proportional hazards regression model was used to estimate the hazard ratios for SE within three years associated with each potential risk factor. RESULTS The final sample included 1,301,700 participants, 140 of whom were hospitalized or had an emergency department visit for first-episode SE during follow-up (3.5 per 100,000 person-years). Older age was the only significant sociodemographic SE risk factor (HR = 1.35, 95% CI = 1.33, 1.37), while health-related risk factors included alcohol or drug abuse (HR = 1.05, 95% CI = 1.02, 1.08), brain tumour or cancer (HR = 1.14, 95% CI = 1.12, 1.15), chronic kidney disease (HR = 1.32, 95% CI = 1.29, 1.36), dementia (HR = 1.42, 95% CI = 1.36, 1.48), diabetes (HR = 1.11, 95% CI = 1.09, 1.12), epilepsy or seizures (HR = 1.05, 95% CI = 1.01, 1.09) and stroke (HR = 1.08, 95% CI = 1.05, 1.11). CONCLUSION The estimated incidence of SE in a sample of Ontario residents was 3.5 per 100,000 person-years. Older age and several comorbid conditions were associated with higher first-episode SE risk.
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Affiliation(s)
- R Grace Couper
- Neuroepidemiology Research Unit, Department of Clinical Neurological Sciences, Western University, London, ON, Canada
| | - Tresah C Antaya
- Neuroepidemiology Research Unit, Department of Clinical Neurological Sciences, Western University, London, ON, Canada
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
| | - Piotr Wilk
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
- Department of Paediatrics, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- ICES Western, London, ON, Canada
- Departments of Epidemiology, Maastricht University, Maastricht, The Netherlands
| | - Teneille Gofton
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
| | - Derek B Debicki
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
| | - Jorge G Burneo
- Neuroepidemiology Research Unit, Department of Clinical Neurological Sciences, Western University, London, ON, Canada
- Department of Epidemiology and Biostatistics, Western University, London, ON, Canada
- ICES Western, London, ON, Canada
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
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Nadeem MS, Ahmad H, Mohammed K, Muhammad K, Ullah I, Baothman OAS, Ali N, Anwar F, Zamzami MA, Shakoori AR. Identification of variants in the mitochondrial lysine-tRNA (MT-TK) gene in myoclonic epilepsy-pathogenicity evaluation and structural characterization by in silico approach. J Cell Biochem 2018; 119:6258-6265. [PMID: 29663531 DOI: 10.1002/jcb.26857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 03/12/2018] [Indexed: 02/06/2023]
Abstract
Variations in mitochondrial genes have an established link with myoclonic epilepsy. In the present study we evaluated the nucleotide sequence of MT-TK gene of 52 individuals from 12 unrelated families and reported three variations in 2 of the 13 epileptic patients. The DNA sequences coding for MT-TK gene were sequenced and mutations were detected in all participants. The mutations were further analyzed by the in silico analysis and their structural and pathogenic effects were determined. All the investigated patients had symptoms of myoclonus, 61.5% were positive for ataxia, 23.07% were suffering from hearing loss, 15.38% were having mild to severe dementia, 69.23% were males, and 61.53% had cousin marriage in their family history. DNA extracted from saliva was used for the PCR amplification of a 440 bp DNA fragment encompassing complete MT-TK gene. The nucleotide sequence analysis revealed three mutations, m.8306T>C, m.8313G>C, and m.8362T>G that are divergent from available reports. The identified mutations designate the heteroplasmic condition. Furthermore, pathogenicity of the identified variants was predicted by in silico tools viz., PON-mt-tRNA and MitoTIP. Secondary structure of altered MT-TK was predicted by RNAStructure web server. Studies by MitoTIP and PON-mt-tRNA tools have provided strong evidences of pathogenic effects of these mutations. Single nucleotide variations resulted in disruptive secondary structure of mutant MT-TK models, as predicted by RNAStructure. In vivo confirmation of structural and pathogenic effects of identified mutations in the animal models can be prolonged on the basis of these findings.
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Affiliation(s)
- Muhammad S Nadeem
- Department of Biochemistry, Faculty of Science, King Abdul Aziz University, Jeddah, Saudi Arabia
| | - Habib Ahmad
- Department of Genetics, Faculty of Life Sciences, Hazara University, Mansehra, Pakistan
| | - Kaleemuddin Mohammed
- Department of Biochemistry, Faculty of Science, King Abdul Aziz University, Jeddah, Saudi Arabia
| | - Khushi Muhammad
- Department of Genetics, Faculty of Life Sciences, Hazara University, Mansehra, Pakistan
| | - Inam Ullah
- Department of Genetics, Faculty of Life Sciences, Hazara University, Mansehra, Pakistan
| | - Othman A S Baothman
- Department of Biochemistry, Faculty of Science, King Abdul Aziz University, Jeddah, Saudi Arabia
| | - Nasir Ali
- Department of Genetics, Faculty of Life Sciences, Hazara University, Mansehra, Pakistan
| | - Firoz Anwar
- Department of Biochemistry, Faculty of Science, King Abdul Aziz University, Jeddah, Saudi Arabia
| | - Mazin A Zamzami
- Department of Biochemistry, Faculty of Science, King Abdul Aziz University, Jeddah, Saudi Arabia
| | - Abdul Rauf Shakoori
- School of Biological Sciences, University of the Punjab, Quaid-i-Azam Campus, Lahore, Pakistan
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Taipale H, Gomm W, Broich K, Maier W, Tolppanen AM, Tanskanen A, Tiihonen J, Hartikainen S, Haenisch B. Use of Antiepileptic Drugs and Dementia Risk-an Analysis of Finnish Health Register and German Health Insurance Data. J Am Geriatr Soc 2018; 66:1123-1129. [DOI: 10.1111/jgs.15358] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Heidi Taipale
- School of Pharmacy; University of Eastern Finland; Kuopio Finland
- Kuopio Research Center for Geriatric Care, School of Pharmacy; University of Eastern Finland; Kuopio Finland
- Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
| | - Willy Gomm
- German Center for Neurodegenerative Diseases; Bonn Germany
| | - Karl Broich
- Federal Institute for Drugs and Medical Devices; Bonn Germany
| | - Wolfgang Maier
- German Center for Neurodegenerative Diseases; Bonn Germany
- Department of Psychiatry; University of Bonn; Bonn Germany
| | | | - Antti Tanskanen
- Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
- Department of Forensic Psychiatry, Niuvanniemi Hospital; University of Eastern Finland; Kuopio Finland
| | - Jari Tiihonen
- Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
- Department of Forensic Psychiatry, Niuvanniemi Hospital; University of Eastern Finland; Kuopio Finland
| | - Sirpa Hartikainen
- School of Pharmacy; University of Eastern Finland; Kuopio Finland
- Kuopio Research Center for Geriatric Care, School of Pharmacy; University of Eastern Finland; Kuopio Finland
- Department of Psychiatry; Kuopio University Hospital; Kuopio Finland
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San-Juan D, Mayorga APM, Calcáneo JDDDC, González-Aragón MF, Alonso-Vanegas M, Rico CD, Staba RJ, Anschel DJ, Cole AJ. Periodic epileptiform discharges in mesial temporal lobe epilepsy with hippocampal sclerosis. Seizure 2013; 22:735-42. [PMID: 23787169 DOI: 10.1016/j.seizure.2013.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Revised: 05/21/2013] [Accepted: 05/22/2013] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Periodic epileptiform discharges (PEDs) are an uncommon, abnormal EEG pattern seen usually in patients with acute diseases and less frequently in chronic conditions, such as mesial temporal lobe epilepsy (mTLE). Evaluate the clinical histories, neuroimaging findings, and serial electrophysiological studies prior to the appearance of PEDs in patients with mTLE secondary to hippocampal sclerosis (HS). METHODS We searched 19, 375 EEGs (2006-2012) for the presence of PEDs secondary to mTLE due to HS. RESULTS 12 patients were included. The patients with PEDs had a high prevalence of psychiatric comorbilities, including major depression (50%), interictal psychosis (16%) and dementia (8%). All of the patients had intractable epilepsy with similar clinical findings. We observed a sequential neurophysiological worsening of the EEG patterns prior to the appearance of PEDs. Five patients with PEDs underwent epilepsy surgery and four were seizure free at follow-up 15 (±9) months. CONCLUSIONS PEDs are rare in patients with mTLE and HS and their presence in these cases could reflect clinical severity and neurophysiologic worsening, clinically manifested by intractable epilepsy and severe psychiatric comorbidities. The presence of PEDs in EEGs of patients with mTLE, however, was not associated with poor postsurgical seizure-freedom.
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Affiliation(s)
- Daniel San-Juan
- Neurophysiology Service, National Institute of Neurology, Mexico; Centro Neurológico, Centro Médico ABC, Santa Fe, Mexico.
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Pariel-Madjlessi S, Opéron C, Péquignot R, Konrat C, Léonardelli S, Belmin J. Syndromes démentiels du sujet âgé: démarches diagnostiques. Presse Med 2007; 36:1442-52. [PMID: 17628389 DOI: 10.1016/j.lpm.2007.04.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Accepted: 04/17/2007] [Indexed: 11/24/2022] Open
Abstract
Dementia is a deterioration in several cognitive functions that affects daily living and is observed in the absence of impaired vigilance. Dementia may be revealed by symptoms of memory loss but also by a loss of functional autonomy, onset of depression or by behavioral problems; it may also be recognized during a screening examination. Evaluation of cognitive functions is an essential stage of this diagnosis. Simple tests that any physician can perform provide a first approach. A more detailed cognitive evaluation by a specialist or neuropsychologist is then necessary (except in advanced cases). Once dementia is diagnosed, a causal investigation is required to assess its severity and extent, in order to organize management. Lack of recognition of dementia in the elderly and delay in its diagnosis raise the question of screening to detect it at an earlier stage.
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Affiliation(s)
- Sylvie Pariel-Madjlessi
- Service de gériatrie et consultation mémoire, Hôpital Charles Foix et Faculté de médecine Pierre et Marie Curie (Université Paris VI), Ivry-sur-Seine (94).
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